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After my 13 years of medical training, early in the early 1990’s I was often asked by physician colleagues, “I don’t get it, what exactly is a ‘pain doctor’?” Followed by, “why would you want to specialize in that!?” Those questions used to confound me. But indeed, “pain management” was a new specialty. At that time, it was a new board certifiable specialty.
The real answer to that question is only known to my family and closest friends. But it took me several years to understand it for myself!
I have always been physically active and physically competitive. i.e. Running, biking, lifting. I love competition and trying to improve what God gave me. One night after a long day as a young medical intern, I was training for a road bike race, and I crashed my bicycle. I landed on my right hip, and my head so hard that my helmet broke. Despite trying, severe pain occurred with any attempt to even just stand. Ambulance ride to the same hospital of my internship. I hit so hard, my helmet broke, and my groin was a “10/10 pain”. E.R. exam and x-rays “only showed a small fracture in your pubic bone.” “Shouldn’t hurt much,” said the chief orthopedic resident, with agreement from his attending physician.
I forged on, determined to not let this delay my internship year – a year no one wants to repeat. Incredible pain in my right hip and groin with each step. Sheepishly, I asked if there might be something else wrong. The pain was so severe! I couldn’t take a step, and it had been almost 2 weeks! “You must have a low pain tolerance Javery!” replied my colleagues. It hurt so much I KNEW something was wrong. But I started to doubt myself. “What’s wrong with me?” “Maybe it’s in my head.” Finally, I had enough! I reached that point of “I don’t care what they think!” I demanded additional tests, which revealed an 8-inch fracture of my entire hip and pelvis from acetabulum to iliac wing, and hip socket to the upper outer pelvis!
Like many patients, I was relieved that the test confirmed “it was real!” How ironic! Happy that my pelvis was fractured, and now facing 6 months in a wheelchair so it would heal. It took a CT scan to restore faith in myself. What a shame! Seeking validation from others when I knew something was wrong. That concept to this day is a work in progress. But more importantly, I saw firsthand that medicine needed specialists that ‘LISTENED” to their patients. I didn’t invent Pain Management, but that lesson (and many more after that) helped to teach me not only the gift of empathy, but the harm that self-shame produces. Though it took me years after that to hone the ‘gift’ of listening (something I need to practice every day still). The treasure of offering grace to others. The ability to say to a patient (or my wife, family, and friends) that sometimes “I don’t know the answer, but I will continue to try to help you, if you will continue to try to work with me!”
Dr. Keith Javery
