Rivista per le Medical Humanities

Lella Ravasi Bellocchio
rMH 42, 2019, 11-14

A pain is stronger in the spring

Pain makes your heart ache, stiffens your feelings and imprisons the suffering person in a mask. Only by recognising our shared humanity can we through it make ourselves an instrument to make sense of what is happening. And right then, while meeting the other, while taking care of the other, we also take care of the part of us that is being evoked by the other. How does our unconscious come into contact with the unconscious of the other, and take care of the other, thanks to this capacity for empathy and relationship? How to let the other enter inside us? What are the words that can be said in the face of suffering, and why choose just certain ones rather than others? The poetic word can actually give comfort and help us endure pain. Starting from this conviction, the author, a Jungian analyst, chooses to evoke here emotions and feelings through poetry and music.

Edoardo Tasciotti
rMH 42, 2019, 15-16

Relieving acute pain, relieving chronic pain

In the field of anaesthesiology, the treatment of acute pain and the relief of symptoms, especially in the post-operative period, constitutes a primary objective: indeed, obtaining an adequate pain relief allows a rapid rehabilitation, a reduction of post-operative complications, rapid hospital discharge and a reduction in terms of hospitalisation-related costs. However, pain professionals are also confronted with the management of chronic pain, which is identified as nociceptive, neuropathic and idiopathic. In these terms, pain is characterised by a corollary of symptoms that, as they become chronic, contribute to developing a real illness. Its treatment poses a major challenge for pain therapy specialists which cannot be pursued while leaving aside multidisciplinary cooperation. In the context of chronic pain too, the therapeutic offer is founded on evidence based medicine: the use of international guidelines supported by ebm and the presence of scientific societies. Unfortunately, the managerial and organisational apparatus in the welfare context still remains, nonetheless, too different from country to country.

Giorgia Melli
rMH 42, 2019, 17-20

When pain becomes a real illness

Pain is a physiological and adaptive alert response to a danger potentially harmful to the body. In evolutionary terms, therefore, it is a favourable mechanism for protection from external dangers. However, when pain becomes chronic, its protective function comes to an end and it turns itself into a real illness. As a result, there are different types of pain, each characterised by different physiopathological and neurobiological mechanisms. The most common classification divides pain in two groups, namely: nociceptive and neuropathic. The paper tackles the issue of neuropathic pain approached from the point of view of its aetiological classification, in diagnostic and prognostic terms as well as of therapies, acknowledging the difficulties that taking charge of this complex condition entails.

Michele Ravetta
rMH 42, 2019, 21-24

O vos omnes qui transitis per viamů

“Come, all who pass by the way, pay attention and see: is there any pain like my pain?”, reads the passage of the Book of Lamentations (1,12) chosen for the title. The human being has always been confronted – or at least it has been so from his expulsion from the Garden of Eden – with his own finitude, with the materiality of his body growing old until declining, with pain and suffering, meant as staying in suffering, without any possibility of ecstasy, i.e. ex-stare (staying out). Now, suffering, either physical or spiritual, has such a disruptive and destructive power as to overturn the values – even the existential ones – that have accompanied a life until its advent. The awareness of the heaviness of the moment we are living can then lead us to feel a need to rediscover the spiritual dimension as human beings, in which case spirituality reveals itself a resource to be on the way up again. Spirituality, however, cannot be improvised, it cannot be invented à la carte: it must instead be welcomed and cultivated well before adversity makes a breach to get into our life. From a Capuchin friar an invitation is addressed to health professionals and carers so that they cultivate, even in a secular key, a spiritual vision that enables them to learn how to look beyond through the eyes of their soul.

Graziano Martignoni
rMH 42, 2019, 25-36

The eighth pain

Pain is here explored as an existential dimension, a manifestation of the fragile and breakable character of the human being, poised on the edge of t he wor ld, o n the brink o f b ecoming a si ck, wounded and abandoned body, at constan t risk of shipwreck. What possible horizons of meaning are still open in our time? What scenarios remain, beyond the “metaphysics of the tragic” of the classical world and of the “covenant theology” of the Jewish-Christian tradition? What “new covenant” between heaven and earth is conceivable today around the mystery and scandal of death and pain? What relationship with the world of technology we appeal to rightly to be delivered not only from useless pain but also, at the same time, yet deceptively, from unhappiness? The issue of pain thus eventually ends up by facing the theme of salvation and happiness, but also of evil, in its manifold forms and variations. The paper proposes a wideranging reflection, which crosses cultural history, with the aim of helping us understand how the present aphasia towards pain has come about.

Guenda Bernegger
rMH 42, 2019, 37-43

Tantus labor non sit cassus. Pain, faith and transcendence

If it is true that the way each person suffers and e xperiences pain is a result of his own conception of existence, to what extent is such suffering conditioned by the fact of believing or not in a transcendent dimension? Faith in a transcendence has always offered a key to read and go through suffering, giving it a meaning, thus fulfilling the hope of the Dies Irae mentioned in the title: “May so much suffering not be in vain”. This is a conception recognisable primarily in Christian culture, but it is also possible to recognize in other cultural responses a similar function of understanding and signification of pain and suffering: this is the case for the secular perspective, which sees them as a privileged way to get to knowledge – as evidenced by the ancient tragedy, but also by the romantic tradition. So what has thus become of the experience of pain and the possibility of signifying it, in an increasingly secular framework alien to any form of transcendence, such as that of contemporary Western society? A framework in which the active struggle against pain has progressively asserted itself, in a strenuous effort to fight it, exclude it, conceal it, having no longer tools to signify it. Medicine is involved in this mission, seen as a source of salvation and hope, provided that it manages to defeat the enemy. However this emptiness of meaning too needs to be taken care of, in order not to rule out the possibility of another meaning, another narration, another hope.

Graziano Martignoni
rMH 42, 2019, 59-60

Clinical meditations

  Duri ng their train ing path, the parti ci pants in the supsi Certificate of Advanced Studies in Clinical Humanism and Clinical Ethics were invited to write some Meditations, starting from a textual cue suggested to them at the end of each module: a sort of “ homework” to be prepared in the time interval between one meeting and another. The journey told in the Meditations involved, in additio n to the conven tional lessons held within the walls of the Sasso Corbaro Castle in the period 2017-2018, extra moenia moments: “extraordinary” meetings, in which they were capable of breaking the ordinariness of the training structure modules, characterised by different themes and approaches, though united by a focus on the artistic dimension and the experiential component. Emotional events, therefore, which allowed the participants to rediscover the dynamic arts that can advantageously establish a dialogue with the care.