Why Can’t We Talk About Pain

When my husband was wheeled into the recovery room after a hernia operation, the nurse leaned over and asked him to give his pain a number between one and 10. I could see him woozy and wincing so I whispered (rather loudly), “Ten! Just say ten!” I wanted him to get much-needed painkillers.

“Miss,” the nurse huffed at me, “he can speak for himself.”

Well that’s the problem. Few of us can express our aches and hurts accurately, particularly when we are in the throes of them.

Last week, I wrote a review of Abby Norman’s memoir Ask Me About My Uterus. It’s about endometriosis, a chronic and debilitating illness triggered by uterine-like cells growing outside of the womb. Women with the disorder have heavy, agonizing periods along with a litany of other symptoms depending on where the rogue cells lurk: bowel and urinary tract disorders, leg pains, and on rare occasions breathing problems if endometriosis lands in the lung.

Lena Dunham, Whoopi Goldberg and Padma Lakshmi are among a slew of celebrities who have gone public with their stories about suffering from this illness that typically gets ignored or dismissed for years.

What struck me reading Norman’s book was more than the information about endometriosis. Yes, this disease needs more attention and more research that will, I hope, lead to better treatments.

But the broader message is about communicating pain. Our language for letting doctors know how we really feel is so limited. Stabbing? Throbbing? A two? A ten? To be sure, the smiley faces can help young children communicate the level of their discomfort—pointing to sad face or cheery one may be easier than talking to a grown-up.

David Biro, in Listening to Pain: Finding Words, Compassion and Relief elaborated on this issue. (Biro, by the way, has got an M.D. and did his Ph.D. studying the language of pain.) All of us have had something hurt at some point—some of us worse than others—but without explicit words it’s often hard not only to let our loved ones know how we feel but most importantly it’s nearly impossible to convey these crucial clues to our doctors.

The big push in medical schools these days is learning to listen to patient’s full story (as opposed to simply jotting down lab findings). What we truly need to help doctors and patients understand each other are better ways to express what we are feeling inside. We need to devise a better system so people in pain do not need to rely on their loudmouth wives yelling “Ten! He’s a Ten!”