Sometimes Karma Really Hurts

This story was told to me by one of the participants. There is a lot of background and associated internal politics and policies that I’ll not go into for the sake of brevity.

In a Japanese private hospital in the 1990s, there is a doctor — let’s call him Dr. Painful — who firmly believes that all painkillers, and especially the stronger opiates available, are not necessary and are even harmful. He either doesn’t prescribe any or seriously under-prescribes. Despite protests from the nurses and other doctors, he persists in this belief. His direct management, as well as their manager, are spineless toadies who refuse to overrule this doctor’s decisions, and his colleagues aren’t allowed to directly interfere.

One day, a patient is admitted claiming extreme pain in the abdomen. Dr. Painful claims it can’t possibly be that bad and predictably refuses to prescribe sufficient painkillers. This woman is crying in pain, but he won’t budge, despite the protests of the patient, the nurses, and other doctors. Finally, one of the nurses loses it and jumps several levels of management to browbeat the director into taking action.

Another doctor from a different department overhears this conversation and volunteers to take the patient for an MRI, where they discover a cancerous growth. Yes, its location would cause extreme pain. At this point, the patient’s mother has already moved the patient to another hospital, so there’s no follow-up. The nurse is reprimanded for daring to jump over direct management, despite an acknowledgment that nothing would have happened had she not done so. Nothing happens to Dr. Painful, as far as anyone knows.

Sometime later, Dr. Painful is admitted to that same hospital for a hernia. He’s in a lot of pain. The doctor he’s assigned to writes his prescription, quote: “Dr. Painful special treatment: no pain medication.” Dr. Painful is crying in pain and begging for painkillers, but the nurses and the other doctors refuse to give him any. He is shown the prescription, saying that he’s receiving the same treatment he gives to his own patients, and they wouldn’t want to insult him by doing anything different. They quote him at every turn, using his own excuses against him each time he asks. Lucky for him, the hernia is shortly resolved and he’s discharged.

Dr. Painful never stinted on painkillers after that episode. Seems pain can teach empathy after all.