Chronic pain in particular often doesn’t have a discrete material location, or an identifiable cause. “That doesn’t fit into the rubric of what it means to be a Western medical practitioner,” said Daniel Goldberg, a bioethicist at East Carolina University and author of the recent book “The Bioethics of Pain Management.” This leaves its sufferers vulnerable to skepticism, prejudice, and “accusations of malingering,” he said. It doesn’t help that many pain medications are addictive, and some people really do feign pain to scrounge their next prescription.

Because pain has such a strong psychological component, finding objective tools to diagnose it is not a simple proposition. Research emerging in the last few years has suggested that certain types of pain create a distinct signature in the brain, and even that sensitivity to pain might be connected to brain structure. But the idea of a practical and affordable tool for measuring all kinds of patient pain is a distant dream at best. And that leaves pain susceptible to doctors’ prejudices, including unconscious ones. What it comes down to is: Do they trust their patient’s account of their own pain?

I don’t feel your pain – Ruth Graham. A superb account; please read it all.