When we think about pain, we must also think about dignity.
January 2023 readings
NPR podcast: Remembering Anarcha, Lucy and Betsey: The mothers of modern gynaecology
Moultrie, F., Shriver, A., Hartley, C., Wilkinson, D., Ewer, A.K., Rogers, R., Adams, E. and Slater, R., 2019. A universal right to pain relief: balancing the risks in a vulnerable patient population. The Lancet Child & Adolescent Health, 3(2), pp.62-64.
Page, K., 2012. The four principles: can they be measured and do they predict ethical decision making?. BMC medical ethics, 13(1), pp.1-8.
This month the readings will challenge you to the deepest core of your biases, and this is exactly what is needed to be safe and inclusive pain therapists and clinicians.
As usual, this month begins with the humanities piece. Please be aware that this piece draws up the history of non-consensual gynecological surgeries performed on Black enslaved women in America by white biomedicalist surgeons.
You may already be aware of the story, but I invite you to come to this as if it were the first time. Allow yourself to feel and observe your thoughts and feelings of urge or action. It might be helpful to have a piece of paper next to you to note some of those things down.
This is both an honoring of the content and the person in the story.
Exploring the humanities is not something you can be told about, it is something you do. As readers of art, we are tasked with the enormous privilege and responsibility of completing the final step of it’s creation - we need to feel something.
This month, the humanities piece is both an illustration and the story of the illustration. You cannot appreciate one without the other so take the time to embrace and take in both.
Illustration of Dr. J. Marion Sims with Anarcha by Robert Thom. Anarcha was subjected to 30 experimental surgeries. Pearson Museum, Southern Illinois University School of Medicine
Here we have an image of an important historical moment in gynecology told through the pen of a white man, but this image is not the full story of events. The podcast episode NPR: Remembering Anarcha, Lucy and Betsey: The Mothers of Modern Gynecology tells the story of the same event but through the experiences of the enslaved women whose bodies and pain were the price paid for the fame and success of Sims.
So this month, you are invited to contemplate this illustration whilst listening to the podcast.
The historical un-truth that Black people experience less pain is still present in healthcare today with Black and ethnic minority children less likely than white children to be offered appropriate pain relief and achieve pain relief in emergency rooms (Goyal et al 2020).
And so, while on the one hand, this is an historical illustration, the context and implications of the events are still felt within pain care today.
This leaves us with an ethical and moral responsibility as pain therapists to explore not only the experience of pain, but who experiences pain? Whose voices have been left out of our stories?
Who in our communities and society still needs us to fight for equity, equality and justice when it comes to accessing pain care?
I leave you with this quote from poet BEttina Judd featured in the NPR podcast:
Sims invents the speculum
I invent the wincing
The if-you-must of it all…
Goyal, M.K., Johnson, T.J., Chamberlain, J.M., Cook, L., Webb, M., Drendel, A.L., Alessandrini, E., Bajaj, L., Lorch, S., Grundmeier, R.W. and Alpern, E.R., 2020. Racial and ethnic differences in emergency department pain management of children with fractures. Pediatrics, 145(5).