23.8.09

If we both cut our hands, the same depth, the same length... whose will hurt more?

There's something that's been troubling me for quite some time now. Since I'm working on a predominantly (and technically) surgical floor, prior to surgery patients will commonly ask how much it will hurt afterward. And fair enough-- it's a legitimate concern when you're about to submit to a complete stranger cutting you open and fiddling with your insides. I usually give a safe and appropriate response which is that there will of course be pain, but that we're usually very good at keeping it under control with appropriate pain medications as ordered by their doctor. What they hear is they'll be drugged and not feel anything. But really what I mean is just that-- under control. Mitigated. Diminished. But not always (usually?) eliminated. There will be pain. How much? I have no clue. I've never experienced it. And even if I had, I still couldn't tell you. I understand why people insist on asking about something so ridiculously subjective and relative, but why do they insist on asking about something so ridiculously subjective and relative?

I don't mean to be insensitive. But removed from the situation of another person in distress or pain, the sensitivity feelings don't come so readily. I'm a reactive person. And there's no stimuli to react to right now. I'm just trying to be upfront about a tricky topic called pain. And pain straight up sucks to begin with: and it's a nightmare when you get all emotional about it.

But back to my troubling. One thing I've pretty much universally observed is that young people are way more intolerant of any shadow of pain than older adults. A 90 year old wisp of an old lady can have the exact same surgery as a prime, sturdy 28 year old man, and yet she'll be smiling and thanking you, and he'll be sobbing and using you as his verbal whipping-boy, hating to his core every fraction of your being simply for being present and a representative of the institution that has traumatized his innards (despite the necessity, and overlooked life-preserving qualities of the procedure). And then of course later on when he's at the max dose of vicodin and a morphine drip he'll still be whimpering, though pretending his earlier abuse never happened.

Now my question about that is this: Do younger people in general just have lower pain thresholds due to higher physical sensitivity (pain receptors presumably encounter some degree of deteriorating with age like the rest of the body), greater general use/abuse of pain killers, or what have you, or are they just more self-consumed and less capable of gratitude towards others or being aware of themselves as being part of something bigger, rather than a whole unto themselves?

Don't get me wrong. Gratitude is not a requisite for me at work as a caregiver. Most of the time I couldn't care less; it makes my job easier on a personal level, but doesn't change all that much in terms of what I do or what I need to say. I have to set more boundaries with ungrateful people-- mainly because they tend to be more abusive and needy to their detriment. But I still need to do the same things regardless of their attitude, because that's my job. I have clearly defined responsibilities and standards of care. (Ugh. When will I stop "being careful" and feeling the need to explain myself when talking about this stuff. WHEN will my readers stop doubting my professionalism!! ;))

But that being said, does anyone else see how ingratitude and being self-consumed, self-pitying, could play into this whole pain relativity thing? It just sets the standards so high, and therefore the pain threshold so low. If that makes any sense. But yeah. Just something I was wondering about in relation to how older adults are so much more capable of handling pain than younger adults. The more I observe it, the more it seems like it's not just a matter of the physical (pain receptors, drug ineffectiveness due to overexposure), but a matter of attitude. And well, older people in general just seemed to have learned that there's more to the world then themselves and their tribulations, and reflect that in their attitude-- not just their attitude towards others, but their attitude when thinking about and perceiving themselves in the context of that greater world.

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2 Comments:

Blogger Krista said...

I couldn't agree with you more, I think it has ALOT to do with self-pity, focusing too much on yourself, and your attitude. I have noticed this with my own pain (I really don't know about anyone else's pain). But with mine, if I am having a bad day, and am wanting to cry anyway (READ: I am feeling sorry for myself) Elijah stubbing my toe by moving a chair can be apparently SO painful. But it's not really. It's just that in reality, I was looking for an excuse to cry, and excuse for pity, etc. Pair this with the experience of giving birth drug-free, and going through 95% of the labor without crying, because I am focused on something else, someONE else. I don't want self-pity- I want a child, so I suck it up and deal with it.

I don't know if that all made sense, but basically I am trying to agree with you and say I have noticed this difference in pain tolerance with myself. Some days it is high, some days it is low. I am convinced it is my outlook.

Sun Aug 23, 03:45:00 PM  
Blogger Unknown said...

Yeah, that makes sense. It seems like it goes along with having an entitlement attitude - if you think life owes it to you to keep you comfortable, you'll become bitter and resentful when it does not.

Part of it too is probably just that young people aren't as used to being in pain, so there's more of a shock factor.. But again it's your attitude that makes you able to deal with the shock or not.

Thu Aug 27, 03:44:00 PM  

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