A World Without Pain: Does Hurting Make Us Human?
Joanne Cameron, a 72-year old retired school teacher living in a village in the Scottish Highlands, suffers from a rare genetic mutation. An Indian doctor – who used to work in the Indian Navy and now works for Britain’s NHS – upon discovering this mutation realised that Ms Cameron’s rare condition (which has never been found in any other human being) can shed new light on how the human body works. This remarkable story highlights why New Yorker is the home of the best writers on the planet.
Ms Cameron’s rare genetic condition means that her body and mind rarely registers pain or fear or dread or anxiety: ““I know the word ‘pain,’ and I know people are in pain, because you can see it,” Joanne Cameron, a seventy-two-year-old retired teacher, told me, in the cluttered kitchen of her century-old stone cottage in the Scottish Highlands. Cameron has never experienced the extremes of rage, dread, grief, anxiety, or fear. She handed a cup of tea to Jim, her husband of twenty-five years, with whom she’s never had a fight. “I see stress,” she continued, “and I’ve seen pain, what it does, but I’m talking about an abstract thing.”
Because of a combination of genetic quirks, Cameron’s negative emotional range is limited to the kinds of bearable suffering…When something bad happens, Cameron’s brain immediately searches for a way to ameliorate the situation, but it does not dwell on unhappiness. She inadvertently follows the creed of the Stoics (and of every twelve-step recovery program): Accept the things you cannot change.”
Experts now believe that if they can understand the precise nature of Ms Cameron’s genetic mutation and how that has altered her mind & body, they might be able to create drugs which allow all of us to live the sort of happy life Ms Cameron has lived (inspite of her first husband suffering from bipolar disorder and then subsequently dying after a prolonged battle with mental illness).
Cameron was “discovered” by Devjit Srivastava, a former Indian Naval Officer. “Srivastava is the consultant anesthetist at what he calls a “frontier hospital”—Raigmore, in Inverness, which serves the whole of the vast and remote Scottish Highlands…When Srivastava met Jo Cameron, six years ago, she told him that she wouldn’t need painkillers for the surgery she was about to undergo. He assumed that he was just dealing with a kindred imperturbable spirit….
Cameron was having a trapeziectomy, an operation to remove a small bone at the base of the thumb joint…Srivastava told Cameron that, Scottish stoicism notwithstanding, he intended to use an anesthetic block during the operation. After she left the hospital, he reviewed her chart: “She had only one paracetamol”—a Tylenol—“immediately after the operation in the recovery area. And that was only because the nurses give everybody a paracetamol after surgery. I checked the full records of hip replacement the previous year: after hip surgery it was the same thing—nothing taken for pain. That’s when I called her in.”
He remained slightly skeptical until Cameron let him perform a maneuver that anesthesiologists use on patients who are having difficulty regaining consciousness after sedation: they press hard on the inner edges of the eye sockets, and the pain shocks people awake. Cameron, of course, felt only pressure.
Srivastava was surprised that no doctor or nurse had been curious about her pain insensitivity before…Srivastava recognized that her case was extraordinary—“This doesn’t fall into every anesthetist’s life,” he said—and also that understanding it would require him to supplement his own expertise. He developed a research protocol, and enlisted highly regarded scientists from around the world to try to figure out what caused her condition.”
So what exactly is the mutation that Ms Cameron suffers from? Why exactly is it that she’s so extraordinary?
“Cameron does not have neuropathy: she can feel all the sensations the rest of us do, except pain. The most striking difference between her and everyone else is the way she processes endocannabinoids—chemicals that exist naturally in every human brain. Endocannabinoids mitigate our stress response, and they bind to the same receptors as the THC in the kind of cannabis you smoke. Normally, they are broken down by an enzyme called fatty acid amide hydrolase, or faah. But Cameron has a mutation on her faah gene that makes the enzyme less effective—so her endocannabinoids build up. She has extraordinarily high levels of one in particular: anandamide, whose name is derived from the Sanskrit word for “bliss.”
About a third of the population has a mutation in the faah gene, which provides increased levels of anandamide. “That phenotype—low levels of anxiety, forgetfulness, a happy-go-lucky demeanor—isn’t representative of how everyone responds to cannabis, but you see a lot of the prototypical changes in them that occur when people consume cannabis,” said Matthew Hill, a biologist at the University of Calgary’s Hotchkiss Brain Institute, who was a co-author of the Cameron paper. The faah gene, like every gene, comes in a pair. People who have the mutation in one allele of the gene seem a little high; people who have it in both even more so. Jo Cameron is fully baked.”
In fact, Ms Cameron’s mutation is such that it makes her close to being the “perfect human being”: “Paul Bloom, a professor of psychology at Yale and the author of the book “Against Empathy,” maintains that relating to suffering has little to do with the capacity to be helpful and kind. He has published research suggesting that compassion, not empathy, drives altruistic behavior. (Most research on the subject blurs together empathy and compassion, but Bloom argues that this is a failure of experimental design: “The standard measures suck.”) “Empathy can actually get in the way—if you are in terrible pain and I feel so much empathy for you that, being with you, I feel it, too, I may decide to stay home,” he told me. “The Buddhists knew this. There’s all this teaching that says, ‘Don’t get sentimental. Joyously and lovingly help others, but don’t get in their heads.’ ” Cameron, he told me, was a perfect illustration of his point: “She’s my dream girl. She doesn’t feel the pain of others, so she doesn’t feel empathy per se. But she cares for others.””