What does pain look like?

painrachelle3There’s a terrible misconception that if a person is in pain, it would be visible to the people around them. And it’s a misconception and a bias that those of us living with chronic pain and arthritis confront regularly. From judgements on whether we’re worthy of disability access and parking, to people second-guessing our illness, it’s never-ending. But why do people believe that they can see another person’s physical pain? I still haven’t figured out where the idea that pain is always outwardly visible comes from, and it does a lot of disservice to everyone. Not to mention, it can be outright dangerous.


A couple weeks ago, I was confronted with how the misconceptions of what being in pain looks like can cause harm. And not for me, but for my daughter.


My little girl (age four) fell off her bike. She has been working hard at learning to ride her new, bigger bike, and I was letting her pedal around the sidewalk while I worked in the garden. When she fell, like any other four year old out there, she cried. But, in a move that was unusual for her, she was inconsolable. After nearly an hour of me cuddling, kissing, and offering up her ice pack, I decided it was time for someone else to take a look at her. Her arm was very slightly swollen to me (and trust me, after 11 years of living with arthritis, I’m good at spotting swelling).


Ultimately, I got her to the doctor’s office (a weekend hours urgent clinic), and I got her calmed down. I was especially proud of myself that she was no longer screaming in pain, considering the state she had been in. But apparently, the fact that she was now calm and happy and responsive was a disservice to her care. The doctor didn’t take my complaints seriously. She introduced herself and told me that since my daughter seemed happy she didn’t think it was anything serious. I explained to her why I made the decision to bring my daughter in and that it was out of character for her to be inconsolable.


The doctor didn’t do a thorough exam of my daughter’s arm, rather only making sure she could move her fingers. I now know the exam should have included having my daughter move her arm at the elbow.


Then the doctor didn’t seem to listen when I told her,  “I know my kid, and this is not like her.” At the time, I was feeling frustrated that I wasn’t being heard and maybe even a bit embarrassed that I brought my daughter in for something that the doctor didn’t seem to be too concerned about. But, I still had a nagging feeling in my gut that things weren’t right. In the end, we were sent home with a vague description of “she’s fine, maybe it’s a slight sprain, but she’ll be okay.” I felt as though I had been dismissed as an over-concerned mother, and I just wanted to get my kid home.


So, I got her home and she was still holding her arm close to her body, she was still unwilling to extend her arm fully, she was still not letting me hold it or touch it, and she still was happy, smiling, and playing. After more of the same on the following day, I called the on-call pediatrician for the weekend, and they suggested I bring her in on Monday. Even my own mother, husband, and sister told me that they thought the kiddo was fine because she was willing to play and smile. And every time someone told me that he was “fine” because she was “happy,” I wanted to scream “THAT’S NOT HOW IT WORKS!” Especially because these are people close to me, who know what I go through, it was a hard pill to swallow. Add to that the nagging mom feeling that something was wrong with my kid.


I listened to my mommy intuition and took my daughter to see her own pediatrician. After hours at the pediatrician, and more at the hospital, we did find that my daughter had a fracture near her elbow. My kid had a broken arm. And the urgent care doctors sent us home saying there was nothing wrong.


Even weeks later, any time I think about what happened I get angry. It’s enough of a bitter pill when my own pain is doubted and my own care suffers. But to think that this happened to my child makes me see absolute red.


It’s about time we redefine what pain looks like. Because things like this should never happen.