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Speaker 13: 00:53 Wait you're listening...

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Speaker 3: 01:01 You're listening to Radiolab. Radiolab.

Speaker 4: 01:01 Shorts!

Speaker 3: 01:04 From WNYC and NPR.

Jad Abumrad: 01:12 Alright, 3, 2, 1, Hey I'm Jad Abumrad.

Robert Krulwich: 01:15 Okay, I'm Robert Krulwich.

Jad Abumrad: 01:18 You're cheery today!

Robert Krulwich: 01:19 I was cheery.

Jad Abumrad: 01:20 This is Radiolab.

Robert Krulwich: 01:21 And this is our Podcast version.

Jad Abumrad: 01:22 Yes, and today on the Podcast stay in that cheery frame of mind.

Robert Krulwich: 01:25 Okay. 

Jad Abumrad: 01:25 Because we're gonna to talk about pain today. So here's the quandary, it is really hard to put words to pain. To describe to somebody, “I have this pain in my back and it feels like, 'groans' it really hurts.” It's really difficult to describe to someone in a way that would let them feel it too. It's like one of these classic empathy barriers, right?

Robert Krulwich: 01:49 That's true.

Jad Abumrad: 01:50 But, if you could quantify it, measure it, if I could know exactly, numerically, what you're going through, maybe that would help. Maybe we could be better friends.

Robert Krulwich: 02:01 If you could, do you think you could? Is that what this is-

Jad Abumrad: 02:06 I don't know. But we're going to try. 

You see, our producer Tim Howard over the last few months, has encountered three different people who in different ways are trying to measure pain, share it.

Robert Krulwich: 02:17 So we're going to do three episodes of pain...

Jad Abumrad: 02:21 Calibration.

Robert Krulwich: 02:22 Calibration.

Jad Abumrad: 02:23 A tryptic of pain calibration. 

Robert Krulwich: 02:24 Okay, bring it on.

Jad Abumrad: 02:27 Here's Tim.

Justin Schmidt: 02:28 Hi, come on in. 

Tim Howard: 02:30 Hey, how ya doing?

I got started with all this when I met this guy. 

Justin Schmidt: 02:33 I'm Justin Schmidt, I'm a research biologist.

Tim Howard: 02:36 But he's really a bug guy.

Justin Schmidt: 02:38 I like to try to get into the head of the stinging insect.

Tim Howard: 02:44 He lives in Tucson, Arizona, and works in this one story building on a residential street. 

Justin Schmidt: 02:49 Right now we're in my laboratory at Southwestern Biological Institute.

Tim Howard: 02:53 Could we just take a quick glance around?

Justin Schmidt: 02:57 Yeah- [crosstalk 00:02:57]

Tim Howard: 02:58 I would love to just know what it is that we're looking at.

Justin Schmidt: 03:01 Underneath those cabinets are 48 drawers of insect specimens, so these are- [crosstalk 00:03:08]

Tim Howard: 03:07 Oh wow.

He's got wasps.

Justin Schmidt: 03:09 That's apoica, and it's a nocturnal wasp.

Tim Howard: 03:12 That is terrifying, this one here.

Different kinds of weird ... What is this guy? ...hornets.

Justin Schmidt: 03:17 That's actually a flightless grasshopper.

Tim Howard: 03:20 He's got a lot of ants.

Wow there's some little furry...

Justin Schmidt: 03:23 Yeah those are velvet ants.

Tim Howard: 03:24 They're huge.

Justin Schmidt: 03:25 If you pick up one of these things and get stung by it, it's going to feel like, “Oh my goodness, that could kill a cow!” 

Tim Howard: 03:32 Okay so, this all started for Justin back in the seventies when he was a grad student.

Justin Schmidt: 03:37 And I just thought, for a lark, I took a seminar course in Entomology. We had one entomologist in the whole university. 

Jad Abumrad: 03:44 This is a course in bug science?

Tim Howard: 03:45 Yeah, this was in Georgia and he was outside one day in the field and he was trying to get a sample of...

Justin Schmidt: 03:51 A harvester ant!

