This is an episode I would like nothing more than to have my family watch it. The story is about a man that has been suffering from chronic pain for 2 1/2 years and is finally at the end of the rope. The writing here is simply brilliant since it examines chronic pain from the perspective of not only House and the patient suffering, but that of his son, wife, and doubting doctors.

Though this story is not a word for word account of my ordeal, it does show very well the impact of unexplained pain has on someones sanity. The episode also shows how doctors view people that are in constant pain starting with their first interaction as well as their continuous interaction. The first thought that goes through one of the doctor’s mind is that he is a drug seeker, this is quickly refuted when it is brought to his attention that he has at home a pharmacies worth of narcotics.

If you have already watched the episode or would not mind spoilers continue to read more about how I relate to this episode. 

At the start of the show we see the patient suffering and he wants nothing more than to end his pain, after 2 1/2 years of suffering and seeing doctors he still has no explanation, the medication has become less effective, and the pain is getting worse. The patient sees no other alternative than to end his own life. This action infuriates one of the doctors causing anger and hostility towards the patient. The doctor could not understand why a man with a wife and son would be a coward and try to kill himself because he is in pain. The doctor cannot understand why this man could not just suck it up for the sake of his family.

The son makes a notable observation when he says, “That isn’t my father, just please let him die.” When the wife wants to take him home with the obvious but not verbalized intention of allowing the character to end his life House agrees. House, who is suffers constant pain of his own empathizes with the character much more than the rest of the staff. This is something that only someone has felt constant pain for an extended period of time can understand. 

In my journey through the past couple of years I found the only one that could truly relate to what I had been going through was my uncle. My Uncle Joe, who was very badly wounded in Vietnam, told me that only someone that has been in a similar situation can relate to the pain that I was suffering. Only my wife Jen could really see the day to day impact that this pain has had on me as well as the impact of doubting doctors and family members. 

In the end we find that the patient suffered from eplisy, however the seizures were in an abnormal place, his testicles. The character lived virtually every day feeling like he was constantly kicked in the groin. This is something that men can relate to far better than women can, however only to a certain point. To truly relate to the character a man would have to be kicked in the groin multiple times a day for two years. Then while suffering this intense pain imagine being treated like you are a drug seeker and or as weak for not being able to “suck it up.” Though the doctors rarely if ever say that to the patients face, those that suffer from persistent unexplained pain know when a doctor thinks that. 

In my situation despite being in intense pain the wait to see a doctor was ridiculous to me, however the doctors felt that if I have had it for a month then what is a week, it isn’t cancer so there is no hurry here are some pain killers. When one month turned into two, two to four, four to eight, the sense of urgency for me to be bumped to the front of the line was all but lost on 99% of the people involved. When surgery was inevitable and we were looking at an extra week before the surgery was to be performed the insurance refused to hospitalize me on the grounds that I had been suffering for so long, what is an extra week? This would make sense to anyone that was not in the pain, or having to watch their husband or patient suffer the way that I did.

I took what you said about dictating my care to heart and gave the pain specialist “university” approach a try. I have to admit I feel somewhat let down. I was told that three blocks would be done, and only two were done. I feel like Dr. T id the same as the pain specialist from Kaiser and abandoned the diagnostic direction and changed the course that we had all agreed upon. I was under the impression that we would block al three sections before moving forward. When two were blocked yesterday and it did not resolve the issue Dr. T referred the block over to you in a very vauge manner. He had a patient on the table and I was not able to get a full understanding of what he was planning or where we were going.

Both myself and the nurse attempted to contact you and Dr. Kroop about what the next step for my care would be. I have been in this hospital room for seven days now and this ordeal has been dragged out for months now. When you left the other day I was optimistic that we were all going to work together as a team to solve this issue. I feel that once the pain specialist got involved, as happened in the past, this team of ideas began to break down. It appears that Dr. T has taken control over the direction of my care and write now the incoherence of this letter is due to the fact that I am in the worst pain I have been in since my arrival here and the worst pain I have been in for some time. I am feeling once again abandoned by the doctors when the slam dunk nerve block didn’t work. I am not sure if there is something wrong with me as a person and if there is a perception that I am exaggerating this problem of my I am not sure if I am fulfilling a profile because of answering the questions incorrectly. I do know that I feel like once again I am left with no more options and the hype and promises of fixing my pain is just that, hype.

I feel foolish now thinking that this was all going to work out. I boasted on how you told me that if you could not figure out this then the world is a big place and you would help me find someone that could. That was the last I have heard from you. I understand that you were out of town and you would not be getting back until today. Dr. Kroop was ready to release me based upon your notes and ready to turn my care over as an out patient to Dr. T. I am hoping that the pain is cloading my perception right now and that this is a communication hiccup.

