Chasing the pain

Dear President Biden,

Laura had surgery on her right shoulder Friday. When the surgeon called me after the procedure to update me he said that when he got in there he could see why she’d been in so much pain.

Laura opted for a nerve block (in addition to the general anesthesia, of course), which she was told would buy her somewhere between 24 and 72 hours of relief from the surgical pain. Well, by the time I got her home three hours after surgery, the block was wearing off. She could wiggle the fingers on her right hand and rotate that wrist. Not good.

And then the pain hit.


It was awful. And of course there’d been the thorough admonitions about only using the oxycodone if the staggered doses of Tylenol and ibuprofen didn’t do the trick, so she dutifully started with the non-narcotic pain meds, eventually notching up to 1 oxy when the pain was at an 8. She/we were chasing the pain well into the night, always staying within bounds on the meds (one really shouldn’t mess with opioids), but definitely resorting to the allowed dose of 2 oxys along with the Tylenol and ibuprofen. Her pain finally, finally settled down some on Sunday and was pretty good yesterday. Today looks to be another matter, but we’ll see.

We were able to get a partial refill on the oxycodone out of the proverbial Fort Knox that is her healthcare system so if she needs it today, she can use it. Although it’s a good thing from a public health standpoint that they’re being super cautious, when someone you love is in excruciating acute surgical pain, the whole routine of reciting the non-narcotic pain relief efforts that aren’t working is quite trying, to say the least.

In addition to the worrying messaging around using too much oxycodone for too long, the various providers also stressed that she should get ahead of the pain, that chasing the pain is not a good thing. Obviously those are tricky, fairly mixed, messages to try and navigate.

Ok, so all of this about one dear, but to you, completely random person trying to do damage control in the suboptimal context of a nerve block failure must seem like a “so what’s her point” topic for a POTUS letter. Well, Laura’s unfortunate pain chasing situation seems akin to some of the points Carl Lozada made in his recent long WP piece entitled “9/11 was a Test. The Books of the Past Two Decades Show How America Failed.” It’s a super long, super heavy piece that I had to read over several days and while there’s a lot packed in, the main thing that’s sticking with me now is how there were all sorts of warnings that an attack from some Middle East group or groups was coming, but we apparently couldn’t muster any sort of proactive response (financial, diplomatic). Lozada’s take is that we refused to see the growing threat for what it was.

Quoting Richard Clarke, author of one of the books he covered, Lozada says:

“Clarke’s conclusion is simple, and it highlights America’s we-know-better swagger, a national trait that often masquerades as courage or wisdom. “America, alas, seems only to respond well to disasters, to be undistracted by warnings,” he writes. “Our country seems unable to do all that must be done until there has been some awful calamity.””

We have done much the same thing around global warming, air, water, and ground pollution, the crisis that is the lack of affordable housing, health disparities, the carceral state, etc. The difference, with these off the rails freight trains though, is that we’re well into full on calamity mode and we still can’t (won’t) muster the will and the grit to do something real about them. We can go bomb the shit out of other countries and then try to “rebuild” them in our image (which, let’s face it, is really stupid on so many levels), but we refuse to take care here even as tens of thousands of people are dying and the planet is on the verge of ejecting most of us. At the risk of blowing the “chasing the pain” analogy, one wonders whether all of this is by design.

May we all be safe from greed.
May we have the will to deal with reality.
May we find the strength to truly take care.
May we accept that chasing the pain is like trying to stop a runaway train – it doesn’t work and people get hurt.

Tracy Simpson

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