Pain

June 26, 2000
Wall (The Challenge of Pain), a professor of physiology at St. Thomas's Hospital Medical School (London), presents an alternative to the traditional theory of pain. Earlier theorists attributed painful sensations to nerve endings that transmitted a message from the spinal column to the brain. Drawing on the latest neurological research, Wall hypothesizes instead that when nerve endings are stimulated by painful sensations, the message is transmitted, but then, the brain analyzes this data to determine the appropriate motor response. One's response to the stimulus is, in part, based on personal history and expectations. According to Wall, this interconnectedness explains why people experience pain differently, and it also accounts for why a strong belief in the efficacy of a placebo may actually reduce an individual's pain. Although he doesn't examine specific conditions--like cancer and migraines--in as much depth as Frank Vertosick does in Why We Hurt: The National History of Pain (Forecasts, May 29), Wall is a sympathetic and thorough writer: he describes the physiology of the nervous system; he explores, philosophically and scientifically, the history of pain and its treatment; and he suggests some improvements to popular medical approaches to pain management, explaining (in detail) the different ways in which pain can be eased. Postoperative patients, for example, deal with their pain better when they are able to regulate their analgesic medication (because control helps them overcome their feelings of physical helplessness). In this generally thoughtful text, Wall offers his belief in the benefit of narcotic medications for cancer patients in pain. B&w illus.

July 1, 2000
Wall, a well-known researcher of the clinical aspects of pain, has a refreshing and direct writing style as well as broad knowledge of his subject. He inveighs against the "mountain of hogwash written about patients inventing their pains." The patient's mood and attitude don't create pain, he holds, though the moods and attitudes of those around a patient well may be influential. Wall clearly describes what is known about types of pain, their causes, their transmission, responses to them, and treatments for them, and so doing, he demolishes a number of myths. As for truths, he says that a standard cause doesn't produce a standard pain, that pain cannot be specifically located in the brain, and that damage in one area can produce a distant pain. He also deals with the mystery of phantom pain. Wall notes some top-drawer pain clinics, but medical schools don't teach students about pain, he avers, and current "evidence-based" medicine can drive student and physician further away from realizing the role of pain for the patient. ((Reviewed July 2000))(Reprinted with permission of Booklist, copyright 2000, American Library Association.)

June 15, 2000
A British neuroscientist and physiologist who has written several books on pain, Wall provides a broad scientific account of the enigma of the brain and specifically its interpretation and use of pain. His book varies from Frank Vertosick's Why We Hurt (LJ 3/15/00) in that Wall fits facts, relevant data, and bizarre pain cases (abrupt injuries, torture, masochism) into an overall body-brain pain theory. Vertosick is a great storyteller who gives his text a more anthropological context. Divided into 11 sections, Wall's text investigates the philosophy of pain, whole body theories, obvious and mysterious causes of pain, and the placebo response to pain. He also provides practical if obvious advice on personal pain and its treatment. Wall is a sage neuroscientist who challenges younger pain researchers and the "new breed of clinicians" to create a contemporary picture of a "subtle multiplexed reactive system" we call the neurological response to pain. Recommended for academic libraries.--Rebecca Cress-Ingebo, Fordham Health Sciences Lib., Wright State Univ., Dayton, OH

Copyright 2000 Library Journal, LLC Used with permission.