THE PROBLEM WITH PAIN

On one of those few occasions my GP saw me sitting opposite him he uttered the immortal words, "Pain is a good thing John!" I was so shocked into silence that it allowed him to develop his theme a bit more. "You see, pain is the body's way of telling you there is something wrong. Think of it as our safety net." At that moment I was wracked with pain up and down my back and in no mood for bullshit.

"If you think about it," the fucker went on, "Pain is what brought you to see me this morning. Without it you might have ignored things altogether and it could have got worse." It occurred to me at this point that I should share some real pain with him and see how good he thought it was. But my back was too sore to lash out at him. "I see!" I replied, appearing thoughtful."But do you think that now that I've got the message from my, ahem, safety net that you could suggest something to get rid of it? Some sort of nuclear pill or something that will blast it away from me instantly?"

It's not the first time I've come across this either. It's been my experience and that of others I have spoken to that the medical profession appear slow to alleviate pain from the rest of us when we complain to them about it. I don't know if this is some self-righteous sadistic tendency or there is a sound medical reason to leave someone in chronic pain. Certainly when the sufferer presents to one of those white coats, pain relief is top of their agenda. The doctor's agenda is quite different though at those times. They are consumed with knowing what is causing the pain and again I have found they have little interest in your own theories on the matter. Pain relief is way down their agenda as they check this and that and ponder it all wisely.

The problem is when you are in strong pain all else pales to insignificance. You cannot string two thoughts together as your complete concentration is on that piercing discomfort in whatever part of your body you have it. The white coat humming and ha-ing around you drives you wild and as you sit sweating and close to tears. I had a pancreatic infection one time that saw me doubled up in the A&E unable to even think. In the course of admittance procedure my blood pressure was taken and it was sky-high. Alarm bells went off and I was suddenly a big emergency. They fluffed about around me all day to no avail. It was only when one of them listened to me and pumped me full of morphine for the pain that the blood pressure bounced back to normal.

And that is the problem. The doctor is dedicated to the preservation of life at all costs while for the rest of us, it is about the avoidance of pain. When you are deep in bad pain, death is one possible cure for it, though I'm not suggesting it is the best one of course. But that one belt of morphine I had, showed me that the white coats are in possession of some pretty potent solutions of their own and yet they are reluctant to dispense them.

They can be a right royal pain sometimes, can't they?

Comments

THE PROBLEM WITH PAIN — 4 Comments

Michael J. McFadden on December 5, 2015 at 11:49 am said:
John, while I agree with you on the desirability of avoiding pain and with your feelings that pain alleviation/avoidance should be high up on the charts of any treatment for things, I also have to agree with the doc that pain is a pretty important signal for us about things.
I have a pretty screwed up spine: it's shaped sort of like a corkscrew, bending and twisting in all sorts of odd ways. Fortunately the twists 'n turns are in all different directions so for outward appearances I tend to appear fairly normal. It does however, at different points and times coming and going, visit me with some pain fairies who like to jab their little magic wands into various vertibral valleys 'n hills.

When the pains are mild and related to things I am doing, I see them as good reminders that I have to behave myself to avoid aggravating them in the long term. That's a good thing, and I see no need to be gulping pills to cover the reminders over. If the pains get worse then that's a good signal to do a deeper examination of what I might be doing to cause them… not a signal to gulp pills… and maybe, occasionally, a signal that I should visit the fella in the white coat.

But yes, once the pain has served its purpose, then the doc should recognize that and get rid of it: it's no longer doing anything useful and it should be gotten rid of.

– MJM

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- John Mallon on December 5, 2015 at 12:03 pm said:
  Fair point Michael!
  Maybe what I’m saying is that the doctor cannot prevent the pain when it first strikes but he sure as hell can get rid of it when you stagger in his door in agony. For me that should be the first priority and then proceed to discovering what caused it to stop it happening again.
  Incidentally, sorry to hear about your back though I notice it does not dampen your ability or enthusiasm.
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nisakiman on December 7, 2015 at 9:54 am said:
Doctors are always loath to give anyone morphine, as they, like everyone else, have been indoctrinated with a fear of all narcotics, and tend only to use it as a last resort. In fact here in Greece, I believe the use of opoids is forbidden because past governments were convinced that they were inherently evil (thanks to the American narrative, no doubt). This has resulted in a situation where people with terminal cancer spend their last days in excrutiating agony because the doctors will only give them paracetamol, which of course is completely ineffective in that sort of situation.
The reluctance to administer morphine is rooted in the belief that opoids are instantly addictive, an unfortunate consequence of the 'drug war' propaganda drive. Well, yes, morphine is addictive, but you have to take it for a long time before you will suffer withdrawal symptoms. And in terminal cases, that's hardly an issue, is it? Interestingly, there have been a couple of studies on the whole process of addiction which have found that people who have been administered opoid pain killers medically over a long period of time almost never express a desire for them when they have been discontinued. One of the most interesting experiments has been rendered into comic book form (I have the link to the actual research somewhere, but I can't find it right now), and it puts a whole new slant on our perceptions of addiction.
http://www.stuartmcmillen.com/comics_en/rat-park/
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- John Mallon on December 10, 2015 at 11:15 am said:
  You are correct about ineffective dosages being offered instead of something that really works. In Ireland now if you go to the Pharmacy for pain killing tablets you are interrogated, (by law), by the dispensing white coat unless you have a prescription. I am talkinh about Neurofen+ here not a pint bottle of morphine. Years ago the was a female columnist for “The Observer,” who penned witty and insightful stuff for Sunday mornings. Thn he article one week announced to all of us that she had terminal cancer and everything after that read like a diary of her dying days. It was brilliant if disturbing but she told us every week that if she could not get her marijuana, she couldn’t write much less anything else. I’ve never tried any drugs myself apart from the hospital morphine that one night but having read that woman, I would never judge anyone for doing so themselves. I my own brief experience with pain and doctors, it always occurrs to me that he does not feel the pain himself at that moment and can only conjure up an image from his university days of what he was told. But even then, the default mode seems to be, give something mild first and review it a fortnight later. That could be one long agonising wait if/when he’s wrong.
  Reply ↓

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THE PROBLEM WITH PAIN

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THE PROBLEM WITH PAIN — 4 Comments

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