When Doctors Dismiss Chronic Pain: My Experience Interpreting for Injured Latinx Workers
“It just doesn’t make sense that a simple trip and fall over a sofa would result in an inability to work for an entire year,” the doctor said to Lourdes*. As he spoke I looked at the wall behind him, where a diagram of the muscular system hung next to an oil pastel of a stethoscope.
Lourdes was one of the many patients I interpret for who had been injured at work. Before the doctor arrived she and I had filled out paperwork in the lobby, answering questions from Does the pain wake you up at night? to How have your daily activities been affected by your pain? to On a scale of 1 to 10, one being the best, 10 being the worst pain imaginable, at what level is your pain right now?
In between questions, Lourdes talked of oasis villages back in her home country of Peru. She recalled the succulent flavor of a lomo saltado. Many, but not all of the immigrants are from small towns in Central and South America. Others who came from big city life — Mexico City or Bogota or Lima — would tell me of the mariachi; the art beautifying the city’s building facades while also adding an element of grittiness; the nutritional benefit of grasshopper; the multitude of museums; the lively tomato festivals.
The pain resulting from Lourdes’ injury had significantly impaired her ability to perform her regular job duties. In the year she’d been off work because of this, she had received some financial support (albeit minimal) from workers’ compensation. Today she recounted to the doctor the details of how she’d gotten injured, what body parts were affected, and her current lingering symptoms resulting from it.
He responded by saying she needed to go back to work.
“Workers’ comp is meant to support people who’ve fallen from roofs or tall buildings,” he lectured. “Who’ve broken multiple bones or sustained dramatic, visible injuries. Not workers who only tripped. Even for those workers, the system’s only meant to cover them for a few months, not long-term.”
It was a struggle for me to interpret these sentences — as interpreting statements that I don’t agree with or that I feel are unkind always is.
Lourdes began to respond but the doctor held a hand up, insisting that she let him finish.
“And you need to lose weight,” he added.
By the time the appointment was over, the doctor swiftly left the room, while Lourdes remained, tears in her eyes.
I recalled a similar incident from months earlier, when I interpreted an appointment for Esmeralda*, a middle-aged Mexican lady who had gotten hurt working out in the fields two years prior. After laboring on farms for the majority of her life, she’d remained mostly sedentary since the injury. Almost all activities — walking, cooking, sewing, bending over — aggravated her pain. No doctor had prescribed her pain medication, so she’d been taking only sporadic doses of Advil.
The doctor that day instructed Esmeralda — who had gained 40 pounds and lost considerable abdominal strength in the months since her injury — to exercise more and take better care of herself.
“The pain will only get worse if you don’t do anything. You need to take responsibility for your health and your life because no one else will,” the doctor said.
Though I know medical professionals are trained to say these things, it was still hard to listen to, harsh and invalidating of Esmeralda’s particular situation as it seemed. For a woman who’d spent her life working in the fields, lack of motivation and willpower didn’t seem to be the real issues here.
As a medical interpreter who primarily covers workers comp appointments, I am constantly hearing from patients about the extent to which their injury has drastically altered their lives.
They talk about how ineffectual they feel. How badly they wish they could be productive members of society again. How they feel trapped inside bodies that work nothing like the way they used to.
The vast majority are low-income, putting their bodies and physical safety on the lines to do jobs most of us wouldn’t want to do. Such work exposes them to greater risk and increases the probability of injuries.
At times workers get injured after taking on a disproportionate amount of duties at work. Exploitation and overworking on behalf of their bosses are not uncommon.
That said, when doctors imply that patients are exaggerating their ailments or in any way trying to “game the system” out of laziness or poor work ethic, it’s upsetting.
In my experience, the patients I’ve worked with don’t stay on workers comp to get a free pass. If anything many of them wish they could work.
“My whole life changed. I’m not the person I once was. I can’t do what I used to,” I’ve heard many say.
“Men are supposed to be the rocks that their family can depend on. With pain like this I can’t do nothing. I’m not that rock no more. They can’t depend on me,” one patient said.
“Why am I living? Why am I here? I’m just taking breath from other people and not giving back,” said another.
These doctors’ attitudes also communicate an offensive lack of understanding of the nuances of the chronic pain predicament. Healing from these injuries can be a highly nonlinear process, one that drags on for many years. The pain might leave for a while only to come back with a vengeance when the person thinks it’s finally gone.
Our society often knows what to do with visible pain. We know less what to do with the pain that doesn’t show up on any test. Or pain that isn’t “quantifiable.”
A podcaster once commented that when you have a cast, people run up to sign it, but when you have depression (or a mental health condition), people run away.
The only way to measure chronic pain is through listening to the hurting person’s accounts of their subjective experience — something that these two doctors, and unfortunately too many others, seemed either unwilling to do or uninterested in doing.
The sadness in patients’ eyes when they share their stories is so apparent to me. I can see that their pain is real, even if I can’t see a wound, a gash, or a visible sign of illness.
My heart went out to Lourdes, who went to seek help for the pain that she was in, only to be dismissed by the person who was supposed to be helping her.
When friends don’t try to understand what you’re going through, it can be hard on the soul — but when the lack of understanding comes from medical professionals or people in authority, it also complicates access to treatment.
Instead of dismissing what we can’t see, why not attempt to learn about it? Women like Lourdes deserve that. So do injured workers everywhere.
*Names have been changed
Photo by Omar Lopez on Unsplash.