Pain, Empathy and Public Health: Amy Baxter at TEDxPeachtree (Transcript)

Amy Baxter

Here is the full transcript of Amy Baxter’s TEDx Talk: Pain, Empathy and Public Health at TEDxPeachtree conference.

Amy Baxter – Pediatrician and entrepreneur

As a doctor, I’ve come to accept that some pain in life is unavoidable. I got used to this idea in medical school because sometimes I had to cause pain.

But making something painful that doesn’t have to be is just wrong, so as part of my practice, I research how to prevent unnecessary pain, and I teach other doctors why patients’ pain matters. When my four-year old had to go for his shots, it was the pain management marathon I’d been training for my whole career. Numbing cream an hour in advance, check Distraction tools at the ready, totally. The check-up went great and after the doctor left the room was our big moment.

An utterly indifferent shot-giver, bore down on her tray, glared at my son and said: “You better sit there and be still or it’s really going to hurt.” I started to educate about numbing cream and “that stuff don’t work”; boom, boom, boom, boom! Uhh, so that didn’t go as expected. How do you respond when the place that you trust to keep you healthy hurts you? Or ignores your plan, or ignores you? I couldn’t even pretend to my son that this was how I intended for him to get his shots. It was obvious that this person and I did not have the same goals to keep him healthy. So I left feeling unsettled and ashamed, I guess.

Over the next couple of years, I responded to this experience by inventing a device called Buzzy that my kids could take to the doctor to block needle pain. While I developed the device, my son developed a fear of going to the doctors. Like puke on the floor, phobia-caliber fear. As I pivoted my research from preventing unnecessary pain to understanding needle fear, I realized that we have had an erosion of empathy in medicine. Somehow, we’ve decided to ignore the fact that shots hurt.

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And it’s kind of not even cool to say that out loud, because then you’re a wimp, and as a pediatrician, shots are how we keep kids safe. But parents today watching their kids get stuck don’t feel safe. They feel unsettled. By allowing indifference, and by ignoring that shots hurt, health care has created an environment where parents are questioning whether they and their doctors have the same goals. They’re questioning vaccinating itself and by ignoring pain, we’re endangering the future of health care.

Doctors need to own the problem of pain and patients need to become empowered in ways that matter. OK, this is a TEDx empathy check. This is why we need to work on this. The fact that we’re laughing is because as a nation, we value strength, we don’t want to be wimps, and we’re proud of dealing well with pain, so we’re proud of dealing well with shots. But the opposite of pride is shame and we make fun of what we’re ashamed of.

We don’t talk about it. Until recently, we didn’t even research it. In 1995, a study was done that found that 10% of adults and 25% of kids had a severe fear of needles. This was groundbreaking. More adults feared needles than had insomnia. More kids feared needles than had asthma. Turns out that 5% of this fear is physiologic. You get light-headed or pass out. But the paper suggested that the rest of this fear, above that 5%, was caused by health care.

In my training, I never heard about needle phobia. It didn’t hit my radar. Logically, how would it? If you’re afraid of needles and you’re embarrassed, do you go and talk to your doctor about it, or do you just not go? If a fear of needles were growing, and if it were pervasive enough to threaten preventative health care, how would we know? We have a blind spot and to understand it, let’s go back to this picture again.

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