What's the question?

A top-down, stylised digital artwork in a mosaic style made using AI. The image depicts a dense urban landscape where hundreds of tiny, multi-colored tiles form buildings and greenery. The focal point is a network of vibrant, intertwined roads in primary colors that spiral and curve to perfectly outline a large question mark in the middle of the frame.

Often, I sit and reflect on where I'm at in my career and I wonder why I've not written more academically on the subject of pain. In truth, it's not just a quesion I ask myself but one I'm regularly asked. Its a sore point really becauseI am a trained writer, so why am I not writing?

On my self-critical days, I might berate myself for not having taken advantage of the offers I've had over the years to write and collaborate, or pushing harder to become a PhD student when I've been holding the opportunities in my hands.. afterall - I critique the work of others regularly, shouldn't I be giving others the opportunity to critique my ideas? It would only be fair after all - cue the self-doubt.

On my kinder days, I reflect that I've been distracted with builidng a professional career as a therapist. I've been DOING the work, applying the theories, testing out the techniques and translating this for other clinicians. Whilst also being a mum, an immigrant, learning (and working) in a second language, getting divorced, carving out a new specialist relationship with pain teams... I mean, surely that's enough?

On my more honest days, I simply don't know what I'd write about. I walked away from my fledgling journalism and copy writing career disillusioned with the state of reporting and writing and entered the healthcare profession to become useful and practical in changing the suffering of the people around me (and myself). There was so much unethical bullshit in that industry, that I wanted to work in something good. Be something good in the world. So when I rekindled an interest in Physiotherapy I'd had as a young teenager and went back to University, it was never with the intention of becoming an educator or writer. I just wanted to help people enjoy their lives and feel cared for.

I spent the first ten years or so, just mouthing-off and pushing my way into the big rooms - remember begging to be accepted on my Masters programme at Kings' College. I just wanting to learn from the best, the most passionate and the most progressive clinicians and academics. When I found myself speaking to an audience that clapped back. Sometimes in really shockingly mysogynisitic and gate-keeping ways. I noticed that pretty much everyone looked like me in these rooms and hated that I was just bringing another middle class white woman to the table. A table often filled by people I didnt align with ideologically and resented having to package up my outrage at the racism, ableism, sexism and queer-phobia in healthcare as 'social determinants of health' so as not to offend - because above all - we must not offend.

It made my skin crawl.

I started building my own spaces, trying to nurture more inclusivity and hold a safe space for discourse without liberal or conservative censorship. Recognising that not all working class folk have the language of EDI but they have the values, not all clinicians can read high level academic articles, but they have the wisdom needed to integrate them into something helpful and locally sensitive and not all of us speak English but we all speak in kindness and care - and there's always google translate.

These spaces take time and are also not perfect. As white women, we come with our limitations - and let's face it, we aren't necessarily going to be well trusted by folk who have been harmed and oppressed by people that look just like us and promise safe and courteous spaces... just like we do.

Nor would I expect them too. Trust should be earned and regularly tested.

In doing this, I widened my view on my role so vastly, that I'm not even sure what is the right question to ask anymore or what I want to say about pain and pain care. I look back on my posts and reflections and teachings from 10 years ago and I sort of laugh fondly, I was so certain, so sure of what I was working towards. I knew what my role was and I wanted to do it well.

But how can I write about pain when I don't even know what the word pain means anymore? How can I come up with experiments when I don't even know what I'm testing?

In many ways, I'm glad I've waited (on my kinder days atleast!) because now I'm here, still with a relatively clean slate, at the beginning, with my 15 years of discourse as a foundation simply asking two questions:

"What is pain, why do feel it, why does it hurt, why does it linger for so many and what does it mean?"

and:

"what is it about being a modern day homo sapien that builds and curates a global and local society where people suffer at unfair rates, for no obvious moral reason at all, and at the same time have a small group of people (often made up of the group that are suffering in some way), who willingly enter into an under-funded and over-worked labour system, that task themselves with somehow changing the suffering of strangers, despite us having no real idea of what it actually means to be a complex, relational, biological organism that can think and feel and adapt in a sea of manufactured certainty for profit that often, only adds to the problem it promises to solve?"

Or, as AI so sycophantically puts it:

This is a deeply layered observation that touches on sociology, evolutionary psychology, and political economy. To reword this for an academic context, we can break it down into the tension between systemic inequality, prosocial altruism, and biological reductionism.

Here are a few ways to frame your question depending on the specific field of study:

1. Sociological & Macro-Economic Focus

"How do the structural imperatives of late-stage capitalism reconcile the systemic production of inequitable suffering with the emergence of 'altruistic labor'—specifically, why do marginalized groups often provide the under-resourced labor intended to mitigate the very systemic failures that oppress them?"

2. Evolutionary & Biopsychosocial Focus

"To what extent does the disconnect between our biological evolution as relational organisms and our current 'manufactured' digital/economic environments contribute to a paradox where prosocial behavior (care-taking) is commodified, yet remains fundamentally unaligned with the complex needs of the human organism?"

3. Philosophical & Existential Focus

"In a landscape defined by 'manufactured certainty' and profit-driven solutions, what are the ethical implications of a society that offloads the burden of systemic compassion onto an over-worked labor force, while simultaneously failing to define or respect the ontological reality of the human experience?"

And, maybe even more revealing, why do I think I should have anything interesting to say on this matter?

Wishing you a week of meaningful questions and the courage to look beneath the surface.

-Laura x