Friday, February 23, 2007

How Real is Your Pain? -- Feb. 20, 2007 -- TIME

"And now would you please choose a number from one to 10 describing your pain — one being almost no pain and 10 the worst pain imaginable." The ER nurse's voice seemed to trail off as she got to the end of the mandated recitation.


Medical technology has yet to invent a machine that can look into another's mind to see what he's feeling, or thinking. No doubt the body, with its physical brain, responds physically to noxious stimuli. But the non-physical mind is yet the only realm in which the bad experience of suffering exists. Mind and brain are mysteriously related. Lobotomized or drug-loaded patients can still answer questions. Stick one with a big needle and ask: does it hurt? Yes, it does, doctor. You can get him to report a VAS number. They might even withdraw from the needle. But there is no grimace, no groan. They certainly feel pain — but they don't care. And they don't need pain medicine.

There is, however, a mind-reading machine that certain doctors and nurses can use in cases like Charlene's and Jacob's. Its use is frowned upon by many in administrative positions and specific measures to render these machines useless, most notably long forms, committee meetings and menu-driven care algorithms, are being implemented with increasing ferocity. It is only this machine that can make rational and humane treatment decisions for the suffering though. It is, in fact, only this machine which suffers. See past the ones that beep and blink; the mind remains our most important machine in medicine.,8599,1591681,00.html

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