Pain — a wince, a grimace, a cry that cannot be ignored. (photo: Leon V. Kofod)
“You shall lie down in a place of pain” (Is) (photo: Rev. Patrick Mooney)
A physicians view of suffering is tempered by a constant exposure to pain. While philosophers and theologians may ponder the societal value of suffering, the medical doctor must deal daily with the evils of uncontrolled pain, and help to resolve in the individual patient the apparent tension between theological theory and clinical reality.
The control of pain is the fundamental mandate of medicine. The incredibly rich history of medicine possibly the noblest record of human activity is the tale of an endless search for the means to free the patient from the destructive impact of pain.
One of the foundations of modern medicine was the discovery of anaesthesia in the 19th century. Only then could prolonged surgery be performed and complicated childbirth, for example, be managed with care. Until that time pain was always the limiting factor; panic a predictable response; shock or death the inevitable result.
Medicine has evolved as both a science and an art. The ability to measure observations, to objectively record impressions, to devise specific techniques that allow comparisons overtime these are the essential methods of the science of medicine. One can, for example, determine the extent of damage to a heart muscle through the tracing of an electrocardiogram, and measure the amount of morphine required to eradicate the sensation of pain. But in dealing with pain, the science of medicine does not have the tools to measure a victims concerns, or fears, or suffering.
Each patient brings to his or her illness a certain cultural and personal influence. It is through an understanding of the mystery of the patients uniqueness that the good physician practices the art of medicine. This elusive quality of medicine, a most subtle experience, permits the physician to share in the patients suffering while simultaneously alleviating pain.
Last year, our beloved Archbishop of New York and President of the Catholic Near East Welfare Association, Terence Cardinal Cooke, referred to his last few months on earth as a grace-filled time of my life. It was a time when the world watched a saintly man approach death while celebrating life in a series of memorable messages. It was also a time of agonizing pain distilled into edifying suffering. For the physician it was a time when the science and the art of medicine coalesced.
Pain was an evil whose wince and grimace and cry could not be made romantic by any rhetoric; it had to be conquered so that the Cardinal could continue the life he loved and prepare, through prayer and suffering, for the eternal reward he sought. Drugs had to be constantly titrated so that pain could be tolerated without sacrificing the mental clarity so necessary for his final contributions.
The patient who experiences that creative tension between suffering and pain must be sustained by both the art and the science of medicine. Thus, the perspective of the physician is indispensable to even the spiritual assessment of this complex and universal experience.
Dr. Cahill is an internationally known physician and former Special Assistant to the Governor of New York State for Medical Affairs.