Doctor, Heal Thyself...

[LasVegasRN]

Had quite an interesting meeting awhile back. A group of anesthesiologists came to our office to talk about their practice, they specialize in pain management. The head of the group, a very well-respected pain specialist, was there and I had not seen him for about 3 years. He walked in with a cane, looking like in was in a lot of pain. Since the years that I saw him, he was in a horrible car accident that left him with several compressed vertebrae and other fractures of the legs and hip.

We discussed current pain management practices, the latest trends and research going on in the field. I couldn't help but notice how uncomfortable he looked during the meeting. It was obvious that he is trying very hard to continue to be involved, although he wasn't currently practicing, but he still looked to be in a great deal of pain.

I wanted to ask him, so badly, how his perspective may have changed now that he, a pain management specialist, is dealing with chronic pain issues himself. I wanted to ask how or if it has changed his approach to dealing with patients with long-standing pain issues and how he feels about the very methods he promoted - are they helping him? Has he changed his philosphy or has this experience enhanced it?

Has anyone had similar experience?

[dianah, ASN]

I have no personal experience to draw from but I do recommend long-term pain sufferers (such a the chronic low back pain pts we get for MRIs) ask about pain clinic consultations. I get so many that tell me they don't take their prescribed pain meds for whatever reaon: "I don't want to get addicted," "It zonks me too much," "It doesn't help" . . . I tell the pts that new combinations of meds (some that previously weren't given for pain) have been found to help decrease the level of the pain without sleeping all day or being "out of it." I'm always concerned when pts don't take meds "because they don't help," yet don't inform the prescribing MD of the med's inefficacy!! I tell 'em, "You sound like my husband. For all the doctor knows, the pills are helping you!! YOU have to call him and tell him THEY'RE NOT WORKING. He needs to know this, you need to pass this info on."

I would have wondered the same as you, LVRN, about the MD's perspective, philosophy and treatments in light of his recent experiences. I would hope he would become a STRONG pain management advocate!! Would you ever get the chance to, say, informally interview him?

[LasVegasRN]

I got the impression he was still in a lot of anger over having being put in that situation to begin with. I don't know if he has started back doing inservices, but if the opportunity arises, and I get the feeling he is more comfortable talking about it, I'll ask.

[Alley Cat]

Boy, does this sound familiar! Actually, the problem is, I'm the one with the chronic pain in my side (not a pun, folks!), and my family physician has 2 responses: a) I'm depressed and having physical symptoms, and b) "sometimes we never find out what's causing it and just have to put up with it." He had some emotional issues (attempted suicide after his wife filed for divorce), therefore he thinks that's what's wrong with me. I am currently exploring other methods of treatments (at least he's referred me to a chiropractor who respects me, understands where I'm coming from, and is helping me find other resources to help alleviate my problem, which most likely stems from adhesions post hysterectomy for fibroids & adhesions from endometriosis). What has frustrated me in the whole situation is that doc wants to attribute ALL my problems to stress and emotions, which granted can affect me physically, but there IS a physical problem, not just an emotional one. I already have so many allergies to medications that I don't want to take more stuff and add to the list; don't just throw pills at me and expect me to be quiet!

I guess part of the problem is that physicians have really big issues with letting anyone see that they're (gasp!) HUMAN!

They're so focused on being analytical:specs: that they can't get beyond it. I also think there is a big lack of support amongst physicians themselves: ever notice how when something goes wrong in their personal lives that they either bury themselves in more work, or do a 180 and totally drop out of sight? OR if they have professional practice issues, they cover each other in an effort to keep up a front? Heaven forbid they should admit one of their own has a problem of some sort! I don't mean to be disrespectful or anything, but the culture amongst the docs doesn't allow for wearing hearts on sleeves or talking openly about difficulties, physical or otherwise. Kind of sad, really.

[EXOTIC NURSE, RN]

I never really understood pain management until I worked on the oncology unit....plus studying for my Boards I see that pain must be addressed as an objective issue if the patient say they are in pain then it is our responsibility as a nurse to follow doctor's orders and medicate them......LasVegas RN that is a good point you have there I hope you keep us informed as to the outcome if you ever get a chance to talk to him........I for one would be interested to know what he have to say on the matter.