Shopping Basket
Your Basket is Empty
Quantity:
Subtotal
Taxes
Delivery
Total
There was an error with PayPalClick here to try again
CelebrateThank you for your business!You should receive an order confirmation from Paypal shortly.Exit Shopping Basket

A World War 2 Trilogy

By FRED NATH (Novelist and Neurosurgeon)

Fred's Blog

Blog

Pain. Empathy and Doctors

Posted on 30 December, 2018 at 5:22

I once recall a conversation (a little heated) with one of my nieces when I said I understood how bad a labour pain was. She had started by saying that female obstetricians must be better than male obstetricians. My claim to understand labour pains provoked a rather more volatile response than I think it merited along the lines of, ‘You’re a man. You can’t understand.’

I felt at the time that although I don’t have a uterus, I have delivered 22 babies and witnessed many more deliveries when I trained and since then seen pain in many forms. I do understand. It’s the empathy all doctors strive to have. One never becomes inured.

So, four days ago, I hurt my back (don’t laugh). Initially (I was shifting a mattress) the pain was so bad I just collapsed on the bed and lay there until the worst acute pain died down enough to allow me to get up.

It persisted, but I was able to walk and finish what I was doing. Not surprisingly, the pain gradually escalated throughout that day. By the evening I was unable to walk because every time I put my foot to the floor excruciating pain shot down my leg and it just gave way beneath me.

Day 2 was no better. Day 3 (yesterday) I could weight bear for about five minutes before the pain became too bad and I had to sit down. Today I’m comfortable sitting and can last out upright long enough to make a cup of coffee.

I’ve operated on maybe a thousand lumbar spines in my time and always tried to expedite treatment in patients who seemed to be in a lot of pain, even though a lot of surgeons would wait longer and see if it resolved with pain-killers and rest.

Reflecting on my discomfort, I realise now there is a big gap between empathising and experiencing. My niece may have been right. I don’t have a uterus but I do have a sore back .

Many years ago, some psychologists did an experiment in which they took a Scottie-dog puppy and brought it up in a padded environment, designed so that it was isolated from other dogs and any objects that might stimulate any kind of discomfort. They then prodded the poor creature with pins. It did not react in a normal fashion and seemed unable to avoid those things causing pain. The conclusion was that they had raised a creature that felt pain but did not recognise it was noxious. They thought it meant that most of pain is subjective and without the psychological expectation, pain is not necessarily too bad. There is a grain of truth in that – only a grain.

I think that once one takes away the fear provoked by pain and it is replaced by knowledge and experience, acute discomfort can have much less effect on us than otherwise.

Mindfulness training can help patients with chronic pain because it teaches one to accept the pain, and in their terms (not mine) befriend it. See it for what it is.

Easy to say maybe – it’s just a temporary discomfort and I know it will get better in time, but for those who do not understand their anatomy and do not realise that most pain is temporary it is a fearsome and terrible thing.

I guess I’ve metamorphosised (not like the guy in Franz Kafka’s tale).

 Experiencing pain does make you a bit more empathic. For once, I can tell a patient – ‘I understand the pain you have and its severity.’ It sounds daft, but I would recommend a severe back pain to any Orthopaedic or Spinal Surgeon because it makes you appreciate what your patents are feeling. Not just by extrapolating what you have seen, but by knowing.

My patients will tell you if it’s going to make me a better doctor. One hopes that it will, but you know, memory of pain fades. If it didn’t ,no one would ever have a second labour, would they?

So, we come back to the argument where we started. Do female obstetricians make better labour-carers than men?


Categories: thoughts

Post a Comment

Oops!

Oops, you forgot something.

Oops!

The words you entered did not match the given text. Please try again.

19 Comments

Reply Creague
19:51 on 28 July, 2022 
Viagra Online Offerte viagra and cialis online Generic Priligy 90 Mg
Reply peakspits
16:38 on 17 August, 2022 
Comprar Cialis Contrareembolso buy stromectol 3 mg tablets Tadacip 20 Canada
Reply whownwerb
16:13 on 1 September, 2022 
Take it slow where can i buy cialis on line
Reply Thidivy
21:54 on 3 September, 2022 
Unlike Viagra , which usually provides relief from ED for four hours per dose, a single dose of Cialis can improve erectile function and prevent ED for as long as 36 hours priligy amazon
Reply Scoonse
20:37 on 5 September, 2022 
5, 5 or 10 mg taken once daily, might offer another valuable option for ED treatment generic for cialis
Reply spoomma
4:45 on 8 September, 2022 
best price cialis 20mg One has Sexual Stress Symptoms erectile dysfunction after da vinci prostectomy white hair, the other southflaortho
Reply foograx
19:56 on 10 September, 2022 
I told my mum as well; the 12-week thing was not even a consideration. clomid tablet
Reply slinianob
22:41 on 13 September, 2022 
I m so sorry for your loss. 20 mg nolvadex pct
Reply Feengam
13:36 on 17 September, 2022 
The average cost of managing an outpatient case multiple consultations was US 100. doxycycline purchase in china
Reply Impenna
14:27 on 8 October, 2022 
Too controversial and too easy to target lasix complications
Reply Adurnag
5:30 on 14 October, 2022 
?? How y?? all make Mark mad coupons for cialis 20 mg
Reply Plairee
9:30 on 28 October, 2022 
buy ivermectin 3mg tablets Ester is a hormone that is produced in the ovaries and adrenal glands and is associated with female reproductive health
Reply Fagmapiep
3:26 on 5 November, 2022 
stromectol precio Investigators are also looking into its role in setting benchmark interest rates known as LIBOR
Reply Suisilt
19:57 on 7 November, 2022 
Jamel, USA 2022 05 05 01 12 08 buy priligy usa Converting methyl 1 mercaptomethyl cyclopropaneacetate to a metal salt X using a metal hydroxide, ii
Reply Unwilla
16:18 on 9 November, 2022 
5 mm agreement and reliability study best place to buy nolvadex
Reply HonyShene
21:20 on 17 November, 2022 
Can breast cancer patients with her2 dual equivocal tumours be managed as her2 negative disease stromectol in canada Emily, USA 2022 06 16 18 54 15
Reply Kigcruics
17:24 on 18 November, 2022 
can doxycycline make you extremely tired I picked a Part B plan to cover the 20 percent of charges that basic Medicare also known as Part A does not cover
Reply Jeolovevy
23:36 on 20 November, 2022 
Dementia is defined as a significant decline in two or more areas of cognitive functioning pct clomid dose Did that and had no major night distruption and slept well
Reply Wasyelusa
0:19 on 22 November, 2022 
Metastatic disease to the eye is by haematogenous spread, therefore the most frequent location affected is the perimacular choroid because of the increased vascular supply to this area lasix water pill So in the fourth quarter of a meaningless exhibition, the fifth year quarterback played behind an exceptionally weak second team offensive line and was crunched by Marvin Austin, causing the injury