Does hurting make us human?
By Ariel Levy
January 6, 2020 (NewYorker.com)
We like to think that what doesn’t kill us makes us stronger, or more resilient, or . . . something. Deeper. Wiser. Enlarged. There is “glory in our sufferings,” the Bible promises. “Suffering produces perseverance; perseverance, character; and character, hope.” In this equation, no pain is too great to be good. “The darker the night, the brighter the stars,” Dostoyevsky wrote. “The deeper the grief, the closer is God!” We atheists get in on the action by insisting that the agony of loss elucidates the worth of love. The hours spent staring into the dark, looping around our own personal grand prix of anxieties, are not a waste of time but a fundamental expression of our humanity. And so on. To be a person is to suffer.
But what if our worst feelings are just vestigial garbage? Hypervigilance and pricking fear were useful when survival depended on evading lions; they are not particularly productive when the predators are Alzheimer’s and cancer. Other excruciating feelings, like consuming sadness and aching regret, may never have had a function in the evolutionary sense. But religion, art, literature, and Oprah have convinced us that they are valuable—the bitter kick that enhances life’s intermittent sweetness. Pain is what makes joy, gratitude, mercy, hilarity, and empathy so precious. Unless it isn’t.
“I know the word ‘pain,’ and I know people are in pain, because you can see it,” Joanne Cameron, a seventy-two-year-old retired teacher, told me, in the cluttered kitchen of her century-old stone cottage in the Scottish Highlands. Cameron has never experienced the extremes of rage, dread, grief, anxiety, or fear. She handed a cup of tea to Jim, her husband of twenty-five years, with whom she’s never had a fight. “I see stress,” she continued, “and I’ve seen pain, what it does, but I’m talking about an abstract thing.”
Because of a combination of genetic quirks, Cameron’s negative emotional range is limited to the kinds of bearable suffering one sees in a Nora Ephron movie. If someone tells Cameron a sad story, she cries—“easily! Oh, I’m such a softie.” When she reads about the latest transgression by Boris Johnson or Donald Trump, she feels righteous indignation. “But then you just go to a protest march, don’t you? And that’s all you can do.” When something bad happens, Cameron’s brain immediately searches for a way to ameliorate the situation, but it does not dwell on unhappiness. She inadvertently follows the creed of the Stoics (and of every twelve-step recovery program): Accept the things you cannot change.
Cameron, who has white hair and was wearing denim overalls over a purple striped shirt, has a bouncy, elfin energy. She described the closest she’d ever come to experiencing real terror: an incident when her son, Jeremy, a musician, was beaten up so badly at a gig that he had to be hospitalized. “He was defending someone,” Cameron said. “The lead singer was gay—we’re talking a good few years ago, when they weren’t quite as tolerated—and they started calling the gay chappie names, and then suddenly the whole lot of them came on top of Jeremy.”
“They punched him, and kicked him, stamped his head,” Jim, a tall, genial man, with a white beard and a thick brogue, added gravely.
When Cameron got the call, she remembers, “initially, I thought, Oh, God, I hope he doesn’t die—I felt that. Then we got in the car. I wasn’t fretting, I was just thinking, We’ve got to get to him, he needs me.” They drove a hundred and thirty miles on the single-track roads that wind east from their home in Foyers, near the snaky banks of Loch Ness, to Peterhead. “We got to the hospital about four or five in the morning. He looked like an elephant man, my handsome boy did,” Cameron said, laughing. “He looked like nothing on earth!”
In addition to Jeremy, who is forty-two, Cameron has a daughter, Amy, who is thirty. Her experience of motherhood has entailed none of the rumbling terror that most parents feel over their children’s safety. “Some time ago, someone said to me, ‘When the baby comes, the first thing you do is count the fingers and toes.’ I thought, I never looked at anything!” Cameron said. “I never dreamed of there being anything wrong.”
