No one wants to be the candy man: Ambivalent Medicalization and Clinician Subjectivity in Pain Management

Pain, despite being an elemental bodily experience and the most common reason for seeking medical care, occupies a place of profound ontological and moral uncertainty in U.S. biomedicine. Taking seriously the highly charged emotions-frustration, anger, even disgust-frequently expressed by clinicians regarding their patients with pain, this article draws on ethnographic research to explore both the origins and the implications of such anxiously ambivalent responses to pain and pain medications among the clinicians charged with treating it. Set against the recent history of pain medicine as an emergent specialty in the highly fragmented landscape of U.S. biomedicine, we examine at close ethnographic range some of the key ways that U.S. clinicians frame the experience of contending with pain in their everyday practice. Emergent from these clinician experiences are the ways in which pain and pain medications remain both incompletely medicalized and ineffectively medicalizing in U.S. biomedicine, as well as the threatening effects on what we call the pharmaceutical subjectivity of clinicians themselves of this persistently ambivalent medicalization.