“Doctors hate pain. Let me count the ways. We hate it because we are (mostly) kindhearted and hate to see people suffer. We hate it because it is invisible, cannot be measured or monitored, and varies wildly and unpredictably from person to person. We hate it because it can drag us closer to the perilous zones of illegal practice than any other complaint.
And we hate it most of all because unless we specifically seek out training in how to manage pain, we get virtually none at all, and wind up flying over all kinds of scary territory absolutely solo, without a map or a net.
The events of the last few decades haven’t helped much. First came a consumer-driven “pain power” movement — justified, for the most part — pointing out that pain was wildly undertreated by most doctors. And then, more recently, came the new statistics on the widespread abuse of prescription narcotics, which now saturate street corner markets everywhere and cause more overdose fatalities than heroin and cocaine combined.
In other words, we are now cautioned in the strongest possible terms against giving too little medication and too much, being too free and too parsimonious, underprescribing to the right people and overprescribing to the wrong. Most official guidelines and policy statements, even fuller than usual of vacuous general principles, aren’t of much help in figuring how to do any of this.”