In sharp contrast to her near-inability to feel awful, Cameron has an expansive capacity for positive emotions. She is exceedingly loving and affectionate with her husband. When I first came to the door, she greeted me with an embrace, crying, “Ooh, I’m very huggy!” Her seventeen years as a special-education teacher required great reserves of compassion. “I had a Down-syndrome girl—who was actually quite high-functioning—and she would come in every morning and she’d walk up to me and spit in my face, and say, ‘I hate you, Jo Cameron! I hate you!’ And I’d stand there and say, ‘I don’t like being spat on, but I don’t hate you!’ ” Cameron told me, smiling. “Oh, I’ve had some very difficult students. I’ve been bitten; I’ve been spat on; I’ve been kicked!” Over the years, the Camerons have provided short-term foster care for four children. One of them stole all their vacation money from the cookie jar. “She did take things for the sake of taking them,” Cameron said pleasantly. “It took us years to catch up! When eight hundred pounds is gone from your vacation kitty, it takes a long time to recoup.”“Think of this as intensive training for being in a can.”Cartoon by Victoria Roberts
Even seemingly sorrowful things, like the loss of her mother a year ago, can fill Cameron with appreciation and pleasure. “My mother’s death was the least saddest thing ever,” Cameron declared. “She used to say, ‘I’ve had the most wonderful life.’ And she died after she had an iced lolly and went to sleep.” When the doctor arrived, Cameron recalled, “she said, ‘Don’t take this the wrong way, but that’s the most beautiful corpse I’ve ever seen.’ Then we sat in the kitchen and had a fantastic wake: we toasted Mum with Tia Maria till the early morning.”
Cameron plans to leave her own corpse to science when she dies. “They’ll whisk the body away, and stick us in a drawer somewhere and chop us up, won’t they?” she said. “I don’t mind.” She will also spend a good deal of her remaining time alive being studied by scientists, who hope that her genetics will provide a path to new treatments for anxiety and trauma, as well as for pain management and healing. In addition to her unusual emotional composition, Cameron is entirely insensitive to physical pain. As a child, she fell and hurt her arm while roller-skating, but had no idea she’d broken it until her mother noticed that it was hanging strangely. Giving birth was no worse. “When I was having Jeremy, it was the height of everyone doing natural childbirths,” she said. “My friends would come up to me and say, ‘Don’t listen—it’s murder. If you’re in pain, take everything they give you.’ I went in thinking, As soon as it gets painful, I’ll ask for the drugs. But it was over before I knew it.”
Remarkably, Cameron didn’t realize that she was any different from other people until she was sixty-five. “Lots of people have high pain thresholds,” she said. “I didn’t think people were silly for crying. I could tell people were upset or hurt and stuff. I went through life and I just thought, I haven’t hurt myself as much as they have.”
Devjit Srivastava was an officer in the Indian Navy for a decade—an experience that taught him to stay cool under pressure. Composure is also important in his current job, which is unpredictable and high-stakes: Srivastava is the consultant anesthetist at what he calls a “frontier hospital”—Raigmore, in Inverness, which serves the whole of the vast and remote Scottish Highlands. His first day on call, he was pulled into a helicopter to help with a “field amputation” on a farmer who had got caught in a thresher.Get the best of The New Yorker every day, in your in-box.Sign me upWill be used in accordance with ourPrivacy Policy.
When Srivastava met Jo Cameron, six years ago, she told him that she wouldn’t need painkillers for the surgery she was about to undergo. He assumed that he was just dealing with a kindred imperturbable spirit. “The Scottish are known to be stoic people,” Srivastava said, drinking coffee in the bustling hospital cafeteria. “I thought, She’s just trying to tell me she can tolerate pain very well. And, actually, it’s a busy list, and we have to crack on.”
Cameron was having a trapeziectomy, an operation to remove a small bone at the base of the thumb joint. Though her hands never hurt, they’d become so deformed by arthritis that she couldn’t hold a pen properly. She’d had a similar experience with her hip, which had recently been replaced; it didn’t hurt, but her family noticed that she wasn’t walking normally. She saw her local doctor about it several times, but the first question was always “How much pain are you in?” And the answer was always “None.” (“The third time I was there I think they figured, ‘We’ll just take an X-ray to shut this woman up,’ ” Cameron told me. “Then the X-ray came in and it was really bad. Everything was all distorted and mangled and crumbling. He said, ‘Wow. This has got to be done.’ ”)
Srivastava told Cameron that, Scottish stoicism notwithstanding, he intended to use an anesthetic block during the operation. After she left the hospital, he reviewed her chart: “She had only one paracetamol”—a Tylenol—“immediately after the operation in the recovery area. And that was only because the nurses give everybody a paracetamol after surgery. I checked the full records of hip replacement the previous year: after hip surgery it was the same thing—nothing taken for pain. That’s when I called her in.”
