Free
Education  |   July 2019
The Experience of a Pain Patient
Author Notes
  • From the Duke University Medical Center Greenspace, Duke University School of Medicine, Durham, North Carolina. zachary.smothers@duke.edu
  • Accepted for publication November 27, 2018.
    Accepted for publication November 27, 2018.×
Article Information
Education / Mind to Mind / Pain Medicine
Education   |   July 2019
The Experience of a Pain Patient
Anesthesiology 7 2019, Vol.131, 211-212. doi:10.1097/ALN.0000000000002590
Anesthesiology 7 2019, Vol.131, 211-212. doi:10.1097/ALN.0000000000002590
When I was 17 years old, I thought my life was going perfectly. My days mostly consisted of going to school, playing sports, and trying to stay out of trouble (which was harder than it sounds). I was living in a small farm town in the middle of nowhere Ohio and couldn’t wait to get out. Honestly, I was a bit cocky; I was a good athlete, for which I received an acceptance to the Air Force Academy, my ticket out of the rural life. I would spend four years in school, and the rest of my life serving my country, not a bad living. This was the grand plan; well, until I herniated a disc in my back and found out how horrible a medical condition could be.
I realized that this level of pain was not right. It was too intense and slowly began to impact my life in other ways. The things I loved to do (running, playing basketball, staying up all night) became more difficult and emotionally draining. I had never been taught how to live like this, and I began to doubt my own “toughness.”
It took three weeks for me to be convinced to go to the doctor’s office for an appointment. My physician walked in, asked questions like “When did it start?” “Has this happened before?” and “Does anything make it better or worse?” After this came the physical exam, and his conclusion: a pulled muscle.
This answer bothered me. Spending my whole life in sports, I knew what a pulled muscle felt like, and this was not it, not even close. I felt like I had to make my doctor understand the pain I was in, it seemed he just didn’t get it. The way he responded to this I describe as “paternalistic.” When he began “informing” me on the opioid epidemic in our area, I felt like a scolded child. Despite this, I wouldn’t be beaten by him, I needed something more. Eventually he caved and provided me with a referral to an orthopedist, but not before giving another short lecture on waste in the medical system.
Another four weeks passed (roughly seven weeks after my injury) and I was no longer myself. This pain consumed me, and dragged me into depression which I could not climb out of. I wasn’t sleeping, my family and personal relationships were degrading, and people seemed to be annoyed with me. I felt as if I was a burden, that I was the problem, not the pain.
Finally the orthopedist appointment came and mirrored my first primary care appointment. After the short interview and physical, the doctor stood up, sighed, and asked me quite bluntly, “Why are you here?” I went blank. It wasn’t until a few moments later that I understood the true meaning of his question. What he actually meant was, “Why are you wasting my time?”
Once I saw this conversation was going nowhere, I begged for an MRI, something I thought could prove my case. I was met with another scolding, being lectured on waste in the medical system a second time. Again I left a doctor’s office with no answers and a feeling of hopelessness.
Another four weeks (around 11 weeks after my injury by this point) went by and I continued to live in pain. My personal identity was completely lost, and I began to seriously consider suicide. I scheduled another appointment with my primary care physician, hoping he could find something that would convince me to not end my life. I will spare the long details of the encounter, but it was similar to the previous, with the conversation going nowhere. This caused me to be consumed by a feeling of hopelessness, and forced me to have an emotional “breakdown” to my physician. I don’t know exactly what it was about this show of emotion that changed my physician’s feelings, but he finally got it, he saw my pain.
A week later I found myself in a neurologist’s office. They found evidence of nerve damage that prompted them to order an MRI. The results came back with confirmation of a herniated disc at the L4/L5 level. The next couple of months flew by. I was connected to pain management physicians, psychiatrists, and eventually a neurosurgeon. At the end of it all, I would undergo surgery to correct the herniation and had a relatively speedy recovery. This whole process took close to six months, cost me my appointment at the Air Force Academy (I eventually attended the Ohio State University and loved it), and almost took my life.
Today, I am a 25-year-old second-year medical student at the Duke University School of Medicine interested in pursuing pain medicine. I understand more about my condition from a medical standpoint, but still struggle with the humanistic side of my experience. How could physicians ignore my obvious pain? Why did no one offer me an MRI until I showed up months later in tears? My story is not unique. Every day we see patients who may share my story, and it is crucial to understand where our patients come from and the suffering they have already experienced when they eventually walk into a pain management clinic.