The Pain Commensuration Technology Lab (PaCT Lab) will embrace and celebrate cross-disciplinary methodologies to: collect and interrogate already existing and proposed pain scales; research the next generation of pain measurement and visualization; and produce interventions (scholarly, artistic, or otherwise) that seek to empower the patient in pain to advocate for a more just experience in the clinical setting. Throughout each of these endeavours, the ramification of turning the qualitative human experience into data and metrics will act as the overall lens for the project.
This project considers the moment in which a medical practitioner measures a patient’s pain. At the core of this interaction are a few simple questions: for example, how would you rate your pain? Where is your pain? What kind of pain is it? Often, a patient is presented with a pain scale to accompany these questions, an oral or visual aid meant to facilitate the communication of the quantitative (i.e., severity) and qualitative (i.e. location) properties of their pain.
In The Body in Pain, Elaine Scarry (1985) argues that pain is, by default, private and incommunicable while also objectless—that is, until it is expressed, either through a scream or yell or through metaphorical description (“I have a stabbing pain in my arm”). In the former scenario, a torturer has extracted the expression of pain through infliction and has subsequently objectified his subject, unmaking the subject’s world. In the latter, the subject has utilized their own pain to create a mental image with which to communicate with their interlocutor. In both scenarios, without the interpersonal exchange, there is only that private and incommunicable void inside the subject. The algorithms governing tools of pain commensuration are determined by their originators while the knowledge traversing their translational logic belongs, ultimately, to the patient experiencing pain. Following Scarry, as soon as that knowledge is imparted via these tools, the practitioner gains ownership and control.
What might be done to reclaim pain from these tools? This is the question at the heart of the PaCT Lab’s third initiative: producing and curating multi-modal interventions. Here, we lean on Jacques Rancière’s assertion that making art is about “undoing and rearticulating the connections between signs and images, images and times, or signs and space that frame the existing sense of reality” (2009). Via studio-based mentorship and arts/writing residencies, lab members and affiliates will repurpose scale visuals, public study data, their own pain measurements, and other, yet-imagined sources. Output may be a static image, an interactive experience, a zine, a sound or video piece, poetry, or any number of other works. The lab will fund a biennial featuring these pieces and ensure their public availability on its website as well.
For someone experiencing pain, an encounter with a practitioner—it might be a seconds-long consult or, if they are fortunate, a more in-depth discussion—can be the difference between an insurance claim, medication prescription, critical diagnosis, or, as is the case so often especially for those from marginalized communities, being told that the pain is not real or not worthy of more attention. This project’s foundational tenet is that by unpacking the intricacies of how each scale works, why it was proposed, by whom and for whom it was developed, and whether it is in use today, can all be valuable information for the patient in pain. Presenting opportunities to understand why their experience is shaped the way it is may provide a space from whence they can find hope, or, at the very least, comfort.