He remained slightly skeptical until Cameron let him perform a maneuver that anesthesiologists use on patients who are having difficulty regaining consciousness after sedation: they press hard on the inner edges of the eye sockets, and the pain shocks people awake. Cameron, of course, felt only pressure.
Srivastava was surprised that no doctor or nurse had been curious about her pain insensitivity before. (Cameron told me that she didn’t think it was particularly notable: “They’ve got so many people demanding their attention, screaming—they’re the ones you focus on.”) Srivastava recognized that her case was extraordinary—“This doesn’t fall into every anesthetist’s life,” he said—and also that understanding it would require him to supplement his own expertise. He developed a research protocol, and enlisted highly regarded scientists from around the world to try to figure out what caused her condition.
Cameron is beguiled by the idea that she can help alleviate others’ suffering—she remembers the terrible migraines that tormented her mother. Her father, however, was pain-free. “I never saw him take an aspirin,” Cameron said. “I’m convinced he was the same as me, because I never heard my father complaining about any pain, ever. He died suddenly, of a brain hemorrhage—I think other people would have had a warning.” She continued, “He was the kindest man you’ll ever meet. Every morning he’d wake us with a cup of tea and a carrot from the garden and tell us a poem.” Then he’d accompany Cameron to school, hand in hand and skipping all the way.
The scientists who took on Jo Cameron’s case were working in a young field. Geneticists have been studying congenital insensitivity to pain only since the nineteen-nineties. In that time, several hundred cases have been reported; presumably there are others, but no one knows how many. The condition is almost always caused by neuropathy, an interruption in the transmission of painful sensation along nerve fibres. People with severe congenital neuropathy tend to die young, because they injure themselves so frequently and severely. (Without pain, children are in constant danger. They swallow something burning hot, the esophagus ruptures, bacteria spill into the internal organs, and terminal sepsis sets in. They break their necks roughhousing. To protect some patients, doctors have removed all their teeth to prevent them from chewing off their tongues and bleeding to death.) There are also people whose neurons stop working, as the result of a disease: syphilis, lupus, diabetes, rheumatoid arthritis.
In recent years, advances in genetic science have made it possible to link particular variants of pain insensitivity to mutations in specific genes. Six members of the Marsili family in Italy, for instance, share a mutation in the gene ZFHX2; consequently, they rarely sweat, experience pain only fleetingly, and are completely insensitive to heat. “We live a very normal life, perhaps better than the rest of the population,” Letizia Marsili, the matriarch of the family, said in 2017. (She once broke her shoulder while skiing in the Italian alps; she continued skiing without any pain for the rest of the afternoon, and got around to seeing a doctor only days later, when it was convenient.) There are downsides, though, to what’s been named Marsili syndrome. Letizia’s mother suffered multiple fractures in her youth without noticing them; her bones were never set properly, and they healed awry.
In 2006, Geoff Woods, a geneticist at Cambridge, published his findings on members of several families in a remote region of northern Pakistan, who share a mutation in the gene SCN9A, which renders them both pain-free and unable to process smell. (Since then, people with the same mutation have been identified all over the world, but the Pakistani patients were an ideal group to study: they were all the products of cousin-to-cousin marriages, making their gene pool unusually easy to map.) “The lack of a sense of smell is really helpful, because it provides us with a simple question we can ask new patients,” James Cox, a former researcher of Woods’s who is now a prominent geneticist at University College London, said. Cox has been studying Cameron’s DNA for five years, and has co-authored a paper with Srivastava about her case, which was published last March, in the British Journal of Anaesthesia. “Jo is quite unique,” he said.
Cameron does not have neuropathy: she can feel all the sensations the rest of us do, except pain. The most striking difference between her and everyone else is the way she processes endocannabinoids—chemicals that exist naturally in every human brain. Endocannabinoids mitigate our stress response, and they bind to the same receptors as the THC in the kind of cannabis you smoke. Normally, they are broken down by an enzyme called fatty acid amide hydrolase, or faah. But Cameron has a mutation on her faah gene that makes the enzyme less effective—so her endocannabinoids build up. She has extraordinarily high levels of one in particular: anandamide, whose name is derived from the Sanskrit word for “bliss.”
