By Mary O’Brien. M.D.
Are you a terrorist? Are you a drug dealer? Perhaps a criminal of some other variety? The fact that you are reading this makes any of those possibilities quite unlikely. And yet, our culture now assumes the worst of nearly everyone. In an airport, we’re all treated like potential terrorists. Hand the clerk in a grocery store a hundred dollar bill and she checks it to see if it’s counterfeit. Anyone needing pseudoephedrine to breathe normally is treated like as if she may be running a crystal meth lab in her garage. That’s ridiculous. I don’t have a crystal meth lab in my garage. It’s in the attic. These days, too many people can’t recognize humor, much less reality.
Needing to fly somewhere does not make someone a terrorist. Wanting to pay cash for groceries does not make someone a counterfeiter. Trying to breathe more easily does not make someone a meth dealer. Hoping for some pain relief does not make someone an addict. As a society, we are making some very misguided judgments. I recall that seven years ago I sought help from another internist when a long list of autoimmune diseases began spiraling out of control. The “medical assistant” asked me what my main complaint was. When I explained I had increasingly severe pain in my hands and feet, she quipped, “We don’t do pain management.” I had to restrain myself. I was there for a diagnosis, not a prescription.
Pain is the single most common symptom of most malignancies, autoimmune diseases, vascular diseases, and serious infections. Renal disease, neurological disorders, metabolic diseases, and any inflammatory process can cause agonizing pain. And we haven’t even touched on trauma. Most patients who complain of pain are totally genuine and honest. Some people exaggerate, some are manipulative. Some, but not most.
Today, we have many veterans suffering constant pain from multiple amputations and other terrible conditions. In many cases, they cannot obtain a month’s supply of pain meds. They are forced to endure preposterous “policies” and “protocols” created by sanctimonious idiots.
If we really understood as much as we think we do about pain, pathophysiology, or pharmacology, we would ensure that patients have the pain medications they need to function. Opioid addiction and overdoses are devastating problems. But forcing patients with documented causes of severe pain to suffer needlessly is simply wrong. Everyone who has had a cocktail, a beer, or a glass of wine does not become an alcoholic. Everyone who needs chronic opioid treatment does not become an “addict.”
The whole point of health care is to relieve pain and suffering. Perhaps we all need a little reminder.