Pain and Its Consequences : Part 2

Doctor and Patient
by S. Weir Mitchell, M.D.

(Page 5 of 9)

I hardly knew what she meant, but it shows the reigning mood of one who used to better ends a life half pain than most of us use the untroubled health of existence. Very irritable in youth, her clear brain and strong sense of duty overcame it in proportion to the growth of what in others creates it. All opiates she disliked, and could rarely be induced to take them. "If my mind gets weaker, I shall go to pieces - - ;" and, laughing always, "the bits would be worthless as the scattered bricks of a sound house." Surely such a life is a fruitful lesson in the uses of endurance, for be sure that both she and all around her were the better and happier, yes, and she the less a sufferer, for her mode of dealing with a life of pain.

The illustration I have given saves me from dwelling at great length on the values of all the means within a woman's control for lessening the evil consequences of suffering, and if to few is given the largest moral and mental outfit for such a struggle, none are without the power to cultivate what they have, and, in the lesser ills of life, to make use of the lesson we may hope and know few will be called on to apply to an existence such as hers.

Pain of body, hurt of mind, all the sad gamut from discomfort to anguish, depend for their influence on her life upon how nature and training enable the woman to meet them.

To endure without excess of emotion saves her from consequent nervousness, and from that feebleness of mind and body which craves at all cost instant relief. It is the spoiled child, untaught to endure, who becomes the self-pampered woman. Endurance of pain has also its side-values, and is the handmaid of courage and of a large range of duties. Tranquil endurance enables the sufferer to seek and to use all the means of distraction which this woman I have described did use. It leaves the mind free, as it never can be otherwise in the storm of unrestraint, to reason on her troubles, and to decide whether or not her pain justifies the use of drugs, for on her the physician must measurably rely for this knowledge, and as she is morally strong or weak the decision will be.

There are those, indeed, who suffer and grow strong; there are those who suffer and grow weak.

This mystery of pain is still for me the saddest of earth's disabilities. After all is said that can be said on its values as a safeguard, an indicator of the locality of disease, after the moralist has considered it from the disciplinary view, and the theologian cracked his teeth on this bitter nut, and the evolutionist accounted for its existence, it comes at last to the doctor to say what shall be done with it. I wish it came to him alone. Civilized man has ceased to torture, but nature, relentless still, has in store possibilities of utmost anguish, which seem to fall alike on the guilty and the innocent, the poor and the rich, and in largest proportion on the gentler sex.

But while pain is still here with its ever-ready presence, the direct means of lessening it have multiplied so that hardly a month goes by without some new method being added of destroying for a time the power to suffer. For, bear in mind that it is not usually the cause which can be at once destroyed by drugs, but only the bodily capacity to react to it in the fashion we call pain. Ether, chloroform, cocaine, and many other drugs enable us to-day to feel sure that the mass of real pain in the world is vastly less than it was. It is, indeed, possible to prevent all pain, and pain has no real value which we need respect and desire to preserve; at least this is so from the physician's stand-point.

The temptation which comes to us out of the accumulation of anæsthetic agents is one which every tender-hearted man can understand. The temptations which it presents to the suffering they only know who have suffered. To this all that I have said leads up. To most women, even to strong women, there comes a time when pain is a grim presence in their lives. If brief, the wise physician calls upon them for that endurance, of the value of which I have spoken. On some he calls in vain. Even if it recur at intervals, as in the shape of neuralgic headaches, in the name of reason let him be the sole judge of your need to be relieved by drugs. He well knows, as you cannot know, that the frequent use of morphia seems in the end to increase, not to lessen, the whole amount of probable future pain, and that what eases for a time is a devil in angelic disguise. If you are urgent, weak of will, unable through unrestraint to comprehend him, the fault will be only half his, if you plead too eagerly for help and too constantly claim the relief he holds.

But suppose that the woman I address is a long and true sufferer, and that the physician desires to use such help often, then comes her time of peril and his day of largest responsibility. If he be weak, or too tender, or too prone to escape trouble by the easy help of some pain-lulling agent, she is soon on the evil path of the opium, chloral, or chloroform habit. Nor is prevention easy. With constant or inconstant suffering comes weakness of mind as well as body, and none but the strongest natures pass through this ordeal of character unhurt. If the woman be unenduring and unthoughtful, if the doctor fail to command her faith, and be too sympathetic, at last she gets possession herself of the drug, or the drug and the hypodermatic needle. Then there is before her one of the saddest of the many downward paths which lead to destruction of body and soul.

More often, in my experience, the opium habit is learned during an illness of limited duration, and for the consequences of which there is always some one to be blamed.

As I remember these patients, and I have seen them by the score, far on in their evil ways, such women are most often those who lack the power, even in health, to endure pain. Some defect of training or of nature has made pain, or even distress or insomnia, ills to be relieved at once regardless of cost. Let them but feel that relief for the time is possible, and self-restraint is over. They will have the thing they crave. You cure them of the vile opium habit at awful cost of suffering, and they relapse on the first new trial of endurance, and men of their type more surely than women.

I see a good many cases of opium, morphia, or chloral habit, and I am sure that these forms of intoxication are becoming more prevalent than they were a generation ago. Is this due to an increase in the disorders which are eased by such drugs? Is it not rather due to the softening influence of luxury, and the fact that we are all being constantly trained to feel that it is both easy and our right to escape pain, however brief?

About the Author

Silas Weir Mitchell was an American physician and writer. He studied at the University of Pennsylvania in that city, and received the degree of M.D. at Jefferson Medical College in 1850. During the Civil War he had charge of nervous injuries and maladies at Turners Lane Hospital, Philadelphia, and at the close of the war became a specialist in neurology.