The Meaning of Pain

I have awarded Jenny a Pain ASBO. She is no longer permitted to complain about pain within a 1-mile radius of the hospital.

Before the PASBO, Jenny claimed it was agony each time I took her blood - despite my getting it first time, with a tiny needle, no digging around, in and out in 30 seconds. She found the experience excruciating, despite receiving the "Magic Cream".

The "Magic Cream" is a local anaesthetic that you can rub into the skin, deadening the nerve endings. It's used mainly in paediatrics, mostly because children like the idea of magic.

We all smiled when Jenny requested the cream - especially when she earnestly referred to it as "The Magic Cream". Jenny's a 60 year old lady, and you could hear the capitalised letters in her voice. We stopped smiling when we realised she was serious, and wasn't prepared to have any blood tests without it.

It's easy to envisage a world where hers would be a perfectly normal request. As people emphasise the importance of customer service in medicine, and patients become 'clients', the idea of leaving a customer in any pain at all sounds increasingly ridiculous. The hospital's Pain Team - a nurse-led conglomerate of specialised nurses and anaesthetists - even talks about the human right to be free from pain.

But pain, just like blood pressure and temperature, is a really useful indicator of how things are going. When the pain of the next blood test is the worst thing on the horizon - not the pain of the disease that brought you into hospital - things are actually looking up: you're probably getting better. So, whilst you're cringing at the thought of that needle, the doctor's cringing at the thought of the discharge paperwork.

I don't think being in hospital can ever be a totally comfortable experience. If you really wanted a relaxing couple of days with a good-looking man in a white uniform, you'd book yourself into a spa, not somewhere that looks like Wormwood Scrubs. Still, it needn't be agony. A quick chat with the medical team about how reassuring it is to fear the odd blood test should make things less painful all round.