The NY Times Magazine has a fascinating piece this weekend on whether and at what stage a fetus can feel pain, and what that even means. Some of the descriptions of fetal reactions to surgery will make you wince. As I read about studies of fetuses and premature infants who received or did not receive anesthesia during invasive procedures, I couldn’t help but wonder if anyone was following up on the two groups as they grew up; stress hormones can have longterm effects and an early experience of intense pain or stress might show up in later development. This was addressed later in the article:
“When we do something to a baby that is not an expected part of its normal development, especially at a very early stage, we may actually change the way the nervous system is wired,” she says. Early encounters with pain may alter the threshold at which pain is felt later on, making a child hypersensitive to pain — or, alternatively, dangerously indifferent to it.
And then there’s the fetal environment: the womb, which appears to provide some anesthesia of its own.
“Have you ever wondered,” one visiting professor asked, “why a colt doesn’t get up and gallop around inside the mare?” After all, a horse only minutes old is already able to hobble around the barnyard. The answer, as Mellor reported in an influential review published in 2005, is that biochemicals produced by the placenta and fetus have a sedating and even an anesthetizing effect on the fetus (both equine and human). This fetal cocktail includes adenosine, which suppresses brain activity; pregnanolone, which relieves pain; and prostaglandin D2, which induces sleep — “pretty potent stuff,” he says.
My other recurring thought was, what makes pain count as pain? Must it be a conscious experience, or is the presence of high levels of stress hormones plus certain patterns of brain activity enough? Must one be able to acknowledge, name, or be consciously aware of a feeling for that feeling to be real? And if the physical phenomenon is real, and can affect one’s well-being in the short- or long-term, does it really matter? Here are one scientist’s highly-controversial thoughts on the matter:
The theory, in this case, is that the experience of pain has to be learned — and the fetus, lacking language or interactions with caregivers, has no chance of learning it. In place of distinct emotions, it experiences a blur of sensations, a condition Derbyshire has likened to looking at “a vast TV screen with all of the world’s information upon it from a distance of one inch; a great buzzing mass of meaningless information,” he writes. “Before a symbolic system such as language, an individual will not know that something in front of them is large or small, hot or cold, red or green” — or, Derbyshire argues, painful or pleasant.
The article raises fascinating biological and ethical questions. Science writing seems like such a great career, to be able to talk to all these people and then explain what you’ve learned to the public in a way that stokes their sense of wonder and makes them consider things from a new perspective, ask new questions. In teaching, I get to do a lot of this translating, capturing what makes something interesting and important and what are the most important conceptual and factual details to convey in order to lay the groundwork for both future interest and future, higher-level understanding. But the things that interest me most are a bit too complex for my middle schoolers.