Gawande, "The Itch"

Discussion questions: Gawande, "The Pain Perplex" (2002)

1. What are the current theories about pain? What are the current unknowns? (Might the unknowns post more of a challenge to the current theories than Gawande acknowledges, and if so, how?)

2. Gawande notes that chronic pain can be related to inorganic factors or be caused by social conditions (111, 128-9). Explain why he then says "none of this should be taken to mean that people [who experience chronic pain] are faking it" (129).

3. If pain exists in the brain, should we be able to overcome it by willpower, the way dancers learn to ignore mild pain? Are those who suffer chronic pain somehow inferior to those who don't? Or is failing to take chronic pain seriously an ethical problem that society needs to confront? Is it comparable to how mental illness was blamed on patients and their families before the discovery that chemical imbalances play a part in such diseases as schizophrenia or depression?

4. As usual for him, Gawande starts with one patient's story. How effectively does this story introduce the main topic of the essay? How does Gawande make the transition from it to the more informational part of his essay? How do his subsequent transitions work?