Hammering Screws
My grandfather was a carpenter and a craftsman. He built entire homes. In his profession he learned and mastered the skill of using tools. As a kid I marveled at the number and variety of the tools he had in his workshop, and it amazed me to watch him go through his collection to find that just right tool for that one specific task. In modern society we seem to have lost that skill.
As our lives, jobs, social systems, and governments become increasingly more complex we seek simple solutions to the problems of life. That’s understandable, because who has time to stop and think through each of the issues we’re expected to deal with? There’s barely enough time to cook a meal or sit and reflect on the beauty of the day.
I remember, as a young doctor, learning that we (the medical community) were expected to see pain as a vital sign. What is the significance of that? Well, if it’s a vital sign then the right level of pain is a factor in the ability of a person to live. Too much pain might kill a person or shorten his life. Okay, that makes sense. But what does too little pain mean? That was never defined. Who hasn’t been asked by a doctor or nurse to rate their pain on a 0-10 scale? It is always implied that zero is the goal, and the medical professionals are taught to eliminate pain. But why should that be so? What about the other vital signs? We measure the body temperature because if it’s too high bad things happen – the same is true if the temperature is too low. Blood pressure is the same. What happens when the respiratory rate goes to zero? So why is it that pain is the only “vital sign” that we obsess about eliminating?
Once we conclude that all pain needs to be eliminated we need a powerful tool to accomplish that task – because pain is everywhere and comes from many different sources, and we don’t have time to stop and reflect to deal with the source. That tool also needs to work quickly. Well, we found the fast acting and powerful tool that is at the ready to do the job – opiate pain medications. And man do they work well – to the tune of eliminating pain in the over 18,000 people per year in the United States that die from overdose. In addition, we cannot even count the number of people whose lives have become dysfunctional wrecks because of the dependence on those substances – I hazard to guess that each of us is connected to one of those people.
Opiates are our hammers and we’re running around pounding screws with them. Screws need to be gently turned to become flush – to fix the break. Not every pain is meant to be quickly, violently eliminated. As a matter of fact, violence is at the heart of pain. I’ve witnessed the violence perpetrated by pain medication, when it is used as a hammer. We need a better tool box.