Andy Goodman’s latest article in Free-Range Thinking (PDF) discusses one of the main ways leaders are successful – and that’s by telling stories. The first story he says leaders must tell is the “story of self.” It seems in our experiences working with some of the nation’s top scientists and non-profit leaders that telling stories about themselves is really tough. They don’t think they have one to tell. But when we ask them, “Why do you care about what you do?” or “What led you to become so passionate about this field of work?” in many cases, what we heard silenced the room. Even made those in the room hold their breath for just a minute. They are truly memorable.

Once I asked a pain expert, “why do you care about pain treatment so much?” The story that followed – about a dying girl writhing in pain who changed the course of his medical career - silenced the room. And then It became the lead to an opinion editorial he published soon after in Toronto’s Globe and Mail. More leaders need to open up and share what drives them day in and day out.

You can read Dr. Finley’s op-ed after the jump or at The Globe and Mail (subscription required).

Suffer the little children
By G. Allen Finley, Globe and Mail
December 28, 2005

Sixteen years ago, a four-year-old girl named Caitlyn taught me about pain. Caitlyn was consumed by agony: She was dying from cancer, and spent her time curled up under her blankets, not talking, not reacting, ignoring the rest of the world.

After starting treatment with morphine, she began laughing, joking, singing songs, and drawing pictures. Her parents had six weeks of the child they knew and loved before she succumbed to her disease. She changed my life.

Imagine being the parent of a child with cancer who won’t even let you hug her because it hurts too much. Imagine being a teenager with chronic pain who nobody believes. Imagine being too young to find the words to say when it hurts. We do a better job with children like Caitlyn these days, but children still suffer severe pain from surgery, arthritis, injuries, burns and hospital needle pokes, even though doctors and nurses know how to prevent or treat most pain. This pain also hurts their parents, their loved ones, and those who care for them.

Twenty years ago, many doctors and nurses believed that newborn babies did not feel pain. We now know that even premature babies feel pain, and that children of all ages can benefit from pain-relieving medications and from non-drug therapies. We also believe that pain suffered at a young age can have long-term effects and increase sensitivity to physical hurt and discomfort later in life.

Why don’t we do more to prevent suffering in the most vulnerable members of our society? What are the barriers to providing better pain relief for children?

It can sometimes be hard to recognize when children are suffering. A sudden injury or painful injection almost always causes a response, but children often cope with long-term pain from surgery or disease by becoming quiet or withdrawn, or by trying to sleep or even play. Parents almost always know when their child is acting out of character, but they don’t always recognize pain as the cause. Children need to be asked about their pain. When they tell us that something hurts, we should believe them, and do something about it.

Pain should be prevented if possible, and treated when it occurs. We now have anesthetic creams that reduce or eliminate the pain from needles and injections, and we know how to use psychological techniques such as distraction to block pain signals from reaching the brain. Both approaches take time and cost money but are safe and simple to use. Doctors are often reluctant to prescribe morphine and other strong medications, even for cancer or post-operative pain, although these drugs can be used with great safety and effect.

Fortunately, the problem of pain management is getting more attention. The first week in November was National Pain Awareness Week, and Oct. 17 saw the launch of the Global Year Against Pain in Childhood. Health professionals around the world are beginning to focus on the importance of preventing and treating children’s pain. Because infants and children often can’t speak for themselves, we have an obligation to speak for them and protect them. We all have a part to play.

It will take change at every level to safeguard current and future children from needless suffering. Parents should know that children’s pain can usually be prevented or reduced. They need to ask their doctors and nurses for pain treatment. Health professionals must educate themselves about recent pain research and learn how best to apply it to caring for their patients. Policy-makers and health administrators must ensure that pain in hospitals is assessed and that resources are available to prevent or control it. Pharmaceutical companies must extend drug research to children, not only testing the safety and efficacy of new drugs for them, but also developing preparations that are “child-friendly” (making them in liquid form, instead of large capsules, for example). Governments must ensure that effective drugs for children are available, either through importation or local production.

We can not ignore the importance of children’s pain. Caitlyn taught me that.

G. Allen Finley is professor of anesthesia and psychology at Dalhousie University, medical director of pediatric pain management at the IWK Health Centre in Halifax, and president of the International Association for the Study of Pain Special Interest Group on Pain in Childhood.