In her 2005 poetic essay “The Pain Scale,” author Eula Biss challenges the conception of medicalized pain rating systems. She describes how pain ranked at “0” or “10” seems unfathomable, given the impossibility of representing pain’s absolute absence or its “worst imaginable” presence (Biss 30). She also critiques how patients often succumb to the “tyranny of the mean” in clinical evaluations, and she wonders, “Where does pain worth measuring begin?” (28, 26). Her gorgeous and haunting ruminations in this piece contend with the difficult articulation, quantification, and interpretation of pain both within and outside of medical settings.
Biss acknowledges the impossibility of expressing one’s experiences of pain—whether aches, injury, loss, or trauma—as intersubjectively recognizable scenes, much less rendering these experiences through standardized assessments such as the widely used McGill or Wong-Baker scales. Though she proposes that “the sensations of [her] own body may be the only subject on which [she is] qualified to claim expertise,” she questions that same embodied authority, noting that pain also constitutes a terrifyingly isolated state wherein conveying discomfort “feels like a lie every time” (9). Her writing gestures beyond the prevailing biopsychosocial models of pain to wrestle with the larger ethical, affective, and structural meanings derived from the many perspectives of those who experience or negotiate pain.
I was reminded of this narrative essay by Eula Biss over the last month as I listened to a new Serial Productions podcast titled “The Retrievals” (2023), written and hosted by Susan Burton. The five-episode series captures the harrowing tales of dozens of women who endured invasive egg retrieval procedures sans pain relief at the Yale Fertility Center in 2020. Despite a number of complaints of excruciating pain during and long after their fertility treatments, the women’s sufferings were largely dismissed until an anesthesiologist eventually stumbled upon a compromised fentanyl vial. As the subsequent criminal investigation later revealed, a clinic nurse who had developed an opioid addiction spent months switching hundreds of patients’ painkiller doses for basic saline.
Like a podcasting shepherd, as reviewer Nicholas Quah says, Susan Burton “favors a softer touch” rather than a resolute investigative stance in this series (Quah). After all, the case against the nurse was legally resolved by the time Burton picked up the story. Interspersed with tender and critical dialogue from the host, the episodes rotate through deeply emotional responses from the Yale Fertility Center’s affected patients, providers, and legal representatives, as well as perspectives from people acquainted with the convicted nurse.
While allocating space for each of the individual voices of the women who had eggs surgically extracted without any pain support, Burton also manages to represent pain as a phenomenon of collective existence. In her chapter “The Contingency of Pain,” scholar Sara Ahmed addresses how pain testimonies represent compilation narratives that are “irreducible” to a universal truth, as they are contextualized and transformed inherently by their contact with “other stories of pain and suffering” (Ahmed 37). She demonstrates how the lonely experience of suffering which cannot be translated directly across bodies is nonetheless “continually evoked in public discourse as that which demands a collective as well as individual response” (20).
