Pain Medicine
Posted: Sat Apr 24, 2010 3:51 am
(repost)
I went to the hospital some time about 5 months ago with severe abdominal pain. I didn't know what caused it, and I still don't. It was bad though; I was paralyzed on the floor and on the verge of passing out for about half a minute during the worst of it. The pain became bearable enough by the time I arrived at the hospital and was put in a bed that I was able to force myself to relax. Not long after, two nurses came in and started poking me with sharp things. One poke for a blood test, one to administer a salt-watery solution, etc.
"Now we're going to give you something for the pain" the nurse said. (I'm certainly not accounting it word-for-word but this will be pretty close to how it happened)
I asked what it was.
Nurse: "Morphine".
Me: "I don't want any".
Nurse: "Oh, well I can't give you anything if you don't want me to. But can I ask why?"
Me: "Because I don't think I have any need to take it, at the risk of any possible side-effects"
Nurse: "Are you worried you'll become addicted?"
Me: "No, but isn't it only to make me feel better?"
Nurse: "Well, yes"
Me: "If the only reason you're giving it to me is so I feel better, I don't need it, and I don't want any"
Nurse: "Why did you come to the hospital then? People come to the hospital to feel better"
Me: "That isn't why I came to the hospital. I came to the hospital to BE better."
This is where the conversation took a somewhat philosophical turn. I explained that I came to the hospital for two reasons: primarily to become healthy again, and secondarily to find out exactly what happened so I can avoid it from happening in the future. I explained that my comfort could play no part if it were to affect the outcome of my primary goal even to a trivial extent. Even if it didn't, my comfort was of negligible utility to me, as I couldn't do anything except lie in a hospital bed anyway; I wasn't preforming any sort of task that discomfort would impede. I acknowledged that treatment of pain could be involved in the optimal outcome of my primary goal, but this still does not mean that my comfort is a goal in itself. For example, a patient will tend to fare better over a long period of time with pain medication so that they are able to get adequate rest, as opposed to a patient who is kept awake by his discomfort. In another case, extreme pain like mine might cause involuntary muscle spasms, which could cause further damage to the ailed part of the body. But my muscles were not spasmodic at the time, and at least in the short term, I didn't see any positive health effects from taking pain medication. And there are, almost without exception, side-effects to pain relieving drugs. Even if these are trivial, they are still weight on the optimal healthy outcome. I didn't pretend to know at what point it starts being beneficial to give a patient pain medication, but I gathered from her replies that she wasn't used to thinking about the problem in this way. In light of all this, I asked her to give her best judgement based on her medical knowledge. She couldn't give me an answer either way. So we took what we thought was a safe estimate and decided that I would receive some morphine if the pain became prolonged, or it got worse again.
On reflection, I see this as a parallel to many problems in life, with which I usually take a similar approach. These problems come in all forms, but I'm mainly talking about those that cause emotional or mental pain or discomfort. And with all of it, I think pain medicine is something people are all too ready to snatch up. They might drink alcohol to alter their emotional state, or transplant themselves into a virtual fantasy of World of Warcraft to forget about reality, or rationalize or deny as ego-defensive cures for their cognitive dissonance.
For many people, religion is their morphine. Religious beliefs grant people long-term relief to discomfort or even despair over the conflict between their values and reality such as: mortality; bad people not being punished, and good people not being rewarded; uncontrollable situations; apparent purposelessness of life; unattainable desires; mundanity of humans/kinship to animals; uncertainty and ignorance; lack of caring father figure or other close emotional relationships; lack of authoritative presence; etc. These and others can all be important problems for the emotional well-being of an individual, and they all have the quality of having imperfect solutions. There is no way to absolutely render immortal one's self or loved ones, no way to punish every criminal for every crime, no way to absolutely control forces of nature, no way to be certain about an objective purpose of living, etc., etc.. Religion really is the swiss army knife of emotional painkillers. But just as morphine treats physical pain, a symptom of an illness or injury, religions treat symptoms rather than problems. Religion is a way of ignoring the reality a believer finds himself in using comfortable illusions, to his benefit or detriment. And just like morphine, it can be part of a process to reach a goal, and it has side-effects as well. A side effect could very well be the illusion itself. Pain, more often than we realize, is a good thing, and we feel it because it's a good thing. It's what tells us to take our hand off the stove. Decisions based on illusions are always irrational, no matter the outcome. And because religion too builds up a psychological dependence, it becomes hard to break free of it when it is no longer beneficial. I'm not going to talk about specific benefits and detriments of religion here, but I think the question is the very same one I asked myself in the hospital: At what point do the costs of religion outweigh the benefits, or vice versa?