Jad Abumrad: 03:52 Harvester ant, what does that look like?

Justin Schmidt: 03:55 They're about a third of an inch long, and they're bright red. Pretty good sized ants actually.

Tim Howard: 04:00 And he was trying to get one into a jar and...

Justin Schmidt: 04:04 I got stung by one. Then I kind of, thought, "Oh that's odd."

Tim Howard: 04:10 Didn't really hurt at first.

Justin Schmidt: 04:12 Okay, it sorta felt like somebody was using a dental syringe, a really fine needle slowly injecting a little bit of water. It had this kind of, crystalline feeling. It wasn't an immediate pain, this was a delayed thing. And so, then I thought, “Oh, okay.” But after about a minute, it started really hurting. 

I said, “Oww, this really hurts!” It was this really deep, sort of visceral pain. Something was going in and tearing out your nerves and your muscles and your tendons.

What struck me was how dramatically different this was from anything that I had experienced from a bumble bee, honey bee, sweat bee, yellow jacket, paper wasp, hornet-

Tim Howard: 05:09 And once the pain subsided, he thought, "Man, I need to study that!"

Justin Schmidt: 05:14 Yeah!

Tim Howard: 05:16 You know he had all these, kind of, higher level science questions about evolution of pain and insects and how different stinging insects developed.

Justin Schmidt: 05:24 But the problem was, Oh! Okay, pain. What do we do about measuring pain?

Tim Howard: 05:32 If he was really going to get to the bottom of why one insect was more or less painful than another, he couldn't do that with just words like, 'more' or 'less.'

Justin Schmidt: 05:42 I need numbers.

Tim Howard: 05:43 With numbers, he could do all kinds of research. Not to mention it would make working with other bug scientists a lot easier.

Justin Schmidt: 05:51 I started looking into this and found out, oh, this wasn't anything new, nobody really knows how to measure pain. 

Tim Howard: 05:58 Because no two people feel pain the same way.

Justin Schmidt: 06:02 Some people have higher pain tolerance than others.

Tim Howard: 06:04 On the other hand, that harvester ant was objectively way more painful than anything he'd ever been stung by.

Justin Schmidt: 06:10 Oh yeah.

Jad Abumrad: 06:11 So Justin realized, what I need is a universal, insect sting, pain scale.

Tim Howard: 06:19 So Justin starts traveling all around the world and every time he hears about a bug, especially a stinging bug, he goes looking for it.

Jad Abumrad: 06:30 In order to be stung by it?

Justin Schmidt: 06:31 Well, I don't like pain.

Tim Howard: 06:34 So he says he's not trying to get stung, but it usually happens. And as far as he's concerned that's a good thing. For example.

Justin Schmidt: 06:41 I was petrified of this synoeca, which I call the warrior wasp.

Tim Howard: 06:46 A synoeca is this black wasp with this metallic sheen.

Justin Schmidt: 06:50 Down in Central America.

Tim Howard: 06:52 And they're known for this warning sound that they make with their nests.

Justin Schmidt: 06:55 They have this big carton nest, carton being kind of paper, kind of goes, "woooooooo woooooooo"

Tim Howard: 07:02 Justin was there with another scientist and they're tromping through the jungle. And then they find a nest.

Justin Schmidt: 07:07 Here we are, this nest.

Tim Howard: 07:08 And it starts to make that sound.

Justin Schmidt: 07:11 Well, sure enough, we eventually got a kamikaze that came out and nailed me.

Tim Howard: 07:18 Where did it sting you?

Justin Schmidt: 07:19 Kind of on my forehead. And I just sort of sat on the stump and said, "Ohhh this really hurts!" It hurt like a yellow jacket or a hornet, but it was just a whole lot more.

Tim Howard: 07:31 And it kept hurting, for an hour.

Justin Schmidt: 07:34 And so I recorded what the feeling was for this hour.

Tim Howard: 07:39 So you're sitting there on a stump or something and your forehead is throbbing and you're taking notes?

Justin Schmidt: 07:44 Well what else can you do?

