Lorimer Moseley: Learning from Phantom Pain

Lorimer Moseley shares an interesting anecdote about phantom pain that helps bring understanding to the complexity of pain.

“I walk like Dad, and he ended up in a wheelchair.” With knowledge and logic, you start putting this together. This hap­pens by neural connections—other sensory cues.

I’ve told the story of a baker I saw once who got extreme phantom hand pain. He’d had his hand amputated. He got his hand stuck in an industrial bread kneader and he had it amputated.

Ten years later, he would get severe phantom hand pain on Saturday mornings. After a while, he worked out—more with detective work than anything else—Saturday mornings was when his neigh­bors came home with a fresh loaf of bread. It was the smell of bread that set off his hand pain.

His very sophisticated pain management program was to stuff tissues up his nose first thing on Saturday mornings so there would be no bread molecules going up his nose.

He retrained for Scotland Yard, and one Sunday he rang me on my mobile, which I don’t give out. I was walking along and my phone rang. It was a private number.

“Hello, this is Lorimer.”

“Hi, Lorimer, it’s David,” said with a real nasal voice I couldn’t understand.

“I’m sorry, it’s who?”

“It’s David.”

“I’m sorry. I can’t understand you.”

“It’s David, the guy with the hand.”

It didn’t sound like him at all.

I thought for a second, then said, “You don’t mean David, the guy without the hand?”

“Oh, very funny.”

“David, you can take the tissues out.”

“Oh. Hi, it’s David.”

He still had the tissues up his nose 36 hours later.

His very sophisticated pain management exposure program was to wait slightly longer every Sat­urday morning before he put the tissues in. Over about eight or nine months, he weaned off the tissues and he had no more phantom hand pain—a few serious sinus infections, but it was worth it.

In that particular situation—and that’s the most profound example I’ve had—it was other sensory cues that set off his pain neurotag.

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