About a third of the population has a mutation in the faah gene, which provides increased levels of anandamide. “That phenotype—low levels of anxiety, forgetfulness, a happy-go-lucky demeanor—isn’t representative of how everyone responds to cannabis, but you see a lot of the prototypical changes in them that occur when people consume cannabis,” said Matthew Hill, a biologist at the University of Calgary’s Hotchkiss Brain Institute, who was a co-author of the Cameron paper. The faah gene, like every gene, comes in a pair. People who have the mutation in one allele of the gene seem a little high; people who have it in both even more so. Jo Cameron is fully baked.
“When I met Jo for the first time, I was just struck by her,” Cox, an affable forty-year-old with a scruffy beard, told me, one afternoon in his lab at U.C.L. “She was very chatty. Did you notice that?” (It’s hard to miss.) “I said to her, ‘Are you worried about what’s going to happen today?’ Because she was meeting our clinicians to have a skin biopsy and do quantitative sensory testing—pain-threshold tests. She said, ‘No. In fact, I’m never worried about anything.’ ” Cox told me that it was difficult to get through everything in the time they’d allotted, because Cameron was so friendly and loquacious with the scientists, even as they burned her, stuck her with pins, and pinched her with tweezers until she bled. This imperviousness to pain is what makes her distinct from everyone else with a faah mutation. They, like even the most committed stoners, can still get hurt.
Cameron had the same faah mutation that many other people have—but there had to be something else at play. The scientists started their inquiry by isolating DNA from her blood, and then analyzing the protein-coding subset of her genome—the part that’s traditionally considered to be significant. “We didn’t really find anything,” Cox said. “So we decided, O.K., why don’t we look across the whole genome for bits that are deleted or duplicated? And, at the time, this new chip was just available, which enabled us to scan the whole genome and look for deletions”—snippets missing from her genetic code. “It was a lucky strike: we found that there was this deletion. But it was distinct from faah. It was away from faah, just downstream.”
The scientists noticed that the right edge of the deletion overlapped “a gene that was annotated as a pseudogene,” Cox said, and frowned. “Which is a term I don’t like.” A pseudogene is what’s been thought of as genetic detritus—a copy of a gene that’s just sitting there, not doing anything productive. One biochemist I spoke to likened a pseudogene to a rusted-out car you stumble on in the forest—only, in Cameron’s case, they put a key in the ignition and the car turned on. “To call it a pseudogene is misleading, because this is a gene that is expressed—it makes a product, a sequence in the DNA,” Cox said, with excitement. “It’s a real fascinating class of genes which have been severely overlooked in genetics until very recently.” Cox and his colleagues named this particular pseudogene—“It’s nicer to call it a gene,” he insisted—faah out. “It was a wordplay, really,” he said sheepishly. “The challenge now is to understand what it’s doing. Jo is the first person in the world that we know of with this.”
Cameron’s case is important in genetics, partly because it may supply evidence that pseudogenes are more significant than they were previously thought to be. Moreover, if scientists can replicate her neurochemistry they might be able to develop treatments that alleviate the opioid epidemic. They could potentially treat otherwise intractable anxiety and depression. Perhaps we could all be a little more like Jo Cameron: joyful, compassionate, unperturbed by all the nasty, roiling feelings that turn us, from time to time, into goblins.
I asked Matthew Hill—a renowned expert on cannabinoids and stress—if there was any downside to Cameron’s biology, and he laughed out loud. “Yes! From an evolutionary perspective, it would be tremendously destructive for a species to have that,” he said. Without fear, you drown in waves that you shouldn’t be swimming in; you take late-night strolls in cities that you don’t know; you go to work at a construction site and neglect to put on a hard hat. “Her phenotype is only beneficial in an environment where there is no danger,” Hill asserted. “If you can’t be concerned about a situation where you’d be at risk of something adverse happening to you, you are more likely to put yourself in one. Anxiety is a highly adaptive process: that’s why every mammalian species exhibits some form of it.”
Unlike other pain-insensitive people, Cameron has made it into her seventies without getting badly hurt. Sometimes she realizes that she’s burning her hand on the stove because she smells singeing; sometimes she cuts herself in the garden and sees that she’s bleeding. But none of that has been severe, and Cameron did raise two children safely into adulthood.
“The human brain is very capable of learning, ‘This is what’s appropriate to do in this situation,’ ” Hill said. Cameron’s relative cautiousness may have developed imitatively. “And there may not have been that much threat presented to her—she’s lived in a rural community in Scotland,” he concluded. “Maybe she hasn’t had to deal with that much that would physically or emotionally harm her.”