Tim Howard: 07:47 He talks about getting stung by something that makes him hurt so much that he just starts-

Justin Schmidt: 07:52 Screaming in pain.

Tim Howard: 07:54 For like an hour and lying on the ground because that will make the pain less, I guess.

Justin Schmidt: 07:58 My left hand is sitting here shaking, trembling, and it's going up and down, and I said, "Oh darn hand, stop that!" 

Jad Abumrad: 08:04 And with his other hand he's taking notes about exactly how it feels.

Justin Schmidt: 08:07 This left one's here flapping away and I'm... In any case.

Jad Abumrad: 08:11 How many times has he been stung?

Tim Howard: 08:13 He told me he's been stung by like 150 species and probably about 1000 times.

Jad Abumrad: 08:19 What?

Tim Howard: 08:19 And he's used all those experiences to build up a scale.

Justin Schmidt: 08:22 Which you could say is a five-point scale. Zero, One, Two, Three, and Four. Zero being essentially trivial.

Tim Howard: 08:31 And four being...

Justin Schmidt: 08:32 It really hurts!

Jad Abumrad: 08:34 But wait, how does he deal with the whole subjectivity thing? Because your four is going to be different than my four.

Tim Howard: 08:38 He did something pretty clever, which is that he took that one sting that we pretty much all know and decided, I'm going to use that as...

Justin Schmidt: 08:49 A reference. So I anchored it with the honey bee.

Tim Howard: 08:54 Which is?

Justin Schmidt: 08:55 Ouch!

Tim Howard: 08:56 Which you can talk about with anybody, anybody's been stung by a honey bee. 

It also doesn't hurt too much and it doesn't hurt too little.

Jad Abumrad: 09:03 So it's like a mid point?

Justin Schmidt: 09:04 Exactly, a middle point in this case was easier than a top or bottom because I didn't know what the top or bottom was, there's no way to know what the top or bottom is. So a honey bee was that and you give that a two.

Tim Howard: 09:16 Two out of four, the prime meridian of pain. And every time he gets stung by a new bug he'll ask himself,

Justin Schmidt: 09:24 Is it more than a honey bee, less than a honey bee, about the same as a honey bee? A whole lot more or a whole lot less. 

Tim Howard: 09:31 Then he gives that sting it's own number. Dig this: 1.0 - sweat bee, light ephemeral, almost fruity. 1.8 - bull horn acacia ant, a rare piercing, elevated sort of pain. Someone has fired a staple into your cheek. 2.0 - bald faced hornet, rich, hearty, slightly crunchy, similar to getting your hand mashed in a revolving door. 

Jad Abumrad: 09:51 Oww.

Tim Howard: 09:51 3 - red harvester ant, bold and unrelenting. Somebody is using a drill to excavate your ingrown toenail. 

Jad Abumrad: 09:58 This is his pain scale?

Tim Howard: 09:59 Justin calls this his tongue-in-cheek version.

Justin Schmidt: 10:02 That was more fun.

Tim Howard: 10:03 But yeah, these are some of the stings he's measured.

Jad Abumrad: 10:05 And what's the worst, what's the top of the scale?

Tim Howard: 10:08 The bullet ant.

Justin Schmidt: 10:10 It sends excruciating waves of burning pain, that are undiminished for 12 hours, and you get these pulsations, this pain crescendo that goes to you just about wanting to scream and then it backs off a little bit and so you say, "Ahh" you kind of give it a sigh of relief, and then it ascends back up, and it keeps doing this, these hills and valleys of ascending pain and then decrease. Even the decreasing to the lowest still hurts.

Jad Abumrad: 10:41 So this scale works for him? He uses it to communicate with bug scientists?

Tim Howard: 10:46 Yeah, yeah.

Jad Abumrad: 10:47 Wow. Well alright. That's kind of cool, but I gotta be honest, I'm wanting more right now, because I like the scale, but I'm thinking actually beyond bugs too. Let me just put my cards on the table, like child birth, okay? When we talk about the gap between two people feeling pain and being able to share pain, that's where the rubber meets the road.

Robert Krulwich: 11:17 Well it's used in a lot of marriages as a constant, "You don't know! You don't know what!"