From my point of view I see yet another path not fully followed through with no clear explanation to why. The heart of the bitterness right now is that I am here in a great deal of pain after being hooked up to th TENS device. The pain is so bad right now I cannot speak. I am frantically doing whatever I can do to take my mind of this pain. I feel that I need to write down what I am feeling and going through because these are the moments that are never seen by the doctor. These are the moments in which I feel abandoned and them moments that make me not trust the pain management route. It wasn’t until I was done with the Physical Therapist before I realized I had been duped into doing something that I have been trying to avoid. You convinced me to let down my guard and to trust the doctors here and that these doctors were looking out for my best interest. Once again I feel like another test subject not a patient.

I found out later that the electro stimulation was not a course of treatment that was agreed upon by anyone outside of Dr. T. When the PT removed the patches I asked him if the elctro stimulation would penetrate any nerve entrapment or scar tissue. His answer was vauge and I had the impression that it was not. Dr. T was pushing the TENS and I feel that he pushed it on me without consulting Dr. Kroop first and am not sure if he contacted you or Dr. F about it. In doing my research today I found that though TENS has been around for some time, it is a new approach to pain management and to symptoms similar to mine, but not mine. This is why I was so gaurded about the pain specialist and their course of treatment.

I honestly feel like I was duped into this course of treatment and the only person that gave me any information on it was my nurse Megan.

I was told that I would be well informed about any treatment and that any treatment options would be discussed between all the doctors envolved and to have a physical therapist read my history, do a short evaluation, and try this treatment on me before we were able to follow the path that we all agreed upon I feel a bit betrayed.

I know this letter is one side and from what I gathered when meeting you I do not want to fill in the blanks without talking to you. I know enough about myself to know that sometimes I get nervous and around doctors and they have disappeared before I could ask all the questions I want.

When I got here I had the feeling that the doctors knew that this was not something I was making up, and that there was something really wrong here. I got the same feeling when I first went to Kaiser. Now I have the feeling that the opinion that this is real is in question and that some how I am doing something to cause the doctors to give up. I know that I am not explaining everything right, because if I were then I would not get this abandonment feeling from the doctors that treat me.

I know I use the word abandon often, and I am sure that someone might think I should talk to a psychologist, but I know I am not crazy and I know this is real and this pain has brought my life to a halt and I just want to get better. I feel lost and I feel like if I stand up for myself and protest treatments like TENS then I will loose this set of doctors too and have to start again.

I have been dealing with this issue for 10 months, I spent 8 weeks on medical leave only to be dicked around by the doctor’s of Kaiser. I came here for a 24 hour hospitalal stay so the needed tests and doctors could be consulted. I have been here for 7 days and have no clear idea when this will be over. I have put my life on hold, my job in limbo, I am spending my last dime on co-pays. When we last talked I felt that you had the best idea of where the problem was and that you were the best hope of fixing it. I feel like I listened to what Dr. T had to say and I trusted him with the nerve blocks. Then I feel like I have been blind sided with the TENS treatment and am horrified that Dr. Kroop might think that Dr. T is write and we should continue with his course of care.

Right now I am in unimaginable pain. I can get my fingers to type and as long as my mind focuses on what they are doing I can cope with the situation. I don’t know where my doctors are. I don’t know what my status of care is. I am in a dark room and cut off. I am afraid to move and the feeling of hope and that this will be resolved is all but vanished. I feel like I am back at the beginning. I feel that there truly is no hope for me and that my resolution is tolerating this pain. Even  that I can live with, but what I can’t live with is being in this dark room, hoping that any minute the nurse will come through the door with a message from the doctor. I have given up that a doctor will come in to talk to me, to ask me what went wrong, and to figure out what to do next so I have something more to look forward that this impending doom. If my only option is the route of TENS, and if you and the other doctors have given up, I wish you could let me know now so I can leave this place. Given the rate of increase over the last 10 months of this pain, and the amount of my strength that has been depleted, I truly feel like this is the end of the line and the more I write and the long this letter gets the less hope that someone is going to come through that door and save me becomes.

When I say save me, not fixing me right away or waving a magical wand, but to tell me what to expect tomorrow, to let me know where we are at, what are the results of the test, did Dr. Kroop get a hold of you , are we going to do the final nerve block. The only thing I know is that the PT is coming back to try again. Please understand why I would sooner die than allow that thing to go on me again.

I hope that this is the pain talking and I pray that this isn’t really happening and that you would set me straight and tell me that this is not the end of the line. But nobody is calling. Nobody is coming through that door. Once again, I resign myself to defeat.

I no longer trust doctors when they say they will follow through. I wasted more time and money, risked my job and gone through hell just to have the doctors give up without finishing what they promised to do. I guess you can sympathize a little more to why I acted the way I did in the beginning and why I was reluctant to trust the pain specialist, and why next time I should dictate my care, at least I have a vested interest in following through.

Vincent Clark