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Needless Suffering offers a sociological examination of a complex medical problem: chronic pain and the inability of doctors and other health professionals to understand and manage it in their patients. People in pain, writes Dr. David Nagel, are the poor of the medical world. Like the poor, they are stigmatized and left at the mercy of powerful social actors who tend to work in their own self-interest, frequently at the expense of those they propose to serve. This leaves those who suffer with little control over their own destinies and creates a dysfunctional status quo that harms instead of helps. Drawing on his own experience witnessing his mother’s chronic pain and numerous clinical stories from over thirty years’ expertise as a pain management specialist, Nagel looks first at patients, their families, and their doctors (usually not trained in pain management), and then broadens his canvas to elaborate a pain power structure that includes the entire healthcare community, insurers, lawyers, government regulators, employers, politicians, law enforcement agencies, and painkilling drugs. Concluding with concrete reforms to create more effective and compassionate pain care, this book is designed for pain patients and their families, healthcare providers, legislators and other public policymakers, judges, personal injury and other attorneys, insurers, government regulators, law enforcement personnel, and health care businesspeople.

As the United States rushed toward industrial and technological modernization in the late nineteenth century, people worried that the workplace had become too competitive, the economy too turbulent, domestic chores too taxing, while new machines had created a fast-paced environment that sickened the nation. Physicians testified that, without a doubt, modern civilization was causing a host of ills—everything from irritability to insomnia, lethargy to weight loss, anxiety to lack of ambition, and indigestion to impotence. They called this condition neurasthenia.

Neurasthenic Nation investigates how the concept of neurasthenia helped doctors and patients, men and women, and advertisers and consumers negotiate changes commonly associated with “modernity.” Combining a survey of medical and popular literature on neurasthenia with original research into rare archives of personal letters, patient records, and corporate files, David Schuster charts the emergence of a “neurasthenic nation”—a place where people saw their personal health as inextricably tied to the pitfalls and possibilities of a changing world.