Scotland is notorious for “one of the vilest climates under heaven,” Robert Louis Stevenson, who was born in Edinburgh, wrote. “The weather is raw and boisterous in winter, shifty and ungenial in summer, and a downright meteorological purgatory in the spring.” But the week in autumn when I visited was blissfully sunny. Farmland rolled under a gleaming blue sky for miles around the Camerons’ property, green and gold and dotted with sheep. Behind their cottage, they grow vegetables in little plastic greenhouses, and their chickens peck about in a modest orchard of pears, apples, and plums. “We look after the hens very well,” Cameron said. (She is a vegan; her husband is a vegetarian who sometimes indulges in an egg.)
The Camerons “do everything together,” Jo said. They make wine, and take weekly trips to Edinburgh to visit Amy; they’re in a local theatre troupe, for which Jo is the stage manager. (She doesn’t act, because she can’t remember the lines. As we were walking through the garden, a pizza was burning in the oven: Cameron had forgotten that she was making one for lunch.) “I love Jim to bits,” Cameron said. “He’s smashing—I’m so lucky. Having had a marriage before where . . .” She trailed off, thinking about her previous husband. “I mean, I loved him. But you never knew what you were coming home to.”
Cameron’s first husband, Phil, died after a prolonged battle with mental illness. “He’d either be full of fun and laughter, or he’d be so depressed he’d be curled up in the corner in the fetal position,” she said. “He was like this—” She mimed a seesaw going violently up and down. “Bipolar.”
They met when they were both university students near Birmingham, England, where Cameron grew up. “He was lovely,” she said. “But he always had a dark side. He would get down, and I would be the one that would bring him up again. You know, there’d be a game going: ‘Oh, it’s not that bad, come on.’ ”
Phil had his first major episode as the family was on its way to a vacation in Sardinia, when Jeremy was little. “He just cracked,” Cameron said. “On the plane, all the way there, he was kicking me, pinching me.” (It’s impossible to say how hard; it didn’t hurt.) “We got to the hotel, and I said, ‘Can someone please come and help me? My husband is having a breakdown.’ ” She recalled the difficulty of finding a flight home on short notice, of thinking of an excuse to give Jeremy. “He always had it under control,” she said. “But suddenly he couldn’t control it.” Phil tried a variety of medications and saw several psychiatrists over the years. “I always went to every session,” Cameron said. “The last time he went to see somebody, the doctor said to me, ‘This is terminal, you know. At some point, he will . . .’ And six months later, sure enough, he did.”
I asked Cameron what she felt when the psychiatrist said that. (And I imagined how I would feel: desperate, heartsick, powerless, distraught.) “I looked at the state he was in, and I thought, Maybe it’s good,” she said. Cameron was back at work the day after the funeral. “It sounds cold. But you say to people, ‘I’m not being cold! Look, horrible things happen.’ I’m not in airy-fairy land. Horrible things are going to happen. You have to cope with it. You have to say to yourself, ‘I can’t help that person.’ You help them as much as you can, but when you can’t help them anymore, then you have to help everyone else.”
Amy was a year old at the time, and Jeremy was thirteen. “We all went to the beach every weekend after Phil died,” Cameron recalled. “I said to Jeremy, ‘What we’ll do every Sunday is we’ll put Amy in the back of the car, and you get a map’—because he loved maps—‘and I won’t know where we’re going, just direct me.’ He’d go, ‘Turn left, now turn right, go along here.’ And we’d turn up in all sorts of places, and we’d have Sunday lunch. We had a great time doing that.” Whenever I pressed Cameron for details about a seemingly devastating occurrence, she wasn’t evasive; she was mystifying—always ending up on a lovely memory, via a route so unforeseeable it was as if it, too, were determined by a child with a map.
Cameron began dating Jim, who was teaching science at the time, and had known her late husband from their village chapter of Roundtable, a kind of Scottish Rotary Club. Five years later, they married, and Jim adopted Amy. (Jeremy was already a young adult.) Cameron said of her daughter, “She’s geometrically opposite me. She worries about everything.” From an early age, Amy demonstrated talent as an artist, and her work has been exhibited across Europe. Her portfolio includes sculpture, earthworks, and intricate, realistic drawings, often interspersed with text. In one piece, above the image of a sleeping baby, float the words “feeling/the sacrifice/cut through/and sectioned/kept alive by/these unfortunate animals of emotions—fear, disgust, anger, etc. Odder still people feel nothing.”
