A Tale of Two Nails

Scenario one:

I presume that many of you have heard the famous story, written up in the British Medical Journal, about the man who jumped onto a large nail and was immediately in agony. An animated Ted-ED on the subject has been circulating recently. As the story goes, when they eventually removed the boot, they found that no injury had occurred, the nail having passed between the toes. On this revelation the pain dispersed….

Scenario two:

As a teenager, whilst helping out on a building site, I jumped off a wall with several bricks in my hand, onto a protruding 15cm nail which went straight through my mid foot. At this stage there was no pain. I thought that it was not a good idea to leave the nail in, so I stood on the piece of wood it was nailed through and pulled my foot off the piece of wood. Still no pain. I went into the house, slightly limping because I thought I should I suppose, but no pain, to tell my Dad of the incident. He took some forceps and proceeded to fish around in the wound to see if there was any debris. Still, I felt no pain, just a little sore. The only treatment and care was a tetanus injection.

What’s the difference Doc?

The difference is context, that is to say, the temporary environment of the event. I would imagine that my colleague in self harm was horrified that his reinforced boot had allowed the nail to penetrate. Wow that must be bad! Everyone around might have panicked adding to the importance of the damage. An ambulance was called, sirens rang, a hospital at the other end. The smells and sights of A&E all compounding the importance of the damage and danger. Antigenic responses having a party.

In my case, I was alone. No care, no sympathy, no ambulance and no hospital. A tyrannical father was waiting for me to blame my stupidity for the accident and the inconvenience to him that work had been interrupted and a perfectly good pair of boots ruined!

It’s all about Context

It’s all about context at the end of the day. In my case, it was not to my advantage to add pain to an already bad situation. I did not require the additional protection that a pain construction can provide, my cognitions and metacognitions ‘overriding’ any associated molecular patterns (AMPs) produced in my body.

Next time you see someone who is – or who is not – suffering in proportion to what you might believe is normal, have you just been judgemental as to their character? Or have you really cared and dug deeper into their story and their context?

Would you like to know more?

Check out page 58 in Explain Pain Supercharged for the latest on the AMP’s family.

– David Bolton, London