I am the doctor of pain these days. I treat it, listen to it, witness it, live with it, and pass it out. Pain seems to wait for me at every turn; the next patient, the next test result, the next meeting, the next issue. When I go home some nights it feels as though I have 10 thumbs, all hammered.
The other morning I saw 12 patients in the office, and all but one was in some kind of mental or physical pain. The lucky one was a child of 2 who needed no shots that day, or she would have had pain, too. But her dad was laid off from his job a few days later, so it turns out the pain was just hiding around the corner.
The worst pain is the psychic pain I cannot fix, whether with words or pills. There is no treating the hurt a teenager feels because she is too troubled for her family to allow her to live at home. I can prescribe more pills than a cloud has raindrops, but none works for the woman whose marriage is falling apart after 20 years and three children. Despite multiple attempts, I have yet to be able to fix someone who wakes up at the age of 48 and realizes his life is in shambles because he just got laid off, his degenerative arthritis in multiple joints makes the physical labor he has done since age 17 now impossible, and he has no high school diploma.
Many of my patients live with chronic physical pain, the kind that works tirelessly to run their lives into the ground. I send them to the pain specialist for injectable magic, to the physical therapist for therapeutic exercises, to psychologists for pain management counseling, to surgeons for surgery and to the pharmacy for their pills. But none of that works enough for long, so they come back to me and tell me what hurts and how much. To see them is to feel their pain; it spills over onto me as they describe how their pain affects them. At the end of a long day of feeling others’ pain, my heart aches, my head hurts and I would just about kill for a patient with nothing wrong.
A close third for the worst pain award is the pain I distribute, because it hurts someone else and then hurts me, too. In recent days as a hospital chief executive officer I have laid off people whom I knew and liked, and decided to close a hospital program that others staffed and loved. I have spread financial pain around to everyone who works there in order to avoid more painful layoffs to a few. The knowledge that this is all for a good cause is like mental ibuprofen, dulling the ache but not taking it entirely away.
There’s more pain to be had outside my office and hospital. Like other states, Maine has a state budget that is in a world of hurt. In the next couple of months, legislators here must cut $800 million out of the state budget that starts July 1, and some of that pain is coming my way. There will be hundreds of thousands of dollars in cuts to my hospital, which will have to cut those dollars out of its hide. Services for the mentally ill and the poor are bound to suffer cuts, and “mentally ill and the poor” includes many of my patients.
Beyond Maine we are a nation in pain. The economic news has been so bad of late I have stopped listening to news on the radio some evenings as I drive home from work because I have enough misery to deal with on my own without hearing about more of it in the refuge of my car.
When all of this pain weighs me down, I take heart from the little sign my wife gave me for my desk that says “Storms always give way to the sun.” Then I remind myself that I have a job and good health, do work that I love and have a healthy family I love, and that it’s time to stop my whining.
Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region. He is also the interim CEO at Blue Hill Memorial Hospital.