By Susan Callaway, RN

Do you ever go to a doctor and ask him/her if you are hungry? Do you usually ask a politician if he/she thinks you need a laxative or a new bottle of hot sauce? Do you think you should need a prescription for coffee and buy it from a pharmacy – a cup at a time, of course?

Didn’t think so.

All those things are subjective, and most things in our daily life are subjective. Only you know when you are hungry, and what you might enjoy having to eat or drink. Only you know your body, your schedule and budget. Just think of the difference between supper at home, a meal in a nice restaurant, and what you would get as a hospital patient. At least for now, only the latter is dictated by government regulations and someone else’s idea of what is good for you. You have no control of the time or place, and only a superficial “choice” among pretty much equally unappetizing offerings.

OK, so let’s relate this to pain.

Do you wait for the doctor or, God forbid, a politician to tell you about your pain? Do you need someone else to describe the location, intensity or the nature of your pain? How in the world would anyone else know? Why would their judgment of how you feel be more valid than your own assessment?

There are several different kinds of pain, to be sure, and not all require or respond to the same treatment, but a great deal of the pain most of us experience is pretty straight forward. If we fall down, we have bruises and maybe some scrapes. If we are careless in the kitchen, we can have burns and cuts. The potential for minor accidents and the consequences of occasional periods of stupidity would fill a book. Most of that can be handled with soap and water, band aids, rest and the passage of a little time.

More serious injury and surgery produces more serious pain and other symptoms, which are not at all unrelated. If you’ve ever had major surgery (or injury), I’ll bet you remember vividly the first time you were able to have a normal bowel movement, and how much better you felt afterwards. The narcotic analgesia given in these situations causes a disruption in a number of other body systems and functions, some of them very significant and some fairly subtle. Some can be measured, monitored and treated by others, and some cannot. Only you know if you are nauseated, have no appetite or feel dizzy. Being “stoic” and not sharing these things can bring on more problems. Even worse, if your caregivers ignore your message, or make light of it, you’ll be less apt to confide in them and you will be the one to suffer.

Only YOU know how you feel. Every professional needs to listen to your description of your pain and other symptoms, how and where you feel it, as well as how you see it affecting all of your body and well being. This is the part that is neglected or even rejected all too often – and all too often even by the patients and families themselves because they’ve been convinced that the doctor knows best.

All of this becomes even more important when the pain is very bad, as in some forms of terminal cancer and various neurological conditions. Chronic pain, with no clear cause and which responds poorly or not at all to treatments, is such a vast subject I could write a book on it. I’ve suffered such chronic pain for 53 years now, and studied pain management intensely as a nurse, so it’s something I understand very well.

And then, not at all the least of them, is psychological pain, whether it is combined with physical pain or not. The idea that such pain is “all in your head,” and therefore irrelevant or unworthy of treatment, is one of the greater failings of modern medicine and, maybe surprising to some, a terrible failure of psychiatry itself. Treating pain and suffering as some kind of “mental illness” without actually doing anything to relieve the pain is truly crazy. And treating the “mentally ill” with drugs that just further scramble their brains and body systems is included in my definition of insane.

There are numerous substances, herbs, plants, even chemical “drugs,” which can treat pain. Some are more successful than others, and the effectiveness is very often a matter of context. The environment, both physical and emotional, is probably as important as the source of the pain and the treatment chosen, but are usually the least considered by caregivers and health care professionals outside of hospice.

Finding an appropriate person to assist you in choosing the most effective substance, herb, or treatment of any kind is important, and that is the only proper role for the health care professional in the long run. They understand (or should) the various kinds pain, and know how to ask the right questions so you can give them that information.  They will need a fairly complete medical history in order to spot potential problems with any given treatment. The doctor or other professional needs to inform you and/or your advocates of each potential treatment, their benefits and risks, so you can decide among them. You need to be free to change your mind about treatment or who you trust with it at any time.

And if you decide to find “medicine” without assistance from professionals, then you take on all of those risks and accept the consequences, many probably completely unknown. But it is your life and your body. Only you ultimately have the authority to control your own body and health.

How does this compare to the “health care” you’ve encountered? How does it compare to what we can so clearly see in the near future? You might give some thought to just why that is so frightening. Think about total government control of your health care, your pain, and – increasingly – your appetite and food choice. Think about why anyone assumes that the “president,” or any other politician or bureaucrat, has any legitimate authority over your life, your choices, your subjective feelings and needs.

And then picture yourself going to a politician to ask permission to take aspirin or eat an apple. It could happen.

Next we’ll explore a little of the world of “addiction” and “drug abuse.”