A small number of people are born with a rare condition called congenital insensitivity to pain (CIP). Sufferers are susceptible to repeat injuries – everything from burns and cuts to unnoticed fractures and damage to joints. Children may bite their tongues because nothing tells them to stop. Adults continue walking on a bum ankle that doesn’t hurt.
The classic example is putting your hand on a hot stove. A normal nervous system tells you: move your hand now! Someone with CIP may recognize a change in temperature while not receiving the warning that tissue is burning.
There were times in the last month I wished I had CIP, at least temporarily.
The pain after my recent bowel surgery was devastating. For weeks, nothing seemed to help, even while I was hospitalized and had access to the best drugs.
Acamol, opioids, or Optalgin?
My main go-to was Acamol (Paracetamol or Tylenol), delivered via IV so it kicked in faster than swallowing tablets – but it wasn’t enough.
The opioids I’d come to rely on during my CAR-T period in 2025 were off the table, as they can worsen ileus, the condition after abdominal surgery where the bowel “forgets” how to work. I had gotten that already and didn’t want to make it worse.
Although morphine has a similar bowel-stopping effect, I was put on a continuous drip immediately after I came out of surgery. During my three days in the ICU, the morphine made me hallucinate. I’d close my eyes and start a detailed conversation out loud with a person in front of me, only to discover I was alone in the room.
Nine years ago, I developed some nasty back pain and was prescribed Optalgin. I took it for about a week, then developed a stomachache that lasted for three years. Was there a connection or was it mere coincidence? Optalgin is widely used in Israel and Europe but banned by the FDA due to a rare but dangerous drop in one’s white blood cells.
I never took Optalgin again. That is, until the doctor at Hadassah suggested Optalgin could provide more relief than plain Acamol. Maybe I was wrong about the correlation? I decided to give it another try.
Within a day, that familiar stomach pain from nine years earlier was back. It could very well have returned anyway as part of my post-surgery recovery, but as far as I was concerned, Optalgin was out – this time, forever.
Intense pain consumed me for weeks. With no way out but to wait, I tried to distract myself by exploring its meaning in human existence: physiologically and psychologically.
IT’S CLEAR from the CIP story why we need to feel pain as a warning signal. It’s clear, too, that people have different pain thresholds. Mine is pretty low. When it ratchets up too high, I get so despondent I sometimes throw my hands in the air and scream, “I’m done! I can’t take this anymore.”
I told Avital, the Hadassah Medical Center chaplain, a lovely English-speaker who functioned as my temporary therapist while regular sessions, even by Zoom, seemed too awkward to conduct from my shared room in the surgery ward.
She wanted to know how serious I was, because she might have to report me.
I assured her I was not going to act on it, but pain can drive you crazy that way. It takes over everything, transforming its recipient into a smartoot (floor towel) tossed onto a bed, curled up and groaning.
Can AI feel pain?
Pain can be used as a way of getting out of something. When our four-year-old grandson didn’t want to go to summer camp one day, he came down with a fever. It was real – but remarkably ended as soon as the camp day did.
Something like that happened to me when I was in college, albeit for the opposite unconscious motive. I had planned an outing with friends from the dorm to an amusement park. I was really looking forward to it. The morning of the excursion, I was feverish and had to cancel. The fever was gone by the time they returned.
Even worse than pain, for me, is uncertainty. When you don’t know when something difficult is going to end – whether that’s healing from surgery, getting discharged home, or being stuck in a traffic jam behind an unforeseen accident – it sucks away all hope.
When my surgeon told me I could eat again, I was filled with anticipation of a return to normal life. When a day later that turned into violent vomiting (ileus, but not from opioids), it felt like one step forward, 10 steps back.
Can AI feel pain? I wondered. I asked my favorite chatbot.
“I can produce language that sounds remarkably like pain: ‘That hurts,’ ‘I don’t want this to happen,’ but that’s not evidence that there is an unpleasant experience occurring inside me,” ChatGPT replied.
It suggested I compare AI pain with a thermostat which “reacts differently when the temperature is wrong, but we don’t imagine the thermostat is miserably cold.”
“The First Noble Truth” of Buddhism states that “clinging to impermanence breeds dukkha, a suffering that can encompass everything from outright pain to a quiet feeling of unsatisfactoriness that runs through ordinary life.”
Freud presented a more positive, if measured, view when he wrote, “The best we could hope for would be insights that leave us feeling common, ordinary, everyday happiness.”
At this point, I’d be happy with a little less pain, a few more of those insights, a small dose of dukkha, and the occasional opioid.■
The writer’s book, TOTALED: The Billion-Dollar Crash of the Startup that Took on Big Auto, Big Oil and the World, was published earlier this year as an audiobook. It is available on Amazon and other online booksellers in print, ebook, and Audible formats. brianblum.com