Jad Abumrad: 11:22 Exactly, thank you, Robert. Does Tamar use it the way Carla uses it? 

Robert Krulwich: 11:26 Well I can't say that in a recording. No, not at all, really never. [crosstalk 00:11:33] It wouldn't cross my mind. 

Jad Abumrad: 11:35 Carla, who's a very sort of understating lady when it comes to this subject she'll be like, “You have no idea. You don't even begin to know what you don't know about what we just went through.” 

Tim Howard: 11:46 Well that brings me to my second story. 

Paula Michaels: 11:49 Can I take it from the top?

Tim Howard: 11:51 For this one, we go back a few years.

Paula Michaels: 11:53 So we're in 1948.

Jad Abumrad: 11:57 Who is this lady?

Tim Howard: 11:58 This is Paula Michaels, she's a professor of history of medicine. 

Paula Michaels: 12:02 I teach at the University of Iowa.

Tim Howard: 12:04 And she told me this story that takes place in New York, at New York Hospital, in 1948. 

Paula Michaels: 12:10 Right, so there's James D. Hardy, there's Carl T. Javert.

Tim Howard: 12:14 Hardy and Javert are doctors.

Paula Michaels: 12:15 And they're trying to test drugs. What drugs are going to be useful to alleviate the pain of child birth. And in this period, there's a whole range of things that are being used.

Tim Howard: 12:25 What are some of the ones that they're using?

Paula Michaels: 12:27 Well like morphine and scopolamine, demerol is a big thing.

Tim Howard: 12:31 Nice.

Paula Michaels: 12:32 And heroin. Which to me sounds completely crazy. 

Jad Abumrad: 12:35 They play around with crack, too? 

Tim Howard: 12:37 They would have if they knew about it. The problem is, they want to be able to test all these drugs so that they can use them in a standard way. But, they weren't actually sure how much pain women were really in.

Jad Abumrad: 12:50 I guess you kind of have to know that in order to know how much drugs to give them.

Tim Howard: 12:53 Yeah, they had no idea, and it was a source of a lot of debate.

Paula Michaels: 12:57 Yes. One man, Grantly Dick-Read, a British physician, basically said straight out, it's in women's minds not their bodies. 

Tim Howard: 13:07 What?

Paula Michaels: 13:07 Childbirth is a completely painless experience, entirely psychological in origin.

Jad Abumrad: 13:13 Wow that is an incredibly bold thing for a man to say. 

Paula Michaels: 13:17 Yes. That's chutzpah.

Tim Howard: 13:18 Now, Hardy and Javert didn't take it that far, but they wanted to get past the whole messy, psychological part of childbirth.

Paula Michaels: 13:25 And, eliminate that woman's subjective experience of pain from the calculation of whether these drugs are affective or not. 

Tim Howard: 13:34 And how are they going to do this?

Paula Michaels: 13:36 Well their method is pretty crazy. They had this apparatus called a Dolorimeter. 

Tim Howard: 13:45 It was this little wood box that had dials and knobs plugged into the wall and then was connected by a wire to another part.

Paula Michaels: 13:50 What they called the exposure unit.

Tim Howard: 13:52 That was like a heat gun with an aperture that can shoot out heat. Then they got some volunteers.

Paula Michaels: 13:58 Some of them were nurses. Some of them were the wives of obstetricians or other physicians.

Tim Howard: 14:04 All very pregnant and they told these women, "This might not be very pleasant, but by participating, you are going to be making childbirth so much better for every woman to follow."

Paula Michaels: 14:14 That's right.

Tim Howard: 14:14 And the women were excited to help.

Paula Michaels: 14:16 And then when the woman went into labor, 

Tim Howard: 14:19 Hardy and Javert would show up bedside with the dolorimeter and they would wait for the contraction to finish. 

Paula Michaels: 14:28 And then between contractions-

Tim Howard: 14:30 During that pause they would take the heat gun and they would put it against the back of the woman's hand and they would say to her, "Alright, we want to know about that contraction."

Jad Abumrad: 14:38 The one you just had? 

