Thursday, November 23, 2006

The Difference Between Life, Death, and Drug Seekers

When you come into the ER yelling, moaning, and twisting in agony because you have a sprained ankle - I will hate you. Why will I hate you? I will hate you because the man in the next stretcher is dying of an excruciatingly painful form of cancer, yet he is silent. He is silent, and dignified, and asking for pain medicine "when you can get to it dear. It's really not a big hurry. I've been dealing with this for 6 months now." You, on the other hand, are screaming at me to "hurry up and get my fucking morphine bitch! I've been waiting for 20 minutes now! I'm in pain, ya hear me? I'm in fucking pain!". Yes, that is why I will hate you.

The difference between life pain and death pain has amazed me more than once. The man who threw his back out hauling cement blocks is begging for relief, while the woman who is here on hospice respite and is probably going to die in the next 2 or 3 hours is calmly waiting for her turn on the IV morphine train. The woman with a knife in her leg is screaming like she is dying, but the man who is actually dying next door - he just wants his family close so he can say goodbye.

I don't understand it. I'm not sure I want to. I just want people to respect the fact that someone having a bigger crisis than them may be in the bed next to them. And I may be needed more over there. I probably won't respond quickly to you if you scream at me to get your pain medicine. I will be busy with the man next door who is passing from this world. His problem supercedes yours. Your pain may last longer - but you'll still be alive at the end of it. He won't.

Now I'm not saying that all people in pain are whiners. I'm not saying that if you come in complaining of pain I will roll my eyes, take a deep breath, and say, "Whatever - come on back." I will believe you are in pain. I will treat your pain as able. I will be respectful to you as a human being. The moment you start screaming and cussing at me - you've lost me and my respect. The moment you disrupt every other patient in the ER by demanding your "fucking morphine" you will have lost me.

Pain is subjective. Reactions to pain can be controlled. Most of the time.


MandyHamm said...

Pain truly is subjective; I've been on the "other side of the bed" and it's not great; being in pain and having it relieved with meds is great; mine was a complicated problem but the underlying problem was surgically corrected; so now I still have pain but it's a GOOD pain; I've been in all of those situations you describe and its awesome to get a fresh perspective...
...BTW, my sp is horrendous in my previous comments to you! Hellllo?! Do I not have spell checker? Do I type that fast!
Good to be back!

Nurse Practitioners Save Lives said...

What a great post regarding the needs of patients. Sometimes I have just layed in the line and told patients that while they are important, someone else just happens to be more important at the moment.

Anonymous said...

Hi Julie,
I'm writing about medical blogs for a newspaper. This entry was cited in a recent analysis of health blogs in the Journal of Gernal Internal Medicine, and I'm hoping to get your take on it. Please drop me a line at jlite AT and I can fill you in some more, as well as give you a phone number where I can be reached. Thanks very much, Jordan