Is pain always indicative of injury?

My wife and I are in a childbirth class with a group of about 30 adults, and recently the question of pain came up. One student (apparently a scientist) argued that all pain was indicative of injury—the normal pain of childbirth, even emotional pain and grief involves small tissue damage in the brain. Fascinating! Who knew?

But as I thought about it that night, I found that there was something in the argument that didn’t sit right with me. The next morning I realized what it was: It’s one thing to point out that pain is linked to some kind of cellular rending as a clinical fact, but to claim that all pain is by definition injury is to step out of the magisterium of science and onto my turf—because at that point we are talking about the meanings of words.

The word injury carries with it a strong connotation of wrongness. It comes from the Latin injuria (in = not jus or jur = right, eg justice, jurisprudence). There are some types of pain that don’t feel wrong at all—in fact, they can feel very right. Exercise is one example. I think of the line from Chariots of Fire, when Eric Liddell responds to his sister’s demands that he give up his shot at the Olympics by saying. “God made me for a purpose, but He also made me fast. And when I run, I feel His pleasure.” I wouldn’t call it God, but I certainly have felt an overwhelming sense of rightness in my own running as I push up against the barriers of pain. Injury is an imprecise, misleading word if it describes something that feels right. (NB this is subjective. Running a 60-second 400 meters will be injurious for one person and sublime for another).

So what is the right word to describe pain of childbirth, a pain that is usually chosen (and there is bound to be pain in the process, even with an epidural), wanted at some level? Damage (damnum – a loss, eg damn) and harm (old Norse for sorrow) have connotations similar to injury. There are other, less uncomplimentary words, to describe the breaking down of one thing to deliver something new: Tilling, the act of plowing under one kind of life to produce another comes from the German zielen (to strive) and seems appropriate in nuance, but too poetical for practical use. There is deconstruction, change, transformation, all of which are adequate. Transformational pain seems more on point than injury. All transformations involve some destruction (tree to table, table to ash, ash to tree), but the word does not connote loss or gain.

Perhaps this is too obvious to see, but it would also make sense to call desired pain labor. All labor, whether intellectual, manual, or uterine, is painful in varying degrees. But it is also productive of something desired. Labor does rend cells, but in the long run it usually makes them stronger. The word in Latin is the same (labor) and it means toil and trouble—though trouble in this Latin sense simply implies changing things up (from turbidus – turbid, trouble the waters).

These days labor is frequently used in a negative context: laboring fruitlessly, belaboring the point, laboring under a false assumption. It tends to imply the Luddite banging his head against the wall, too stupid or unskilled to utilize the wings of technology. But I think labor deserves more respect. Now that machinery allows us to satisfy our desires with such airy ease it’s possible to see how unsatisfying such labor-free gratification can be. That which comes easily tends to pass me by almost unnoticed (how many cookies have I eaten?). The things I truly value are those that trouble me, which demand attention—and respect—which force me to sweat, to prove my worth, to become a slightly better person before yielding themselves. In those pursuits I accept (sometimes grimly, sometimes joyfully) the pain, and I think it would be wrong to call it injury.