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Coping with chronic pain, illness and incarceration: what patients and prisoners have to teach each other (and all of us)
  1. Drew Leder
  1. Correspondence to Professor Drew Leder, Philosophy Department, Loyola University Maryland, Baltimore, Maryland, MD 21210, USA; dleder{at}


This article proposes the benefits to be had from an unusual conversation: that between those suffering from chronic pain/illness and from long-term incarceration. Taking a phenomenological approach, a series of experiential commonalities are outlined: pain and illness, like incarceration, can cause (1) a constriction of lived space and the range of possible action; (2) a disruption of lived time, such that one is trapped in an aversive ‘now’, or ever trying to escape it; (3) isolation, as meaningful social contacts diminish or are ripped away; and (4) disempowerment and depersonalisation, especially when the ill person feels caught within a medical system that can be dehumanising in ways that echo prison life. Drawing on pathographies, and my published conversations from teaching philosophy classes in prison, I outline some of the strategies whereby creative individuals help relieve these modes of disruption. These include (1) adaptability, as individuals learn to live differently, but well, within the limits imposed by pain/illness or incarceration; (2) appreciative presence, the ability to find joy in, and richly utilise, the ‘now’; (3) mental freedom, which includes the capacity to choose emotional responses, and to expand the intellect and spirit even when the body is confined; and (4) community, surmounting isolation through empathic relation with others. I suggest a conversation between these groups can bring mutual benefit, and teach us all how to live well in extreme circumstances, which we may encounter some time in our life.

  • patient narratives
  • medical humanities
  • pain management
  • philosophy of medicine/health care
  • prison medicine

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.