PAIN, SUFFERING, AND DEATH IN PERSPECTIVE
Christopher Ebbe, Ph.D. 4-16
ABSTRACT: Pain, suffering, and death are put in a biological and evolutionary context that allows them to be seen as natural and inevitable aspects of human existence.
KEY WORDS: pain, suffering, death
Human beings naturally seek to avoid harm and painful feelings and therefore do their utmost to get away from pain, suffering, and death. This strong instinct, however, makes it much less likely that we will use our reflective skills to deal with pain, suffering, and death, thus leaving us with only avoidance and escape options. Pausing to think about these issues may increase our options through putting these difficult issues in a different perspective and suggesting additional coping mechanisms.
PAIN
Many one-celled and several-celled organisms have observable reactions to stimuli that convey to the organism the presence of chemicals (or simply molecules) that will damage those organisms. These reactions usually appear as a sort of wriggling of the cell or cells, which we can presume have developed because occasionally this wriggling will move the organism enough that it survives the threat. These organisms probably do not “feel pain,” but their behavior presages such behavior in “higher” organisms such as human beings. Every organism senses some dangers and responds with some life-saving actions.
We do not know at what point on the phylogenetic chain organisms begin to have experience rather than simply responding to stimuli without consciousness of those stimuli, but human experience includes the experience of pain. Cats and dogs also seem to “feel pain” and have other experiences. Human beings are the only species that we know of that uses symbols to remember and express pain. Pain is what we experience when certain stimuli are sensed which cause pain nerves to fire and trigger areas of the brain that “deal with” pain. Pain seems to be felt only when those areas of the brain are stimulated and not simply when our somatic pain receptors or pain nerves are activated.
Scientific study is stymied by the idea of experience, since we cannot see how to envision experience as a physical process so that we can investigate it scientifically. We can identify some parts of the brain that are associated with some types of experience (a major brain area that “deals with” vision, for example), but we don’t know what experience “is.” Experience is certainly not a tangible “thing,” and we don’t know how to measure it. We don’t know how the experience of seeing red is distinct from just having neurons firing that respond to visual stimuli that have the red frequency, if those are even different. So, perhaps currently we can best understand experience as one of the things that “happens” inside us when certain stimuli occur and our brains are active enough to process those stimuli. Experience seems to be a moving record of our organism’s inner workings, some of it “recorded” (to some extent and with some degree of accuracy) in memory. Some of this is conscious in the sense that it can be reflected on and stored for future reflection, and some of it is unconscious, though once again capable of storage. (Some would call only the former “experience,” and others would argue that everything entering into the organism that is responded to, either in consciousness or unconsciously, should be included in “experience.”)
Various patterns of neurons are always firing in the brain, and these patterns are complex and constantly changing. When enough nerve dendrites (little extensions of a neural cell) are stimulated, the neuron as a whole “fires,” thus stimulating dendrites of other neurons to fire, etc., etc. These connections are strengthened by repetition, thus forming predictable large patterns of firing. (It takes most of us several repetitions of the same stimuli, like a new word, in order for us to “learn” the word, for example.)
The activation of pain areas of the brain leads to muscular responses aimed at survival and at lessening the experience of the pain. It would be theoretically possible for an organism to have responses to the pain stimuli without experiencing pain, but if an organism “experiences” pain, it would seem that this might be evolutionarily useful to enhance the learning process for future useful responses to the danger. So, it seems possible that we experience pain for its motivating quality that leads us to get away from whatever is stimulating us to feel pain and for the resultant possibilities of learning new behaviors that will be even more successful in getting us away from the danger and avoiding it in the future.
Since our environment is full of dangers (heat, asphyxiation, bodily damage) and since it is adaptive for us to avoid these dangers (helps to keep us alive), and since pain is a primary means by which the human organism is set up to avoid harm, it is inevitable that we experience pain. Without pain, our complex brains could not learn what to avoid (because we are not born with that knowledge but have to learn it little by little throughout life). Our pain system is primitive enough that it doesn’t just notify us of the presence of a danger and then stop triggering pain experience, with other parts of the brain then doing something about the pain; the experience of pain continues until our pain receptors no longer sense the threat. We have no scientific explanation for why we are built the way we are built (except that it works to keep the species reproducing and surviving).
So, while as individuals we are strongly motivated to make pain go away, it would be bad for the human organism if we could really be more pain free (except perhaps for chronic pain that serves no additional purpose by continuing). The maladaptive results of having no pain experience (as is true of a few unfortunate people) are clear, since those people have insufficient guidance with regard to avoiding dangers and often undergo harm because they don’t know when to change behavioral direction.
It is also important to note that if we had no pain experience, we would not be ourselves as we are now. (We would have to be a very different organism, which would not be human.) The organism that we are now as human beings requires pain as part of its modes of successful operation. We could not survive in our present form as human beings without pain.
