What a Pain

The first person who says this'll make me a more compassionate physician gets popped in the nose. I don't care how much it hurts me. I remember laying on a gurney in the ER having painful exam after painful exam while they tried to determine if my appendix needed to come out when the attending surgeon of all people had the nerve to say just that. It's a good thing his neck was not in reach. For starters it was not what I would call a teachable moment. I also found it very presumptuous of him to assume first of all that I wasn't already sufficiently compassionate and second that I hadn't perhaps already had enough experience with pain in my life to have learned my lesson if indeed I needed one.

Fast forward several years and you find me, you guessed it, treating all kinds of people with all kinds of pain. I have my ups and downs with it. Some days I don't want to deal with it anymore. It just seems like too much. Trying to piece together a diagnostic work-up spread out over many years and several hospitals. Trying to get a coherent story out of a person who has become accustomed to being mistrusted and is often in significant unrelieved pain while trying to tell the story. Trying to filter through the various emotional overlays of grief, resentment, humiliation and fear that have accumulated over the years. I feel like giving up. Then I have a fraction of a second to think and I realize my patient doesn't have that luxury or for that matter any other doctor to whom to turn. So I hang up a Frieda Kahlo calendar in the hall and soldier on.

Now in December for no apparent I suddenly remembered this book I'd read in med school called The Gift of Pain by Paul Brand. I loaned it to someone years ago and never got it back. I decided it was time to reread it and got myself a new copy. Before I could get around to reading it my hands started to hurt. I was stunned. At first I tried to believe I had developed hand pain because I just inherited about 100 patients with hand pain from a surgeon who retired. But really, I'm just not that suggestible. Nevertheless my hands hurt and they continue to hurt. It hurts to hold a book. It hurts to take a cap off a pen. It hurts to pull the covers up in bed. It hurts to drive. It hurts to open a door. It hurts to palpate somebody's belly. It hurts to take a blood pressure. It hurts to pick up a chart. It hurts to lift a pan of food off the stove. Long story short, I've been driven to seek medical attention from someone other than myself and I appear to have either arthritis or carpal tunnel syndrome. I take acetomenophen. I take ibuprophen. I nearly burn myself with the heating pad. I sit immobile like a sick cat. I grump at innocent bystanders. I have pain. I am a pain.

I'm glad I've taken pain seriously all these years. I just wish the karmic pay off was coming sooner.