LIFE Before Death #12: Back to School

2011 August 5

Short Film 12 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing affect palliative care services can deliver to patients and their families around the world.

In “Back to School” we discover that pain education is a not a priority for medical schools in many parts of the world.

Professor Joan Marston (South Africa) reflects; “If you don’t have doctors and nurses who are adequately trained in pain management and how to use the drugs… it doesn’t matter how much morphine you’ve got in the country — it’s not going to get to the patients.”

“When the Institute of Medicine reviewed why we had so much difficulty in providing palliative care and providing access to pain relief,” states Dr Kathleen Foley (USA), “The report began ‘we’ve identified the problem and it’s us’ IE the health care professionals.”

“Pain has never been a priority in the training of medical schools and nursing schools, “continues Dr Cynthia Goh (Singapore).

Dr MR Rajagopal (India) explains how medical students in his hometown of Trivandrum graduate without having seen a single tablet of oral morphine. We see Dr Rajagopal challenging students from Trivandrum Medical College; “Do you think there is something lacking from our medical education?”

Dr Natalya Dinat (South Africa) reflects on testimony from a peer proudly pronouncing that the ward they oversee in a large hospital in Johannesburg is “morphine sparing.”

Liliana de Lima (Colombia) reports ; “When you look at what curriculums are out there for physicians and nurses, they are getting very little training if anything, and most of the countries do not even address the issue of pain evaluation.”

Dr Rajagopal reiterates a key principle during a nurse training session in Trivandrum, “This is the most important definition that we have: ‘Pain is what a patient says hurts’.”

Dr Anne Merriman (Ireland) continues; “In every country I’ve been into the doctors are the biggest opposition, particularly the senior ones who have been trained that morphine is addictive and they think we’re making addicts out of everybody.”

“I personally was afraid of using morphine when I started my internal medicine residency,” admits Dr Sophia Bunge (Argentina), “As if it was a really scary drug to use but it turns out it was really easy.”

“If all the physicians at least have some basic training on how to do appropriate pain assessment,” concludes Liliana de Lima, “I think that would make a difference.”

Featuring Professor Joan Marston (South Africa), Dr Kathleen Foley (USA), Dr Cynthia Goh (Singapore), Dr MR Rajagopal (India), Dr Natalya Dinat (South Africa), Liliana de Lima (Colombia), Dr Anne Merriman (Ireland), Dr Sophia Bunge (Argentina).

If you’ve missed previous episodes, catch up on the LIFE Before Death website…

2 Responses
  1. Dr Shiv Rana permalink
    August 7, 2011

    We should come forward to give training to upcoming medical students regarding pain management. In fact , Pain medicine should be incorporated in Medical Curriculum. Govt should also encourage medical colleges to provide pain education

  2. Dianne Gray permalink
    August 8, 2011

    I agree with Dr. Shiv Rana… we experienced a lack of pain management education and as well, a real lack of understanding about the need for even a basic pain management consult as part of our 32 day hospital stay years ago. My son had been diagnosed with a rare neurodegenerative brain disorder. He suffered profoundly. In working in the pediatric and palliative care field now as a catalyst for change and a communications consultant, I am constantly surprised by how many care providers are nervous about prescribing and/or dosing morphine, especially to children.

    “Work in progress” as they say, but in the meantime, how many children suffer due to a lack of confidence or education on this topic?

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