How we understand pain

I recently had a run in with pain as I have injured my back quite badly. Whilst I was in hospital recovering I began to think about all the aspects of communicating pain that were going on around me.

The first question I was asked was: on a scale of one to three, three being childbirth, how much pain are you in? The baseline on this is seriously flawed as I have had three entirely different experiences of childbirth, at three very different levels of pain. It also made me wonder how this question would be applied to men experiencing pain. Here my pain was owned by a scale of one to three for the benefit of statistical assessment with no definition of my own experience.

The second was being eyed by a suspicious nurse who told me that 'I couldn't be in much pain as I hadn't asked for painkillers at six o'clock'. This entirely subjective view on the part of the nurse was working on an assumption and not on my reality. I had not asked for painkillers at six o'clock because I had no buzzer to summon a nurse and could not walk up the ward to ask. Here my pain was owned by the nurse who was assuming based on his own perception.

The third was an account given by another nurse who told me, whilst holding the key to the pharmacy cupboard, that many patients admit themselves to the hospital with fake illness in order to obtain strong painkillers that give them a buzz. This societal problem of addiction is another way of communicating psychological and societal pain. However, it didn't help me as I was really in a lot of pain. My pain was owned here by an objective risk assessment of whether or not I was faking my injury.

In my five day visit to the hospital, no professionals asked me how I was feeling. Several nurses and doctors looked at me and made an assumption based on how I appeared outwardly or how I was holding my body. An MRI scan revealed my injury had caused a herniated disc (see diagram above). No one acknowledged that my pain was my own, and that I could find words to express it myself. By overlaying my pain with other measures that rely on someone else making and assessment, my pain was negated into a construction of something external to my body. This is not a satisfactory situation for someone who is in acute pain, or in any circumstance.

Because I am not someone who will make a fuss, I was discharged with a prescription for paracetamol and ibuprofen, whereas someone else with the same injury as me who cried and complained more was discharged with much stronger painkillers. It seriously worries me to think that in the NHS today it's the person who shouts loudest who gets the best treatment. What happened to an adult, non-hierarchical conversation about how we are feeling? What happened to someone listening to my expression of how I feel instead of form filling and rating my pain for me?

I took my pain home with me, whereas my pain 'outcome form' still lies in the bottom on my hospital file.

For my notes on a lower back herniated slipped disc please click here

Avoiding the hole in the road

Original Post

My lack of blogging over the past weeks has been due to some extreme focus on writing a paper that has taken my interest. I love being focused and interested; instead of getting caught up in family's and friends' drama I can retreat into my own world of thinking.

Whilst this may sound really boring to some people, it serves me a a kind of gestation time, an incubation of my thinking process where I can be quiet and alone and consider ideas that may, one day, be woven onto the fabric of my external life.

It's been a strange couple of months preceding this, with lots of difficulty and joy, being let down and realising people are not what they seem to be. Lot's of moving around outdated areas of my life to make room for the future, which looks very, very bright. So, instead of constantly going back over old things, reliving learned helplessness and old patterns, I am making my own new patterns. Making these new patterns depends a lot on whether you listen to other people's advice and to yourself.

Years ago someone gave me an anonymous poem (it was passed to me as anonymous, but I now realise it was based on Portia Nelson's 'Autobiography in Five Short Chapters') and it is still relevant today when culling the dead wood.

Edit notes 18th April 2011 Many thanks to the reader who left a comment below. It's interesting because when I wrote this blog I was working from my own memory of this poem, and from notes I took, at a time when I was working very hard to change my life. The comment relates to my not giving credit to the author, which of course I will do immediately. The poem was 'Autobiography in Five Short Chapters' by Portia Nelson. However, my own interpretation of this poem, through the lens of time and personal experience, and maybe even forgetfulness and sadness, has been mistaken for a misquote, and I will remove my own interpretation of this poem on this post, but not from my heart; this was how it filtered through my consciousness when applied to myself, an example of how memory can sometimes distort words to provide personal comfort - and perhaps exactly what the author intended.