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Complainer

Christina Phillips

The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She'd come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she'd come by taxi. The veins in her arms were small, threadlike and collapsed, like those of a ninety-year-old or a recreational drug user.

Her medical file was huge, with reports from her primary-care physician, from local hospitals and from the gastroenterology department of a highly regarded teaching hospital across the state.

She told the ER doctor that her pain was caused by chronic pancreatitis--a permanent inflammation of the pancreas-- and that the pain had worsened over the past two days until she could barely stand. She urged him to contact the teaching hospital, whose specialists were familiar with her condition, and asked to be transferred there.

"I can give you fluids, but no pain medication," the doctor replied, adding, "You know, taking narcotics is really not good for you." He didn't call the teaching hospital, nor did he read the gastroenterologist's note stating that the patient was not drug-seeking and confirming that her pain did stem from chronic pancreatitis.

Chronic pancreatitis often occurs in alcoholics and drug users, but in my mother's case it was caused by a rare birth defect in her pancreas anatomy. When the pancreas becomes inflamed, the digestive enzymes it secretes attack the organ itself. In response, the organ's damaged nerves send out sharp, persistent jabs of pain that worsen whenever it's jostled or stressed, as in walking or eating.

It was 2:00 pm when Mom's number popped up on my phone. I was walking to my organic-chemistry lab at the university where I was in my senior year of premedical studies. We were going to isolate the red pigment lycopene from tomato-paste samples. After that, I planned to park myself somewhere and study for the next morning's animal-physiology exam.

I pressed "Answer."

"Christina, don't freak out--but I'm at the hospital again," said my mother's voice. I sucked in a breath.

"The pain isn't going away?" I asked. "Do they believe you?" Walking into the science building, I waved to a friend, then ducked into an alcove by the lab door.

"No." I heard her exhale, then start to cry. The sound felt like a punch to my diaphragm.

"Let me talk to them," I said. "Are they sending you up to your gastroenterologist?"

It had been almost three years since my mother developed pancreatitis. At first her attacks happened only sporadically; I spent the summer before sophomore year shuttling her to appointments and sitting in hospital rooms, watching reality shows while she received her fluids and nutrition through tubes. My father was out of the picture, and my younger sister (and only sibling) is intellectually disabled, so all of the caretaking fell to me.

My mother's bouts of pain started to come every month, then became constant. Throughout all of this, she worked full-time as an engineer for an aeronautics lab while also taking care of my younger sister.

The pain was controlled by prescription narcotics--until it wasn't anymore. My mother became a shell of her former self, barely able to load the dishwasher, much less work. She sank into depression and had trouble sleeping. Approved for surgery to repair or remove her pancreas, she began the nine-month wait to reach the top of the surgeons' list.

While waiting, Mom tried to manage her pain by not eating solid foods, lying on her stomach or lifting heavy objects. When these measures failed, she had no choice but seek relief at the local hospital.

"Christina, they're just sending me home. I can't do this, I hurt so much."

"I know, Mom. I know."

I peered through the lab window to where my professor was setting up test tubes. He saw me and waved.

"Can one of your friends drive you to the teaching hospital?" I said. "If not, I'll fly home tonight." This would mean a 900-mile cross-country trek--and missing tomorrow's exam.

On the other end of the line, I heard her ask the nurse, "Why don't you believe me?"

To me, she said, "I'll call someone. I have to go, they're sending me home. I'll text you when I get a ride."

She hung up, and I walked into my lab.

There I did what thousands of organic-chemistry students do every semester: I went through the motions of pipetting substances into test tubes, weighing them and transferring them into new test tubes.

Weighing the samples, I reflected that it was easy to view each one as identical with all the rest and to prepare it using the same methods and shortcuts that had worked countless times before. I could understand how medical professionals might do the same with their patients--how, looking at my mother, they might see a patient like countless others who'd complained of pain without necessarily having it.

But she's not one of those patients, I thought. As I pictured my mother's suffering at the hands of doctors who could have eased her pain, but chose not to, I felt helpless and furious.

After college, while working as an EMT, I would encounter plenty of patients who were classified as "drug-seeking," "oversensitive" or "complainers," including one Vietnam veteran whose nursing-home attendants had ignored his complaints of heel pain; half of his heel came away with the bandage I removed from his foot.

Whenever I felt tired at the end of a long shift, and disinclined to give a patient a full exam because I suspected that he was drug-seeking, I tried hard to remind myself what it's like to be on the other side.

