Doctors shouldn't be dismissive when patients' pain source isn't obvious

Regarding "Negotiate with patients on treatment of pain" (Column, April 3): In his Ethics Forum column comments, Mark D. Sullivan, MD, PhD, eloquently wrote about the frequency of, and lack of consistent treatment for, noncancer chronic pain.

I became ill several years ago with bilateral and atypical inner ear disease. Moderate to severe ear and head pain became persistent after six months. Many physicians I went to flat-out did not believe me, nor did they offer treatment for it, as "there was no known cause for my pain." As there was no cause, there was no belief in my need for treatment.

This was devastating and dehumanizing to go through. I felt like I was a drug-seeking felon. I was also confused and hurt, as I had always practiced medicine in such as way as to sometimes treat patient symptoms even if testing did not reveal an obvious cause.

The pain interfered with my work duties. I felt even more useless and horrified that I might never be able to function again as the intelligent, successful MD I once was.

I was supremely lucky to finally find an internal medicine specialist who was both wise and compassionate about my rare illness and chronic pain.

We negotiated treatment as Dr. Sullivan has suggested, and I take opioids at night and use biofeedback and imaging in the daytime to control my pain. I have not increased my usage of opioids in five years, and I am back to work. My life now has meaning and dignity.

There is no substitution for a physician validating a patient's symptoms, and I know that most chronic pain patients would love the chance to reduce pain but also be able to independently function and have some quality of life.

I am eternally grateful to my physician for not labeling me, and for believing in my pain and desire to return to work. I think Dr. Sullivan has addressed a problem that most doctors would not like to acknowledge. I praise him for his courage and insight.

Sue Maurer, MD, Haslett, Mich.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/04/24/edlt0424.htm.