The primary work of a doctor is to treat pain and relieve suffering.

The primary work of a doctor is to treat pain and relieve suffering. We often speak of these two entities as if they were the same thing. Eric Cassell, a physician who writes frequently about the moral dimensions of medicine, argues, in a now classic paper, that pain and suffering are very different. Pain, according to Cassell, is an affliction of the body. Suffering is an affliction of the self. Suffering, writes Cassell, is a specific state of distress that occurs when the intactness or integrity of the person is threatened or disrupted. Thus, there are events in a life that can cause tremendous pain, and yet cause no suffering. Childbirth is perhaps the most obvious. Women often experience pain in labor but are rarely said to be suffering. And those who are suffering may have no pain at all. A diagnosis of terminal cancer, even in the absence of pain, may cause terrible suffering. The fears of death and uncontrollable loss of autonomy and self combined with the fear of a pain that is overwhelming can cause suffering well before the symptoms begin. There are no drugs to treat suffering. But, says Cassell, giving meaning to an illness through the creation of a story is one way in which physicians can relieve suffering.