Thursday, March 20, 2008

How Nurses and Doctors See Back Patients

This is how most nurses and doctors see back pain patients:

...the author says that 50% of chronic pain sufferers have personality disorders or affective disorders. I can vouch for that. They wear you out, the people who come in for chronic pain because they are people who are neurotic and difficult to work with. Antidepressants have been found to be very helpful in these people, along with psychological help. They seldom get it.
What ER Nurse describes in her post is that she's worn out; that pain patients are "difficult to work with" is a matter of projection. Let's try rewriting that paragraph:

...the author says that 50% of people who treat back pain have personality disorders or affective disorders, including sociopathy, narcissism, and inflated ego. I can vouch for that. They wear you out, the people whom you have to see for chronic pain because they are people who are neurotic and difficult to work with. Antidepressants have been found to be very helpful in these people, along with psychological help. They seldom get it.

One of ER Nurse's commenters believes that back pain patients believe that no level of pain is acceptable. Actually, most of us learn to deal with a high level of pain all the time, often without medications. And when we finally medicate, to get sleep or because the agony is so intense? Then we're considered drug addicts. Obviously ER Nurse could have benefited from some courses in medical humanities or medical ethics, but apparently they didn't have those when she was in school.

If she had taken statistics or remembered it, she would also know not to confuse causation and correlation. What many current studies show is that back patients often do experience depression, but as a result of the injury, not preceding it. And even if people who are depressed are more likely to get back pain, that doesn't make it their fault. People who are depressed are also more like to get stomach problems, headaches, and major heart problems, and no one blames them for those. Instead, they get treated. But it's faulty logic to assume that because some people with depression get back pain, all back pain patients are depressed, or neurotic, or whatever.

ER nurse also writes:

Why would you commit yourself to changing your lifestyle with exercise,
relaxation, etc. when you can go to the ER and get a quick fix?

Does she not realize that most chronic back pain patients spend fortunes on chiropractors, acupuncture, physical therapy, physical rehab, spine specialists? Back problems cause measurable functional disability. And yes, many people are going to get depressed about that, when they can no longer work and the bills start piling up, and when they can no longer enjoy regular life activities.

The lack of basic human empathy demonstrated in ER Nurse's post reflects what's wrong with medicine today. While I've not sought help at the ER, I should have two different times after accidents, and I did have to go to urgent care once when I was shrieking in pain. I had never tried a muscle relaxer before, but it did the trick, taking the pain down to a manageable level. Thank God the doctor didn't think I was an addict, and I was able to get on a plane 36 hours later as I was scheduled to do. And thank God for my regular doctors, who are trying to help me and help the pain, believing me in the process.

2 comments:

Liz said...

I hear you Frida. It's amazing the attitude a lot of doctors have.

So few of them understand at all, exactly your point about correlation and causality.

FridaWrites said...

I am very grateful for my current doctors. While I have no doubt that there are some drug abusers claiming any range of possible problems (back pain being only one), I'll bet a lot more people are undertreated or disbelieved just because their illness fits a stereotype.