Patient Still 10/10 Pain Even After a ‘Being-Set-On-Fire’ Analogy

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NEWARK, NJ – Patient Deborah Skemp woke up today at 6:30 a.m. during rounds by her physician Dr. Waters.  He asked her the usual morning questions that one would ask for a typical abdominal pain admission: “How was your pain last night?”  Skemp replied, “Oh, just terrible!”

Since “terrible” isn’t a coding measure, Dr. Waters asked, “If you had to rate your pain on a pain scale from 1 to 10, with 1 being no pain and 10 being the worst pain of your life, what would you rate it?”  This is where Dr. Waters made a horrendous mistake.


I’d rate it a 10,” the patient that was asleep 7 minutes ago responded.  Dr. Waters rephrased the description of the pain scale.  “So, a 10 would be similar to the time you gave birth.  A 4 or 5 is about where most people start feeling uncomfortable and ask for pain medicine.”  He then asked the patient, who was confused about the pain scale being in base 2 instead of base 10, about the pain medication she had received.

Patient Still a 10/10 Even After a ‘Being-Set-On-Fire’ Analogy
“I’ll try not to get too close because I may catch on fire”

“They haven’t really helped. I’m still a 10,” the patient who wasn’t in active labor responded.  “I have a really high pain tolerance, but I need more medication.”  Skemp, allergic to many pain medications except for Dilaudid, was still on IV narcotics for pain.

“To put it differently, a 10 would be if someone was literally on fire.  They couldn’t physically be in any more pain, the maximum amount of pain possible.  Every inch of their body… in flames… with several knives jabbed in their side,” Dr. Waters said waving his hands around his body signifying where the flames would be if he himself were on fire.

“Yes, like I said I’m in 10/10 in pain.  I usually have a high pain tolerance but nothing except for Dilaudid works for me,” the patient whose heart rate was 56 bpm, respiratory rate 16, and BP 123/78, pleaded with her doctor.

Dr. Waters told the patient, who had not yet spontaneously combusted that her scans were negative except for the severe constipation finding likely from the opioid pain medications.

“Doc, I can’t go home.  I’m allergic to that hydrocodeine.  Also can you pass me my food tray, I’m starving.  I hope the eggs aren’t too runny.”

Dr. Waters was later seen logging onto monster.com, with his username “Killmenow.”

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