He also discusses an interesting detail of pain, “reactive dissociation”. In my pain taxonomy, I split the various kinds of pain disorders into useful/motivating/qualia; the only combination I was missing was a kind of pain which is experienced as painful and yet was not motivating/aversive/unpleasant. “reactive dissociation” turns out to be just that—if morphine is administered after pain starts happening, people apparently frequently will report that the pain is excruciatingly painful, and yet they don’t mind it.
Aspirin by antagonizing bradykinin thus prevents pain at the earliest opportunity. This is interesting because aspirin is also unique among analgesics in lacking the ‘reactive disassociation’ effect. All other analgesics (e.g., the morphine group and nitrous oxide in sub-anesthetic doses) have a common ‘phenomenology.’ After receiving the analgesic subjects commonly report not that the pain has disappeared or diminished (as with aspirin) but that the pain is as intense as ever though they no longer mind it. To many philosophers this may sound like some sort of conceptual incoherency or contradiction, or at least indicate a failure on the part of the subjects to draw enough distinctions, but such philosophical suspicions, which we will examine more closely later, must be voiced in the face of the normality of such first-person reports and the fact that they are expressed in the widest variety of language by subjects of every degree of sophistication. A further curiosity about morphine is that if it is administered before the onset of pain (for instance, as a pre-surgical medication) the subjects claim not to feel any pain subsequently (though they are not numb or anesthetized—they have sensation in the relevant parts of their bodies); while if the morphine is administered after the pain has commenced, the subjects report that the pain continues (and continues to be pain), though they no longer mind it.
...Lobotomized subjects similarly report feeling intense pain but not minding it, and in other ways the manifestations of lobotomy and morphine are similar enough to lead some researchers to describe the action of morphine (and some barbiturates) as “reversible pharmacological leucotomy [lobotomy]”.^23^
23: A. S. Keats and H. K. Beecher, “Pain Relief with Hypnotic Doses of Barbiturates, and a Hypothesis”, J. Pharmacol, 1950. Lobotomy, though discredited as a behavior-improving psychosurgical procedure, is still a last resort tactic in cases of utterly intractable central pain, where the only other alternative to unrelenting agony is escalating morphine dosages, with inevitable addiction, habituation and early death. Lobotomy does not excise any of the old low path (as one might expect from its effect on pain perception), but it does cut off the old low path from a rich input source in the frontal lobes of the cortex.
Dennett throws in this disturbing anecdote in footnote 27:
Scopolamine and other amnestics are often prescribed by anesthesiologists for the purpose of creating amnesia. “Sometimes”, I was told by a prominent anesthesiologist, “when we think a patient may have been awake during surgery, we give scopolamine to get us off the hook. Sometimes it works and sometimes not.”
Daniel Dennett turns out to discuss precisely this problem in the context of curare/analgesics/anesthetics/amnestics in Dennett 1978, “Why You Can’t Make A Computer That Feels Pain”.
He also discusses an interesting detail of pain, “reactive dissociation”. In my pain taxonomy, I split the various kinds of pain disorders into useful/motivating/qualia; the only combination I was missing was a kind of pain which is experienced as painful and yet was not motivating/aversive/unpleasant. “reactive dissociation” turns out to be just that—if morphine is administered after pain starts happening, people apparently frequently will report that the pain is excruciatingly painful, and yet they don’t mind it.
Dennett throws in this disturbing anecdote in footnote 27: