John Kay - Why pain is good – in both medicine and finance

Why pain is good – in both medicine and finance

John describes the vital role that pain – the gift no-one wants – plays in the evolution of business and finance.

Pain has been described as the gift no one wants. There cannot be a single reader who has not, at some time, wished not to experience pain.

But we are better off with the capacity to suffer pain than without it. A few people are born with a genetic deficiency that leaves them completely free of pain. They rarely survive to adult life. Leprosy has for thousands of years been the most dreaded disease. Only in the 20th century was it realised that the disfigurement was not the result of the illness itself but of inadvertent injuries caused to soft tissues by damaged nerve endings that did not allow the sufferer to register pain.

When you put your hand on a hot stove, you pull it away. That is not because you have calculated that prolonged exposure will damage your skin, but because it hurts: the reaction is faster than the calculation. Evolution favoured people with quick responses to pain over those with a deep insight into the mechanism of traumatic injury. You may never have put your hand on a hot stove in the first place because your mother warned you that it would hurt, but even before you discovered her advice was generally right, you discovered that it was wise to follow it. Cultural learning – aided by mental and physical pain inflicted by our parents – has reinforced our instincts.

The pain response is faster than the calculation of costs and benefits – and more intelligent. Modern technology makes it possible to simulate pain for people who do not naturally experience it. You can construct a machine that says “pull your hand away” when you touch a hot stove or even one that fires appropriate neurons in your brain. But neither machine works well. You can ignore the robot’s exhortations, as you may have ignored your mother’s exhortations. Moreover, you can do what you were never able to do with your mother: switch the machine off. People do switch it off when they encounter pain, and hurt themselves.

There is a paradox here. You are worse off if you can control your experience of pain – by reaching for the off switch – than if you cannot. The paradox is compounded because it is sometimes useful to master the pain response, as when you agree to an injection. The soldier is trained, and subjected to social pressure from his peers, to be brave and frequently is killed or injured in consequence. But your pet cat will never agree to an injection, even if the treatment would save its life. The balance of advantage between reason and instinct is evidently complicated.

But research on pain has identified the surprising ways in which the pain response attunes itself by distinguishing between reactions in which the response is useful. The pain you feel when you stub your toe is not just something in your toe but the result of the way your brain reacts to the signals emanating from your toe. Pain is most often felt when you can act either to avoid what is causing you pain or take action to relieve the damage. There is useless pain – like that associated with advanced cancer – but pain is, taken as a whole, good for us.

Pain is beneficial because, on balance, evolution is smarter than you are at deciding how you should respond in situations that could hurt you. Anaesthesia is invaluable but we have good reasons for only allowing it to be administered by trained and trusted physicians and warning people against undertaking complex tasks under its influence.

As in medicine, so in the world of business and economics. Pain is the gift no one wants. Although we might wish we could switch it off, on balance that capacity does more harm than good. Opiates – medical or financial – should be administered with great care, and usually only in the context of surgery or terminal illness. When someone says “I feel your pain”, they have completely misunderstood the nature of the phenomenon. They cannot and they do not.

The phrase “the gift no one wants” comes from Paul Brand’s inspirational study of leprosy sufferers. Our modern understanding of pain can also be appreciated from the work of Antonio Damasio (The Feeling of What Happens) and Patrick Wall (Pain: The Science of Suffering)

 

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