Thank you so kindly for prompting me. So this is a tricky topic, not just because the subject of pain is complex, but also because it’s one that impinges much more readily into the real world than initially meets the eye. I’ll try to make my least preachy fist of it.
“Most things don’t exist. Don’t let it bother you” – Ruollf, 1999
I do date myself here. Once upon a time, I was an engineering undergraduate student, and the above statement was one of the many quips my mechanics professor would throw out. It was absurd enough for me to remember and the older I grow, the more true it’s turned out to be.
In all my ramblings, there are just two things I’d like to have as takeaways.
Pain is processed in the brain.
When someone says (or acts as if) it hurts, believe them.
There is no objective measure of pain. There are no pain molecules that can be detected. Pain is a sensation that is processed and interpreted by a person’s brain as being noxious. It is always and entirely all in your head. Doesn’t make it any less real. While pain is thought of as being a response to damage to the body, no amount of physical damage to one’s body can definitely be linked to a given experience of pain – some people don’t feel pain at all, many people have a reduced ability to feel pain, and many have a heightened ability. And quite a lot of pain has no immediate physical source. It is entirely subjective – you will always only have the individual’s report of it to go on. The same is true for you: to others, they have to believe that your report of pain is true.
The issue that comes in is that believing that others feel pain reflects quite horribly on our empathy and prejudices, with people believing that those they are biased against feel less pain. It has real consequences: in healthcare, in the justice and corrective services, in teaching… doubting or discounting the pain of others causes real distress, measurable harm and needless death [1,2]. Pain can’t be measured – other people’s pain are a fiction you have to choose to believe and it’s dangerously easy to refuse to do it.
Anyway, let’s go on. Does Genos feel pain was your question. The answer, as I said, is yes. But it’s a question that needs to be picked apart.
I call it easy because this is the sort of pain we all find easy to appreciate: physical damage provoking a pain response. It’s probably the question you’re asking. The answer for Genos is yes. The prosthetic parts of his body are not pain-sensitive; he can feel touch – watch him turn when someone taps him on the shoulder, but not pain. Just as well given how hard he uses them. Or not: if they hurt, there’s some things he wouldn’t do.
someone didn’t get the memo about not sticking your arms in the rotating blades
However, when it comes to damage to his somatic body proper, it does hurt. The clearest place is his upper back. When the Deep Sea King spat acid at the little girl and Genos caught it, there was no question it really hurt as it sank in.
Some people like to doubt that and say it’s only in the manga or the anime, so here’s a look at webcomic, manga and anime (link). No, no question: it looked like it hurt, he is acting like it hurts. It hurts.
That hurt: top, the webcomic, middle, the manga, and bottom, the aftermath, needing to be pieced back together under general anaesthesia.
His upper back has become even more heavily-armoured since:
Just to drive the point home, you can dismantle most of his body save head, neck and upper torso without causing Genos any distress, at least not in the short-term.
I had really wanted to be a fly on the wall for this conversation – it sounds like it was intense. But alas, JC Staff couldn’t find the space…
So. In short, if you can get at Genos’s body proper, it will hurt him. But you have your work cut out to do so.
This kind of pain is a little bit harder to appreciate. As I said, pain is something the brain processes in response to messages received from nerves. The trouble is nerves don’t always give accurate reports of what’s actually going on and the brain doesn’t always interpret the information it is given accurately. The first question Dr Kuseno asked Genos when the latter received a new body is an extremely important one: ‘how does it feel?‘ (chapter 80). Even if nothing is mechanically wrong, feeling good isn’t a trivial thing: getting good, appropriate sensation back from his body is just as important as being able to move it.
Who is touched by this in real life? Anyone whose body interfaces with a prosthetic, whether it’s exterior ones you can see or interior ones like the million people a year who get joint replacements. Many times, inappropriate pain is a sign of poor fit or infection, but sometimes it’s not and it can be very frustrating to get relief. An even bigger subsection are people who have experienced major injury and find that long after the original injury is healed, it still hurts. Cancer survivors who have had chemotherapy often find themselves contending with inappropriate pain from the damage it has done to their peripheral nerves. How medical practitioners deal (or fail to deal with) these kinds of pain is a topic well above my pay grade and the remit of this answer.
As I said earlier, pain is processed in the brain. Just because a body part doesn’t exist any longer doesn’t mean that its representation within the brain has gone anywhere and this leads to a phenomenon known as phantom pain, which sounds more cute than it is. While it’s called phantom pain, the actual sensations felt range from pain to itching, cramping, senses that the limb or body part is distorted in shape and many more disturbing feelings. A good 80% of amputees do get phantom pain. Shockingly, only 17% of patients who complain of phantom pain get the help they need, with many of them told that they’re mentally disturbed. [3] It’s completely unacceptable given that there are many therapies available. When it comes to Genos, if you’re asking if a quadruple amputee with additional extensive defleshing and major organ resection feels pain, not only is the answer yes, but hell yes. The only question is how much and where? The only thing we can say is that in Genos’s case, he’s got it managed well enough not to interfere with daily life. The good news about phantom pains and sensations is that for most people it’s not constant and does usually diminish with time but it can and does flare up intermittently even after many years. That’s our weird brains for you. [You will notice that I’ve not touched on somatic symptom disorders where no organic cause can be found for the pain, but the pain is absolutely real. Again, it’s outside the remit of the question.]
I hope you’ve not minded this whistle-stop tour of what is a really big and complex topic. Pain is entirely a phenomenon in your head. It doesn’t mean it’s not real. As someone with his brain and all mental faculties intact, Genos has 100% of what a person needs to feel pain. And he seems to. Which ought to be good enough for anyone. [4]
[1] Patient–physician gender concordance and increased mortality among female heart attack patients. Brad N. Greenwood, Seth Carnahan, Laura Huang. Proceedings of the National Academy of Sciences Volume 115, Issue 34 Aug 2018, Pages 8569-8574; https://doi.org/10.1073/pnas.1800097115
(While there are a lot of studies showing that female physicians outperform male ones across the board, this study focusses on heart attacks, where assumptions made about the patient by the physician really matter. They find that not only patients treated by female physicians more likely to survive regardless of gender, but male doctors are particularly bad when it comes to treating women. The kicker? When male physicians work alongside female ones, they stop killing so many of their female patients.)
[2] Jazmine Ulloa , 22 April 2019, ’These California bills would train nurses, judges and police how to spot their own biases’. Los Angeles Times. Available at: https://www.latimes.com/politics/la-pol-ca-implicit-bias-legislation-california-20190422-story.html Accessed: 30 May 2020
[3] Phantom limb pain L. Nikolajsen, T. S. Jensen BJA: British Journal of Anaesthesia, Volume 87, Issue 1, 1 June 2001, Pages 107–116, https://doi.org/10.1093/bja/87.1.107
[4] Then again, I know the occasional dumb-ass who would still deny that Genos feels pain. For which Jeremy Bentham’s question might suffice: “…the question is not, Can they reason? nor, Can they talk? but, Can they suffer? “ I trust that even the most mind-dead would deny that he can and does suffer.
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