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Many points were brought up on Tuesday night that I found particularly difficult to wrap my mind (and/or brain?) around. I found myself bouncing back and forth, agreeing with one suggestion and then changing to the opposite side of the argument. My difficulty in making conclusions may be mostly due to the incredibly number of factors that go into "pain" - the sensation truly depends on the setting, one’s reaction to the context, and one’s personal biological, psychological, and socio-cultural inner dialogue.

The subject of “treating pain” especially caught my attention. I can’t decide how recent the idea of treating pain as “pain” truly is in our world today. I partially agree with the statement based on my limited knowledge of the history of medicine. However, people have been treating symptoms of diseases forever. Now, whether we would like to actually include pain as a symptom or rather as a result of a symptom (e.g. pain due to inflammation), I’m not sure. But whatever the case, it seems like the goal for a long time has been to actually reduce pain, the physical and mental interpretation experienced by the individual. Maybe a drug given actually does cause a decrease in viral load by some specific effect (whether placebo or not), but the ultimate goal has been to reduce pain, not decrease viral load. Therefore, maybe the treatment of pain in and of itself in our current society is based on the idea that we always try to have answers and explanations for everything. For example, what if someone goes to his/her doctor with some unexplainable pain and then takes some random drug that has been shown to sometimes help in similar situations. Since we don’t know what the caused the pain (if there even was a cause), we also can’t know whether this was simply a treatment of the pain itself or of some underlying factor(s).

The best ways of treating people in pain closely relates to all of this. As someone interested in entering the art of practicing medicine, I found this subject particularly interesting. There seems to be an increasing desire to have explanations, charts, reasoning, and numbers to rationalize what pain is and how people feel it. Money is pouring into inventing new technology to make our hospitals even more state-of-the-art. However, as the posted Time article (“How Real is Your Pain?”) eloquently articulates, the real art may be in trusting our physicians experience and interpretation:

“Medical technology has yet to invent a machine that can look into another's mind to see what he's feeling, or thinking… 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.”

Maybe our medical education system needs to change its approach and focus more on training people to interact and treat individual patients. I don’t know how likely this is, but it’s definitely something I’m going to think about a lot over the coming years…