If you ever wondered whether sticks and stones can break your bones, I can tell you they do. I was trying to pass another cyclist on a crowded bike path near my house when he suddenly turned left in front of me. I avoided hitting him, but my bike struck the corner post of a city bus stop while I flew over the handle bars. After I landed on the ground, I couldn’t move my left arm. When the paramedics put me in the ambulance, they warned me that the road to the trauma center was littered with potholes. They could not give me anything for pain, but I could curse all I wanted. At the ER, the doctor told me I had shattered my left wrist, broken a rib and three vertebrae in my neck, torn my left vertebral artery, and punctured a lung.
After six days in the hospital and one four and a half hour surgery, I returned home wearing a cervical collar and an external fixator. I felt as though someone was inflating a prickly cactus inside my arm then pouring hot coffee on it. I needed generous amounts of hydrocodone to keep the pain at bay. Every time I saw the hand therapist over the next three months, he asked me to rate my pain on a scale of one to ten. A “four” never seemed to adequately describe the prickly cactus in my hand or the tearing feeling in my fingers as the therapist forced them to bend in a direction they did not want to go. After a while, I found myself picking a number just to satisfy him. I really wanted to say “today the pain is there, but I can handle it” or “that hurts like a @*%!.” My mental state affected my pain number more than the intensity of the pain did. Some days the pain got me down, but other days I knew that the only way to get better was to push through no matter how much the exercises hurt. Some days the best pain medicine was sitting in the swing in the back yard listening to my iPod. I knew the burning and prickly feeling in my wrist would stop someday, but I had no idea when that day would come. Riding a hundred miles or running in a fifty mile trail race hurts too, but I know when that pain will end.
We can digitize and quantify our patients’ health as much as we want, but we must always remember to ask them how they perceive what is happening to them.