“Pain – The Science of Suffering” – Patrick Wall“Pain – The Science of Suffering” – Patrick Wall

In the first emergency period of 45 minutes, where survival, escape and rescue had the clear priority, there was injury but no pain. He was mentally and physically supervising his own rescue. …In the second period, when pain began, recovery from the injury had priority. Pain was present and increased with movement or touch.

President Ronald Reagan seconds after being shot in the chest with a 9mm bullet on 30 March 1981 outside a Washington hotel. He felt no pain and did not know he had been shot until he began to feel faint as blood poured in to his chest cavity while in the car racing from the scene.

We can now summarise key points of sudden injury. For a start, sudden injury may or may not be painful. The victims can be coherent and rational throughout. There may be no pain from the moment of injury. The pain-free state is localised precisely to the site of the injury. And all victims are eventually in pain.