I went to the hospital some time about 5 months ago with severe abdominal pain. I didn't know what caused it, and I still don't. It was bad though; I was paralyzed on the floor and on the verge of passing out for about half a minute during the worst of it. The pain became bearable enough by the time I arrived at the hospital and was put in a bed that I was able to force myself to relax. Not long after, two nurses came in and started poking me with sharp things. One poke for a blood test, one to administer a salt-watery solution, etc.
"Now we're going to give you something for the pain" the nurse said. (I'm certainly not accounting it word-for-word but this will be pretty close to how it happened)
I asked what it was.
Nurse: "Morphine".
Me: "I don't want any".
Nurse: "Oh, well I can't give you anything if you don't want me to. But can I ask why?"
Me: "Because I don't think I have any need to take it, at the risk of any possible side-effects"
Nurse: "Are you worried you'll become addicted?"
Me: "No, but isn't it only to make me feel better?"
Nurse: "Well, yes"
Me: "If the only reason you're giving it to me is so I feel better, I don't need it, and I don't want any"
Nurse: "Why did you come to the hospital then? People come to the hospital to feel better"
Me: "That isn't why I came to the hospital. I came to the hospital to BE better."
This is where the conversation took a somewhat philosophical turn. I explained that I came to the hospital for two reasons: primarily to become healthy again, and secondarily to find out exactly what happened so I can avoid it from happening in the future. I explained that my comfort could play no part if it were to affect the outcome of my primary goal even to a trivial extent. Even if it didn't, my comfort was of negligible utility to me, as I couldn't do anything except lie in a hospital bed anyway; I wasn't preforming any sort of task that discomfort would impede. I acknowledged that treatment of pain could be involved in the optimal outcome of my primary goal, but this still does not mean that my comfort is a goal in itself. For example, a patient will tend to fare better over a long period of time with pain medication so that they are able to get adequate rest, as opposed to a patient who is kept awake by his discomfort. In another case, extreme pain like mine might cause involuntary muscle spasms, which could cause further damage to the ailed part of the body. But my muscles were not spasmodic at the time, and at least in the short term, I didn't see any positive health effects from taking pain medication. And there are, almost without exception, side-effects to pain relieving drugs. Even if these are trivial, they are still weight on the optimal healthy outcome. I didn't pretend to know at what point it starts being beneficial to give a patient pain medication, but I gathered from her replies that she wasn't used to thinking about the problem in this way. In light of all this, I asked her to give her best judgement based on her medical knowledge. She couldn't give me an answer either way. So we took what we thought was a safe estimate and decided that I would receive some morphine if the pain became prolonged, or it got worse again.
On reflection, I see this as a parallel to many problems in life, with which I usually take a similar approach. These problems come in all forms, but I'm mainly talking about those that cause emotional or mental pain or discomfort. And with all of it, I think pain medicine is something people are all too ready to snatch up. They might drink alcohol to alter their emotional state, or transplant themselves into a virtual fantasy of World of Warcraft to forget about reality, or rationalize or deny as ego-defensive cures for their cognitive dissonance.
For many people, religion is their morphine. Religious beliefs grant people long-term relief to discomfort or even despair over the conflict between their values and reality such as: mortality; bad people not being punished, and good people not being rewarded; uncontrollable situations; apparent purposelessness of life; unattainable desires; mundanity of humans/kinship to animals; uncertainty and ignorance; lack of caring father figure or other close emotional relationships; lack of authoritative presence; etc. These and others can all be important problems for the emotional well-being of an individual, and they all have the quality of having imperfect solutions. There is no way to absolutely render immortal one's self or loved ones, no way to punish every criminal for every crime, no way to absolutely control forces of nature, no way to be certain about an objective purpose of living, etc., etc.. Religion really is the swiss army knife of emotional painkillers. But just as morphine treats physical pain, a symptom of an illness or injury, religions treat symptoms rather than problems. Religion is a way of ignoring the reality a believer finds himself in using comfortable illusions, to his benefit or detriment. And just like morphine, it can be part of a process to reach a goal, and it has side-effects as well. A side effect could very well be the illusion itself. Pain, more often than we realize, is a good thing, and we feel it because it's a good thing. It's what tells us to take our hand off the stove. Decisions based on illusions are always irrational, no matter the outcome. And because religion too builds up a psychological dependence, it becomes hard to break free of it when it is no longer beneficial. I'm not going to talk about specific benefits and detriments of religion here, but I think the question is the very same one I asked myself in the hospital: At what point do the costs of religion outweigh the benefits, or vice versa?