Tami Minnier, University of Pittsburgh Medical Center

Find Tami Minnier’s display at Duquesne University.

“Pain doesn’t always look like pain. You might want to say it’s the anguished face, but not always. Some people are stoic and won’t show it. To me, pain is people who are just not themselves.”

My life began as a nurse when I was 19 years old. I was from a small town in upstate Pennsylvania. I was thinking I wanted to be a doctor, but I was a girl. The local guidance counselor said, “Honey, who’s going to raise your children? Your parents don’t have a lot of money, so maybe you should just be a nurse.”

I became a nurse. I loved taking care of people. I remember being very nervous early on giving medications that could actually cause harm to someone. To watch how the field of being in pain has evolved during my career has been an incredible journey. Early in my career I had a patient with lung cancer in excruciating pain. I remember giving them a significant dose of morphine, ordered by the physician. I knew the implications of that. Yet, I knew they needed it to be comfortable. It was scary, but right. Early on, I recognized the impact of pain on life, emotions, and goals.

If people were uncomfortable, we needed to take care of them. I came across people that were judgmental about others who expressed pain. “They’re just looking for drugs.” “They’re just looking to sell something.” “They’re not in that much pain.” I would think, “How do you know?” If you don’t walk in that person’s shoes, you have no idea what they’re experiencing. It doesn’t seem like the job we were supposed to undertake as nurses.

The pain scale has become a task as opposed to a conversation. We’ve burdened nurses with so many required boxes to complete, that they’ve lost the meaning of looking at someone and listening. Technology and tools will never replace the human ear. Pain doesn’t always look like pain. You might want to say it is “the anguished face,” but not always. Some are stoic and won’t show it to you. To me, pain is people who are just not themselves. They may or may not be able to express what they’re experiencing. They have a sense of helplessness, like their world is shut down. If you’ve ever been in pain for any period of time, which I think most of us have, you know you’re not yourself.

Memorial Day 2016 my son’s father passed away. He was 53 years old. He died of a heroin overdose. He had unknowingly taken heroin that was laced with Fentanyl. It was a day that changed my life and my son’s life forever.

His pain came physically from a back injury. He injured his back at work and given a prescription to an opioid that in the early 2000s was marketed as “non-addictive.” They were wrong in that endeavor. He followed that classic path from pain medication, which becomes very expensive. I’m far from an expert on the street, but I know today you can spend up to $200 a day on a pain pill addiction. When you struggle with that, you can get heroin for $50 a day. It comes down to economics. My son’s father had been somewhat estranged from his own father, even though he had a wonderful family. Anytime we have voids in our lives, that should be filled by loving, supportive relationships. Otherwise we become more vulnerable to anything else that will take emotional or physical pain away. He felt that void, which was ironic in the sense of how much he loved our son.

When I came to the realization that I wasn’t able to support his recovery and my son and I needed to focus on us staying healthy, it tested my core because I was a caregiver. I can fix anybody. I can solve anything. I can help. I’m a nurse. To accept that I couldn’t and that I needed to walk away from a commitment was very hard. It shook me.

People that sell heroin illegally in the United States thought they would make it even “better” by adding a more potent illicit drug on top of it that is 100x more powerful than heroin. The people that make these drugs aren’t pharmacists. I have no doubt that my son’s father didn’t want to die. He certainly had an addiction but he did not want to die. He and Seth were going to play baseball the next day.

My experience of addiction produced a higher tolerance for loss, struggle, and trouble in the work environment in ways it’s not frequently expressed. In healthcare, we are in the most incredibly intimate human business. It needs to be treated with that degree of respect, kindness, and understanding. It absolutely has to be. Anything less is unacceptable.

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