Saturday, March 29, 2008

The worst pain of my life!

I named this blog 20 out of 10 in reference to the pain score most of my ER patients give me. This is especially frustrating because when I introduce the pain scale to them I tell them that a 10 is "the worst pain you can imagine".

Then they tell me that they are having 20/10.

So this is worse than the worst pain you can imagine? Please tell me how that is possible.

Invariably, these same patients are at the same time asking for something to eat, wanting to know why we don't have TVs in our ER, casually telling jokes to their friend who came along for the ride, and asking for the strongest narcotics they know of, because "it is the only thing that works."

Now I'm not one to deny that somebody is in pain just because they are laughing, and I know that hidden pain exists. I am always telling jokes and laughing, even when I'm in pain or tired or depressed or whatever, but if you are showing me absolutely no signs of pain and then tell me that you pain is so severe that the scale doesn't even contain it, then you are going to have an uphill battle to really convince me.

If you want my sympathy, then tell me that your pain is very severe, give it a realistic number on the pain scale and keep me up to date with how the medications and treatments are working. You be cool with me, and I'll be cool with you. Cool?


annahannah said...


oh, someone today told me that their migraine was a 12.

Anonymous said...

The Pain Scale is a bunch of BS. I work in a large Peds clinic, and we are required to do a pain scale on everyone. On younger kids, I use "a little(1-3), more than a little (3-5), a lot(5-7), a real lot(8-9), or the most pain you ever had (10)"? But even that isn't accurate (when comparing to objective signs).

I have to chuckle to myself when an older adolescent/young adult comes in and says that their sore throat is a 9 out of 10, and yet they are talking normally. Having experienced 10 out of 10 pain, I do my best to refrain from making a smart ass judgemental comment...

Braden said...

Thanks for leaving a comment on my blog. Please stick around. I am going to be posting soon (read: when I get around to it) another post on the pain scale with a link to a stand-up comic's take on the issue. Look for it.