Unless you are either female, a minority, young, or have chronic pain in which case any mention of pain you have, no matter how extreme, is considered a drug seeking attempt.
The ER will diagnose people based on their race, sex, gender, and age before they’ll diagnose you based on your symptoms. It doesn’t matter how much you are suffering, how much pain you are in, or how close you are to killing yourself because you can’t take it anymore. ER doctors have no empathy unless you fit a certain demographic.
I hurt my back during training and since it really started hurting after-hours I went to the local ER. The same ER all of the serious training incidents go to.
The ER doc eventually said “this seems like drug seeking behavior”.
To which I responded. “No shit. I didn’t come in here for a hug. I need muscle relaxers and pain meds so I can fake it through PT in the morning.”
Which hilariously worked? He gave me what I needed and I left.
As a former heroin addict (clean for a decade at least) I am terrified to be treated that way.
I’ve made it clear to anyone with any decision making ability in my life that unless they say, “he’s dying, there’s no hope.” they are to refuse opioids even if I’m begging and pleading.
Doctors don’t know I feel that strongly about it, but they can pull up my chart and see that I’ve been a junkie in my life. I hate that.
My son wears a medical bracelet that says no opioids except for end of life palliative care.
He fought too long and too hard to get sucked back into addiction.
I’m happy for you; you have beaten addiction into the past and that’s where it’s going to stay.
Happened to me when I was 18. I had severe Sun Poisoning (extreme allergic reaction to moderate sunburn) and not only was I inconceivably itchy, the pain I experienced was indescribable. Waves of pain so bad THROUGH MY ENTIRE BODY I could only scream and cry. I was shaking and incoherent. My mom was with me the whole day, and was the one who brought me to the hospital. Of course, with my behavior as extreme as it was, the hospital staff let me suffer very loudly in the emergency waiting room because they thought I was a drug addict. My mom, who has worked as a nurse, spent about an hour chewing people out left and right about the situation. I eventually got treated but that was probably the most traumatic experience I’ve gone through my whole life
Is that EPP? My partner’s childhood best friend has one of the worst EPP reactions known to medical literature. I can’t imagine anything that sounds half as bad.
I have this and this is maybe the first time I’ve heard of someone else with epp. I think mine is pretty mild, but it really sucks! I hate the sun!
Edit since I guess this is kinda relevant to discussion: I never had visible symptoms, just pain and extreme sensitivity to temperature /sun when it flares up, so until I was ~16 people told me I was making it up. Finally got a rash at one point and was able to get tests done and was diagnosed.
Please don’t pull an ‘all lives matter’ here. Women and minorities are systemically discriminated by the medical system as a whole. Patient outcomes are statistically better if you fit the correct demographic.
https://www.medicalnewstoday.com/articles/racism-in-healthcare
My mother in her last months was in terrible pain. She, an elderly white woman in Appalachia could not have her pain properly addressed. I had to threaten her care providers in order for her to have barely adequate pain management. “If you don’t see to this right now, I’m going to video her screaming in pain, put your name on it on YouTube and point every media outlet in the tri-state there.” It was literally the only thing that worked.
It’s not a pact to discriminate, it’s that they’re a high traffic area that tries to quickly treat people through the path of least resistance.
That’s great if you have visible, obvious issues like a missing limb. If you have anything internal though, forget it. The bevy of tests they’ll need to determine anything will take multiple days, so as long as you can still walk with assistance they’ll do their best to shove you out the door and tell you to schedule an appointment with your doc, regardless of how much pain you’re in.
I hurt my knee and I couldn’t walk easily even with assistance. They did x-rays and determined it wasn’t broken and said I probably (and that word is important) just sprained it and I would be fine in a couple weeks. The hospital refused to sell me crutches, and when I said I needed them to walk, they told me I could walk just fine because it wasn’t broken. Several months later and I’m still not better and I’ve been told I probably tore a ligament and I might need surgery. Gee, maybe I wasn’t being a dramatic cry baby after all???
https://www.sciencedirect.com/science/article/abs/pii/S0196064423002676
https://www.washingtonpost.com/wellness/interactive/2022/women-pain-gender-bias-doctors/
Individuals who are intersectional in groups that are under prioritized for health care have it the absolute worst.
https://www.tandfonline.com/doi/abs/10.1080/13557858.2021.1899138
Interestingly I saw one study while pulling this up from 2009 that came to the conclusion that there isn’t a major disparity in pain treatment between races and genders, but I think we’ve learned a great deal about the social determinants of health since then, and these more recent studies and articles show the opposite.
It’s less to do with a pact, and more to do with ignorance. Most clinical signs are taught in north America on caucasian skin (though there’s a really neat clinical guide put out I think by St George’s university in the UK that I highly recommend to all health care providers- it’s called mind the gap and it’s free afaik). Additionally, cultural and language differences change how people raised in different cultures express pain. Finally, women’s health is probably 50 years behind where it should be because any pain to do with female reproductive organs (and by extension abdominal pain) is often written off even when it’s debilitating.
