I offer this as an observation not a condemnation of my patients. I was reminded of it as I have had a slight dose of 'man-flu' this week and this has resulted to me getting some abuse for my failure to cope with a minor viral illness.
I have yet to meet a patient who claimed to have a low pain threshold.
It is quite common to be told, with no trace of self-consciousness, how patients are in possession of a high pain threshold. Claiming this particular personal attribute seems to be free of the usual shackles of modesty. I would treat someone who declared their huge intellect or stated how drop dead gorgeous they were with deep suspicion. Similarly, worried relatives will often comment on how stoical their ill one is and how 'they never bother the doctor'. I try hard not to let this irritate me as I realise that patients are just trying to signpost how concerned they are about their problems.
On one level it could be counter-productive. For example, I might be far less inclined to offer pain relief to an individual with a high pain threshold. Ultimately, I believe my patients. If they tell me they are in pain I believe them. I try to understand how that pain is affecting their life. It is not uncommon for doctors to complain they haven't been told the whole truth by patients but I suspect in most cases it might be related to how the question has been asked. I work with heroin addicts on a regular basis and I have hard objective evidence of being lied to on occasions. But I try not to get cynical and I remain prepared to always believe them.
I can't imagine there could be any hope for a doctor-patient relationship without that trust. I guess the 'high pain threshold' patient needles me because I feel the patient is starting from a position of not entirely trusting me to believe them.
As for me, if I suffer from any painful conditions in the future, I am going to 'fess up to being a big girl's blouse, declare my incredibly low pain threshold and hope they admire my honesty as they give me a nice big injection.
An idea!
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I have a suggestion for our latest health ministers. Now, let me see, who
are the health ministers this month? Ah Yes, Mr Andrew 'Andy' Burnham MP and
Mr M...
2 hours ago
6 comments:
Aw, you are just being a man.
(and don't forget that a nice big injection comes by way of a nice big needle!)
Almost certainly a Y chromosome issue here. Interestingly, my wife in her pregnancy was very positive about the delivery as she anticipated her "high pain threshold" would see her through. She readily admits she got it wrong and the next two were much easier with plenty of painkillers!
A friend once said "I'm going to give birth as nature intended..... in a hospital surrounded by doctors and drugs!" I stick to this philosophy like glue - after all, why give us the intelligence to develop them if they are not essential :)
My wife felt the same about it. I always felt there might be a touch of the female version of machismo at work here. The 'I-gave-birth-in-a-yurt-with-only-a-sandalwood-joss-stick-for-pain-relief' brigade can be just as guilty of their own version of macho posturing.
Tolerance of pain is an interesting thing. I've got a chronic condition, so some level of pain is usually present. I may be deluding myself, but I think I have got used to it to some degree, so don't now necessarily reach for painkillers at times when I would have in the past. Or it may be that Y chromosome again...
Beattie - I have no doubt that most people with chronic pain develop coping mechanisms to get through the day and that probably will translate into less medications on occasions. It seems that if you are doing a bit of self-delusion in these difficult circumstances that is exactly what is needed!
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