Tuesday, July 13, 2010

Pain Patient Treatment Misstep on Boston Med


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Is anyone else watching Boston Med on ABC? It's a fascinating look inside some great hospitals. However, I was very disappointed with the way one of the interns treated a pain patient in last Thursday's episode.

As so many of us have experienced when we've had to seek treatment for intractable pain at an emergency room, he started his conversation with the patient by saying, "I'm not giving you narcotics." Had she asked for them, I could understand, but she didn't. You're the doctor, you should suggest the course of treatment, you pompous ass. Needless to say, the patient and her daughter were extremely upset by this. Starting off that way with a patient in pain is insulting and degrading. When someone is in real, ongoing chronic pain and suffering it is very difficult to brush off the ignorance of a new doctor and take it in stride. Similarly, when you're concerned about a loved one you have little patience for the ignorance of a doctor. Unsurprisingly he couldn't understand why they were so upset and refused to deal with her any longer. In my humble opinion he was the worst of what medicine can be.

I had one very bad experience when I wasn't as educated as I am now about the options for breaking an intractable migraine. When I got to that point where I either needed to die or get better my husband took me to the emergency room for treatment. After waiting we were finally taken back to an exam room. The doctor came into the room and verified that I was there for a headache. Not a headache, of course, but I didn't challenge her on that point. Her next statement was, "Well, I'm not giving you narcotics." I hadn't asked for them, nor did I desire them. I simply wanted to feel better and expected a doctor to figure out what might bring about that result. The crazy part was that after it was all said and done she ending up giving me a shot of pain medication. She didn't know about IV meds, which are ordinarily considered the best way to break an intractable migraine. Not only did she have a bad attitude, but she was not knowledgeable.

Since that time I have learned a lot about the better options for treating a stubborn migraine and have had wonderful experiences with knowledgeable doctors at the same ER. I also take a different approach when I need to seek emergency treatment. I bring a copy of my medical information document that lists my doctors and their contact information, my current meds, my diagnoses and other medical history. This is not only helpful to the hospital staff when they are trying to make sure they know what I'm taking and what conditions I have, but I think it also establishes the seriousness of the pain I'm experiencing. Of course I could still be a drug seeker, but a call to any of my doctors quickly establishes that this is not the case. In fact, on more than one occasion the ER doctor treating me has called my primary care doctor to collaborate on the appropriate treatment for my situation, which I truly appreciate. I don't think these steps would have necessarily led to a better outcome with the insulting, ignorant ER doctor. She had a bad attitude and a bias against people who came there for pain. But I'd like to think these doctors are few and far between.

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DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.