Gotta Love Pain

You can get all kinds of things by being in pain.  Especially here in the U.S., where pain is considered the “fifth vital sign.”  I have a colleague in Japan who said they never treat chronic, non-specific pain with narcotics.  Not so here.  You can totally work the system, too.  Narc addicts barely even have to try these days.  Did you know you can be admitted to hospitals with the diagnosis of “pain”?  You don’t even need a source.  Just pain.

Here’s a recent paraphrase of a conversation I had the other day:

“How are you today, Mr. Davis?”

“I’m still in pain.”

“Do you think you can go home?”

“I really truly wish I could, you know.  But.  I’m still in pain.”

“I think you’re probably better.”

“No.  Pain.”

“You sure?”

“Yep.  10 out of 10.  Worst ever.”

“Like, the kind of pain you might have if someone poured acid all over your body and then threw you into a wood chipper?”

“Wow.  How did you know?  Yeah.  Just about like that.”


“All over.  It won’t go away.  You haven’t done anything to help me.”

“I’m not sure there’s anything we can do.  I really think I should send you home.”

“Ok.  Fine.  The pain is centered around my chest on the left side and I’m pretty sure I’m going to kill myself over it.”

“Congratulations, Mr. Davis, you’ve just earned yourself another 4-6 days in the hospital while we work up your suicidality and chest pain.”

“Thanks.  You’re a great doctor.  When can I have my meds?”

2 thoughts on “Gotta Love Pain

  1. “a recent paraphrase of a conversation I had the other day…” Well, as i have only your word for the veracity of both the situation and the accounting, what response would you like?
    I am glad you are able to vent your anger and frustration. All of us who work for a living — even those of us who are retired tired professionals — encounter the unnerving, the preposterous, the systemic flaws. I could give you some new paraphrases of old conversations that I had in better days — but in oh-so-prestigious places — that would no doubt bore you to tears but still put a fire in my belly.
    I would like to challenge the medical blogging community to consider relating a (HIPAA vetted) case wherein the patient suffers from severe chronic pain, let’s say from a well-documented (ergo legitimate, right?) source, or even several well-documented sources. Said pain is being managed by a Pain Mgt Physician with a combination of opiates, NSAIDS, and ongoing PT. The patient is compliant. Feel free to ramp up any details you like to make the patient sound nasty and undeserving — maybe s/he is one of the great unwashed stinky homeless people! Maybe s/he is so ugly s/he would make your Mama cry! Shoot, maybe s/he is so stupid that you can talk gibberish and s/he won’t know until the translator gets there!
    Remember that it is more fun to denigrate whole classes of people, not just one individual drug-seeker. Go for broke! Ach! Stop right there! Do *not* stop to tell me about catharsis or equal rights to freedom of expressions of disgust, fatigue, worn-out compassion, slavery to a broken system — no need, I get it! Luckily, there is enough intelligence (and amendments) to go around. Anyway, make the pain real, the patient’s medical emergency real, and yourself real — but treat the patient and tell us the details. [What did you do, Dr. SecretWave, to merit such a comment? Nothing.]


  2. Kim

    Y’know, it just kills me that not too many years ago (2002 IIRC), I spent a night in the hospital after a cholecystectomy with *absolutely no pain medication* — I ended up checking myself out before my surgeon came by the next afternoon, so I could go home and take some frickin’ Tylenol and get some sleep — because apparently either my surgeon or the hospital staff felt that “toughing it out” was better for me than the IMO imaginary risk of opiate addiction. But random drug addicts looking for a fix? Oh, they get what they “need” no problem. Too bad I was in too much legitimate pain to make a nuisance of myself, I guess!


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