Professor discusses understanding of chronic pain in Thailand
Scott Stonington, assistant professor of anthropology and internal medicine physician, explored a Thai physician’s claim that chronic pain doesn’t exist in Thailand during his lecture, “Toward Anti-Ontology: The Unmaking of Chronic Pain in Thailand” Monday afternoon.
While conducting fieldwork in Thailand, Stonington said he learned through a conversation with this physician that “there is no chronic pain in Thailand.” The lecture examined the ways in which Stonington found this to be both true and untrue.
He began the lecture by discussing the traditional way of dying in Thailand.
“Dying in the hospital is incredibly bad,” Stonington said. “Hospitals are terrible places to die partly because they are haunted by ghosts and they’re haunted by ghosts because (hospitals are) where bad, bad deaths happen.”
That fear leads many people to rush their loved ones home from the hospital before they die to ensure a peaceful death. This has led to some people taking extreme measures on the trip home from the hospital and in some situations, more painful deaths.
“(The patients are) mostly sedated: They’re sedated on opiates, they’re sedated on anesthesia, and then we take all of that away and we put them in a truck and drive them home,” Stonington said. “So sometimes we take them off and they wake up screaming in horrifying pain.”
In Thailand, patients aren’t allowed to take any opiates home with them due to a law banning all opiate use and possession outside of a hospital, with the exception of treating pain linked to cancer.
Throughout the lecture, Stonington referred back to Western medicine and the differences between Western and Thai medicine to further delve into chronic pain in Thailand. Will Thomson, a post-doctoral student in anthropology, he thought Stonington’s research has various applications to Western medicine, especially in context of an ongoing opioid epidemic in the U.S.
“With all the opioid addiction and use, rethinking the way we think about and experience pain is probably a useful medical, social and political project,” Thomson said.
Stonington explained the ban and history of opiates has a long history in Thailand, possibly dating back to the Opium Wars in the mid-1800s and the CIA Secret War in Laos.
More recently, in 2003, Thaksin Shinawatra, then-Prime Minister of Thailand, launched a war on drugs, giving the police permission to kill anyone suspected of an association with the drug trade,which has lead to roughly 2,500 extrajudicial killings.
In general, Stonington said, definitions of pain in Thailand are different.
“We don’t have that in Thailand,” Stongington said. “Chronic pain is a Western invention. You can say that something hurts, but pain itself is not a thing. It’s just a judgment.”
Information graduate student Pei-Yao Hung said she appreciated Stonington’s comparisons between differing perspectives on medicine.
“I come from Taiwan and so it was interesting to see people bringing Western medicines into perspective and try to understand it … in a different kind of context,” Hong said.
During his remarks, Stonington also bought in personal stories in relation to the ideas of Thai physicians, such as one of a man who had abdominal pain, but his pain was not treated until the day he found out he had pancreatic cancer.
“He said, ‘That day was the best day of my life,’ ” Stonington said. “It shifted him from this category, of pain that wasn’t being treated, into cancer pain.”
Stonington also shared another story of a 76-year-old woman who went to the doctor because of pain in her legs. After two visits of telling the doctor of her pain, she received no help. After a third visit, when she told the doctor her legs felt “slow,” she received treatment and had an X-ray taken on her legs.
“‘I don’t like taking X-rays, especially for pain,’” Stonington said a Thai doctor told him.
Stonington concluded the lecture by posing a question to the audience about what he characterized as the overall issue at hand — his attempts to try to make sense of something that exists, yet is actively erased.
“How do you make sense of sort of a silence where everyone knows that something exists but no one can name it or talk about it or identify it?” he said.