If Jeff Mogil and Ron Melzack are right about genetics and pain, fifty years from now, generic Tylenol tablets will seem as quaint to us as a bottle of sarsaparilla tonic. Instead, we'll take our genotype ID bracely to the local genopharmacologist to order some bespoke pharmaceuticals. Or we may rise at four A.M. to meditate on the part of our nature that is painful and feel better for it. Along with social insurance, we'll carry geno-cards that list our predispositions: photosensitivity, osteoporosis, and poor response to codeine.

These doctors, who had long experience with people in pain in addition to their traditional training and schooling, had discovered that nothing happens without communication, treatment based on evidence of outcome, and what used to be called a good bedside manner.

Simple intervention - the time spent with a patient - is a very powerful ingredient of the patient-doctor contract. The evidence is against the traditions such as surgery for back pain being true - the evidence says it doesn't work.

Well, delusions are a wonderful thing, and they keep you company, too.

When a mother comes home with her new baby, she will find her abstractions are all concrete now. 'Freedom' now means being able to take a shower. 'Mobility' means being able to reach the glass of water on the dresser while not breaking the baby's suction on the breast. 'Flexibility' means being able to push the Record function on the VCR without dropping the baby.

Why are we, the most medicalized of societies, a culture in pain?

Housework hassles go on, are never resolved, and will probably extend into the afterlife ('Why am I the one who takes the clouds to the dry cleaners?').