"I understand that you're in pain but..."

This is a phrase that none of my patients like to hear. As soon as you say you "understand", they usually fly into a sermon about how you don't understand because you've never been in such pain like they are now. The other part, the "but", gets people too. Basically, it is my reasons why I am "causing" their pain. And they really don't like that.

Some of the reasons include:

- this is the best thing for you

- I have given you all of the pain medication that I can

Nobody likes those "excuses". Today, I had a patient who drove herself to her physician's office. She was involved in a car accident about 3 weeks ago and has been having increasing pain, numbness and tingling along the left side of her body since then. The physician was worried about a cervical spine fracture (very, very bad). So, in order to transport her in the best way to protect her neck, we had to put a collar around her neck to help her remember to keep it still and we put her on a long spine board (which are very uncomfortable). She was not happy with me for requiring this of her and even after explaining the reasons why (i.e.: keep her neck and back straight, protect the spinal cord to prevent more damage, prevent paralysis, keep her breathing...) she was still not thrilled with me. However, she managed to get on there and lay relatively flat.

The entire way to the hospital (all 8 miles of the journey), she continued to tell me how much pain she was in and that I needed to do something about it. She heard the "I understand you're in pain but..." phrase many times.

In the end, she was transported to the hospital and released into their care. I hope she understands that I was not trying to put her in pain but help her and try to protect her level of activity by preventing further injury. That is all I try to do: help people. I don't like seeing them in pain...honestly...but there are times that nothing can be done about it in a pre-hospital setting. I carry a lot of equipment and a lot of medications but my office is 9' x 6' and there is only so much that I can fit in there and still be able to move. I do the best I can for all of my patients with what I have. When I leave you, I want you to be in better shape/feeling better than when I first met you. Sometimes this is a feasible option and sometimes it is not. But, whatever I do, it is in your best interest and you have to trust me on that one.