Because I got sick of reading newspapers about 5 weeks before the 7th September 2013 and because I was also very busy around that time and I was often throwing them out (even without unwrapping the plastic), I cancelled the paper. I sort of miss it at times – on the weekend, to read the Arts and Entertainment section and the magazine. But I have this great new arrangement with my Mum. I’m not sure where she gets much out of the arrangement, but I am extremely grateful for it. She reads the papers and cuts all the interesting articles out for me and gives them to me in a nice bundle every couple of weeks. A sort of summary of the news. I think a teenager recently signed a deal with a multi-national corporation to do something similar electronically for a squillion dollars.
This morning I am reading The Last Word column by Kathleen Noonan- another regular column I DO miss- about The Messy Art of Conversation (Courier Mail, January 18, 2014). Kathleen was discussing the difficulties young people seem to be having about connecting with other people simply through conversation. Of course, technology is to blame – Facebook, texting, computers, Twitter – the same culprits that are the favourites when analyzing the apparent disintegration of society as we know it.
Connecting with patients through conversation is also an important way to extract vital information when assessing patients’ conditions, particularly with patients suffering chronic pain. Very often the important words have to be teased from the sufferer in a process of gentle conversation, because often, the relevance of things that may have occurred many years ago is not immediately apparent to the patient.
Towards the end of the article there was a paragraph that caught my eye. I will quote directly from Kathleen’s article except I have taken some license and changed the ‘hims’ to ‘hers’ because I mostly see ‘hers’. ‘Carl Rogers, one of the most influential psychologists, writes in his book, On Becoming a Person:
‘ If you really understand another person…if you are willing to enter her private world and see the way life appears to her, without any attempt to make evaluative judgments, you run the risk of being changed. You might see it her way, you might find yourself influenced in your attitudes or personality. This risk of being changed is one of the most frightening prospects most of us face …So, the first requirement is courage.
Since seeing so many chronic pain patients over the last two years, I think I have been changed. I always have said in any lecture I do about the pelvic floor that the damage I sustained through the glorious birth of my three magnificent, much-loved (9lb) children has helped me be a better pelvic floor physiotherapist because I personally know all too well many of the conditions that my patients suffer and can therefore pass on, with confidence, the necessary treatment strategies……. in an easy-to-understand way.
But also I know each story I hear from each individual chronic pain patient, influences the way I approach the next patient – it gives me insight, confidence to know some strategies work all the time; some work some of the time and a few work rarely- but may be the very thing that unlocks the puzzle for one particular patient- and solves their pain issue. Our tendency with research is that if there isn’t a large positive result with a treatment strategy across a large cohort of patients, then the treatment strategy isn’t worth promoting. But if that one strategy changes that person’s life and restores the quality to their life by getting rid of the chronic pain- well that has been worthwhile. When patients explain to their partners, their GPs and even their specialists what their management plan involves, it sounds too airy fairy, there must be a peripheral end-organ cause for their pain; but fortunately by utilizing a bio-psychosocial approach to pain management such as with the Explain Pain approach, there is quality research backing it.
It takes courage for patients to divulge their most personal and sometimes harrowing stories to someone who is a complete stranger – a stranger at least at the first consultation. I thank my patients for those conversations, for being so trusting with their personal journey because if I didn’t hear those elements that have probably shaped their pain, it would be harder to help them solve their pain riddle.