Читать книгу Why It Hurts - Dr. Aneesh Singla - Страница 11

Medicine is an art as well as a science. When it comes to the care of patients with maladaptive pain, there is a great deal of art involved because the science of pain is still very much in its infancy. Pain is both crucial and complex, nothing to be treated lightly. We must embrace what it tells us, because avoiding it completely simply isn’t an option.

“So what do I do when I get the pain?” asks Bob, a patient with spinal stenosis. “Stop and sit down until it gets better, or push through it?” Spinal stenosis is a narrowing of a region of the spine. In the lumbar spine region, it causes lower back pain and numbness in the legs when you stand or walk too long. Sit down, and the pain usually resolves within minutes.

“This is anything but a no-pain, no-gain situation,” I tell him. “Let your pain tell you when to rest and when it’s okay to get up again.”

Physicians are notorious for tolerating discomfort many others would not as they undergo the rigorous training and punishing hours of medical school, residencies, and beyond. How are we supposed to know when a patient is on the right path when we are treating their pain? Do we draw an arbitrary line somewhere in the sand?

In When Breath Becomes Air, Paul Kalanithi relates the pain he experienced from stage IV lung cancer, and how he pushed through that pain to complete his rigorous neurosurgical training at Stanford.

Though he was rapidly coming face to face with his own mortality, his desire to complete the path he was on was stronger than the pain, simple as that. Kalanithi’s book is a beautiful account of pain faced and overcome. Pain makes us present to our lives in a way that would not be possible without it. One passage illustrates the remarkable relationship between pain, suffering, and meaning:

A bevy of new pain medications was prescribed. As I hobbled out of the hospital, I wondered how, just six days ago, I had spent nearly thirty-six straight hours in the operating room…and even so, I had suffered excruciating pain…Yes, I thought, and therein was the paradox: like a runner crossing the finish line only to collapse, without that duty to care for the ill pushing me forward, I became an invalid.

Kalanithi’s mission to become a healer made it possible for him to accomplish anything in the face of extraordinary pain.