Tim Howard: 14:39 Yeah, "We want to know how much it hurt."

Paula Michaels: 14:41 They'd say, "Is it more like 'A' or more like 'B'?" And then the woman would respond.

Jad Abumrad: 14:49 "I guess 'B' is closer?"

Paula Michaels: 14:50 And then they would say, "Is it more like 'B' or is it more like 'C'?"

Jad Abumrad: 14:52 "'C' maybe?"

Paula Michaels: 14:54 That was a way of then saying, okay, that was a contraction of three dols. 

Jad Abumrad: 15:00 Dols? What's a dol? 

Tim Howard: 15:01 The dol is their unit of pain. Their standard unit that they use for everybody. 

And so, over the course of labor, after every contraction, they would repeat this process. Same drill.

Paula Michaels: 15:15 Is it more like 'A' or more like 'B'?

Tim Howard: 15:16 Again.

Paula Michaels: 15:17 'A' 'B'

Tim Howard: 15:18 And again.

Paula Michaels: 15:19 'B' or more like 'C'?

Tim Howard: 15:20 And again.

Paula Michaels: 15:20 Over the course of her whole labor.

Jad Abumrad: 15:22 So wait, on top of all the labor pains, they're just cranking this heat up and up?

Tim Howard: 15:25 Yeah.

Jad Abumrad: 15:26 Wow. 

Tim Howard: 15:28 In the case of one patient, who insisted on going the distance- 

Paula Michaels: 15:33 A pain intensity of ten and a half dols was measured. 

Tim Howard: 15:38 Hardy and Javert called this, 'The Ceiling'. 

Paula Michaels: 15:41 This is the most intense pain which can be experienced. Second degree burns were inflicted upon the hands of this patient by the four tests made at levels higher than nine dols.

Jad Abumrad: 15:51 Second degree burns? 

Tim Howard: 15:53 Yeah.

Jad Abumrad: 15:53 I mean I like what these guys are trying to do but wow. That is sadistic.

Paula Michaels: 15:57 It seems totally twisted, but, it's in the name of science. It's for a greater good. 

Tim Howard: 16:03 Uh huh. Okay. Alright, so then the doctors took all of the data from all of the women and they start going through it looking for patterns, looking for things in common, and then the most incredible part, to me, is that they converted all of that information into a mathematical formula.

Paula Michaels: 16:23 Dols of pain equals ten point five minus one point five times contraction intervals in minutes.

Jad Abumrad: 16:33 What?

Tim Howard: 16:34 Well so they're saying, if you tell us the amount of time between the contractions, at any point in her labor, we can tell you exactly how much pain the woman is in. No more mystery. There's no more wondering.

Jad Abumrad: 16:49 Problem solved.

Tim Howard: 16:50 The code is cracked.

Jad Abumrad: 16:51 And what happens? Does this breakthrough sweep the medical establishment? I'm guessing it doesn't.

Tim Howard: 16:58 Well, no.

Paula Michaels: 17:00 Other people could not achieve the same results that they achieved using the dolorimeter. They were not able to achieve the same results.

Tim Howard: 17:16 When other doctors tried to do it, that formula didn't seem to apply to the women that they look at. 

Jad Abumrad: 17:22 Shocker.

Tim Howard: 17:22 Obviously, there's a lot of problems with the entire approach that these guys had. Right?

Jad Abumrad: 17:27 No.

Tim Howard: 17:27 Yeah! I mean, for starters they were trying to compare pain in the abdomen to a burning sensation on the arm.

Jad Abumrad: 17:35 Yeah, that's like a translation problem.

Tim Howard: 17:38 In my opinion there's kind of a bigger translation issue happening. 

Jad Abumrad: 17:42 Which is?

Tim Howard: 17:43 In order to talk about a pain you're feeling, you need to be able to observe it and stand apart from it in your own head, if that makes sense.

Jad Abumrad: 17:51 Sure.

Tim Howard: 17:52 And when you hear women talk about the pain of childbirth.

Sarah: 17:55 Hello my name is Sarah, I'm in Sacramento, California.

