Cicely on Assessing Pain

The concept of total pain

The pain is real

Importance of assessment

The concept of total pain

One patient in particular, a lady whose name should be recorded, a Mrs. Hinson, there were days that I remember saying to her, "tell me about your pain," and without any more prompting from me, she went on to say, "well doctor, it began in my back, but now it seems that all of me is wrong." And she gave a description about her symptoms. And then she went on to say, "I could have cried for the pills and the injections, but I knew that I mustn't, the world seemed to be against me, nobody seemed to understand how I felt. My husband and son were marvelous, but they were having to stay off work and lose their money, but it's so wonderful to begin to feel safe again." So really, she's talked about physical pain, she's talked about emotional pain of feeling shut away and all the emotional burden that she couldn't share. She was talking about social pain, financial in that case, but the impact on her family. And then the spiritual need, I think it is spiritual, of the security, the safety, to look at herself and who she was and just be herself. And then the concept of what I called total pain and really started to lecture about really comes from there.


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