In this history of American political culture, Keith Wailoo examines how pain has defined the line between liberals and conservatives from just after World War II to the present. From disabling pain to end-of-life pain to fetal pain, the battle over whose pain is real and who deserves relief has created stark ideological divisions at the bedside, in politics, and in the courts.

Beginning with the return of soldiers after World War II and fierce medical and political disagreements about whether pain constitutes a true disability, Wailoo explores the 1960s rise of an expansive liberal pain standard along with the emerging conviction that subjective pain was real, disabling, and compensable. These concepts were attacked during the Reagan era, when a conservative backlash led to diminished disability aid and an expanding role of courts as arbiters in the politicized struggle to define pain. New fronts in pain politics opened nationwide as advocates for death with dignity insisted that end-of-life pain warranted full relief, while the religious right mobilized around fetal pain.

The book ends with the 2003 OxyContin arrest of conservative talk show host Rush Limbaugh, a cautionary tale about deregulation and the widening gaps between the overmedicated and the undertreated.

Keith Wailoo is the Townsend Martin Professor of History and Public Affairs and Vice Dean of the Woodrow Wilson School of Public and International Affairs at Princeton University. He is coauthor of The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease and author of Drawing Blood: Technology and Disease Identity in Twentieth-Century America.