Elliot Krane: Pain is A Disease

“I’m a Pediatrician and an Anesthesiologist, so I put children to sleep for a living. And I’m an academic, so I put audiences to sleep for free…”

You know you are in for the best 8-minute talk when it begins thus. Elliot Krane is a pain management specialist who makes a crucial statement: “Pain is a disease”.

In my few years in the medical field, in my very limited experience of dealing with chronic patients, I have found chronic pain to be the most frustratingly difficult issue to manage. It is all to easy to put it down to psychosomatic pain disorder and send the patient off for psych evaluations, but I believe that is one form of turfing.

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Sometimes there is little we can do to help. For example, the ordeal of a little old lady whom I encountered in my very first month on the Critical Care Unit will never leave me. A missed diagnosis of Pott’s Spine, this hypertensive, diabetic 83 year old lady with advanced diabetic neohropathy was brought to our hospital when it was too late. Her only son, who lived and worked outside the state did not know how bad things were until she woke up one fine morning to find that she was paraplegic. The son came home a day later and took her to a private practitioner who correctly advised institutional treatment. The son, however, was overruled by his relatives who did nothing to help him out prior to this. The lady was put on woo-based therapy, which, obviously, failed miserably. A month afterwards, she was in our unit, suffering from what appeared to be a pulmonary embolism thanks to her prolonged immobilization.

Things went downhill from there. Such a complicated history meant she was not the best candidate for the surgical intervention she needed. So, whatever we did was directed to make her life a little less miserable. On the instigation of the family we pushed and pushed to the maximal limits and we were successful in managing her each and every symptom. However, she was no better off.

Apparently the nerve compression due to spinal vertebral fracture was causing this and there was little we could do to help her out. Since everything else was being managed, she teetered on the line between life and death for 5 weeks before she finally succumbed to a massive myocardial infarction.

This case showed to me how real a problem pain is. But when it comes to chronic pain, somehow, our inability to manage it adequately means that we transfer the onus onto a psychosomatic manifestation.

Hence, this TED Talk was something I listened closely to, I admire how openly Dr. Krane admits the limitations of the armamentarium we have at our disposal. I admire how he openly admits that pain is a disease. I admire how he infuses humor and joy in presenting an issue which lacks even an iota of the same.

All in all, a TED talk I’d recomment highly.

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