It was a total joy to have my brother Dan here in Texas for our debut wellness event at The Cedars Ranch, "Fierce Self-Compassion: Unplug Your Inner Critic" with Dr. Kristin Neff. In families we play certain roles. Dan has been our ‘brainiac’. I found his insights as we debriefed the self-compassion day so fascinating I thought they warranted a general interview!
An Interview With Dr. Dan Martin - Ultimate Pain Treatment
Q: Dan, we've had some interesting talks about your insights into pain lately. Let's start though by having you describe your job for us.
A: I offer post-op medical care following elective hip and knee replacement at a community hospital in Winnipeg, Canada.
Q: What are the related conditions you see?
A: I diagnose and provide management of type 2 diabetes, anti-coagulation, and diagnosis and early management of peri-operative complications such as acute myocardial infarction, cerebral vascular accident (stroke), blood clots, etc.
Q: Tell me more about the extent of who you work with each week.
A: I work with 10 different orthopedic surgeons who do 35-40 cases per week. I'm responsible for discharge medication reviews and prescriptions including high dose opioids.
Q: Are there themes you see in the medications?
A: This particular patient population may be somewhat more overweight than average but generally represents a good cross section of Manitoba's population. There is an overwhelming incidence of type 2 diabetes, cardiac risk factors, hypertension, anxiety and depression.
Q: Do you feel like patients are coming in over-medicated?
A: Patients are, on average, on a huge number of medications including multiple meds prescribed for mental health and many have large number of self-prescribed "supplements". Many are on medications for chronic pain - physical, psychological and a combination of both. Multiple prescription meds may be required to numb the various types of pain, but these mostly deal with the pain symptoms rather than underlying cause.
Q: Are you seeing a connection between the physical and psychological pain in your patients?
A: My job requires me to treat acute post-operative pain, knee replacement being known to be among the most painful of commonly performed surgeries. Many patients already have chronic pain conditions. I'm adding high-dose opioids or other medications on top of their already well-dosed pain-killers, anxiolytics and anti-depressants.
Q: You are seeing people on your unit because of something very physical but you are seeing a lot of mental health suffering. What does that have you thinking?
A: There are huge numbers of people carrying a great deal of pain. My conclusion from that is that there has to be something fundamentally wrong in our culture to create so much pain. The large abundance of medications are inadequate to treat the symptoms.
Fierce Self-Compassion Workshop in the Great Hall at The Cedars Ranch
Q: What are we not doing well?
A: We are not adequately addressing the root causes of this pain.
Q: What do you think some of the root causes are?
A: I suspect a lot of the cause is deeply rooted psychological pain related to people's disconnectedness from each other.
Q: What might be more effective ways to helping people with this pain?
A: Not sure I have the answer. I suspect some kind of psychotheraphy is needed but I don't know what form it would take.
Q: Let's get personal. What have you noticed in your own experience that helps?
A: In my own personal experience I will at time use medication but usually psychological escape in order to numb pain.
Q: What helps to actually deal with it instead of numbing?
A: Becoming aware of the pain in a safe setting with friends and family allows me to feel the pain and then deal with it.
Q: Are there any resources you have found helpful?
A: I have become keenly interested in some of the newer psychological models such as Dr. Brené Brown's Vulnerability and Shame or Dr. Kristin Neff's research on self-criticism and self-compassion. I like how both of their models combine an objective scientific approach with a new awareness of the root causes of human suffering.
Dr. Kristin Neff at The Cedars Ranch - Photo by Alyssa Duty
Q: If you were to prescribe something non-pharmacologic for your patients more often, what would it be?
A: I have the disadvantage of encountering patients for only a short period of time. I try to make my brief encounter with them compassionate and therapeutic. Ultimately my hope for them would be a positive therapeutic relationship with their primary care provider.
Q: What do you wish for them?
A: All too often these patients may be experiencing shame in their primary care setting [Obesity Stigma: Important Considerations for Public Health, J Clin Transl Endocrinol. 2014 Sep; 1(3): 73-76.]. What I wish for them is the ultimate road to healing is to deal with the shame which is often at the root of their pain and their need for pain-numbing medications.
Q: So a summary statement?
A: Shame results in disconnections which causes pain and the cycle continues. A well intentioned medical community anesthetizes the various kinds of pain symptoms, in the process numbing positive experiences of life as well, while unable to treat most of the underlying causes of pain.
Fresh Flowers at Self-Compassion Event - Photo by Alyssa Duty
Thank you Dan.
Until next time,
Marilyn Orr, CEC, PCC is a Leadership and Mentor Coach with Capacity Building Coaching, and Training Partner on EQi 2.0 with MHS. She is co-owner of new Texas Hill Country eco event center and wellness retreat, The Cedars Ranch.
Marilyn provides professional coaching for executives and business leaders, mentor coaching for coaches, and leadership development support in the form of coaching skills training, soft-skills development, facilitation of key discussions and team coaching. Would you like to work with Marilyn? Reach Out to her today.
Marilyn is author of everyday resiliency workbook “How Absorbent Are Your Shocks?”, available on Amazon. Subscribe to “Marilyn’s Musings” twice monthly blogposts for more leadership and professional development content.