There is a patient of mine who suffers terribly from awful back pain. Every time I see her, she enumerates for me the litany of issues that she has stemming from her pain.
Lack of sleep, medication side effects, depression, inability to work, difficulty caring for herself…
Each time I see her she tells me that the pain is excruciating and unbearable. I have no doubt she is suffering. Sometimes patients exaggerate symptoms. She is not.
There is a treatment that may help her. She has never tried it before. If it doesn’t work, she can stop and she is no worse for the wear. Very low risk.
She has no other options. Pain medications did not help, she has tried every last one of them. Neither have injections. Surgery is not possible. All she has left is this.
“Doc. I know my body and I know this will not work for me.”
So each time I see her, I watch her suffering. I see her life shrinking right before my eyes. Yet she remains steadfast in her refusal to try this one thing that may help her.
I wonder why?
Has she been burned too many times? Afraid that if this last hope doesn’t work then she would face a lifetime of despair? Is she just too used to the patient role, realizing that if she gets better that she has to rejoin life again? Does she actually enjoy pain? Has it become a close friend?
Or is it about control? Is it about maintaining that one last bit of control over one’s body when it has failed to obey your wishes in every other respect? A game of chicken of sorts, a dance with pain? See who will push who first off the mountain?
I have asked her these questions. She denies them all as plausibilities. So I sent her away again today, back to her home, with no other hope. I hate that.