Validating a patient’s experience of pain

By Justin Baik, MD, Seoul, Korea & Amy Yu, MD, MS, Johns Hopkins Medicine 

As an observer from Korea at a Johns Hopkins hospital, I observed an internal medicine physician support a patient with opioid use disorder. It taught me a great deal. 

“Let me go!” Mr. H said. This was the cry of a patient who’d been through too much. A man with a body that embodied his struggles: HIV, a failing heart, and a history of injection drug use. Mr. H had been admitted this time for sepsis from infected wounds on both legs. 

“Tell me about your pain,” Dr. L said. 

“Imagine being burned alive,” Mr. H said, his words carrying the weight of someone who’d been dismissed too many times before. “You’ll never understand.” 

I stood there and felt the gap in my own experience. In Korea, injection drug use isn’t as prevalent as in the U.S., I’d only experienced the opioid epidemic through reports, stories, and Netflix documentaries. But then, in that hospital room, the crisis was made real. It was right in front of me, embodied in this man who was in so much pain. 

I didn’t know what to think. I couldn’t help but wonder if Mr. H was genuinely in pain or just seeking more drugs? How was I supposed to tell? 

“I believe you,” Dr. L said without hesitation. “Let’s work together to help control the pain in a way that’s safe.” 

Here’s what I learned:  

1.Build trust. 

Dr. L didn’t let the patient’s presentation or history cloud her response. She sat down next to him and held his trembling hand. She built trust by actively acknowledging and validating the pain. 

2. Validate. 

 The doctor acknowledged not just the patient’s physical pain, but the emotional and psychological pain.  

Finally, I learned that our part as healthcare professionals in the opioid crisis isn’t just about managing medical treatment. It’s about challenging our own assumptions and biases, showing compassion, and treating both body and mind.