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We worship at the feet of pain and pills

Edwin Leap, MD
Physician
March 27, 2013
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I just finished reading Neil Gaiman’s fascinating novel, Gods of America.  I first learned about his work by watching the movie Stardust, then reading the novel.

One of the themes of Gods of America is that the deities of the old world came to America in the hearts of their followers, but over time lose their followers and thus their power.  A war is arranged between the ‘old gods,’ and the new ones that Americans have instituted.  In the story, media, technology, entertainment and others are the new deities for a new age.

I thought about it as I considered my work.  It seems that every day of my life is an endless discussion about narcotics in the emergency department.  Or is it a kind of liturgy to another new god?

“Can’t I get no Lortabs?”

“I can’t take Percocet, all I can take is Dilau, Dilaud, what is it called? Dilaudid? I don’t know anything about those drugs, you know!”

“I’m allergic to the 5mg Vicodin, but I can take the 1omg Vicodin just fine!”

“Somebody stole my Fentanyl patches and my morphine pills, and all of my Oxycontin and all I have left is my methodone, and I only have a few but I don’t see the pain doctor for another month. Now what am I supposed to do, doctor, just suffer?”

“My nerves are torn up.  I’m out of Xanaxes and my brother’s friends came over and stole all of my Klonopin and Valium!  Sure, I still got some Ativan, but look at how I’m shaking!  Oh, and I’m out of Suboxone.”

“See, doctor, I have the degenerating disc disease.  I guess I’ve had chronic back pain since I was, oh, 14.  That’s ten years I’ve suffered!  Nobody will do anything for me, so I just take pain pills wherever I can get them.  Can I get some Percocet?”

I could go on.  It’s dialog in a bad novel.  It’s a sonnet to somnolence.  It’s an endless homage to anesthesia.  It’s all but worship.

So it must be a religion.  The people I see are worshippers of pain medication and anxiety medication.  Or maybe, they worship pain and anxiety, and the offer up the drugs to their deities.  Or perhaps they are slipping into amazing dream states, sleeping all the time, and having epiphanies of wonder and delight.  Scratch that.  They’re dreaming of television and snack food. Of reality shows and disability payments.

And the object, or objects of their worship are taking a terrible toll in lives lost, as epidemic prescription drug abuse sweeps across the land. It’s enabled by a culture that in its own way worships disability and victimization, incapacity and the medicalization of all things.

It makes sense, really.  We cannot possibly suggest that anyone isn’t telling the truth, because a) truth is relative and defined by each person and b) to suggest that would be poor customer service, or discrimination or to be ‘judgmental.’   Furthermore, we reject anything that might suggest an individual take responsibility, or make good moral decisions because morality is relative and faith is irrelevant.

Thus, the internal discord and evil and even legitimate suffering of the human heart must be medical, must be made somatic and mechanistic so that it can be treated mechanistically, and so that no one need concern themselves with uncovering the layers of difficulty and untruth in the human heart, no one need ask hard questions or suggest that one may have guilt or fear for good reasons.  All we want to do is call it a “pain” and offer it a “pill.”

Well there you are, America.  We worship at the feet of pain and pills.  We offer our young and our old and our middle aged and vital to the sleepy gods who accomplish so little and cost so much and offer only restless dreams and ultimately breathless deaths.

I will not worship them.  I hate them.  But I acknowledge their power.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test.

Image credit: Shutterstock.com

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