Tim Howard: 17:58 We asked people to submit theirs through the Radiolab App. And when you listen to these different accounts-

Speaker 5: 18:04 My experience of child birth pain was...

Tim Howard: 18:07 It sounds like there's a certain point where everything shifts. One woman said it was at about seven centimeters dilated.

Speaker 6: 18:14 And that's when you lose your mind. And you can't think, you can't talk.

Tim Howard: 18:19 Suddenly the pain becomes so great-

Speaker 6: 18:21 So, so bad.

Tim Howard: 18:22 That's there's no more reference point.

Speaker 7: 18:24 I just remember-

Tim Howard: 18:25 There's no more objective distance.

Speaker 7: 18:27 Making these noises that were just, unearthly.

Tim Howard: 18:32 And in these submissions, it's usually at this point in the story where the woman either just- draws a blank.

Speaker 8: 18:43 Wow. 

Tim Howard: 18:44 Or, resorts to some crazy analogy.

Speaker 9: 18:47 It felt like there was a freight train bearing down on my vagina from inside my body. And then I could almost hear it building. 

Speaker 10: 19:01 I felt like I was being dragged out to sea.

Tim Howard: 19:03 That's one I actually heard a couple of times.

Speaker 10: 19:05 Waves. Waves of pain.

Tim Howard: 19:09 And it was kind of like that for Paula too.

Paula Michaels: 19:13 I turned very much inward, in a way that made time feel like it stopped. I was drowning. Drowning.

Eula Biss: 19:29 In this lake of pain. And there was a horizon, and when the contractions were intense, I would swim towards the horizon. 

Tim Howard: 19:38 This is Eula. 

Eula Biss: 19:39 I'm Eula Biss, I'm a non-fiction writer.

Tim Howard: 19:42 And she's our third pain calibrator. And for me, Eula kind of gets the closest at finding a way to communicate pain.

If I could say you have a relationship with pain, when did that start for you?

Eula Biss: 19:56 Let's see, about almost ten years ago. I think I was about 26.

Tim Howard: 20:04 At the time, Eula was a grad student in Iowa.

Eula Biss: 20:06 And I just woke up one morning in the fall and I had a terrible pain in the side of my neck, upper back, side of my face.

Tim Howard: 20:19 She had no idea what it was.

Eula Biss: 20:19 It was a burning pain.

Tim Howard: 20:21 With this nauseating tingling sensation.

Eula Biss: 20:23 I've really never felt anything else like it. And months passed and it didn't go away. It was making it very difficult for me to sleep. It started to interfere with my thinking, too. I couldn't concentrate.

Tim Howard: 20:40 So one day, she went to the hospital. By this point she was a total mess.

Eula Biss: 20:42 So I was kind of teary and shaking. I said, "You need to give me something to help me with this." 

Tim Howard: 20:50 And so the doctor said, "Alright, well take a look at this thing up here on the wall. This is called the pain scale."

Eula Biss: 20:52 It had the numbers zero to ten. At one end it said 'no pain' at the other end it said 'the worst pain imaginable'. 

Tim Howard: 21:00 And the doctor says to her, "Okay, what number is your pain?" Eula starts to think about it.

Eula Biss: 21:07 The worst pain imaginable is kind of vague. Is this the worst pain you yourself can imagine? Or is it the worst pain imaginable on earth? 

You know, this was around the time I think a man had died being dragged behind a truck in Texas and I remember sitting in the exam room thinking about that. And then I was trying to do some rudimentary mathematics.

If being dragged behind a truck to your death is the worst pain imaginable, what proportion of that do I feel? And I thought, you know, a third of that seemed pretty significant to me.

Tim Howard: 21:47 So, she says, “Three. I guess?” And the doc is like, “Alright.” And he does some tests, he tries to figure out exactly what's going on, can't really but since she said three anyway, he's like, “Alright, well, have some asprin, go home.” 

This happened a few times, she wasn't getting any better. So, at a certain point, she calls up her dad, who's also a doctor, and she starts complaining.

