Tuesday, December 07, 2004

A Walk Down the Path of Pain

"Oh Doctor, come hold my hand a while as I travel down the path cancer has chosen for me."

I hear these words echoing in my brain, as if from the pale lips of cancer patients waiting quietly in the hall for me to finish my paper work, waiting to guide me into the world of suffering that for me is just a job, but for them a grim reality. They stand silently, like Virgil awaiting Dante, ready to lead me down into the abyss where their tormenter resides.

"You, who claim to be an expert on this disease that has ruined us - what do you know of pain, or of dejection? Show us where you have earned the right to carry our lives in your arms."

True, there are times when I feel ashamed to be lecturing or coaching my patients - attempting to relate to those in pain. Why should they listen to my advice when I have no idea how it feels to endure such agony?

Much has been written about how to diagnose and grade pain, about how to get patients to communicate their pain, and of prime importance, how to effectively relieve pain. We oncologists prescibe pain medicines of all kinds - pills, liquids, patches, intravenous medications. Some of us are better than others at monitoring the efficacy of our remedies, as adjustments must be frequently made to keep up with pain's galloping through the patient. Very few of us, however, have ever experienced the relentless pain associated with malignancy.

Does this make us lesser physicians?

"No," we argue, for all of our training has provided us with a keen sense of how to identify pain in a patient and how to attack pain, usually with narcotics. Pain management is now a respected speciality, replete with new treatments for the sufferer.

Yet still...would a little pain in the doctor's life make him a more sympathetic healer?

My reason for bringing this up is that last year I developed an inguinal hernia. This hurt enough to be annoying but did not cause enough pain to interfere with work, or even a family holiday at Disney World (although I can now speak with authority against riding the Space Mountain roller coaster with a such a condition). Like a good patient I saw a surgeon and had an open surgical repair, which left me with an eight centimeter incision. Like a bad patient, I decided to not take any pain medicines during my recovery. After all, I come from a long line of ignorant, stubborn patients who hate to take pills. Plus I'm an oncologist, and many of us loathe taking narcotics due to the disturbing side effects they create. I therefore treated my pain with a couple of ibuprofen and an ice-pack. I, the defiant one, scoffed at any discomfort. I, the tough oncologist, laughed in the face of pain.

I, who care for people living in pain, journeyed a little down that path they are forced to march every day - just a little ways down the path...for a few days.

The pain was unbearable.

I couldn't find a comfortable position, couldn't concentrate, couldn't even watch Night of the Living Dead on DVD without heavy, aching pain squeezing my groin. Even now I can't adequately describe what it felt like. It was impressive though, and it made me think.

It made me think, even one year later, of pain and how it devastates a human life. Pain consumes a person's spirit and wraps itself around the waking mind like iron chains. It robs the sufferer of the ability to accomplish tasks, or even interact with loved ones. Pain is evil.

Having written this, I shall pledge to always remember what it was like to be in pain, as I pledge to remember what the good men and women in my care are going through on this day, and the many evenings to come.


At 7:22 AM, Blogger Doctor Disgruntled said...

I was reminded of how irritated I get when my patients don't take their antibiotics for the full course, until I had my wisdom teeth out and stopped the amox after 4 days because I couldn't take the stomach-ache anymore.

On the subject of pain and sympathy, specifically, I was thinking of this exact subject just yesterday and your post inspired me to write it down:


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