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Possibly fake, but slim chance its real.
When, a sudden "surge" of pain is felt, within milliseconds the central nervous system places the whole body into shock, therefore, he would not feel pain, just a small pin-prick.
He would however, fall straight over, and be in agony a couple of hours later (as soon as the shock wears off), and then he best pray for some large shots of morphine....
And with the camera, it might just be pure luck that the photographer took the photo at that exact point...stranger co-incedences have happened!
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