Eula Biss: 22:09 I was telling him how frustrated I was that the doctors didn't seem to be taking this very seriously. And he said, "Well when they ask you to rate your pain, what do you tell them?” And I said, “I usually say three.” And he said, "Well there's your problem.”

Tim Howard: 22:24 And her dad tells her, "you should say eight, even if you're not feeling it, that's what you gotta say." And Eula thinks this is ridiculous. Why do we even have a pain scale if I'm not supposed to take the numbers seriously? 

Eula Biss: 22:38 And he said, "In part, it's a tool that's meant to protect practitioners because it's emotionally difficult to have someone say to you, 'It feels like someone's jamming a red hot poker through my eyeball.' Rather than, 'I've got a nine.'"

Tim Howard: 22:57 But then, he made a suggestion, which I think is really clever.

Eula Biss: 23:02 He suggested one scale where it would measure what you're willing to do to get rid of your pain. What would you trade for pain relief. Would you give up your sense of sight for five years. Would you relinquish your ability to walk. 

Tim Howard: 23:28 Did you come up with any answers at that point?

Eula Biss: 23:30 I did, they were disturbing answers. When my father asked would you accept a shorter lifespan, at that point in time I thought, “Yeah, I would.” 

Tim Howard: 23:39 By how many years?

Eula Biss: 23:41 I was thinking, I would take ten years off my life. 

Tim Howard: 23:51 Wow. For me, that was basically the first time I felt like I understood her pain.

Eula Biss: 23:52 But, you know, I was 26 and life seems really long when you're 26. Now I'm in a much different state. My pain is not nearly as bad as it was then. So now I'm not really in the bargaining mood anymore.

Tim Howard: 24:10 I bet, like how about a bad haircut? Would you take a really bad haircut? A mo hawk?

Eula Biss: 24:16 Huh. Okay, yeah, actually I would. 

Tim Howard: 24:23 And these days, Eula is kind of pessimistic about the idea that were ever going to really have a useful pain scale.

Eula Biss: 24:30 At the end of the day, I'm not sure pain is a quantity that is measurable.

Tim Howard: 24:38 Thinking that kind of bums her out.

Eula Biss: 24:40 Because, part of me wanted to believe in the project of quantification.

Tim Howard: 24:45 Why?

Eula Biss: 24:47 I'm not sure. I think because not believing in it is a little bit lonelier. The idea that we cannot feel, cannot understand, and cannot imagine each other's pain is a really isolating thought.

Jad Abumrad: 25:09 By the way, what was her pain from? Did she get a diagnosis?

Tim Howard: 25:12 Well her doctor tried a lot of stuff actually. They did a brain scan, they checked for a spinal infection, and ultimately-

Eula Biss: 25:19 He said, “Unfortunately we don't know what causes this, we don't know how to treat it, we don't know if it will ever get better. But we do know it's real.” And that was my final conversation with him, and he said, "Good Luck out there."

Jad Abumrad: 25:36 Thanks to producer Tim Howard, Justin Schmidt, Paula Michaels, and Eula Biss. I'm Jad Abumrad.

Robert Krulwich: 26:03 I'm Robert Krulwich.

Jad Abumrad: 26:04 Thanks for listening.

Speaker 11: 26:06 Hi guys I just called and I think I messed up so I wanted to try it again, okay? Okay. Hi, this is Therese, I am a Radiolab listener in Jamaica Plain, Massachusets and here the credits. Radiolab is supported in part by the National Science Foundation and by the Alfred P. Sloan Foundation. Enhancing public understanding of science and technology in the modern world. More information about Sloan at wwww.sloan.org. I think that one was better, thanks y'all. Bye.

Speaker 12: 26:36 End of message.

Robert Krulwich: 26:42 Hi, I'm Robert Krulwich, Radiolab is supported by IBM. By 2050, the world population will reach nearly ten billion and food production will need to grow by seventy percent. So, what if artificial intelligence could help? Farmers are already using it to help increase crop yields. Watson and the IBM cloud provide access to weather data and analyze satellite imagery to help them monitor soil moisture levels and reduce water waste. So, as the population grows, more food can be put on tables. So let's put smart to work and find out how at IBM.com/smart.