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by Arthur Rosenfeld
Basic Books, 2003
Review by Patricia Ferguson, Psy.D. on Jun 2nd 2005

The Truth About Chronic Pain

Chronic Pain couldn't be timelier considering how the United States is finally waking up to the issues that millions of Americans suffer from every day. Even though I first read this book as a review book, I had no idea how validating it would be to me personally.  Furthermore, I learned quite a few things about some of the ways to deal with chronic pain. Some of the ways described have already been offered to me personally by my own doctor. However, it took me several years to find this doctor and his physician's assistant, especially considering I live in a small town.

Not only was this book timely for these reasons, but right here in my own small town a doctor has become nationally renowned for his arrest and constant harassment by the DEA. Although he certainly may not have handled his attempt to help chronic pain patients in the best way, he ultimately ended up with a local pharmacist and his wife all being arrested for murder.  Suddenly, no one in a county north of Sacramento, CA, could get a Tylenol three!

I have been working as a psychologist for many years, but one fateful day in 1997 I fell while rollerblading with my son. Little did I know how that one fall would be the ruin of some friendships, my career, and my income. My husband and I decided at the time that our financial situation had changed so significantly that we could no longer own our two houses. We sold both of them at a loss, and unfortunately, the market turned up and up and up, so much so that the very same houses are worth at least three times what we paid for them.

My story is only one of thousands in this county alone. I found out exactly who my friends were and who weren't. It was amazing as it always is, to see who sticks by you in your life when the chips are down.  Other examples besides falling victim to an illness are divorces, deaths or illness such as cancer, and so on. These are not only some of life's trials and tribulations, but they are times of personal growth and, of course, finding out who will be there with you when you are back on your feet again. You never forget those good people.

As Chronic Pain starts with discussing the illness with patients, I myself had often seen patients with some sort of chronic pain. Never in a million years did I think I would be the one in the same position.The difference between my experience, and those of all the rest of the country with chronic pain, is that unlike a divorce, death, or cancer, chronic pain cannot be seen, except on x-ray, MRI, or something related that is not obvious to the casual observer.  And as a result of the invisible disability, those who do not yet suffer from it treat the patient differently than if they DID have cancer or another life-changing illness. In fact, cancer, if cured, is sometimes better than chronic pain, in my opinion, because chronic pain has no cure.

When I traveled out of town, four hours away to San Francisco's well-known spine care hospital, the doctor looked at my MRI and called my husband into the consultation as well. First, he explained that he was surprised I could move my neck! He also explained that my back had so many problems, which he enumerated nonetheless, that the only treatment was medication.  He was well aware of the infamous doctor from my hometown. He said that doctors nationwide were sending money to help that doctor with his legal expenses.

Meanwhile, the issue of medical marijuana was being fought by those who are in the War on Drugs. He said that he would write a report for my hometown doctor so that it would be illegal for him NOT to follow his instructions, since he is the specialist and my doctor at the time was not.

Luckily for me, my doctor followed his instructions without difficulty. He was a slightly older doctor who also had some pain problems and understood what I was going through. Eventually, though, he left, and I sought different help through other doctors I had known in town for years, when I had worked in private practice. Fortuitously, another place was opening in town just to treat chronic pain, and not with physical therapy and psychiatry. Although I had over time received another MRI, and had a new doctor, the radiologist had been unable to see the ten things the pain doctor saw. Unfortunately, the regular doctor got the report first, and told me to "Go home and go to work." Needless to say, I showed up soon after in my pain doctor's office quite upset over this latest occurrence. Once again, my husband was called in and once again, yet another doctor went over my MRI in detail, explaining the numerous reasons why I was in pain, which the radiologist had missed. He said the radiologists often misread MRIs and all too often my experience ended in no treatment at all. I was just lucky I had a specialist to go to.

Chronic Pain begins by interviewing patients. All kinds of pain is covered, and this book is so validating for those of us who have been mistreated by those who do not have chronic pain. It then goes into caregivers of those with chronic pain. The discussion is that opioids are seen as far more dangerous than marijuana. In other words marijuana leads to opioids are considered the "hard stuff." Of course this is not true. If that is true, then so is alcohol and nicotine. The author interviews physicians, scientists, and anthropologists.

There is a "doctor's oath" which is to do no harm, and there is the DEA which puts the fear of jail to the doctors. It's like a catch-22. After several years of this kind of fear, pain management centers started springing up. In my case, I have a regular physician and a pain doctor. Like many other pain patients I have signed a release so that each doctor can communicate with each other. That way, they know that I am not "doctor shopping."

The next section consists of interviews with "thinkers about pain." In this section, philosophical discussions regarding to the pros and cons of treating pain versus drug abusers and arresting doctors are discussed. These "thinkers" are mainly nurses and doctors. All in all, chronic pain is finally being taken seriously, no matter what side a person thinks.  This book should be read by all of those who judge those in chronic pain in a bad way, by those who are doctors, and by chronic pain sufferers. Years ago, when I first became a chronic pain patient, I wish I had such a book to read, and I wish the chronic pain community had been this wise.

 

© 2005 Patricia Ferguson

 

Patricia Ferguson, Psy.D, is a clinical psychologist and author/editor. She has numerous publications, including award-winning Apollo's Lyre. She and her husband and son live in northern California.   She is author of Mean Girls Grown Up (Wiley, 2005).