The pain in the patient and forgiveness
By Dr. Pepe Valencia
Breaking somewhat with the program that I planned to write in my contributions to Atención, I find interesting to share some of what I have experienced throughout my professional life serving the elderly patients and the terminally ill. I know it will be useful, especially if you take a look to some traditional methods to control pain in those who suffer from it, whether or not terminally ill.
Pain is, in many cases subjective.
Keep in mind that those who live a disease that is considered the cause of pain, whatever its intensity, are human beings with human experiences, which have left some sort of trace or memory in their bodies, in all cells which may not be healed or be forgotten.
When treating a patient in pain, we use the appropriate analgesic based in our knowledge or experience, if doesn’t function, we increase the dosage or even change the drug. There will come a time when opiod use is an excellent alternative, however I keep thinking of the benefit, which would be the treatment of pain from his origin or cause and not merely as a symptom.
In one occasion, I had the opportunity to meet a person of the male gender, with prostate cancer and spinal metastases, who was under morphine to control his pain. I spent perhaps two hours talking to him; thereafter he dared to express a deep guilt feeling for not having confessed to his wife and his family that he had two children out of wedlock and never gave them any care. He shared me he felt guilty for these main reasons: being unfaithful to his wife, cheating other two women and never have provided financial support for the two children he had with them.
I decided to investigate and locate these children and their mothers, talked to them very gently, then talked to his family, especially his wife, letting them know his confession -of course with the permission of the patient-, and we all agreed, first of all that his wife will give him the opportunity to speak honestly and confess that burden. As soon as his other two women came with their children and when all were together, I started an exercise in which I made them know how prone we are to make mistakes in our lives, since we are in the University of Life and then invited them to forgive him. All his children came to him one by one and let him know they did not hold a grudge and forgave everything. Likewise his… women, who expressed their forgiveness by an amazing way. So far nothing was as intense and unforgettable as when the two children out of his marriage, who never saw him, approached, hugged, thanked him for giving them life…
This lasted more than five hours, first speaking with the entire family; making them understand that in many, many cases we work really getting carried away by very basic instincts, without the necessary judgment or thought.
That night this man slept as in many months he had not, and then, his physician decreased the dose of morphine to the point of having a fifth of what it took long before. After three days, he died. Died accompanied by all the members of his family, his children out of wedlock and of course the mothers of them.
You need to dig deep into the life of a human being who suffers from any type of pain, in order to find out its origin, which may be a huge burden of guilt he carries on his back for long, long time.