Saturday, January 03, 2004


There’s a problem with the term “pain management” obvious from the moment the phrase is heard: It’s a step back from “pain cessation,” which is itself a step back from “curing a problem.”

There are only two pain management centers in the Boston area, and my bad experience with Caritas St. Elizabeth’s Medical Center in Brighton sent me reeling off to the second one, which is in Woburn. The problem in Brighton was the hospital’s “multidisciplinary” approach, which made its form of “management” seem more like “screwing around with.” The approach is reasonable if the source of pain is mysterious or if obvious treatments have failed, but the source of my pain was easily diagnosed, and the most commonly recommended treatment hadn’t yet been tried. Also, my pain had blossomed in autumn, or at least very late summer, so I was hardly a chronic case.

The multidisciplinary approach may be helpful for some; for me, it would have been like cutting my finger and, instead of running upstairs for a Band-Aid, running outside to gather certain herbs that, when boiled in fresh rainwater, could be combined with Xanthan gum and packed around the wound; replace every hour.

St. Elizabeth’s prescribed me two medications in addition to the Vicodin I’m already taking. It also put off the steroid injection it agreed would help me until after I showed up to take a two-hour MMPI and got through a physical therapy session.

(“Gee, doc, as soon as you’re done fucking around with me, would you mind actually helping me with my pain?”)

The Woburn facility (actually part of Winchester Hospital), meanwhile, gave me an evaluation and scheduled the steroid-injection treatment all before even the physical therapy appointment at St. Elizabeth’s. I couldn’t get the injection because I was getting a cold, an infection risk; they scheduled me again for Monday, which is still before the St. Elizabeth’s appointment.

It is a “pain management” center, but not a “multidisciplinary” one.

Still: pain management? When a doctor in Woburn asked me why I had such little interest in medication, I told him it was because I wasn’t really interested in managing my pain. I actually wanted it to go away. While pain management philosophy is understandable for pain that lingers despite treatment, I’m cool to the idea of being thrust immediately into it for the treatment that everybody recommends. You don’t see hospitals breaking off “disease management” or “injury management” divisions.

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