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September 17, 2010

Simon Fodden

The Friday Fillip

I've just come from the dentist. Yes, I know: too much information. But it got me thinking about pain, which in turn led me to thinking about scales — not the lizard kind, but the kind butchers used to put their thumbs on, or so I was told. Let me explain.

We're beings that like to measure and compare: it's the start of science and the heart of commerce, after all. So we tend to devise scales to rank events and experiences — lots and lots of scales. There are even scientific instruments to measure and compare pain tolerance, known generically as dolorimeters. But since most of us won't have a dolorimeter handy, we might pay attention here to pain scales that use everyday instruments.

Such as stinging insects, for example. I discover that there are scales with which to rank the distress caused by various bee, wasp and ant stings. The Schmidt Sting Pain Index, for example, goes from 1.0, which is the minor spark caused by the tiny sweat bee sting ("Light, ephemeral, almost fruity. A tiny spark has singed a single hair on your arm." What "fruity" has to do with it, I could not tell you.) to 4.0+ for the misery caused by the bullet ant. ("Pure, intense, brilliant pain. Like fire-walking over flaming charcoal with a 3-inch rusty nail in your heel." As who would know?!)

Or, closely related to stingers, chili peppers, for another example. The new world farmers who gave us the Bell pepper also vouchsafed us the cayenne, the habanero, and the naga jolokia. Again, there's a scale, this time of "hotness," another way of saying pain. The Scoville scale goes from the 0 of the Bell pepper, up through the 1,000,000 (yes, 106) of the aforementioned naga jolokia (which, if you're interested, I can get for you here in Toronto at a Bengali shop I know), and on to the 5,000,000 rating of "law enforcement grade" pepper spray. Click here to see the Scoville rating of your favourites.

Or doctors. I know they boast "Primum non nocere," but there are times when it's necessary to do harm to do good, and that often results in pain. Fortunately, in good hands you're likely to be offered medication to assuage your pain. The trick — scales again — is to judge how bad the pain is. And doctors, sensible creatures that they sometimes are, have recognized that when enduring pain a person might not field the most accurate vocabulary, so they've taken to using pictures. The Wong-Baker Pain Rating Scale [PDF] uses unhappy faces, so when you're biting your lip or keeping the upper one stiff, you can simply stab an index at your dopplegaenger.:

click image to enlarge

There does not appear to be a pain scale associated with law, though I can think of a couple of useful tools at least. There might be one used to measure the distress caused by various subjects at law school; it could even be used as a multiplier to weight grades, as is done with diving and other impressionistic arts. Then clients ought to be able to report on a reliable scale their distress level as a result of their interactions with members of the legal profession ("an amusing irritant, good body but leaving a sour aftertaste . . . "), though whether it should be used as a multiplier in relation to fees, I can't say. What other scales of justice, so to speak, come to your mind?

Simon Fodden is the founder of Slaw. He taught law at Osgoode Hall Law School for more than 30 years before he retired to focus on writing, publishing, and IT and law.
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2 Comments on “The Friday Fillip”

  1. Kevin Kindred says:

    I find that pain scale horribly inaccurate. None of those faces say to me "My appendix is bursting" or "Fire ants are eating my legs" or even "I just hit my funny bone". The expressions seems to be:

    "Are you sure those were just regular brownies?"
    "Oh look, there's something good on TV."
    "I wonder if I left the iron on. I think I did. Did I?"
    "This rain is ruining my camping trip."
    "Seriously, does Ezra Levant *ever* stop talking?"
    and, "They — they shot Bambi's mother!"

  2. Actually, we use these all the time in law. I find nearly everything intersects with law in some way, if you're creative enough to make the connections.

    We call these instruments self-reporting pain scales, and they're incredibly important for the "pain and suffering" component in non-pecuniary tort damages.

    The psychometric properties of analogue tools such as the Visual Analogue Scale (VAS) are reportedly better than forced-choice scales like the Wong-Baker. But I've never had the opportunity to bring this out in cross-examination, and suspect I probably won't for some time.

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