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Pain communication is key


Does everything have to be a short interaction? I can understand the need to be efficient and make sure information gets exchanged, but, I feel like society really has gotten reduced to numbers rather than discussions.


This even happens for some of the most important and vital interactions in our society: doctor-patient interactions. Pain is something that happens to virtually everyone. And yet, how we feel it and describe it can really be cut short.


One of the most common ways that people have to report to doctors about their pain is on a 0-10 (or sometimes 1-10) scale. We say a number, and that means…something. If I say “5” and another person says “5” does this mean that we both mean the same thing?


No. Probably not.


For example, let’s compare someone with no chronic pain to someone with chronic pain. Their baselines and also their maximums are likely different. A 1 for someone with no pain likely just

means nothing, but a 1 for someone with chronic pain may be how well they have gotten used to their pain condition; it’s just a part of life at this point; however, a person with chronic pain could also say that they are just always at 4 and any additional pain (even though it is separate from the chronic pain) just adds to that number rather than getting its own number. And then, what does a 3 mean? Or a 7?


These same sorts of issues would apply to happiness, or sadness, or emotions in general. A 5 might seem low, but maybe that actually means I am doing better than normal.


Instead, why don’t we focus on words? Actual words. The things that were literally created to describe things.



There are many ways this could be of major assistance to the doctor-patient interaction, but I’ll focus on 2 below.



1. More detailed information

I am not saying anything groundbreaking here. Just stating the obvious, but I think the obvious needs to be stated because, for whatever reason, we aren’t doing this currently. Perhaps it would take too much time to…talk to patients. Potentially doctors could get this information beforehand so it doesn’t cut into the visit time which are maximized for profit rather than ensuring the patient is actually well taken care of. All the rants aside, words would give more detailed information.


But, Alex, wait. Words are also imperfect and subjective. Hey, you know what, you’re right. And yet, I still think this is necessary. Let’s compare 3 people this time. 1 person says they are feeling a pain of 5 on a 10-point scale for their hand. 1 person says I am a 5 with throbbing pain and the agony in my fractured hand. Another person says I am a 5 with stabbing pain that keeps beating with every breath in my arthritic hand.


Which of the patients gave the least amount of information? Which patient(s) can you help better having talked to them?


That’s what I thought. But, yes, the point is heard that maybe patients also aren’t ready to explain in more detail and also that doctors may not readily take in the information. Is it so bad to want better for our medical system and to teach patients how to better disclose pain and to teach doctors how to be more interpersonally savvy?


Some medical teams already are implementing this already. At least to some degree. Some doctors and nurses will ask patients to describe their pain. Some will read a checklist of symptoms and let the patient say yes or no to the list. Yet, there is no universal and systematic way that this is done. Or if there is, I have somehow always managed to be accidentally skipped over in this process. This leads me to the next point.