Pain ─ A Political History

In this history of American political culture, Keith Wailoo examines why and how pain and compassionate relief has been a battleground for defining the line between society's liberal trends and conservative tendencies. Tracing the development of pain theories in politics, medicine, law, and society, and battles over the morality and economics of relief, Wailoo points to a tension at the heart of the conservative-liberal divide.

Beginning with the post–World War II rise of a pain relief economy in response to concerns about recovering soldiers, Wailoo explores the 1960s rise of an expansive liberal pain standard, along with the emerging conviction that subjective pain was real, disabling, and compensable. These concepts were attacked during the Reagan era of the 1980s, when a conservative political backlash led to decreasing disability aid and the growing role of the courts as arbiters in the liberal-conservative struggle to define pain.

Wailoo goes on to identify how, in the 1990s, new fronts in pain politics opened in states like Oregon and Michigan where advocates for death with dignity insisted that end-of-life pain warranted full relief. And, in the 2006 arrest of conservative talk show host Rush Limbaugh for doctor shopping for painkillers, Wailoo finds a cautionary tale about deregulation, which spawned an unmanageable market in pain relief products as well as gaps between the overmedicated and the undertreated. Today's debates over who is in pain, who feels another's pain, and what relief they deserve are new chapters of this enduring battle between liberal relief and conservative care.

People in chronic pain have always sought relief—and have always been judged—but who decides whether someone is truly in pain? The story of pain in politics is more than rhetoric; it is a story of ailing bodies, broken lives, illness, and disability that has vexed government agencies and politicians from the World War II era to the present.

Keith Wailoo is the Townsend Martin Professor of History and Public Affairs and Vice Dean of the Woodrow Wilson School of Public and International Affairs at Princeton University. He is author of The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease and Drawing Blood: Technology and Disease Identity in Twentieth-Century America, and he is coeditor of Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine’s Simple Solutions, all published by Johns Hopkins.