Our society’s obsession with minimizing pain through medicines ignores the important part that pain plays in our lives. Chronic, intolerable pain should certainly be assuaged, but it is not so clear that the “ordinary” daily pains of typical headaches or other aches should automatically be minimized. Our society’s eager acceptance of pills as the answer to pain, for many people on a daily basis essentially forever, makes it easy for people to assume that pain is an abnormal event that should be “cured” or eliminated. It would be more consistent with our nature as human beings to utilize non-invasive methods of pain management (strengthening certain muscles, managing our stress and emotions better by making better choices, being willing to make life changes that would take away the pain, training ourselves not to get upset about pain, training ourselves to simply put up with minor pain). Reconceptualizing pain so that we think of it as something normal rather than something abnormal would also help with this attitudinal change.
The important message here is that pain is an essential, useful, and inescapable part of our human nature and that we should be judicious about trying to eliminate it. For example, if frequent headaches result from one’s experience with one’s job, rather than simply taking pain-relieving pills, it would be more adaptive in the long run to understand why our job experience is causing the pain and do something about that, such as changing jobs (even if it were inconvenient or would involve lower income), refining out attitude about the cause of the pain (understanding exactly why that co-worker annoys us to much), and developing mental skills and attitudes that would enable us to significantly reduce our awareness of the pain (acceptance, meditation, forgiveness, etc.).
SUFFERING
Suffering is essentially prolonged experience of pain, either uninterruptedly or cumulatively. Suffering can result from extreme pain and its aftermath, and it can result from lower but incessant levels of pain. It may result from physical pain or from emotional pain (shame, guilt, hopelessness, fear, anxiety, etc.). Physical pain is dealt with in the preceding section, but in modern life, just as much suffering is emotional as physical. The non-adjustable nature of our biological pain apparatus makes some suffering inevitable for every human being (including you and me). Once again, an all-out war to get rid of any suffering may not be the most adaptive response, since suffering is evidence of something wrong in one’s life, and recognizing and understanding the causes offers some opportunity to change oneself in order to reduce the suffering.
Western persons generally view pain-relieving pills as just as appropriate for emotional suffering as for physical suffering, but this has the outcome that most people neglect actual solutions based on the causes of the pain, whether those are environmental (moving out of air pollution that causes asthmatic suffering, changing jobs) or internal (attitude adjustment, acceptance, “making friends with one’s pain,” putting one’s attention elsewhere than the pain, etc.). People view pills as an easier solution and often stay in a pain-causing situation, in order to avoid undesired consequences of change, such as getting a divorce or having to move to another town to get a different job, rather than doing something about the cause of the pain (be willing to change to maintain the marriage, accept the necessity of moving to get a different job, etc.).
Among the world’s religions, Buddhism has done the most to develop a conceptual technology for dealing with suffering. The key notions are recognizing the reality of the suffering and the true causes of it, not fighting against the pain, accepting the suffering in so far as it is unavoidable or unchangeable, focusing elsewhere than on the pain (as on one’s activities, on other people, or on one’s internal self apart from the pain as with mantras or other foci of concentration or meditation), and using meditation as a means of clearly seeing reality and letting it be rather than automatically fighting against it. These concepts are starting to be appreciated in Western countries, though usually with the objects and other trappings of popular Buddhist lore playing the part of power symbols (bells, prayer flags, statues of Buddha, etc.).
DEATH
As with pain and suffering, death is unavoidable for human beings, either through disease (which causes our physical being not to function sufficiently well to keep us alive), injury (which causes our physical being not to function sufficiently well to keep us alive), or old age deterioration, in which our DNA and RNA, which control cell reproduction, over time become corrupted (do not reproduce exact copies of themselves) in enough instances that some parts of our bodies cannot do their jobs adequately any longer (heart, liver, kidneys), and we can no longer sustain life. (Throughout our lives the cells in all parts of our bodies are dying and being replaced all the time, and when enough of our new cells are different from what they should be to do their work properly, we naturally start to malfunction.)
Again, we do not know from a scientific perspective why we are constructed this way—that our cells do not live very long and are constantly being replaced, that our structural and chemical processes are so complex that when enough cells don’t do their work properly we malfunction badly, that our DNA can be affected by environmental poisons or x-rays from outer space, etc. Faith may speak to this, but science cannot.