Burton capably and gently bridges this transition from intimate pain to social analysis in “The Retrievals.” What begins with personal anecdotes of surgical encounters marked by dizzying punctures, extreme cramping, immense blood loss, and full awareness of sharp instruments on the flesh—all endured singularly by women in agonizing states of complete consciousness and sobriety—becomes a recounting of pain and trauma well beyond unbearable penetration with probes and needles. Eula Biss’s “The Pain Scale” juxtaposes the available medical verbiage of “burning, stabbing, throbbing, prickling, dull, sharp, deep, shallow” sensations alongside the less categorical “pain of feeling, the pain of caring, the pain of doubting, the pain of parting, the pain of paying” (Biss 8). Similarly, Burton illustrates the fertility treatment clients’ pains during unmedicated egg retrievals as both injurious events and as an opening into broader deliberation over shared reproductive desire and sacrifice, gendered (dis)belief, and the institutional power of medical authority. As expressed by many of the women interviewed for “The Retrievals,” the physical pain on the operating table was matched or mirrored by the pain of not relating to other women’s anecdotes of easy fertility treatment, the pain of being shrugged off as overly hysterical or dramatic, the pain of suspecting one’s body to be abnormally unresponsive to drugs, and the pain of wanting children and not having them…
I find the pairing of Eula Biss’s memorable essay from 2005 with the recently released podcast series compelling—the former as a first-person, semi-fictional meditation on pain and the latter as an anthology of momentous, news-worthy, induced pain. Both pieces yearn to understand, witness, and act upon suffering, and especially suffering’s gendered elements. Biss laments recent studies suggesting that “women feel pain differently than men” and that “pain medications act differently on women than they do on men” (Biss 30). She despises that such findings perpetuate mythically the “supreme mystery” of women’s bodies (30). Burton’s journalistic project, then, appears to follow these earlier theories through to their bitter, realistic end. In light of the excessively painful procedures conducted in 2020 at the Yale Fertility Center, testimonies revealed not that women feel pain differently or respond to medication differently, but that women’s pain is produced, addressed, treated, taught, legally defined, socially sanctioned, and believed differently.
Audre Lorde writes in The Cancer Journals that “pain does not mellow you, nor does it ennoble, in my experience” (Lorde 49). If pain is not consecrated or warranted or even acknowledged, what function does it serve? Likewise, what is the value of essays or (audio) stories about pain, then?
Sara Ahmed potentially offers us a way through. She proposes that pain delineates the boundary or surface of the self, and in doing so, it also exposes the very points at which external forces are impressed upon us. “In other words,” she says, “what separates us from others also connects us to others,” and in this way, “pain that cannot be shared” reflects in its irreconcilability a “different kind of inhabitance,” a “call for action, and a demand for collective politics” (Ahmed 39). Susan Burton’s “The Retrievals” yields a demand of this kind in its granting of the physical singularity and the shared sociality of women’s wounds.
Burton wraps the final episode with an imperative sentence for her audience: “Consider this a record here of the pain the women described individually and as a chorus, again and again” (Burton). If the Yale Fertility Center had been left to its own devices, there might have been no record or acknowledgment—legal, medical, or informal—of this pain at all. To build such a powerful, collective archive of suffering outside of the terrains of healthcare and law is to demand that it be seen, documented. If medical pain spectra represent one way to try to quantify and address pain, then the projects of Biss and Burton offer different modes of divulging pain’s many appearances, meanings, and outcomes; these authors insist radically upon pain’s manifold presences, particularly for women. And, in the case of the women represented in “The Retrievals,” this different mode of storytelling itself “becomes a way, not only to explain pain, but to cope with it, a way to not only make sense of the pain, but to manage it, to tamp it down, get through it. In this way, the story becomes the medicine that the patients weren’t given” (Burton).
You can listen to “The Retrievals” here: https://www.nytimes.com/2023/06/29/podcasts/serial-the-retrievals-yale-fertility-clinic.html?action=click&module=audio-series-bar®ion=header&pgtype=Article.
You can read “The Pain Scale” here: https://harpers.org/archive/2005/06/the-pain-scale/.
Ahmed, Sara. “The Contingency of Pain.” The Cultural Politics of Emotion. Routledge, 2005, pp. 20-41.
Biss, Eula. “The Pain Scale.” Harper’s Magazine, June 2005, pp. 25-30.
Burton, Susan, host. “The Retrievals.” Serial Productions, The New York Times, Summer 2023, https://www.nytimes.com/2023/07/06/podcasts/serial-the-retrievals-yale-fertility-clinic.html?action=click&module=audio-series-bar®ion=header&pgtype=Article.
Lorde, Audre. The Cancer Journals. Aunt Lute Books, 1997.
Quah, Nicholas. “The Retrievals is a Nightmare.” Vulture, August 17, 2023.
Tanner, Erik. “The Retrievals.” Serial Productions, The New York Times.