Friday, March 6, 2015

Physician, heal thyself

This post is about the first chapter in "The Brain's Way of Healing" by Norman Doidge, MD.  Yesterday's post was also about that book. In chapter 1, a pain specialist had an experience of the connection between pain signals and the body's ability to sense danger.  Not all dangers are sensed by the body itself.  


I had a firsthand experience that the brain, all on its own, can eliminate pain, just as I, a conventional pain specialist, had tried to do for patients by using drugs, injections, and electrical stimulation. As long as I didn't move, the pain was zero within about a minute. "When the ambulance came, they gave me six milligrams of IV morphine. I said, 'Give me another eight.' They said, 'We can't,' and I said, 'I'm a pain doctor,' so they did, but when they moved me it was ten out of ten." The brain can shut pain off because the actual function of acute pain is not to torment us but to alert us to danger.


True, the word pain comes from the ancient Greek poine, which means "penalty," via the Latin poena, which means "punishment," but biologically, pain is not punishment for punishment's sake. The pain system is the hurt body's implacable advocate, a reward and penalty signaling system. It penalizes us when we are about to do something that might further damage our already injured body, and it rewards us with relief when we stop.


As long as Moskowitz didn't move, he was in no danger, so far as his brain could tell. He also knew that the "pain" was never really in the leg itself. "All my leg did was send signals to my brain. We know from general anesthesia, which puts the higher parts of the brain to sleep, that if the brain doesn't process these signals, there is no pain ." But general anesthesia has to render us unconscious to eliminate pain; here he was, lying in agony on the ground, and in one moment, his completely conscious brain turned all his pain off. If only he could learn how to flip that switch for his patients!


But it wasn't just movement that posed a danger for Moskowitz. While waiting for the ambulance, he nearly died, because he bled about half of his entire blood volume into his leg, so it ballooned to twice the normal size: "my leg was the size of my waist."


Doidge, Norman (2015-01-27). The Brain's Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity (Kindle Locations 257-271). Penguin Group US. Kindle Edition.


(The chapter goes on to discuss the more complex problem of chronic and learned pain.)


I personally had similar experiences with infected diverticula of the gut.  The alerting function of pain was temporarily eliminated if I deeply, deeply and continuously focused my full attention on it.  It felt like the system knew I didn't need to be alerted if I was paying total attention to the pain, not running from it, not deviating from it.



--
Bill
Main blog: Fear, Fun and Filoz
Main web site: Kirbyvariety


Popular Posts

Follow @olderkirby