Acting Doctor

At 3pm each day on the Hematology/ Oncology Service we attempt to rip ourselves from our wards work to take in a teaching session. It was during one of these sessions that our presenter made this provocative statement: “Pain is not the same as suffering. We can take away a patient’s pain but she may continue to suffer. We may not be able to take away a patient’s pain, but she may yet find a way not to suffer” 

This statement stopped me in my tracks. Each morning we evaluate our patient’s pain, especially important on the cancer service. There is usually a number involved between 1 and 10, giving us a nice clear target to shoot for. When we get that number down to zero, we feel good that the patient is not in pain. And yes, that is a worthy target. But how do you quantify suffering? The presenter offered this definition of suffering “To not feel whole.” 

Patients suffer by being reduced to an illness; they feel less than whole. I once had trouble getting through to patient until I walked into his room without an agenda. We just talked, person to person, not doctor to patient. A doctor can inadvertently cause suffering, the very thing our oath compels us to avoid. At the end of the classic Greek play, Oedipus, the title character is in a great deal of pain, having just gouged his eyes out after realizing he had, despite his best efforts, fulfilled the prophecy of killing his father and marrying his mother. It is a horrific realization and yet he is finally complete in the knowledge of this truth. He is in pain, but he is emerging from suffering. 

The challenge is how we ease not just pain but suffering in others. Or put another way, how do we contribute to another’s sense of wholeness?