This book lacks some serious citation work considering the scientific nature of what the author is trying to explain. Many of his explanations are from disciplines outside his expertise.
This is a gripping, valuable work, but only gets four stars because with this material, he could have done better. Some of his evolutionary accounts of pain are Just So stories: people get migraines to warn them away from stress; women suffer quite so much during childbirth so that they will hurry up and get on with it. Accounts like these express faith that some explanation must exist, but they do not explain.
That said, Vertosick is a neurosurgeon, and has seen things most of us can't imagine. There are clinical descriptions of protracted intolerable pain here that anyone interested in thinking clearly about the ethics of suicide should read. There is an anecdote about a patient undergoing emergency heart surgery coming to and seeing his own exposed heart that is right out of a horror movie. This accompanies a discussion of dissociative amnesiac drugs that I found troubling, but interesting.
On balance, this book is not profound, but it is provocative, informative, and entertaining.
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