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November More Voices: Chronic Pain
Dear readers,
If I had to start my medical career from scratch, I’d devote more time to studying chronic pain. Specifically, I’d want to arm myself with more and better tools for alleviating it.
Over the years, I had many patients with chronic pain, and my success at treating them was spotty. Pain relievers were helpful–sometimes. Physical therapy and acupuncture were helpful–sometimes. A pain-management referral was helpful–sometimes. A conversation about past emotional traumas was helpful–sometimes.
But there were patients whom nothing seemed to help.
Insomnia Dog
I had always been a good sleeper, until about the age of 30. At that time, my father was dying of metastatic breast cancer. I would wake up every night at 2:00 a.m., with a feeling that my chest was bound in steel armor. Those 2:00 a.m. wake-ups have been with me ever since, for the past 25 years. Now and then, I would work on my “sleep hygiene” by trying not to read my Kindle in bed and cutting back on caffeine.
A few weeks ago, I decided that my insomnia had gotten out of hand and asked a
Between
This week marked almost the halfway point of my life: the first half with hearing, the second with deafness and, then, cochlear implants. I’ve lived in between two worlds and cultures, hearing and deaf, never fully belonging to either.
During my first year in medical practice, I lost almost all my hearing in both ears. For most adults, hearing loss is gradual, but for me it was sudden. Despite treatment for autoimmune inner ear disease with some ups and downs, my hearing continued to deteriorate.
I was devastated! After so many years of school and medical training, could I continue
Home of the Free
Today as a family physician I am disabled in a way that I never could have dreamed in 1997 when I joyfully marched across the magnificent auditorium stage. I wore an ostentatious maroon gown and a green velvet sash, an enormous smile and relaxed shoulders. I shook the presenter’s hand and took hold of my diploma. Four years of delayed gratification, hundreds of thousands of dollars, countless late nights and long days culminated in this moment. The camera shutter in my soul CLICKED eagerly to capture it all.
On Grieving during Residency
As time passes, I no longer remember her face or her name. But I know what brought her in. And I clearly recall how, as an intern, I walked into her grim hospital room, where two tired parents sat by her bedside: a young woman with a small pimple patch on her forehead.
She was twenty-four and had no chronic conditions—but now no sign of life. I’d spent six months as an intern at that point and was still learning to become a doctor. I’d written down all I could find about her medical history and headed toward her room,
Assumptions
Floanne, a fellow nurse, was a close friend of mine for thirty years. She was widely known for the grace and compassion she showed to those around her. Sadly, in her later life, she developed peripheral neuropathy. After a million-dollar workup at a hospital, the physician specialists declared her condition a mystery and therefore untreatable. Flo became confined to bed—unable to stand, walk, hold a book, or use eating utensils without assistance.
Dedicated physical and occupational therapists worked with her, and eventually she regained the use of her hands and could tolerate short periods in a wheelchair.
Freedom
As a clinical psychologist, I saw many people disabled by intense emotional problems and psychotic illnesses. All were compromised to some degree. Many of the most compromised were inpatients on psychiatric units that I ran, before such units started closing down. Many ended up on the streets. Some were lucky enough to have family take them in.
One man I worked with was different. My psychology chief at the VA knew I taught relaxation therapy and asked me to see if I could help a patient on the spinal cord unit. After he got out of the service, “Tom” had
Still Sitting Tall
My patient, a middle-aged woman with cerebral palsy, sat beside the exam table in a wheelchair. She had a steady presence about her—a quiet strength that filled the room.
“I used to stand,” she said. “But it’s harder now. My legs don’t work the way they used to.”
She wasn’t seeking pity. She was simply stating a fact. Her face showed both fatigue and resilience.
The Medical Supply Store
I enter the medical supply store to pick up a walker in advance of my upcoming surgery. No one greets me as I approach the counter on crutches.
A clerk is chatting with another employee about their weekend. No one is attending to customers.
The clerk finally acknowledges me, and I explain why I am there. She asks me to come over to another counter, where she is standing, though I am on crutches and it would be easier for her to come to me.