Instructor Spotlight: Erica Bial

Tell us about your background and what inspired you to teach this course

I am a physician practicing the most in-demand, but perhaps least well-recognized, specialty: pain management. I say this because people are often quite surprised to learn that while pain is the #1 reason that adults go to the doctor, physicians specialized in pain care are relatively quite rare; in some parts of the country, there are none at all! Pain is obviously a central experience of living, and yet most people think very little about it. I’m biased, for sure, but I think having an understanding and a vocabulary about our bodies helps us communicate with others and understand ourselves – life skills that I think every college student might want to develop.

Your course looks at pain in a variety of contexts and through a range of lenses. Can you talk a bit about why this wide view is important for understanding pain as a whole? 

As part of building a vernacular for the examination of pain, I feel that having a very broad perspective is foundational. Pain is a difficult experience to discuss without words and context. Think about how you might describe an object with words. Maybe you’d describe size, shape, color, texture. But, describing pain is far more challenging, largely because we lack a common language and partly because interpretation of a painful experience can be highly individualized. Pain is not experienced solely as stimulation of a receptor, and we are intuitively familiar with the idea of physical or emotional pain, but we don’t consider other important influences and ideas of the experience. Pain as punishment, pain as religious rite, and pain expression captured in art or explained in philosophy, as well as personal learning, experience, emotion, culture… these all play a role. A goal for me in assembling the course was to help students recognize the many players and their complexity of interaction.

How does pain manifest in our culture in ways that people might not expect? 

That’s a tough question! In many Western societies, I would guess that a huge fraction of song lyrics and visual art are capturing a painful experience in some way. We’re singing along, but never really think about it. It’s a game I like to play in the car sometimes: “spot the pain.”

I’ll find pain on billboards, in the music. Pain, as a theme, is all around us.

How did the COVID-19 pandemic influence the formulation and content of this course?

Having social society shut down and paring back available healthcare services really shifted the focal point of my magnifying glass in terms of “who is hurting, and why?” Isolation seems to increase pain but decrease its reporting, for example. I think my course materials, every week, are probably touched by the pandemic experience in some way.

Can you tell us more about your final project and how students might engage with the material?

I am asking them to write a term paper, however, that can be of any relevant subject of their choosing, and to try to really do a deep dive, ideally applying a “360 degree view” of a given question or topic. As to many people, my course seems like a healthcare topic, and it has attracted many pre-health-careers students, so I am encouraging students to try to play against type and challenge themselves to follow a curiosity that is outside of their usual academic comfort zones. I was a science major when I was an undergrad at Tufts, and I never got to take a single art history class, and only one English class. I’d encourage my prior self to explore literature or art relevant to a topic in pain, as a result.

What do you hope that students will take away from your course?

First and foremost: curiosity. I am enjoying seeing their perspectives and awareness shift as we delve into new material. I secretly hope (well, less secretly now that I’m telling you) that examining a new topic might open up ongoing thought and consideration and, ultimately, more questions. This is a whole new world for most students, so just knowing it is there will ideally change minds and bring innovation and ideas.

Dr. Erica J. Bial (A97, G97) is an interventional pain specialist physician, as well as a “double Jumbo,” having earned her BS and MS degrees from Tufts. In addition to her clinical work, she is a national lecturer and podcaster on the subject of safer opioid prescribing, and has authored book chapters on the history and philosophy of pain. She received her medical degree from Boston University.