Author: Abdul-Ghaaliq Lalkhen
Publication Information: New York, Scribner, 2021, 218 pp., $28.00, hardcover
Dr Abdul Ghaaliq Lalkhen, with his many years practicing anesthesiology and practicing as a pain specialist, is poised to offer a great deal of insight into the medical perspective of treating pain. An Anatomy of Pain explores the complex physiology behind the human experience of pain while also painting the historical context of our cultural relationship to pain.
The title does a disservice to the depth of the book. The book explores much more than the anatomy of pain. The review of the anatomy and physiology, while important and informative, is the least interesting aspect. The historical review, the patient cases, and the exploration of the psychosocial contributions to the pain experience are far more interesting.
This text fills a unique niche in the literature. Amidst the opioid epidemic, the book offers an accessible, patient-centered account of the challenging work physicians face to help their patients with pain. It reviews the physiology of the pain experience, but also explores the way in which the pain experience can seem to defy physiology. Its historical review is extremely valuable to patient and physician alike.
Dr Lalkhen succeeds at writing both to engage the trained medical professional as well as a general audience. Anyone suffering with chronic pain, family members of those with chronic pain, those with opioid use disorder, primary care physicians, and any medical providers supporting patients with chronic pain would benefit from reading this book. The book is well written and does not sacrifice medical content for readability or accessibility.
This would be a wonderful book for family medicine residency education. Current trainees are often highly attuned to the opioid epidemic but likely have little familiarity with the prior landscape of pain management. The patient cases would help residents develop healthy and realistic expectations of the work needed to support patients with chronic pain.
The flow of the book reminds me of my own clinical journey. As physicians, our medical journeys are really only linear with respect to time. In all other aspects the journey is often circular, weaving in and out of the nuances of physiology, anatomy, pharmacology, emotions, social complexities, and medical best practice. During that journey we are reminded of the aspects of practice that come purely by historical momentum and status quo. I found the book to be somewhat therapeutic for me as a physician; while reading it I felt as if my own struggles to help patients with chronic pain were being validated. This speaks to the authenticity of the author.
I greatly appreciate the medical honesty of this book. As a family doctor I have often referred patients to specialists for interventions from which they have received little to no benefit. In my desperation to help them find relief I have continued to seek procedural intervention first over the psychosocial. While sometimes this is indeed appropriate, my own practice has demonstrated that meaningful results from procedural interventions are the exception rather than the rule and that often a more psychosocial approach is ultimately needed. Dr Abdul Ghaaliq Lalkhen’s work is an honest and open reminder not to take this path of least resistance, but instead to recommit oneself to doing the difficult work of walking with patients on their journey of chronic pain and slowly, diligently helping them turn their locus of control inward once again, or perhaps for the first time in their lives.