Even if that is the case, pain seems to vary greatly in how it affects people. I would be very hesitant to tell someone that they should just let the pain "guide" them, because I have no idea what it is like for them.
My grandfather was an open-heart surgeon. In the days following surgery, he would always insist that his patients get up and take a short walk. They would not want to, but he insisted that this was an important and valuable part of recovery (in several dimension) and that they needed to push past resistance and force themselves to do it.
Later in life, he underwent a surgery requiring general anesthesia and found himself in the same position. He said, "If I had known it was like that, I would not have made them do it."
So I think the surgeon's personal experience of the situation is -- in fact -- highly relevant in practice, even if not in theory.
It is easy for me to imagine a pain that I would never voluntarily experience or inflict (this isn't even a very profound level of pain, I don't like suffering even in small doses). This threshold is regularly breached and I often come out of it as an improved person.
Sometimes, and I'm thinking doctors and the military when I say this, people end up in situations where choices must be made. The situations are not emergencies and the choices affect other people in ways that the decider might not willingly accept for themselves. This is an unfortunate fact of the world not being a nice place.
It was good that they made me do it—by the last day, I was starting to develop nerve pain from so much sitting, propped up in the hospital bed. Walking was torture, but so was sitting.
Since when is that a requirement for knowing what is best for your patients? The doctor is basing their judgement on current consensus within their field, which hopefully involves careful studies.
Medicine is unfortunately not nearly as scientific as you might wish - I worked for the British Medical Journal a while back and they are all about evidence-based medicine... unfortunately, there is still a lot of medicine that's based off of received knowledge or observational evidence, which may or may not be accurate. The situation is changing though as things get proper studies done, but it's not always easy to get decent results and so current consensus can and does change over time as research gets done.
With every medical decision there are trade-offs. Sure, it's best to walk soon after surgery... sometimes. Sometimes it's too early. And sometimes there are trade-offs like torturous pain that no person should have to bear. Many people might choose to forgo the day after walk knowing that their chances of a full recovery might be 0.01% lower.
It reminds me of the mantra that "breast feeding is best". Yes, according to some studies, there appears to be positive relationship. But what if continuing to breast feed causes a mother to stay clinically depressed. What if she can't handle the every 2 hours and it is driving her crazy and she wants to shake her crying baby. Maybe in this case, "formula is best".
A good medical practitioner works with their patients to communicate the risks and rewards clearly and help guide them to make the decisions that work best for them.
Slightly less anecdotally, I have a lot of doctor friends and while they may indulge in overwrought "look at how clever I am" medication schemes for ailments that do not really warrant it, I think that it's mostly because they feel that they don't have the time to rest like the author of the article (and this doesn't involve routine painkiller use either).
Some people argue that in my country (Italy) there is a cultural aversion to painkillers due to the historical influence of the Catholic Church, but it's hard to measure the effect.
I'm perfectly understanding the concern for long term morpohine derivatives for treating post-surgical pain (although there are plenty of studies that show pain delays healing) so there is a bit of picking-n-choosing going on. Many nurses would recommend OTC acetaminophen in combination with ibuprofen as they work quite well and you're definitely still going to "feel it" if you're pulling out stitches with no risk of addiction. Since you aren't using a narcotic, you won't need a stool softener either.
http://www.worldwidewounds.com/2001/march/Pediani/Pain-relie...
I'm a bit concerned by the reliance on ibuprofen for pain (it's great for inflamation but prevents blood coagulation) since it can cause bleeding, although I'd note that she didn't even need that to sleep so her lapro-surgery was either extremely minor or she has high pain tolerance. Normally, combination with acetaminophen is preferred, because the dosage of each can be minimized.
Frankly, this all just sounds like German doctoring. I've also been told that you don't need decongestants (when flying) because your "nose should flow". It's normally acceptable (if inconvenient) advice, but if you're flying it could lead to eat infection and damage. It's not like your ear pain is going to get a pilot to turn a 747 around or help your cold pass faster. Suffering is not the answer to everything any more than a painless existence is.
I (German) openly prefer it, if the dentist gives the option whether to get a anaesthetic injection or not for dental fillings, not to get one, since I strongly prefer 5 to 10 somewhat inconvenient minutes over having a numb jaw for a whole day.
I am of course aware that there are really painful dental treatments such as dental root canal treatments - but in these cases no dentist will give you the choice whether to get a anaesthetic injection or not.
> Luckily, he died before I had any significant issues,
Why didn't you simply change your dentist?
Because I was under the age of 18 and he was my parents dentist I didn't really have a choice. I didn't have any cavities as a child so my first negative dental experience was at 17 when he filled 4 molars "preventatively" (because he didn't know that epoxy capping was a thing). It didn't kill me, but it was an excruciating 30 min and an absolutely miserable day. The muscle tension pain from not moving took days to subside. Not a reasonable trade-off for me.
The resulting aversion conditioning kept me away from dentists until I was 36, when my then-girlfriend coerced me to see a dentist. I needed lots of work, all of which was done using novocaine.
Pain control is part of good professional medical practice. If a practitioner puts you through gratuitous pain, find somebody else.
I he has really "moral qualms" even when asked explicitly, I accept that you better look for another dentist. My claim is rather that it is as a dubious practise to just apply an anaesthetic injection by default.
I've never had to to anything beyond simple fillings so I'd like to think that's the limit for me.
Is it possible only a minority would consider the pain of a drill into the core of their tooth an inconvenience?
i've also skipped the anaesthetics on occasion without problems, but there were surgeries where this would have been madness where the doctor didn't ask.
> I strongly prefer 5 to 10 somewhat inconvenient minutes over having a numb jaw for a whole day.
I am not sure you'd say the same after 3-4 hours of treatment. I've done some root canal treatments here and there, which can take a long time. I'll take a numb jaw for a couple of hours afterwards over being in pain for 3 hours.
But I guess you're right, for 5-10 minutes of pain, it isn't worth it.
Did they find his drill embedded in his occipital lobe?
What do you mean by a filling? Just for a minor cavity? I've never received local anesthetic for a minor plastic filling, just for root canals/crowns, and the pain has never been a problem. This seems to be common practice where I've gotten dental care (Sweden and Japan)
I would have asked if he believed in repeat business—if so, give me the novocaine.
The guy who operated on my penis gave me a grab bag of pills that went right up to serious prescription pain killers and said just to call by if I needed more. I never even took the first day's pills, it barely hurt at all, but then he's a penis surgeon, it's not even essential to _have_ a penis, half the population don't have one so how important can that surgery be?
The guy who used to be my dentist before he retired was a Max Fac surgeon in his day job, dentist was how he relaxed before the weekend. So, normally he's putting back together ruined faces from car accidents and that sort of thing. Need a filling? "I can numb that, but it's in your lower jaw, and it's not touching the root, so I suggest we go without, then you won't drool for the rest of the day". "OK, but it will hurt?" "Barely at all, slight discomfort, weird sensation, no real pain". He was right, it was fine, definitely worth the small amount of discomfort to be in and out quickly and not drooling like an idiot.
On the other hand, when I was a kid I got hit by a car (my fault), they used Entonox (medical laughing gas) back then, I was high as a kite, and given the car smashed me good, that was probably the right call. So I'm not saying "I never use pain killers" but more like "I think pain killers are something to reserve for when it's really bad, not the first thing to reach for every time".
I seem to be lucky and don't feel much pain so did not need any really strong painkillers after the first day or so and Tylenol made me nauseous so I stopped taking them.
The pain buster don't realy do that much as neither did the oral morphine
You should be hesitant, unless you're a doctor.