Chronic pain is the leading cause of disability in the United States, affecting as many as 48 million people in this country alone. It can demoralize and depress both patient and family, especially when there is no effective pain control and no hope for relief. Improperly managed, chronic pain can lead to substance abuse (usually painkillers) and to acute psychological and emotional distress. Pain begets stress and stress begets pain in a wretched downward spiral.

Silver reviews the causes and characteristics of chronic pain and explores its impact on individual family relationships and on the extended family, covering such issues as employment, parenting, childbearing and inheritance, and emotional health. Silver treats aspects of chronic pain not covered in a typical office visit: how men and women differ in their experience of chronic pain, the effect of chronic pain on a toddler's behavior or an older child's performance in school, the risks of dependence on and addiction to pain medications, and practical ways for relatives beyond the immediate family circle to offer help and support to the person in pain.

"The author's multiple voices--scholar, sociologist, victim--provide an academic, yet personal, professional, yet poignant, story....Readers face...the 'contradictory meanings' that an especially articulate woman brings to the final chapter of her life." --Women and Health In 1988, Marianne Paget published the Unity of Mistakes: A Phenomenological Interpretation of Medical Work (Temple) in which she argued that error is an intrinsic feature in medicine--an experimental and uncertain activity. Her subsequent research focused on medical negligence and on miscommunication and silence a as cause and product of error in medicine. While pursuing her research on negligence, she found out that she was an example of it. Chronic back pain that had been misdiagnosed as muscle spasms turned out to be a symptom of a rare and fatal cancer that claimed Paget's life in December 1989. This collection of her personal and professional writings on the phenomenon of error in medicine chronicles a young scholar's courageous struggle to make sense of a tragic coincidence. Discovering that she was living the charges and painful topic that she had studied so deeply, Paget write poignantly and analytically until the last week of her life about this uncanny parallel. "It is very tricky to come to terms with the reality of death without becoming trapped in that reality," wrote "Tracy" Paget to her friends. In this book, she describes "the odd way my life began to mirror my work"; her search for "life rites" when face with tasks involving wills, last rites, and farewells; and her indomitable and forthright attempt to remain intensely alive in the face of death. A Complex Sorrow, her final project, comprises essays, letters, and a journal recording her last year. Ever critical of the distanced and dispassionate stance taken in much social analysis, Paget had experimented with performance as a form for enlivening social science research. The script for her play, "The Work of Talk," about communication problems between a physician and his cancer patient, is also included. Her compelling life-text speaks to those living with illness and those who care for and about them, as the investigation and representation of lived experience. Excerpt Excerpt available at www.temple.edu/tempress "Strangely, my knowledge of error has helped me deal with the errors in my care. Had I not known about the prevalence of error in medicine I would not have been able to process what has happened to me without bitterness. But I had thought these matters through already, and more than once. I now live out the complex sorrow I have before described." --Marianne A. Paget Reviews "Paget's book is stunning. It's a tribute to the invulnerable human spirit. The woman burned like a flame; obviously she died well, because she lived well; she was loved because she was loving. The book is tremendously sad, but it isn't depressing; somehow, one is left with a sense of human possibility." --Joan Cassell, author of Expected Miracles: Surgeons at Work