Eventually, I decided not to go to medical school and stopped working as an EMT. I found it difficult to shoulder the burden of being responsible for a patient's life, and I had to admit that I lacked the knack for caring for strangers. Without the strong emotional attachment that I'd felt for my mother, I found myself becoming impatient when they complained, or when I had to endlessly carry out routine procedures, as medical caregiving requires.

I still haven't forgotten how easy it is, as a clinician, to see the symptoms first and the patient second, and to reach quick conclusions based on previous experience. How can I forget, when just months ago I had to help my mother contend with a doctor who, despite the chart in his hand and the eleven-inch scar across her abdomen, refused to believe that she'd had her pancreas removed?

But I have to keep hoping that, as hard as it can be, my mother's caregivers, and others like them, will find a way to keep an open mind and an open heart.

Because I also can't forget what it felt like to be a twenty-year-old listening helplessly to her mother cry, a thousand miles away, because she was hurting, and nobody else would listen.


About the author:

Christina Phillips is a producer for the live, local call-in news program The Exchange on New Hampshire Public Radio. She received a BS in biology from Furman University, in South Carolina, and an MFA in creative nonfiction from the University of South Carolina. While attending graduate school, she worked as an EMT. Her works have been published in The Rumpus and 1966: A Journal of Creative Nonfiction. "I love to write about science--especially human physiology and genetics--using personal narrative and storytelling. After talking to a medical-resident friend about his experiences with drug-seeking patients in the emergency room, I wanted to share this story."

Story editor:

Diane Guernsey

Comments   

# Dagmar Friedman 2017-02-11 13:53
Deeply moving and important. So wish all health care providers took the time to truly listen to patients and try to understand before treating.
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# Patti Clevenson 2017-02-11 08:56
Your story beautifully illustrated the other side of the pain dilemma we are now facing in this country. The pendulum has swung to the side of avoid pain control because you might get an addiction. I hear it all the time in my work as a pharmacist. Life is not supposed to be easy. You can tolerate a certain level of pain. Meanwhile patients suffer and turn to street drugs to gain control of their lives. The pendulum will swing back eventually. Too late for many.
That we now can dispense naloxone to anyone is just a sign that the street drugs are out of control and killing innocent folks.
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# Henry Schneiderman M 2017-02-11 21:21
Just wanted to add another voice in support. Yes, we have an enormous problem with opiate abuse and street drug abuse. But at the same time we demonize and underuse these drugs, AND disrespect those who need them for control of pain whose severity no attentive person could doubt. The system fails patients all too often. I wish the author had gone on to med school, because hers is the outlook that the profession needs. That said, one can only do what is personally bearable and this work is not possible for some of those wonderful persons who possess loads of brains and compassion.
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# Pris Campbell 2017-02-11 06:02
This stiry resonates with me, too. I was a clinical psychlogist, an active sailer and biker until I woke up one day unable to walk straight, pain all through my body, dizziness, debilitating fatigue, inability to sleep, cognitive confusion and short term memory loss, all of which were finally diagnosed as ME/CFS. In the early years I tried deparately to find help but was told repeatedly that it was all in my head. I realized then that I was truly slone and only a few doctors I found later took me seriously and tried to help however they could. I feel for your mother. It boggles my mind that this hospitsl wouldn't even contact her doctors at the other hospital,
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# Yvonne Sliep 2017-02-11 01:33
Christina you put a human face to both ends of the problem. The only way to build in mindful rresponse is to keep a finger on the pulse. To make it visible. To remind us and then to act differentlt.
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# Bj 2017-02-10 22:36
So sorry for your mother's bad experiences. Alas, a similar problem is happening in hospitals all over the country. Been there, done that. It is so demeaning for someone in need of help to ignored or not believed. I even asked the ER doc if he would have treated me differently if I had medical jewelry explaining my condition. He said no. I believe him because he wouldn't even consider the information in my chart from a previous visit. Maybe instead of just blaming doctors for prescribing too many narcotics, they should help doctors learn how to teach people with respect and take that extra step to decide who really needs pain meds or other resolution for their pain.
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# Ronna Edelstein 2017-02-10 18:49
Christina, your story about your mom resonated with me. I have spent the past eight years in chronic pain due to four unsuccessful jaw/joint surgeries and bone now growing over the prosthetic device in my jaw. I worry that doctors see me as a stereotype--a complaining senior citizen. However, I assure all physicians and health care providers that pain is real--and that real pain diminishes a person's quality of life.
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