Free Anatomy of an Illness as Perceived by the Patient by Norman Cousins

and educators could get together to make knowledge about pain an important part of the regular school curriculum. As for the populace at large, perhaps some of the same techniques used by public-service agencies to make people cancer-conscious can be used to counteract the growing terror of pain and illness in general. People ought to know that nothing is more remarkable about the human body than its recuperative drive, given a modicum of respect. If our broadcasting stations cannot provide equal time for responses to the pain-killing advertisements, they might at least set aside a few minutes each day for common-sense remarks on the subject of pain. As for the Food and Drug Administration, it might be interesting to know why an agency that has so energetically warned the American people against taking vitamins without prescriptions is doing so little to control over-the-counter sales each year of billions of pain-killing pills, some of which can do more harm than the pain they are supposed to suppress.
    If an account is ever written about the attempts of the medical profession to understand pain, the name of Paul Brand may have an honored place. Dr. Brand has worked with lepers for most of his medical career. He is an English orthopedic surgeon, recognized throughout world medical circles for his work in restoring crippled or paralyzed hands to productive use. His principal work at Medical College at Vellore, India, was as director of orthopedic surgery.
    Paul Brand went to Vellore as a young man in 1947. His wife, also a surgeon, joined him at Vellore a year later. Together, they constituted one of the most remarkable husband-and-wife medical teams in the world. Paul Brand restored to thousands of lepers the use of their hands and arms. Margaret Brand saved thousands of lepers from blindness. Both of them taught at the medical college, undertook important research, and worked at the hospital and in field clinics.
    Paul Brand’s main purpose in coming to the Christian Medical College and Hospital at Vellore was to see whether he might be able to apply his highly developed skills in reconstructive surgery to the special problems of lepers. Commonly, lepers’ fingers tend to “claw” or partially close up because of the paralysis of vital nerves controlling the muscles of the hand. Brand wanted to try to reactivate the fingers by connecting them to healthy nerve impulses in the leper’s forearm. This would require, of course, reeducating the patient so that his brain could transmit orders to the lower forearm instead of the hand for activating the fingers.
    He wasn’t at Vellore very long, however, before he realized he couldn’t confine himself to problems caused by the clawish hands of lepers. He would have to deal with the total problem of leprosy—what it was, how it took hold in the human body, how it might be combated. He immersed himself in research. The more he learned, the greater was his awareness that most of the attitudes toward leprosy he had carried with him to Vellore were outmoded to the point of being medieval. He became determined to pit the scientific method against the old mysteries of leprosy.
    He was to discover that the prevailing ideas about “leprous tissue” were mistaken. Wrong, too, was the notion that missing toes or fingers or atrophy of the nose were direct products or manifestations of the disease. Most significant of all perhaps was his awareness that leprosy was a disease of painlessness.
    As head of the research section, Paul Brand first needed to find out as much as he could about tissue from the affected parts of lepers. Medicine had long known that leprosy was produced by a bacillus somewhat similar to the organism that causes tuberculosis. This discovery had been made by Gerhard Henrik Hansen almost a century and a half ago; the term “Hansen’s disease” became synonymous with leprosy. As in the case of tuberculosis, the bacillus leprae