Commentary: A Soldier’s Story – Pain Medication is Often Necessary

David Poole is from my hometown of Helena, Montana. His mother is a patient of mine. His stepfather is a colleague of mine. At the age of 10 he was burned over 60% of his body with 30% third-degree burns and spent three months of the University of Utah Burn Center.

He’s a tough kid who got in some trouble as a youth: perfect for serving in today’s army. And he learned how to tolerate pain in the burn unit that’s for sure.

During his first tour his best friend was killed right next to him. They were in a horrible firefight. David risked his life to try to save his pals. He was wounded in the firefight himself. He’s not yet received his Purple Heart. If you ask me, he deserves a Congressional Medal of Honor. Later in that first tour he was in an armored vehicle that was blown up by an IED. He suffered injuries to his back, underwent surgery on his back and has been in chronic pain ever since.

He told that upon returning for his second tour of duty (that’s right he went twice!) he was in yet another firefight. When it ended, there were bodies everywhere. One of them was a young man that David mentored two years before. His name was Amahl and while the Army saw him as an enemy, David was like his big brother.

But now he had been killed by Americans. David was confused. He wondered, “How am I supposed to feel?” He’s not sure still. He probably will never know.

In order to participate fully in the war theater David had to take pain medications. They were plentiful for him. When he returned United States he was still in a lot of pain and taking massive doses of morphine. He was seeing a pain doctor outside of Helena but because he was unable to live close enough for a pill count they released him from their practice. Additional complications had to do with turnover in that pain practice. He was referred to me by the law-enforcement officer in our state, the so-called task force.

The system failed David as it does so many of our returning “heroes” and he could find no one to treat his massive pain. He was still active military and thus the veteran’s clinic couldn’t (wouldn’t) see him. Does that even make sense?

I stepped in and, yes I’ll say it out loud, I provided him with ongoing pain medication. He also underwent physical therapy and he also tried several alternatives such as acupuncture craniosacral therapy massage and topicals without much relief. The point is he wanted to get better.

He had a feeling he would get better pain relief with medical marijuana but could not take that as an active-duty member of the military. He was finally honorably discharged. We are now weaning him slowly from large doses of oral morphine while he has found improved sleep and pain relief from medical marijuana. His goal is to be off the opiates entirely by fall. This is a laudable and an achievable goal.

The story points out many of the pitfalls of pain therapy. It also points out many of the pitfalls going to war: our heroes come back in pain traumatized and cannot utilize all the options available to them. This gentleman fell through the cracks all the way to me. He is so grateful to have found me and I’m grateful for the opportunity to serve him, but I was his last chance.

Over the year and a half I’ve been seeing him he’s opened up to me and told me some of the stories from his unit, comrades who died in his arms, and those who have killed themselves since returning. Also he shared just how many were, and still are, in chronic pain or suffering from PTSD, or both—caused by war.

We have bonded as friends and I never fail to express my respect and gratitude for his service.

David’s is a success story: he’s alive, he survived the war theater, and is mainstreaming himself back in our society. There so many ways this could’ve gone wrong.

It would seem to me that our government’s focus on pain medication abuse misses one major point. Pain medications do some good and can help a patient—in this case a hero like David—free himself from the grips of chronic pain.

That’s what he wants. That’s what I want for him. Heck, that’s what 100 million chronic pain sufferers want.

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