In Stephen Fry’s novel, The Hippopotamus, the central character brought comfort to people in the true sense of the word: com = to bring, forte = strength, and during my years in clinical practise seeing distress, illness, sickness and suffering I have given a lot of thought to how best I can comfort my patients because most disease isn’t cured with a few pills. And here I use the word disease in the Shakespearian sense = not being at ease.
I have come to one important conclusion about disease and comfort and that is giving someone a medical label or diagnosis can be the last thing that person needs.
Consider…. You go to the doctor with a bit of back pain. She asks if you have had it before. You admit you have. She does some tests. You might even see a specialist. You learn you have ankylosing spondylitis. And what is more, you discover this is an incurable, degenerative disease. Having labelled you, the rheumatologist discharges you to your fate, or your GP, who prescribes pain-killers. You now know there is a good reason for your pain and it is easy to allow it to be a reason to take less exercise, whereas a physiotherapist should be able to get the sufferer back to normal with a strengthening programme.
I have reason to revisit my theory of ‘diagnoses are bad for you’ theory while I was working with Syrian refugees.
Lots had been through hell and back. Many were bereaved. A considerable number had seen specialists before the war who told them they had ‘a disc’. They’d been given an injection and had been able to buy strong and addictive pain-killers over the counter in pharmacies. Now many had a recurrence of their pain. They been traumatised, then left sitting around, unable to exercise, without anywhere comfortable to sit even. Having be told ten years before that they ‘had a disc’, they were convinced they needed surgery.
No-one had told them that the prognosis for recovery from a ‘slipped disc” is similar whether they have surgery or physiotherapy, and that the label needn’t be part of their life - a fixture. That they had the power to recover completely, with some simple targeted strengthening exercises.
The experience of pain is intimately interrelated with one’s psychological state, and the level of pain even those unfortunate enough to be living with cancer is usually much worse in those with a low mood or depression than those who are at peace with themselves and their loved-ones. So much influences pain.
Some years ago I owned a reasonably sized motor bike and many of my friends also preferred two wheels to four. Motor bikes are not good for the health or longevity and many of my friends had experienced accidents. One had come off his bike on a fast road and, lying on the asphalt, slowly stating to take in what had happened to him, he realised that a truck was approaching at some speed and looked likely to run over him. He got up and ran to safety where his legs gave way. In hospital he discovered that both legs had been badly broken but adrenaline had allowed him to run on them without pain.
Short-lived pain is useful; it has a function. Generally, it is the body saying that you need to pause and rest and heal a while. Whereas pain that goes on mercilessly may be a sign of significant illness. More often it is a symptom of poor lifestyle or emotional strife.
Wouldn’t it be amazing if we knew how to channel control over such pain or at least acknowledge that the path to cure may not be through medicines, scans and tests and specialists.