Amy finds her mother’s equanimity confounding. “She’ll say, ‘Why can’t you be a normal mom?’ ” Cameron told me. When Cameron asked, “What’s a normal mom?” Amy replied, “Well, it’s not you. They shout!” Cameron shook her head at the memory. “I sometimes think to myself, I’m being horrible. If someone is really in a rage and really upset, and you’re saying, ‘It’s all right!,’ then they get angrier. I can be very annoying—especially when you’re a teen-ager and you don’t want your problems solved. You just want someone to shout at.”
Paul Bloom, a professor of psychology at Yale and the author of the book “Against Empathy,” maintains that relating to suffering has little to do with the capacity to be helpful and kind. He has published research suggesting that compassion, not empathy, drives altruistic behavior. (Most research on the subject blurs together empathy and compassion, but Bloom argues that this is a failure of experimental design: “The standard measures suck.”) “Empathy can actually get in the way—if you are in terrible pain and I feel so much empathy for you that, being with you, I feel it, too, I may decide to stay home,” he told me. “The Buddhists knew this. There’s all this teaching that says, ‘Don’t get sentimental. Joyously and lovingly help others, but don’t get in their heads.’ ” Cameron, he told me, was a perfect illustration of his point: “She’s my dream girl. She doesn’t feel the pain of others, so she doesn’t feel empathy per se. But she cares for others.”“It’s a pretty good piece of fiction. I’m surprised he couldn’t get it published in his lifetime.”Cartoon by P. C. Vey
For nearly a decade, pharmaceutical firms have tried, without success, to create medications that act on faah. In 2016, the Portuguese company Bial Pharmaceuticals abandoned one such drug after a Phase 1 clinical trial in which six participants were hospitalized, and one died. (Scientists believe that there may have been a dosing accident, or that the drug had “off target” effects—it ended up binding to a receptor other than faah.) Pfizer gave up its own attempts at a faah inhibitor in 2012, because the drug didn’t work. Recently, though, it started research again, and Vernalis funded a study at Brigham and Women’s Hospital, in Boston, which is undergoing peer review. The prospect of a breakthrough is too promising to relinquish.
Opioids, besides being addictive, don’t always work: some kinds of chronic pain don’t respond to drugs that target the opioid system, or to other analgesics, such as ibuprofen and corticosteroids, which operate on the prostaglandin system. Cameron may provide the key to a new class of drugs that operate on the endocannabinoid system. Srivastava told me that the paper he worked on with his colleagues was just the beginning. “You realize that this is sort of nature revealing its secret to you,” he said, “and you only worked on part of that secret, but if you worked on the full secret, so to say, it could be astounding.”
For half a century, scientists have accumulated evidence that pain is not simply the result of a one-way flow of sensory information from an injury to the brain. Before the brain gets involved, “gates” in the spinal cord modulate the way we feel pain—whether it is fast-travelling information, as in a stab wound, or the dull, slow-moving kind that characterizes chronic pain. These spinal gates can be opened or closed by a variety of factors. A distracting physical sensation can temporarily close them; when you bump your head and instinctively rub that spot, you are overriding the nerves that register pain with the nerves that register rubbing. Your emotional state, too, can have an effect. It’s evolutionarily advantageous for pain gates to be wide open when you’re stressed: if you were anxiously evading a predator, your body would want to let you know if you were stepping on something sharp that might hinder your ability to escape. Conversely, if you are very relaxed, your gates are less apt to be open. One of the things Srivastava and his colleagues want to explore is the extent to which Cameron’s pain insensitivity is the result of her peaceful state of mind—and vice versa.
The second phase of Srivastava’s research will include Cameron’s son, Jeremy, who has the faah mutation on one but not both alleles of the gene, and who has a high tolerance for pain. (Unlike many faah people, Jeremy, who declined to be interviewed, is painfully shy.) “But this goes much beyond genetics,” Srivastava continued. “We are deconstructing pain mechanisms in Jo.” Because she has sensation but no pain, she presents unique possibilities for research. “We know this nerve carries that, this is how it is done, bit by bit we have progressed—but here is a golden opportunity to do it all at once, and confirm, rebut, or come up with new findings,” Srivastava said. He has been contacted by doctors and scientists in Sweden, France, England, and the United States, who want to collaborate. Srivastava, who is fifty, is an impassive man, but he looked a little fretful as he talked about the research. “I feel slightly overwhelmed,” he admitted,“like I don’t have enough time in this life to properly do it.”
