“The Pain Scale,” from One to Five

[an analysis by Phillip Wenturine]

“The Pain Scale” is a creative non-fiction work about determining what type of pain one is in, using the typical, one-to-ten, doctoral pain scale.

The author, Eula Biss, takes the reader on a journey of the numbers relaying the pain associated with each. Biss is very philosophical and makes the reader think along with her as she details and questions the assumed pain for each digit, or lack thereof. She throws in subtle humor along with hard facts to make this a very light, fun read as she travels up the scale and back down again in this circular story.

Biss’ tone in “The Pain Scale” is philosophical, interrogative, and appropriately witty. The subtle humor creates moments for the reader to sit back and smile as she relays the scale with relatable experiences for every reader.

Biss’ format relies on the scale. She mimics the scale using it to unwind her story. Her tone allows the reader to follow her guide but to question her story as well.

There are five reasons I find Biss’ tone and format in “The Pain Scale” to be effective. Yes, five—not ten—because somewhere between one and ten, people tend to get lost, fluctuating within their answers. Five is short and concise, with a clear median and less room to stray from the intended path. Perhaps that is a problem with the pain scale, that people tend to get lost within the numbers, are not sure whether their pain is above or below the average of five, and if it is whether it strays to a two, three, or four, or a six, seven, eight, or nine. In that case, is five really the mean? Wouldn’t it be closer to five-point-five? Five is only the median when zero is included, but zero isn’t a number, per se, at least not on the scale. So many issues. A five-point scale has less room for error and more room for specificity.



Being that this is creative non-fiction, what better way to stay within the genre than by using statistics? Clearly, when I read something that sounds like a hard-core fact, I have no choice but to believe it.

Biss writes, “Zero is the coldest temperature at which a mixture of salt and water can still remain liquid.” Truthfully, mind blown.

Being an English major, it’s safe to say I did not know that prior to reading this piece, for while I aced Biology class, it seems that I retained nothing. The statistic is given to me straightforwardly, and as such, I have no reason to believe it’s faulty. Biss even let’s me know that she is a mixture of salt and water and “strives to remain liquid.” I hope she remains liquid, too. If she froze, she wouldn’t be able to write anymore.

Biss wants the reader to simmer over these hard, factual statements within her piece. “There is a mathematical proof that zero equals one. Which, of course, it doesn’t.” Zero equals one. No it doesn’t. Wait, what? I’m still simmering over that one.

Without these facts, the story would be questionable as a work of non-fiction. That is the main reason why it is first on the list. Not first because it is in first place; not first because it is the least painful or the least exhilarating; first because without it, it wouldn’t be.



What’s a story without details? It’s just words on a page: bland, boring, blah. Biss takes her statistics and paints a lovely picture—one that is less cliché than the first half of this sentence.

Details such as, “The worst pain imaginable…Stabbed in the eye with a spoon? Whipped with nettles? Buried under an avalanche of sharp rocks? Impaled with hundreds of nails? Dragged over gravel behind a fast truck? Skinned alive?” dictate such specificity and leave the reader feeling anything but wonder about the scene at hand. Biss could have written, “The worst pain imaginable…Ouch.” But no, “ouch” doesn’t hurt as much as being “dragged over gravel behind a fast truck.”

Biss is also very philosophical in her wording. Not only do her details piece together imagery, but they bring together a final image that was perhaps unexpected, one with a twist. “The suffering of Hell is terrifying not because of any specific torture, but because it is eternal.” Most people might assume Hell is terrifying because of being burned alive. But Biss proposes that it isn’t the burning or the pain, but it’s simply the duration alone that makes Hell so horrendous. But if so, a simple burn becomes less than painful, does it not? Biss’ wording is thoughtful and delicious.


The Interrogative

The third reason, coming precisely after the second but before the fourth, is because of its relationship with the interrogative nature of Biss’s voice. As preluded in sections one and two—more so in two, but that is because two comes after one—Biss tends to question the reader as she goes up and down the scale. She makes the reader think when she writes, “Where does pain worth measuring begin? With poison ivy? With a hang nail? With a stubbed toe? A sore throat? A needle prick? A razor cut?” She questions what type of pain is worth measuring and gives six examples of possible answers, but the real interrogative nature lies beyond this, as she is asks, without writing it, if these types are also probable, insisting that the reader formulate some ideas for himself.

Just as Biss questions whether the act of burning or the duration of it is what makes Hell so horrific, she questions the meaning of pain and, perhaps more importantly, what pain is worth the actual idea of “pain” enough to be considered “painful.”


Personal Wit and Relateability

Statistics, details, and questions are fun and all, but let’s get down to it. Without a little personal wit and relatability, why would we read non-fiction? Couldn’t we just watch The History Channel? Even then, with just wit, we wouldn’t read it either. There would be no substance, just sugar. And we all know we can’t have desert without dinner.

Biss writes, “’Three is nothing,’ [my father tells me,] ‘Three is go home and take two aspirin.’ ‘It would be helpful,’ I tell him, ‘if this could be noted on the scale.’” These are my favorite lines. I like to rate pain this way. How many aspirin does it take to solve the problem? One: why bother. Two: average headache. Three: gettin’ pretty serious. Four or more: bump up to morphine. Biss is hysterical, yet serious as she makes this story relatable to the reader, and her subtlety is key within her humor.

Another line, “I am incapable of imagining the worst pain imaginable. Just as I am incapable of understanding calculus,” also relates with the reader. Who understands calculus? No one. That has to be the most relatable sentence of all.


The Scale

Last (but certainly not least, although one is not least either, although technically it is, besides zero, which isn’t really a number, although it is) is Biss’ use of the scale within “The Pain Scale.” The whole point of her story is to complicate the scale and make it much more complex than ten digits, eleven if counting zero, which isn’t a digit. Yet without zero, math wouldn’t function properly—but with it, neither would this five-point scale.

Biss writes: “Left alone in the exam room I stare at the pain scale, a simple number line complicated by only two phrases. Under zero: “no pain.” Under ten: “the worst pain imaginable.” However, her whole story proves that pain as well as the scale is much deeper than no pain and the worst pain imaginable. She continues, “One of the functions of the pain scale is to protect doctors—to spare them from emotional pain. Hearing someone describe their pain as a ten is much easier than hearing them describe is as a hot poker driven through their eyeball into their brain.” Here, Biss uses all of the numbers, one to five, showing hard facts, details, questioning the truth of the scale, being witty and relatable, and ultimately, incorporating the scale. Hence the reason the scale is the last point on the scale about the scale.


1 Comment (+add yours?)

  1. Meredith Raiford (@MeredithRaiford)
    Oct 12, 2012 @ 03:13:17

    Oh, Phillip. It’s like you’re in my brain. I *just* recommended “The Pain Scale” to a friend today because it is such a delight to read and ponder. I love your analysis of it, too, using Biss-esque logic to defend your position.


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