Do you want to get better?
It’s a simple question, but many patients find it almost impossible to answer. It is part of the reason why a great number of doctors are hesitant to prescribe medication that patients need. They don’t want to enable irresponsible behavior. They are worried about what psychiatrists call “secondary gains.”
And what are secondary gains? Well, it’s not fun being a chronic pain patient. All of us know that. But you know what? You deserve to stay home from work. You feel disgusting, like a nuclear wasteland.
Why should you have to go to work? In fact, why should you be required to have a job at all when you feel like death all the time? If anyone deserves disability payments, it’s you. And you know what else? Sometimes you really need an excuse to get out of social obligations. “Oh, sorry, I’m not feeling well. Maybe next time.” Except “next time” turns into ice cream and binge-watching Netflix.
The worst part is that you might not even realize you’re doing it. So much of pain is mentally derived that you can be sitting in the doctor’s office in actual agony, an eleven out of ten on the pain scale, screaming about how nobody will help you, and subconsciously you might be the one creating the pain. You like how the drugs make you feel — you feel normal! — so you make yourself feel worse in order to get them. You make yourself need them. The mind-body connection is a hell of a thing.
Even worse than that? You might like the attention that chronic pain provides. You become a survivor. A warrior. “Things are so hard for Jen, but my God, she buckles down and charges forward anyway!” You like being the brave one, the eternally-suffering Tiny Tim. It makes you special. It gives you a story. It makes you interesting.
I worried for a very long time that I was seeking secondary gains. If doctors can’t figure out why I’m in so much pain, am I really in that much pain? Am I creating an echo chamber in my head? Do I really like suffering? Do I want to get out of get-togethers with friends and family? Do I want a ready-made excuse for any situation?
I don’t want this pain. I want to see my family and friends, to take trips on a whim, and to never go to Stop & Shop Pharmacy ever again. I don’t want to take hundreds upon hundreds of dollars’ worth of medical deductions on my tax return. I don’t want to slather myself in Cryoderm every day. I don’t want to have to work from home instead of having an office job. I don’t want to sleep on a special cervical pillow and hard mattress. I don’t want to go to the chiropractor three times a week. I don’t want to be an advocate for pain patients just because I am one. I don’t want to fear the future. And most of all, I don’t need the story. I want to be interesting for other reasons, not because life dealt me a bad hand in the health department.
I want choices. I don’t want to take advantage of my situation — “Oh, well, I am feeling disgusting today, so I deserve X.” This isn’t to say that I haven’t done that in the past; sometimes it’s just easier to stay home and blame it on my back pain. But I want the choice to stay in or go out. I want the choice to work from home or work in an office. I want the choice of being a person or a patient.
Do I want to get better?