In The Body in Pain (1985) Elaine Scarry writes that pain transports us back to a pre-verbal, instinctual “world of cries and whispers.” Those in serious pain look for metaphors that might make them understood, or at least understandable, but too often fail to translate the deeply subjective topography of suffering. In this chapter, I argue that this topography is made more challenging still by the uniquely damaging burdens of chronic pain. While I will claim that the invisibility of chronic pain is central to the suffering of the patient, I also believe that what separates acute pain from the chronic experiences is somatic and psychological, as well as linguistic. First, chronicity is distinguished from acute conditions by the ever-present, yet

often idiopathic, character of chronic pain, leading to a lack of uptake by the medical and lay communities on whom the patient might rely not only for palliation, but also for acceptance and empathy. Thus while the acute pain patient’s suffering might be similarly invisible, it eventually abates, resulting in both a more “proper” clinical model (and thus greater medical uptake), and an endpoint to the experience itself, allowing the patient to eventually move on beyond her condition. In the case of chronic pain, there is no endpoint to either the physical suffering of the condition, or to its continuous rejection by those in positions to act on it. Second, chronic pain is made unique in part by the failure of a shareable

language that adequately communicates the experience of an ongoing collapse of not just one’s body, but of one’s world. While acute pain calls us to a linguistic expression of something unwelcome and unexpected – in fact, acute pain is often recognized by others through, among other things, a verbal exclamation by the sufferer – chronic pain is often accompanied by complaints that, over time, begin to sound to others less like an alarm, and more like malingering, or, tragically, like a flaw in the patient’s character.