Over the years the people of Kashmir have probably become the most pain-conscious people on the face of the earth. For years we have had it drummed into us – in print, on radio, over television, in everyday conversation- that any hint of pain is to be banished as though it were the ultimate evil. As a result, we are becoming a nation of pill-grabbers and hypochondriacs, escalating the slightest ache into a searing ordeal.
We know very little about pain and what we don’t know makes it hurt all the more. Indeed, no form of illiteracy is so widespread or costly as ignorance about pain – what it is, what causes it, how to deal with it without panic. Almost everyone can rattle off the names of at least a dozen drugs that can deaden pain from every conceivable cause- all the way from headaches to hemorrhoids. There is far less knowledge about the fact that about 90 percent of pain is self-limiting, that it is not always an indication of poor health, and that, most frequently, it is the result of tension, stress, worry, idleness, boredom, frustration, suppressed rage, insufficient sleep, overeating, poorly balanced diet, smoking, excessive drinking, inadequate exercise, stale air, or any of the other abuses encountered by the human body in modern society.
The most ignored fact of all about pain is that the best way to eliminate it is to eliminate the abuse. Instead, many people reach almost instinctively for the painkillers – aspirins, barbiturates, codeines, tranquilizers, sleeping pills, and dozens of other analgesics or desensitizing drugs.
Most doctors are profoundly troubled over the extent to which the medical profession today is taking on the trappings of a pain-killing industry. Their offices are overloaded with people who are morbidly but mistakenly convinced that something dreadful is about to happen to them. It is all too evident that the campaign to get people to run to a doctor at the first sign of pain has boomeranged. Physicians find it difficult to give adequate attention to patients genuinely in need of expert diagnosis and treatment because their time is soaked up by people who have nothing wrong with them except a temporary indisposition or a psychogenic ache.
Patients tend to feel indignant and insulted if the doctor tells them he can find no organic cause of pain. They tend to interpret the term ‘psychogenic’ to mean that they are complaining of nonexistent symptoms. They need to be educated about the fact that many forms of pain have no underlying physical cause but are the result, as mentioned earlier, of tension, stress, or hostile factors in the general environment. Sometimes a pain may be a manifestation of ‘conversion hysteria’ – name given to physical symptoms that have their origins in emotional disturbances. Obviously, it is folly for an individual to ignore symptoms that could be a warning of a potentially serious illness.
Some people are so terrified of getting bad news from a doctor that they allow their malaise to worsen, sometimes past the point of no return. Total neglect is not the answer to hypochondria. The only answer has to be increased education about the way the human body works, so that more people will be able to steer at an intelligent course between promiscuous pill-popping and irresponsible disregard of genuine symptoms. Of all forms of pain, none is more important for the individual to understand then the ‘threshold’ variety.
Almost everyone has a telltale ache that is triggered whenever tension or fatigue reaches a certain point. It can take the form of a migraine-type headache or a squeezing pain deep in the abdomen or cramps or a pain in the lower back or even pain in the joints. The individual who has learned how to make the correlation between such threshold pains and their cause doesn’t panic when they occur; he or she does something about relieving the stress and tension. Then, if the pain persists despite the absence of apparent cause, the individual will contact the doctor. If ignorance about the nature of pain is widespread, ignorance about the way pain-killing drugs work is even more so. What is not generally understood is that many of the vaunted pain-killing drugs conceal the pain without correcting the underlying condition. They deaden the mechanism in the body that alters the brain to the fact that something may be wrong.
The body can pay a high price for suppression of pain without regard to its basic cause. Professional athletes are sometimes severely disadvantaged by trainers whose job is to keep them in action. The more famous the athlete, the greater the risk that he or she may be subjected to extreme medical measures when injury strikes. The star baseball pitcher whose arm is soar because of a torn muscle or tissue damage may need sustained rest more than anything else. But his team is battling for a place in the world series; so the trainer or team doctor is called upon to work his magic, reaches for a strong dose of powerful pain suppressants and the pain disappears! The pitcher takes his place on the mound and does superbly. That could be the last game, however, in which he is able to throw a ball with full strength. The drugs didn’t repair the torn muscle or cause the damaged tissue to heal. What they did was to mask the pain, enabling the pitcher to throw hard, further damaging the torn muscle. Little wonder that so many star athletes are cut down in their prime, more the victims of overzealous treatment of their injuries then of the injuries themselves.
In Kashmir, almost, all painkillers are sold without prescription, but the drug, contrary to popular belief, can be dangerous and, in sustained dose can prove potentially lethal. Painkillers are self-administered by more people than any other drug in the world. Some people are aspirin-poppers, taking ten or more a day. What they don’t know is that the smallest dose can cause internal bleeding. Even more serious perhaps is the fact that aspirin is antagonistic to collagen, which has a key role in the formation of connective tissue. Since many forms of arthritis involve disintegration of the connective tissues, the steady use of aspirin can actually intensify the underlying arthritic condition.
Many researches have proved the evidence of a wide range of hazards associated with sedatives and other pain suppressants. Some of these drugs seriously interfere with the ability of the body to metabolize food properly, producing malnutrition. In some instances, there is also the danger of bone-marrow depression, interfering with the ability of the body to replenish its blood supply.
Pain-killing drugs are among the greatest advances in the history of medicine. Properly used, they can be a boon in alleviating suffering and in treating disease. But their indiscriminate and promiscuous use is making psychological cripples and chronic ailers out of millions of people.
The unremitting barrage of advertising for pain-killing drugs, especially over television, has set the stage for a mass anxiety neurosis. Almost form the moment children are old enough to sit upright in front of a television screen; they are being indoctrinated into the hypochondriac’s clamorous and morbid world. Little wonder so many people fear pain more then death itself. It might be a good idea if concerned physicians and educators could get together to make knowledge about pain – an important part of the regular school curriculum.
As far the populace at large, perhaps some of the same techniques used by public-service agencies to make people cancer-conscious can be used to counteract the growing terror of pain and illness in general. People ought to know that nothing is more remarkable about the human body than its recuperative drive, given a modicum of respect.
If our broadcasting stations cannot provide equal time for response to the pain-killing advertisements, they might at least set aside a few minutes each-day for common sense remarks on the subject of pain. As for the Food and Drug Administration, it might be interesting to know why an agency that has warned the people against taking vitamins and painkillers without prescription is doing so little to control over-the-counter sales each year of billions of pain-killing pills-some of which can do more harm then the pain they are supposed to suppress.
(Author is a Research Scholar in Chemistry)