I'm Dr. Rock and Roll: Addicted to Pain

“I hurt myself today, to see if I still feel.”  -- Nine Inch Nails

            Why are we so obsessed with pain?

            It’s a train wreck that we shouldn’t watch, but like an auto accident, we can’t help but look. Maybe it’s because it’s not happening to us; then again, maybe it’s because it is a concept that’s so universally relatable. Annoying aspects of our lives are called a “pain,” and the phrase “I feel your pain” has become part of our social jargon.

            Nowhere do we love pain more than in our music. Pain is the backbone of emo music, and the more troubled the artist is, the more we eat it up. When Percy Sledge talks about “When a Man Loves a Woman,” we sing along as though we’re the ones being wronged. The despaired, drug-laden final years of The King himself are the topic of endless fascination. We love to hear about the duality between rock star and lonely, helpless musician. Janis Joplin once famously said, “I make love to twenty-five thousand people a night, then go home alone.” All too often, these people have breathed their last in the embrace of their most reliable companion, heroin.

            Even if it isn’t that dramatic, we want our pained musicians to remain so. James Blunt rose to fame by writing ballads of unrequited love and, in general, the pain that comes with loving others. With notoriety came attention, including some high-quality female attention. Suddenly painless, his music lost its edge, and his fans were the pained ones. With subsequent heartbreak came the return to form – and his fans were treated to a new round of anguish-ridden music. As much as I love Adele, the music just isn’t as good unless it’s accompanied by heartbreak.

            In medicine, the exact opposite happens. We keep pain at arm’s length, an administrative burden that none of us wish to bear. In the 90s, we were told we weren’t treating pain well enough, so we started flooding our patients with medication, only to be blamed for the resulting epidemic. Then, as always, our response was downright Newtonian, an equal and opposite REaction. Regulations on frequency of visits, mandated drug screens, and pain contracts made an unwieldy process cumbersome. There were even studies that suggested that chronic pain medications weren’t any more effective, prompting some of my colleagues to proclaim that they aren’t prescribing pain medication at all, which only compounds the problem. For all the empathy we give when we hear Levi Stubbs’ pained voice in “Baby, I Need Your Lovin’,” we seem to possess a lack of empathy when it comes to the pain of those we’re treating. I never pretend to know how someone is feeling, so I try to give my patients the benefit of the doubt. Do I take precautions? Of course. But to deny someone based on a study somewhere seems ridiculously short-sighted. We are a profession that is supposed to care about people, and when our actions dictate otherwise, that generates distrust. When looking for sources of provider burnout, that may be a good place to start.

            There’s a lot of pain in this world. Not all of us can sing eloquently about it, and perhaps fewer can do anything concrete to take it away. Sometimes, empathy is all we can provide, and as hollow as it sounds, perhaps the most profound thing to say is, “I feel your pain.” Take care of each other. Listen to each other’s stories. And don’t forget to be kind; hurting people hurt people, and often we have no idea what cross the other person is bearing. Peace.