One might think working as a physician would lead to disrespect for
the human body. After all, most of the bodies we see are broken or
malfunctioning in some way. In my case, however, the opposite is
true. My practice as a pain specialist (particularly chronic pain)
has drawn me into areas beyond the usual options for medical
treatment. In the process, that has led to a fascination with the
human brain and its myriad properties. I think it's safe to say
that most of us take our brains for granted. If we think about them
at all, it's in terms of comparative mental accomplishment (in our
prime of life) or dysfunction (beyond our prime). Rarely do we
stand in awe of all that this eight-pound organ does for us. With
this book, I'm hoping to do my part to change that. The focus is on
the brain's relationship with pain, but discussing that opens a
door to broader considerations. Meanwhile, the potential readership
is literally universal -- all of us have brains, and almost all of
us (except for those with a rare condition described in the book)
have felt pain. What most of us may not realize is that research
into the causes of pain began thousands of years ago. The ancient
Egyptians pondered the question, and Greek philosophers such as
Aristotle, Plato, and Galen made it an important part of their
overall philosophies. Hippocrates was laying the foundation for
modern brain and pain study as early as the late fifth century and
other scientific icons, such as Rene Descartes and Charles
Sherrington, built on what he had discovered and postulated. By the
20th century, some new revelation about pain and its possible
treatment was being reported in the scientific journals nearly
every month. That has only accelerated over the past few years,
which makes the study of the brain and pain one of the livelier
medical specialties. Meanwhile, there has been a significant change
in the attitude toward pain by 20th century physicians, researchers
and hospital personnel. Previously, pain was simply linked to
whatever condition might be afflicting a patient, leading to the
belief that when that condition was cured or managed, the pain
would automatically disappear. Now, though, it has become apparent
that pain might be more than just a symptom. In some cases, it
becomes a condition all to itself. Since pain is literally a
product of the brain, which announces it after being warned by a
small army of nocioceptors stationed throughout the body, it is
also open to glitches in that process. Chronic pain often occurs
when the brain "remembers" pain, even though the condition that
caused it may have been dealt with. This book has a clinical core,
but I have broadened the scope to include not only research history
but touch on several peripheral issuers involving pain. That
includes a chapter on masochism and congenital insensitivity to
pain, another on the opioid epidemic.
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