Add in those natural unconscious biases we carry as humans and no universal pact needed, discrimination happens anyway even with people who don’t realize they are doing it.
For anyone doubting these experiences, I am a US medical student, and implicit biases and racism are big topics we are taught and made aware of due to physicians profiling their patient whether intentionally or not.
This is especially common in the ER where many people without PCPs come in for issues that are generally handled by a PCP. One of the more difficult things that physicians struggle with is balancing time with the quality of care they provide to their patients. Profiling makes the “time” component easy, but obviously that results in very poor quality healthcare.
No one should be doubting people’s experiences of racism and discrimination in the ER and beyond. Doctors are people too, and the bigoted behavior you see in other professions are just as likely to appear with your doctor.
You don’t think age and sex are medically relevant? A 5 year old will scream about a scratch on their knee, but I’ll walk several miles home after making a meat crayon out of myself with my electric longboard and patch myself up.
You speak like someone with no conception of what pain is like outside of your own narrow experiences.
Trust me, lots of us out there would trade being meat crayoned 10 times over to get rid of our painful conditions. You can’t compare other people’s pain to your own if you haven’t experienced what they have. Even then, that’s not an excuse to deny people human pain treatment.
The problem here is that doctors would rather let 9 innocent people suffer to punish 1 drug seeker. You can’t judge how much pain is in by how someone ‘looks’. There is no ‘look’ to pain, especially in people chronic pain sufferers who have mastered the art of suffering unendingly without writhing on the floor because that’s not an option while going out in public.
I have been permanently in pain for 4 years, to the point where I have forgotten what painlessness feels like. Everyday, I wake up to a body that felt like it was sunburned for hours, fell down 3 flights of stairs, and ran 10 miles after. Everything fucking hurts and the smallest bump onto furniture feels like being stabbed with a knife. And yet, I go to the grocery store holding every whimper and tear in because I can’t shop if I’m busy writhing in pain. People see me and think I ‘look fine’ and have no idea the suicidal levels of suffering that come with invisible disabilities. Please don’t be one of them.
I’m really sorry to hear about you dealing with this. I have trigeminal neuralgia, which is an extremely painful nerve condition in the face. Thankfully, I finally found a medication regimen to keep the pain to a minimum where (supplemented with cannabis) I can handle things. But recently, I’ve been going through a mystery health issue and one possible cause is a reaction to one of my medications. It’s unlikely, because I’ve been stable on them for so long, but the only way to find out for sure would be to stop taking both of them and then only take one to see if the symptoms go away. And I don’t know if I can handle that because I was at your level a few years ago and I don’t think I can go back there.
I don’t wish my pain on anyone. Not my worst enemy. And I had to deal with it, like you, all day every day. Excruciating pain. For years. I was even on disability for it because you can’t have a job when you have pain flare-ups that make you scream.
And, also like you, I “looked fine” most of the time. Only my wife learned the signs of when I was in lots of pain in public and got me out of there. Because you can’t function at all if you can’t “pass” as being healthy.
So, again, I am really sorry you have to deal with it. I sympathize 100%. I hope you find a solution. It took me years, but I finally found one.
I was once in the emergency room for hyponatremia and you know how in triage, All the patients are in one huge room But no one can see each other because all the beds are partitioned off with curtains So we have some illusion of privacy in there.
anyway I overheard this twenties-something well-composed polite Caucasian male trying to explain to the doctors that he’s in pain and he needs medication and it was fascinating to listen to because I could tell the doctors had to use all their analytical judgment to determine whether or not he was really in pain or if he was just seeking the good stuff like benzodiazepines for the high (or whatever drug or effect theyre seeking, I dunno) Ultimately the doctors sent him away with Tylenol.
I experience pain on a scale of seven sometimes it wakes me up in the middle of the night It hurts so bad, and all the doctors give me is Tylenol and I can tell you it does nothing to numb the pain, but I have no desire to seek anything stronger than Tylenol because yeah reasons because I don’t want to become addicted to the good stuff I guess. I’ve heard and read and seen too many stories of people caught in that spiral and life is hard enough already and I don’t want to deal with benzodiazepine addiction on top of all the other shit life throws at me.
Weird. When I was 5/6 I split my head open and didn’t make a sound while got stitches done on my fucking forehead.
Good for you. When I had migraines, I was in so much pain I repeatedly banged my head onto the wall until it was bleeding and then kept going until I was too tired. Then I would sit there and cry silently because my vocal cords were spent and breathing made my head hurt, until I reached postdrome.
I don’t know what point you’re trying to make. If you think this is a pain tolerance issue, I don’t think you know how pain works. Consider this, people experience pain subjectively and you can’t ‘see’ how much pain they are in because it’s not measureable by any metric, let alone facial expression. The 1-10 pain assessment chart is the biggest joke in the chronic pain community.