She is one of us; a woman exposed to the invasive nature of pain. More women than men suffer from chronic pain. Chronic pain perseveres, overwhelms the body, mind and blurring one’s identity with oneself and society. Its dark web leaves one vulnerable, exposed, and subjected to its intensity. Yet, this lady stands tall, graceful in the face of adversity. Her golden head is a symbol of knowledge and future brain research for new treatments.

Pain is a particularly unpleasant sensation, a way in which our body alerts us of physical threat or injury; its effects frequently go beyond physical and could significantly impact our core mental and psychosocial wellbeing. On the other hand, psychosocial and spiritual elements of our lives could magnify the expression of pain; total pain is the term coined by Dr. C Saunders used to describe such situations. The young lady in this picture confronted not only the reality of a recent pancreatic cancer diagnosis but the unfortunate complication of surgical treatment leaving a nonhealing fistula and its life-changing consequences (including indefinite dependency on total parenteral nutrition). She embodied total pain/extreme suffering and frequently commented on how she felt death was always peering over her shoulder; a black rose tattooed in her left forearm represented her hope for transcendent healing. The involvement of a compassionate, caring and cohesive multidisciplinary team (including multiple physician disciplines, nurses, dietitians, psychologists, social workers, occupational and physical therapists, spiritual care practitioners) was essential to optimally address her pain management. This illustrates the importance of a holistic approach to pain assessment and management.

Imagining (my) pain if one picture could sum-up my research about the life changing disruptive force of chronic pain this one comes close. Living with pain incarcerates the person weighed down by pain. A burden carried with them every second, minute of every day for life. My applied hermeneutic research delves deeply into the meaning of living with chronic pain and related suffering. Loss of jobs, physical mobility, concentration, personal relationships can often lead to a traumatic loss of identity, the briefcase representing the fading memory of self. Pain isolates people from society, friends and family with damaging repercussions. My research coupled with my own lived experiences of pain endeavours to understand the totality of the chronic pain experience and use this information to build more comprehensive opportunities for people living with pain such as help re-building positive identities and reduce social isolation. A metaphorical chipping away of stone. The picture was taken by Richard Hovey (2017) of the Monument to the Unknown Bureaucrat Reykjavik, Iceland sculpted by Magnús Tómasson in 1994.

This is a picture of a patient in profound agony from chronic orofacial pain. One side is the physical aspect, where pain is variously described as electric shock like, stabbing, throbbing and sharp. On the other side is the psychological aspects that fuel pain - trauma, PTSD, incarceration, natural disasters and so on. This debilitating pain is experienced even though it’s a wonderful day filled with warm sunshine, good food and loved ones. But patients are in such excruciating pain they cannot enjoy themselves.

This abstract mosquito represents the ever-present burden of chronic pain. If you’ve ever tried to fall asleep with a mosquito in your room, you know how distracting and even distressing it can seem!Chronic pain is much worse, buzzing its way into your mind and intruding in your thoughts. Pain makes it hard to concentrate at school, at work, or even on fun activities. Chronic pain can also be menacing, because we expect our bodies to use pain to tell us that something is wrong. Appendicitis, kidney stones, labour pains – these kinds of pain signals are the body’s internal alarms, telling us to get medical help! In chronic pain though, the body’s pain alarm stays on – all the time – even after any injury has healed, or sometimes for no obvious reason. Not only is that mosquito buzzing around you all the time, imagine feeling that it is constantly biting you… when it isn’t. Chronic pain is much worse than a mosquito bite, of course, but I’m sure you get the idea! Even though we’d like to swat pain away, like a mosquito, much more research is needed to make that possible. In the meantime, many people live with constant and long-term pain. Like a menacing mosquito, hovering constantly over your head for months, years, or even decades