Pain: a subjective experience.

I consider myself to be a compassionate, empathetic person.  I loathe seeing other people in pain, and do what I can to make it better.  This is why I became a nurse.  And I truly believe that pain is a subjective experience, and that it's an important goal in healthcare to assess and treat pain based on the patient's description of it.

However, I'm also a firm believer in the principle of personal responsibility.  And when 30 year old Man-Baby, "a frequent flyer" in our hospital, comes in YET AGAIN with diabetic ketoacidosis and hypertension because he failed to comply with the medication regimen prescribed to him, I can't help but roll my eyes a bit when I see his name on my assignment in the morning.  And when Man-Baby's mother comes in and offers to spread mayo on his sandwich for him, I roll my eyes again and sigh. 

When Man-Baby flirts with me, tells me that I "smell good", laughs and jokes and chitchats on his cell phone........ and then fives minutes later grabs the nursing aide and tells her his pain is 6 out of 10... and when I go back into the room to investigate, demands his Dilaudid... I have a hard time believing it.  I have a nagging suspicion that he simply enjoys passing his time in the hospital in an opioid-induced stupor.  I have to give him the medication anyway, so long as it is prescribed.  He falls asleep soon after.  He is pleased to be sedated and numbed and relieved of responsibility for his own poorly managed health and life. 

Down the hall is a 70-year-old woman with ovarian cancer, mets to the lungs and liver, who has just today decided to pursue hospice care.  She is in pain from the cancer, and receiving morphine.  She lets me know when the pain is creeping up again, and we keep it under control as best we can without oversedating her.  She welcomes our suggestions for non-pharmacological pain management techniques.  She smiles through the pain, and talks to me about passing on her "famous" lasagne recipe to her granddaughter.  This woman is experiencing physical and emotional pain like Man-Baby cannot imagine, and is doing so with such grace and dignity and gratitude that it puts us both to shame. 

I really don't want anyone to have to be in such pain... but sometimes, on days like today, I wish that people like Man-Baby could have a little taste of it.  Just enough to give him some perspective.  It's not just about the physical pain... but to feel yourself at the end of your life.  No more time.  If he could feel what that is like... maybe it would scare him enough to start taking care of himself.  Or perhaps it would encourage him to quit doping up on pain meds, and to actually get his young and relatively healthy butt out of bed to go to the bathroom instead of using the urinal... to become an active participant in his care.


When I see a young life wasting away like that due to negligence and apathy... it really does hurt.