By Janet Kozachek

Understanding a complex problem with a long history such as pain in all its permutations and treatments requires detailed and detached observation. In this respect, “The Song of Our Scars: The Untold Story of Pain” by Haider Warraich, MD, falls short.

In his book, Warraich explores the cultural and medical history of pain, including his own after suffering a severe back injury. Although informative on the science of pain, the book contains some misleading information about ancient and modern history that seem designed to advance what appears to be a strident anti-opioid agenda.

Ironically, what benefitted me most in reading this book were the discoveries made in the pursuit of a fuller story, which revealed greater truths and richer vistas through fact checking. But this was a sad lesson on how popular literature reshapes history in order to serve a narrative. The instances of this are too numerous for this review, so a few examples will have to suffice.

In an earlier op-ed piece written in 2019 for The New York Times, Warraich portrays pain as an emotional sensation, a theme which would become his mainstay in subsequent publications, including Song of Our Scars:

"The ancient Greeks considered pain a passion — an emotion rather than a sensation like touch or smell. During the Dark Ages in Europe, pain was seen as a punishment for sins, a spiritual and emotional experience alleviated through prayers rather than prescriptions.”

The ancient Greeks had a rich vocabulary for the physical sensations of pain, as well as an understanding of emotional pain. A quick search through the ancient Greek lexicon reveals four words to describe pain in both mind and body: penomai, algos, odyni, and pathos. Algos is the root word for algia, as in the physical pain caused by neuralgia. Pathos describes emotional pain.

The Greeks not only defined the types of pain, they had myriad treatments for it, including an early version of TENS units, in which they had people dip their feet into a bath of electric eels!

Many gods of classical antiquity are associated with the opium poppy plant. According to Warraich, the Greek god of death Thanatos is “depicted holding a wreath of poppies or wearing poppies on his head.” But in my perusal of classical Greek sculpture and vase painting, there are no images of Thanatos bearing or wearing poppies. He is usually depicted holding a butterfly, sword or torch while guiding the dead into the hereafter.

Warriach also claims that poppies are seen in the story of Demeter, “who overdoses on the milk of the poppy to induce anesthesia and forget the torment of having had her daughter (Persephone) raped and abducted by Hades.” In Greek mythology, Persephone is abducted and taken to the underworld, but I can find no references to Demeter self-medicating, let alone overdosing on anything.

Warriach’s understanding of Greek mythology appears to have been derived from a cartoon by a contemporary artist and Wiki-Fandom, an online community for fantasy lovers.

It was enlightening to become reacquainted with Greek myths. I had a similar experience while researching certain claims made in Song of Our Scars about Great Britain’s Opium War with China. Warriach wrote that “the sale of opium remained banned on British shores – unless the sale was to someone of Chinese or Indian origin.”

“The Opium Wars – The Addiction of One Empire and The Corruption of Another,” by W. Travis Hanes and Frank Sanello, says otherwise:

“For not all opium from India ended up in China: Three hundred chests a year were diverted to England with the same disastrous effects as in the middle kingdom... opium was the opiate of the underclass in England’s grim and grimy industrial cities, where workers on pay day lined up outside the chemist’s for the inexpensive palliative to their industrial hell at the reasonable price of one and two pennies per packet.”

Another interesting instance of fact tweaking occurs with regard to Dr. Hamilton Wright, an anti-opioid crusader who served as a U.S. special envoy to China in the early 1900’s. Warriach wrote this about Wright:

“His travels exposed him to the dangers of opium abuse around the world, imbuing in him a special zeal against the poppy... He told The New York Times that year that thousands of people were “slaves to the opium habit, about five-sixths of whom are white.”

But the original context in the 1908 Times article is missing, because Wright mentions specifically that six thousand opium addicts were in New York City.

This gem from the original article is also omitted:

“While Dr. Wright believes that nearly all the Chinese in the great cities are addicted more or less to the habit of smoking opium, not more than one third of them, take it to a harmful extent.”

Cherry picked facts like that in Song of Our Scars often coincide with amorphously defined data like this:

“Multiple studies show that women are more likely to be prescribed opioids, in higher doses, and for longer periods than men.”

Research cited in Maya Dusenberry’s book, Doing Harm, show that women are actually less likely to be prescribed opioids than men. One explanation for the disparity may be that the studies cited by Warraich appear to rely on raw numbers rather than ratios and percentages.

Warraich does admit to this, which begs the question what his purpose is in bringing up gender differences. Was it an attempt to ascribe opioid addiction largely to women? It would be wiser to consult the National Institute of Drug Abuse, which reports that addiction falls more heavily on men.

Misleading information like this leads to misunderstanding, which may in turn provoke inappropriate actions -- especially if a narrative is shaped by an agenda. Hopefully, this review may serve as a cautionary tale to read popular literature such as Song of Our Scars with a healthy dose of skepticism.

Janet Kozachek lives with a cluster of painful disorders.

She is an internationally trained and exhibited artist, and holds a Master of Fine Arts Degree in painting and drawing from Parsons School of Design in New York and a Certificate of graduate study from the Central Academy of Fine Art in Beijing.

Janet is the author of The Book of Marvelous Cats, My Women, My Monsters, and A Rendering of Soliloquies: Figures Painted in Spots of Time.