Most species survive by trying to reproduce in great quantities (viz., the thousands of seeds given off by many plants, only a few of which will grow to be able themselves to produce seeds, the ninety-five percent of baby turtles that are eaten before they can grow up at all, etc.). This system only works if most do not succeed and each seed-producing generation dies off, since if all seeds and sperm-ova combinations succeeded, growing things would cover every inch of the planet and most would die of starvation or deprivation. We are going to have a difficult time producing enough food reliably for the seven billion human beings now on the planet, let alone a larger number if we do not curb our reproduction. Human beings are part of this life-cycle system, where species reproduce as much as possible until the numbers can no longer be supported by the environment, and then many die. The point is that our very nature as beings includes death as a natural part of the species process, either through DNA corruption or species over-reproduction. Some would like to believe that human beings stand apart from the natural processes that all other living beings in creation submit to, but there is little evidence in the observable world to support this hope.
Human beings are almost universally afraid of death, which probably arises from (1) the wish to avoid losing others who are important to our own well-being and avoid the emotional pain that naturally occurs with those losses and (2) our general, inbred (genetically determined and “instinctual”) motivation to stay alive ourselves. It is augmented by our fear of everything we do not understand but think may affect our well-being negatively. Human beings attempt to deal with this fear by (1) denial and distraction (“It won’t happen to me,” “If I don’t think about it, it isn’t real”), (2) imagining what “life” might be like after death (nothingness, heaven, hell), (3) interpreting near-death experiences (“I saw a bright light”) as evidence that there is existence after death, and (4) accepting it and therefore not fearing it.
We have no way of being certain about what happens after death, but the assumptions we act on in this regard play a role in our overall quality of life. Assumptions that there is life after death have been used to increase motivation to act morally in order to make that experience after death positive (if you are good, you’ll go to heaven; if you are good, you’ll come back in a higher form), and this may have acted overall in societies to increase the general level of moral behavior, but it also has led to much of this effort being calculated (I’ll go to church just in case there is a God) rather than a genuine expression of “goodness,” and has led to deciding whether to act morally on a cost-benefit basis (do I prefer my sinful pleasures now, or my heavenly rewards later?). Establishing detailed expectations of various rewards for acting morally or to please God may be motivating (the jihadist interpretation of the Koran that martyrs for the cause will be given 79 virgins in heaven), but they have also resulted in a legalistic view of the transactions between man and God that encourages man to bargain and “get the best possible deal.”
SUMMARY
The important points covered here are that (1) pain is part of the human adaptation in our current type of being, (2) suffering occurs when serious pain is not dealt with and cannot be changed, and (3) in our current form as beings, death is an inevitable aspect of life. Acceptance of the naturalness, inevitability, and usefulness of pain could allow us to deal more calmly and rationally with it and to minimize at least our upset about having pain at all.
Looking at the larger perspective, far beyond our own personal pain, we can see that while effectiveness at survival and reproduction have shaped our species’ evolution toward being the beings that we are today, our own attempts to escape from and banish pain and painful feelings are leading in the direction of making the species less functional. If pain is a signal to change something in one’s existence, then suppressing it without dealing with the causes takes away our opportunities to make those changes (through purposeful genetic corrections or simply through the natural selection process of evolution). This leaves us overall weaker as individuals, and if we reproduce, it keeps weaker genes in the gene pool, thus making the species weaker overall.
Trying to keep every baby alive, regardless of viability, is motivated by our innate instinct to protect our young also by our wish to avoid our grief at losing a child, and it has the long-term effect, again, of keeping less adaptive, less healthy genes in the gene pool to continue to reproduce. We praise parents who want to keep less adaptive children alive and dedicate their lives to this project, while ignoring the costs of this to society, both in medical costs and in the additional productivity that those parents could bring to society if they were not dedicated to caring for less adaptive children.
As individuals, trying to stay alive as long as possible in old age, which is also inbred instinct, has the net effect of taking monies away from maximum quality of life for younger persons who are raising children and of making the world more crowded and a less desirable environment for human life. (Older people are not reproducing and therefore have no net effect on the future gene pool beyond the effects they have already had when younger.)
Perhaps we should question our instinctual efforts to survive, which may have been important when there were few human beings and survival was less certain, but now there is really no need for such a strong impulse to survive at all costs, since the species could do fine without that, and our own personal survival is not important in the larger scheme of things. The phrase “all is vanity” recognizes that making ourselves more important than we really are is foolish.
It is worthwhile to reflect on the conundrums of survival—that our own emotions that goad us on to survive ourselves, regardless of purpose, and to keep our children alive, regardless of viability, are acting against the long-term best interests of our own species. This was not an issue in past centuries, when we did not have the knowledge and resources to indulge in these emotion-driven behaviors, but now we can do so much to keep ourselves alive that the medical costs alone will become overwhelming in the near future. The evolutionary costs will take longer to become apparent, but they will be there nonetheless. This is not an argument for immediately offering older people more options to end their lives or for having a “death panel” decide which children will be permitted to live, but at least we should take these self-caused consequences seriously and think about how to respond to them in ways that both benefit all of us overall while respecting our emotions and instincts. Perhaps reflection on these issues would allow us to see what we are doing more clearly.
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