One complicating question is how much of Cameron’s Cameronness is really a consequence of her faah mutation and faah out deletion. She has plenty of other genes, after all, and her upbringing and her early environment also played a role in making her who she is. Since the paper was published, Matthew Hill has heard from half a dozen people with pain insensitivity, and he told me that many of them seemed nuts. “If you had this phenotype and weren’t a generally pleasant person like Jo—maybe you’re, like, a douche-y frat boy—the way that you would process this might be entirely different. Our whole perception of this phenotype is explicitly based on the fact that it was Jo who presented it.”
Srivastava is intent on solving the scientific riddles that Cameron poses. But, in a wistful moment, he suggested that the work also raised profound social questions. “Spending time with her, you realize that if we only had more people like Jo—who are genuinely nice, pleasant, do not give in to anger . . . well,” he said, “you know.”
Misery may not be all it’s cracked up to be. Paul Bloom, who is writing a book about suffering, told me, “There’s a big movement in psychology to say, ‘What doesn’t kill you makes you stronger.’ People talk about ‘post-traumatic growth.’ I think a lot of it is bullshit. Look at the data: bad things are bad.” You aren’t healthier after you have cancer or fall down a flight of steps. And it’s only in the movies that getting hit by a bolt of lightning turns you into a superhero; in life, it turns you into a fritter.
The entire time I spent behind the wheel in Scotland I was suffering what psychologists call an aversive experience—that is, I was afraid for my life. The Scots drive on the left side of the road, which is already a challenge, but in the Highlands near Loch Ness there is only one lane. When another car comes barrelling at you, you’re supposed to pull over on the (nonexistent) shoulder, but this can be hard to remember when you come around a sharp curve—which happens roughly every two seconds—and find yourself in the glare of rapidly oncoming headlights. I was pretty sure that one of these encounters would send me over a cliff, plummeting toward the dark water like Toonces the Driving Cat.
I relaxed slightly when I was back in Inverness, where my only foes were the baffling roundabouts, with their unique Scottish etiquette. I had just navigated such a rotary and was on a seemingly easy stretch of highway when I felt an explosion underneath me, then heard the hideous sound of metal scraping asphalt. I’d hit the curb with such force that I’d popped my front left tire.
I felt my blood pumping and my skin prickling, and I whipped my head around to see how many people I’d killed. In the process, I scratched my forehead on the sharp corner of the seat-belt mechanism, and it hurt. There was nowhere to pull over, so I rumbled loudly onward, afraid that something worse was about to happen—mind racing, pain gates open, tire rim scraping the street. I felt panic about getting to the airport, followed by irate self-recrimination (why am I such a bad driver?), then by irate spousal recrimination (why didn’t he get his stinking passport renewed in time, so he could come with me on this trip and drive?). I was a wounded, furious, frantic goblin.
Then I thought about Jo Cameron, and what she would do in this situation. She would keep going until there was a place to pull over, and she wouldn’t worry about how far that might be or what might happen before then, because there’d be nothing she could do about it. She’d park, call the rental-car place, and take it from there—calmly, kindly, without losing her mind or her sense of humor.
Gradually, my heartbeat slowed, and I saw in the rearview mirror that the scratch on my forehead hadn’t even broken the skin. I remembered something that Matthew Hill had said about how a stress response is biologically designed to reallocate energy for survival—the goblin feelings are just a weird side effect. “Cortisol’s main job is to boost your blood sugar, and adrenaline’s main job is to jack up your blood pressure, so you have fuel and a delivery method to sustain your muscles and brain in dealing with an aversive threat,” he’d explained. “But we have so rapidly out-evolved the requirements of those processes they are almost like an evolutionary throwback. When we check a Facebook page and find out our partner has cheated on us, our brain still mounts that same biological response, even though it has zero value to us anymore.” Even Hill—who told me how disastrous it would be for human beings to float through life without anxiety—conceded, “Maybe Jo is the next evolutionary step.” ♦Published in the print edition of the January 13, 2020, issue, with the headline “World Without Pain.”
- Ariel Levy joined The New Yorker as a staff writer in 2008. She is the author of, most recently, the memoir “The Rules Do Not Apply.”Read more »
