Here is the full transcript of Austin Eubanks’ TEDx Talk: What the Columbine Shooting Taught Me About Pain and Addiction at TEDxMileHigh conference.
Austin Eubanks: Do you remember where you were on June 12th, 2016? A few of you might, but I’m betting the vast majority probably don’t.
On June 12th, 2016, a lone gunman walked into Pulse Nightclub, killing 46 people in the deadliest mass shooting by a single gunman in US history.
Now let’s go back about a decade. How about August 29th, 2005? Do you remember where you were? We’ve got a few heads nodding out there. That was Hurricane Katrina. Over 1,800 dead in the costliest natural disaster ever to hit the North American continent.
Now let’s go back another few years and go for 100 percent recognition. Do you remember where you were on September 11th, 2001? Everybody’s head nodding now. The September 11th attacks left over 3,000 dead in the worst terrorist attack in US history.
Do you remember how you felt? Were you confused? Afraid? Did you feel sick? Were you vulnerable? Every time this happens, we’re becoming more and more desensitized. We frequently see news coverage of mass shootings, natural disasters that result in enormous loss of life, terrorist attacks, and then we change the channel to watch something more friendly.
This is the society that we live in today, but the impact of these traumatic events are no less serious on those who are directly affected, and now the impact of emotional pain on our society is more problematic than ever.
Do you remember where you were on April 20th, 1999? Two students walked into Columbine High School armed with shotguns, semi-automatic rifles, and a bevy of homemade explosives, killing 12 students and a teacher, in what was, at the time, the worst high school shooting in US history. I remember where I was. I had just walked into the library with my best friend in order to meet others preparing to go to lunch.
Moments later, a teacher ran through the same doors we’d just entered yelling for everyone to get under the tables; that somebody had a gun. I remember how I felt. I was confused. I was afraid. I felt sick.
And I was vulnerable. And just minutes later, I was playing dead underneath a table next to a pool of blood. I had just been shot, and I had witnessed my best friend murdered right in front of me as we were huddled together waiting for help to come. I was broken. I was in shock, and I was in pain.
But my understanding of pain that day was nothing like my understanding of pain today. What’s the first thing you think of when you think of pain? Is it a broken arm? Headache? Sprained ankle? Maybe a gunshot wound? Those are the things that I used to associate with pain, and they’re pretty in line with the medical definition of pain: A variably unpleasant sensation associated with actual or potential tissue damage and mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors.
Do you notice anything missing from that definition? Do you see any mention of the emotional components of pain? Me neither. In 1996, the American Pain Society introduced the phrase, “Pain is the fifth vital sign,” meaning that when you walked into an emergency room, the initial assessment of your condition was based on five data points: pulse rate, temperature, respiration rate, blood pressure, and pain. This was brought about by a cultural movement that was adamant that we were under-treating pain.
And patient satisfaction surveys were put in place in order to track the outcome and effectiveness of this new implementation. And what better way to promote these new policies than to tie physician and hospital compensation to patient satisfaction?
A recent survey by the industry group Physicians Practice reports that three out of ten doctors are paid bonuses based upon patient satisfaction surveys, and hospitals with better scores receive bigger payments from insurers. Naturally, administrators and physicians began to support this new movement with the goal being to get everyone’s pain to zero on the scale. That was the mark.
The ethical dilemma immediately became, “Do I issue this person narcotics in order to keep them happy, or deny them, and potentially hurt my compensation, the revenue of the hospital, or at worst, open myself up to a grievance for under-treating pain that could potentially result in the loss of my job?” I have experience with pain.
Less than an hour after scrambling out the back door of the Columbine High School library, I was medicated on a variety of substances that were intended to sedate and to relieve pain. I was 17 years old and I’d never drank a beer or smoked weed, much less anything harder. I had no idea of what these medications were even supposed to do.
All I knew at age 17 was that a lot of highly educated people had prescribed me medications that were intended to make me feel better and they were working, only not in the fashion that they were intended.
Now if you only remember one thing from my talk today, let it be this: Opioids are profoundly more effective at relieving the symptoms of emotional pain than they are at relieving the symptoms of physical pain.