Ngā mihi nui, thank you very much, to family, friends, and colleagues who have read and responded to this piece over the last three years. Ngā mihi nui to the students of SCIS 314 whose feedback and encouragement have resulted in this piece being a Pinch(es) of Pain in this form.

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The Oxford English Dictionary says suffer is “to undergo, endure” and “to have (something painful, distressing, or injurious) inflicted or imposed upon one; to submit to with pain, distress, or grief”.

Is pain to suffer?

“Our Hazel is so brave.”

In 2018, The Listener ran an article about me and my PhD research on the impact of chronic pain on attention. I was excited to be contacted by the column writer. Many people had contributed to my PhD, including participants with chronic pain themselves. I saw the article as a chance to share the work with a wider audience. At the same time, I was terrified to be more publicly open about my own pain. Agreeing to an interview, I was no longer standing on a threshold, not putting a toe out but striding into sight.

What I didn’t expect was the word suffer to appear repeatedly in the draft. “But Godfrey, who has suffered from fibromyalgia…”…. “fellow chronic pain sufferers”…”Like the 20% of people who suffer from chronic pain…”.

Nor did I expect the language used to characterise my experiences: “There were times when Hazel Godfrey’s own chronic pain was so bad she considered abandoning her PhD…”. I felt reduced to suffering.

The column writer was kind and open to changing the suffer words. I felt heard. But I wondered, is suffer how I am seen? Is suffer what I am reduced to? Is suffer my default? Submitting, inflicted, imposed.

“What’s wrong with you now?”

The Oxford English Dictionary says stigma is “a distinguishing mark or characteristic (of a bad or objectionable kind); in pathology a sign of some specific disorder, as hysteria.”

Is pain stigma?

“You hurt too much.”

Pain is invisible yet judged. If I say that I have chronic pain, assumptions are made, I am marked as other.

SUBTLEX_US is a collection – a corpus – of American English film subtitles; 51 million words.

Pain appears in 30.62% of the films in the corpus. Painful 7.65%.

Suffer appears in 10.71% of the films in the corpus. Suffering 9%. Suffered 6.94%.

Stigma appears in 0.27% of the films in the corpus. We appear to be freer to talk about suffering than stigma. Do we act out stigma but don’t speak it?

“There’s nothing wrong with you.”

Thousands of years of meaning are reflected in the words we use. Words come from somewhere. Words are associated with specific stories we tell. Words have expectations embedded in them. The stories other people tell over generations make their way into our word associations.

I read the Book of Job for the first time recently. I didn’t even know that Job is synonymous with suffering (or that you pronounce his name Jobe), yet his story informs even my atheist understandings of pain, suffering, and stigma regardless through the culture in which I learned these words. “But his flesh upon him shall have pain, and his soul within him shall mourn.”

Perhaps the Bible captures the contrasting feelings and attitudes of the healthy toward the unhealthy.

“We had to see you; you said you were in pain.”

Job’s suffering is public – “with sore boils from the sole of his foot unto his crown”.

Job’s suffering is stigma – “They abhor me, they flee far from me, and spare not to spit in my face.”

Job’s suffering is silent – “Therefore I will not refrain my mouth; I will speak in the anguish of my spirit; I will complain in the bitterness of my soul”.

Job’s suffering is not in his control – God is the cause of his suffering and only God can end it. “He will not suffer me to take my breath, but filleth me with bitterness”.

Job’s suffering is deserved – his friend says “The wicked man travaileth with pain all his days.”

Job’s suffering is isolation – “My kinsfolk have failed, and my familiar friends have forgotten me.”

“There’s no such thing as…”

Meanings and understandings matter. They mattered for Job. They matter for my experiences in the world. The misunderstandings we hold slow the pace of scientific and medical progress. They avoidably inhibit the relief of pain and suffering. The widespread use of anaesthesia was delayed from its development in the late 1840s. Routine use of anaesthesia in surgery was slowed until the 1860s, partly because it was thought both that pain-free surgery was impossible and that the pain was necessary to keep us alive. The choice to use anaesthesia or other pain-relief in childbirth was held back by roughly ten years, partly because of the religious view that in labour we deserve to suffer for Eve’s sins.

Pain understandings change; our words don’t keep up.

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Sometimes I suffer. Sometimes I don’t. Only I get to say if so. Though if I speak, stigma may follow.

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There are a lot of views on pain, suffering and stigma. Some that align with my lived experience and some that don’t. These are readings that informed and challenged my thinking here:

1. Fordyce, W. E. (1994). Pain and suffering: what is the unit? Quality of Life Research, 3, S51–S56. https://doi.org/10.1007/BF00433377  

2. Book 18 Job in King James Bible (Project Gutenberg ed., 2nd version, 10th ed.). (n.d.). Project Gutenberg.  

3. Maas. (2017). Genesis to Revelation: Job Participant Book: A Comprehensive Verse-By-Verse Exploration of the Bible. (Updated and revised edition.). Abingdon Press.

4. Oxford English Dictionary. (2000). Oxford University Press. 

5. Seeskin, K. (2020). Job: Innocent Suffering. In Thinking about the Prophets: A Philosopher Reads the Bible (pp. 101–116). University of Nebraska Press. https://doi.org/10.2307/j.ctv138wq6x.13  

6. Snow, S. J. (2018). Surgery and anaesthesia: revolutions in practice. In: Schlich, T. (ed.) The Palgrave Handbook of the History of Surgery. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95260-1_10   

7. Sullivan, M. D. & de C Williams, A. C. (2025). Questioning the boundary between pain and suffering. Pain. https://doi.org/10.1097/j.pain.0000000000003767  

8. Sullivan, M. D., Sturgeon, J. A., Lumley, M. A., & Ballantyne, J. C. (2022). Reconsidering Fordyce’s classic article, “Pain and suffering: what is the unit?” to help make our model of chronic pain truly biopsychosocial. Pain, 164, 271–279.https://doi.org/10.1097/j.pain.0000000000002748  

9. van Loon, H. (2018). Suffering in the opening speech (Job 3): the unrest of being imprisoned in life. In Metaphors in the Discussion on Suffering in Job 3–31. Leiden, The Netherlands: Brill. https://doi.org/10.1163/9789004380936_005