Stupid Faces... I Mean, Stupid Numbers

Every bloody time I go in to the doctor's office - most particularly the ER or the oncology office, a nurse, a doctor, or a janitor asks me what my pain level is, 1-10.

At some time in the past, they used to also show me a little chart with faces attached to each number, which is supposed to help you figure out which number you are at. "1" (or sometimes "0") is a happy face and "10" is crying.

Whether I am in pain or not, I never know how to answer this question. Secretly, I think it is a moronic question in the first place.

If I wasn't in any pain, why would I be sitting in a cold, uncomfortable waiting room for eons, talking to medical personnel, when both of us would rather be outside in the sunshine, eating butterflies or something? So "0" or "1" is already out of the question. But even if we disregard that issue...

How can this chart give any meaningful information to the medical person? I know for a fact that my idea of pain is completely different from another person's idea of pain, that my 3 might be another person's 8, so how can any useful information be gotten from this exercise?

I know this for a fact because once I went to the ER because the giant staph infection in my leg had actually dug so far down into me that it was in danger of actually eating through the bone, so the ER doc had the pleasant task of cutting out all the dead tissue and evil stuff going all the way down through my leg. He did this without anesthesia (by this I mean that he didn't give either one of us anesthesia - my guess is that the process wasn't much fun for him, either). I bit my lip hard and tried not to squeak.

In the meantime, the woman on the other side of the curtain from me was screaming loudly and without pause for breath that she was dying, and why wouldn't anyone help her, her head was going to explode. I'm pretty sure that the nurse dealing with her wished that her head would explode. Instead the Saint of Nursing just kept calmly and patiently telling the woman that she had a very mild ear infection, and the pain would probably go away when the drops took effect in a minute or two.

I think she was probably right, but the woman was too busy screaming to notice that now her ears only hurt because they were getting the full brunt of the intense decibel levels emitting from her own mouth.

My point being that I have had bad ear infections that caused me to vomit every time I moved, and I'd put that on about a 3 level for pain and maybe a 7 or 8 level of unpleasantness (because I hate nausea more than just about anything else), and this woman didn't have anything like that (because she wasn't throwing up, and if her ears hurt that bad she wouldn't have been able to scream like that). The staph infection reaming was much worse than the ear infection pain. But if asked at the time, my bet is that the screamer would have claimed a 10, and I would would have claimed a 6 or 7, tops.

An added complication is that even one's own pain is relative.

For instance, after I gave birth to my son - 36 hours hard labor, most of it on Pitocin, after an entire week of nonproductive but painful contractions every other minute, so that I hadn't slept the entire week - I had to have some X-rays done to make sure they'd gotten all the cancer out of my body two months earlier. I have tiny, rolling, collapsing veins, and the nurses couldn't get hold of any of them in order to inject the contrast dye. The fourth nurse, after fishing around in my arm for five minutes or so and seeing the black bruises blooming on both arms, burst into both apologies and tears. I was very calm and smiling, and just encouraged her to keep trying elsewhere on the arm, that it wasn't any big deal.

And really, at the time it wasn't a big deal. Not compared to the pain of childbirth, which was my yardstick at the time. My bet is that if you'd done the same thing to me ten years later, I wouldn't have been so nonchalant about the whole thing. The pain scale would have been very different.

And now, well, my pain hasn't been the same from one month to the next during this whole ordeal, but my pain scale reportage has been pretty consistent. Because I'm comparing my pain today with my pain yesterday, not with my pain last year. I have a hard time remembering what that felt like. It's been a long time since I wasn't in some pain, so for me that baseline 'normal' pain is now "1" and I go from there.

I doubt I'll ever get to 10 unless they either do major surgery on me without anesthetic, or until my life is in critical danger.

Screaming Woman would be at "10" with my baseline pain now. Because she is used to feeling No Pain, and that is what she expects out of life. Must be nice. I would have envied her, if I hadn't been wrestling so heroically against the urge to tie her in a knot and stuff her feet into her mouth to shut her the heck up.

So unless the only reason they want this information is to gauge your likelihood of erupting into hysterical screaming fits that might frighten another patient into having a heart attack, I don't really see the point of this whole 'Rate Your Pain' exercise.

On the other hand, it did inspire this. Which I think is much more practical as a real gauge. And also makes me giggle, making it doubly effective. I think they should use it in the ER.