PAIN AND THE PATIENT.
Its so easy as a physician to overlook the pain your patient is suffering.And not just think that he is just seeking to be noticed. Ive had a few incidents in the last couple of days which have made me reflect on the pain my patients feel and not just shrug it off as their being unwilling to stand a small amount of discomfort.
Im naturally someone who cannot stand people who whine especially when i see absolutely no reason from my point of view for their crying or sniffling as the case may be. My mum and sister have given up on the two physicians in the house (my dad and i) who are not moved by their sniffles when they have colds or the aches and pains which to us can be cured with some panadol and rest and not by us putting the kettle to boil for some tea and speaking soothing words of comfort and our undivided attention for the period of time they are not feeling well. To put it in their words we are hard!
Anyway i have this bad habit of classifying pain into categories depending on the degree of injury and patients ive seen in the past who have borne the pain with varying degrees of stoicism. An example is the pain of childbirth, i have seen women in labour a good number of times and i am always pleased when i see a woman in labour who does not "baraje"(behave unruly). My favorite example of women who fit this category are the fulani women. Their capacity to bear pain of any degree is something to be admired.
I once monitored a fulani woman in labour who gave no hint of any pain and had her baby on the bed in the first labour room because she did not as much as make any sound while bearing down. (HInt: Where i practice medicine there is no such thing as anaesthesia in labour the most that is done is what we call pele, pele anaesthesia which is simply someone rubbing your back and saying sorry(pele) over and over again.
In marked contrast to the fulani are the yorubas, they are a sight to behold, many of them not all are so overwhelmed by the pain that they scream, curse, cry and shout till they are exhausted and of course when the time comes for them to push out their liitle one they are tired and need to be given a good dose of encouragement to accomplish the task. You can imagine that they are not my favorite example of people who endure pain.
In dealing with the sexes women seem to be able to bear pain more than men, most men especially the yorubas once again are terrible when it comes to enduring painful procedures or when they have been injured. Its no wonder God chose the woman to carry children and not men, if not who knows what the worlds population would be like!
But coming to my perception of the way people handle pain. I have over the last few weeks been changing my opinion about people and pain all because of the way one of my bosses reacts whenever we are with a patient who seems to be in pain. Left to me alone i would write out a prescription for a pain reliever at first, if the patient still keeps on about the pain i would add another or increase the dosing frequency but that would be my limit.
On the other hand my boss would look at the patient and actually empathise with him, he shows that the person concerned is in pain, telling me to understand that the individual is only reacting that way because he is in pain and looks for other ways of addressing the pain issue. Time and time again i have felt that i have fallen short of a standard when i see the way my boss treats them in contrast to my curt dismissal of their attempts to waste my time with their litany of 'pain' complaints.
The lessons learnt:_
1. Put myself in their shoes, how would i react if i were them? Worse i guess.
2. Try and look for the root cause of the pain and address it.
3. Listen really listen don't just dismiss their cries as people seeking attention.
4. Treat them gently and in addition to my prescription add words of encouragement.
I hope i change, pray for me:)
Im naturally someone who cannot stand people who whine especially when i see absolutely no reason from my point of view for their crying or sniffling as the case may be. My mum and sister have given up on the two physicians in the house (my dad and i) who are not moved by their sniffles when they have colds or the aches and pains which to us can be cured with some panadol and rest and not by us putting the kettle to boil for some tea and speaking soothing words of comfort and our undivided attention for the period of time they are not feeling well. To put it in their words we are hard!
Anyway i have this bad habit of classifying pain into categories depending on the degree of injury and patients ive seen in the past who have borne the pain with varying degrees of stoicism. An example is the pain of childbirth, i have seen women in labour a good number of times and i am always pleased when i see a woman in labour who does not "baraje"(behave unruly). My favorite example of women who fit this category are the fulani women. Their capacity to bear pain of any degree is something to be admired.
I once monitored a fulani woman in labour who gave no hint of any pain and had her baby on the bed in the first labour room because she did not as much as make any sound while bearing down. (HInt: Where i practice medicine there is no such thing as anaesthesia in labour the most that is done is what we call pele, pele anaesthesia which is simply someone rubbing your back and saying sorry(pele) over and over again.
In marked contrast to the fulani are the yorubas, they are a sight to behold, many of them not all are so overwhelmed by the pain that they scream, curse, cry and shout till they are exhausted and of course when the time comes for them to push out their liitle one they are tired and need to be given a good dose of encouragement to accomplish the task. You can imagine that they are not my favorite example of people who endure pain.
In dealing with the sexes women seem to be able to bear pain more than men, most men especially the yorubas once again are terrible when it comes to enduring painful procedures or when they have been injured. Its no wonder God chose the woman to carry children and not men, if not who knows what the worlds population would be like!
But coming to my perception of the way people handle pain. I have over the last few weeks been changing my opinion about people and pain all because of the way one of my bosses reacts whenever we are with a patient who seems to be in pain. Left to me alone i would write out a prescription for a pain reliever at first, if the patient still keeps on about the pain i would add another or increase the dosing frequency but that would be my limit.
On the other hand my boss would look at the patient and actually empathise with him, he shows that the person concerned is in pain, telling me to understand that the individual is only reacting that way because he is in pain and looks for other ways of addressing the pain issue. Time and time again i have felt that i have fallen short of a standard when i see the way my boss treats them in contrast to my curt dismissal of their attempts to waste my time with their litany of 'pain' complaints.
The lessons learnt:_
1. Put myself in their shoes, how would i react if i were them? Worse i guess.
2. Try and look for the root cause of the pain and address it.
3. Listen really listen don't just dismiss their cries as people seeking attention.
4. Treat them gently and in addition to my prescription add words of encouragement.
I hope i change, pray for me:)
Wow. i think you generalized about fulani women here, maybe she had a high threshold for pain. i know you dont do epidurals but childbirth is a natural but painful process wherether you are hausa, yoruba or apanish.
ReplyDeleteNice blog by the way.
my mum's from ogborielemosho, nice town.
thanks inuke the fulani woman is not the only fulani (male and female) i have come across bearing pain almost heroically it seems its a clan thing that to show one feels pain is weak and brings disgrace to the family in question, she was just an example. Thanks for stopping by my blog looking 4ward to reading more from you, tomi
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