Ironically, I find the pain scale to be one of the funniest things in the world. In the cold, sterile, and unhappy hospital environment, the pain scale looks ridiculous. It’s wacky, silly, and completely oxymoronic. Besides the absurdity of how it looks, it also makes no sense. Why can’t you just tell the doctor how you’re feeling? Do those pictures adequately describe anybodies pain? To begin, who starts a chart with a zero? And besides, if you’re a 0 or a 1, why the hell are you at the hospital in the first place? Even three is questionable. And if you’re a five, shouldn’t the doctor be able to see that? I mean, do you really need to point to the guy crying if you’re actually crying? Pretty much, only three numbers on that scale are actually useful and since everyone in the hospital fits into those numbers, it’s kind of pointless altogether.
In general, pain is such a subjective feeling that a set scale can’t be accurate. Some people live with pain all the time while others cry when they scrape a knee. For example, I barely feel a thing when I get stuck for blood. I’ve been giving blood for so many years that is just doesn’t hurt anymore. But if a doctor ever needs to prick my finger, I get extremely nervous. So you can take blood from my arm no problem, but come near my finger and I curl up like a baby. Pain has as much to do with being used to it as it has to do with what hurts in the first place. People who suffer from sickle cell, cystic fibrosis, or shingles have a much higher tolerance for pain than the rest of us. Their scale starts at a 5 on a good day. And considering the pain scale doesn’t take disease into account, I’m thinking we should get rid of it.
There are also a lot of different ways of dealing with pain. Some people like to play it down either to show how macho they are or because they don’t want others worrying about them. And then some people like to share their pain, either because they are honest or because they are looking for sympathy. I fit into the former category, although definitely not because I’m macho. I’m one of these people who always says, “I’m doing fine,” even if I’m in the hospital. The fact that I’m actually not doing fine now hasn’t changed my attitude in any way. I don’t want people to worry and I think it even helps to tell myself I’m doing fine, even if I’m not. This has always been my preferred way of dealing with pain but in some ways it can be detrimental. For one, it’s not completely honest. Aviva always tells me how stupid it is that I tell my doctors I’m doing ok when I’m trying to show I need a liver. Secondly, it really becomes a problem when your normal doctor isn’t on call or you have to go to the ER. These doctors don’t know that you might be a low-key person and so won’t take into consideration that you are in much more pain than you usually let on.
Maybe a pain scale works in pediatrics where a kid can’t honestly express his or her pain. But in the world of adult health, it’s kind of ridiculous. Different cultures, different sexes, and different nationalities all deal with pain, well, differently. The scientific sphere is an objective one. But the world of patients, feelings, and pain is entirely subjective. Lets try to keep it that way.
1 comments:
Very funny post. I love the descriptions of each face on the picture.
I've also often thought that the pain scale seems out of place. If the patient is asked to scale his own pain on a number scale, then who needs the pictures? Does a patient look at the picture, and say, "gee, that looks like me, so I guess I am a "7" on the scale after all"?
On the other hand, there is some limited value (which I think you alluded to) such as where the doctor knows the patient well and is scaling the patient against how that same patient felt at other times.
As long as the doctor and nurse puts some thought into how they use this resource (a big if), it can be useful.
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