Let the Truth Be Told About Pain!

Do you remember going to the pediatrician as a child for your vaccinations? Do you ever remember looking at the nurse as she readied the injection and asking her “Is this going to hurt?” Did you ever get back the true answer, something that would go a little like this: “Well, yes, kid, this is going to hurt. After all, usually when a needle sticks through your skin and then a medical substance gets pushed into your body, things kinda hurt. I honestly do my best to make it as painless as possible for you, but given the nature of injections and your own fear, this will definitely feel like more than a little ‘pinch.’ ”

Of course, you almost never got the real answer. Back then, same as now, the truth about pain rarely gets told.

As a cancer patient, though, I want the truth to be told to me about pain. After all, pain makes up an integral part of both my inpatient and outpatient hospital visits. From routine procedures, such as getting blood drawn and receiving injections, to more specialized procedures, such as bone marrow biopsies and catheter exchanges, I spend much of my treatment days undergoing procedures I consider painful.

Yet, only recently, after two and a half months of treatment, did a nurse ever outrightly tell me the truth about the pain associated with a procedure I had to undergo. Lucky enough to be in a clinical trial related to a stem cell transplant, I needed to have some T cells harvested. Since I did not have the proper catheter in place due to a prior exchange, the morning before my procedure I was told that I would need to have the cells harvested through a needle inserted into the veins in my arms. Yet, clearly, my definition of a needle (ie, a small injection needle or one used to take blood) did not accurately depict what awaited me. When I saw the size of the needle to be used for the cell harvest—a needle bigger than I had ever seen, except perhaps in a scene from a diabolical horror movie—I asked the nurse as she readied it, “Is this going to hurt?”

I did not expect her answer. After all, I had become accustomed, perhaps since childhood, to being told that it would not hurt all that much.

To be honest, it is not that no one during my treatment course has ever acknowledged the suffering associated with certain procedures. Rather, prior to this day, when I asked about pain, I would get answers such as, “Well, rather than extreme pain, patients tell me it feels like heavy pressure,” or, “Well, we are going to numb the local area so that you hopefully do not feel pain; if you feel any sharp pain, let us know and we will give you more numbing medicine.” In my mind, the message seemed clear: almost every other patient is able to tolerate the pain associated with this process without taking additional medicine; if you need some medicine to help you get through, you are somehow weaker, not as valiant, more of a bother than they are. In the end, after appearing to contemplate my decision for a few seconds, I always ask for the available relaxation/pain-killing medicine and I always get it. The aggravating part is that I first need to go through the process of being made to feel somehow weak because I am afraid of or do not want to feel the pain; then, only after that, can I get my medicine.

This nurse, though, did not lie to me at all. “It is very painful,” she told me. “Though everyone is different, most patients cry a bit, or at least let out a little scream when the needle goes in. I can easily get you some medicine to help you, though. We simply need to call down for the orders. The procedure may take an extra half hour or so to give us time for the medicine to take effect, but I think it will be better for you. Do you want me to do that?”

Thank you! Thank you! Thank you! You told me the truth about pain! You spared me the physical agony related to the immediate procedure and the subsequent exhaustion that usually haunts me after a hurtful day of treatment. You shielded me from the embarrassment and emotional turmoil of crying and screaming in surprise at the real hurt that this needle would cause. Without humiliating me or making me feel like a bother, you gave me a clear plan to reduce my anxiety about the pain. You did not force me to take any medication, nor did you lead me to believe that I could not make it without the medication; you simply told me that this would hurt and that, if I decided (not you, or the experience of legions of other patients), I could get something that would help me handle the pain.