Sunday, 15 April 2012

Pain control

On Easter Sunday, my brother-in-law and I supported my sister as she gave birth at Pembury hospital in Kent. Until recently it was a depressing and foreboding huddle of Victorian institutionalism — it was originally built as a workhouse — but it is now a £225 million state-of-the-art ode to modern medicine. My sister had planned to take advantage of all that modern medicine had to offer, but she was forced to forego her planned epidural due to the speed of labour and the midwife's reluctance to medicate. It was traumatizing for her. I know that pain; I've given birth without drugs too, but I made a conscious decision to do so and it was that decision that enabled me to cope.

I found my sister's distress profoundly upsetting. The heat, sweat and anguish were palpable, and the delivery room claustrophobic. Though we were trying to encourage her, comfort her and hold her, it felt like we were trying to pin her down against her will. It made me think of Fanny Burney, a woman I am writing about in my book about the history of surgery, who had a mastectomy in 1811 with no pain relief; seven men in black held her down as the knife went in. There was no comforting presence to help Fanny Burney through her ordeal.

Hundreds of years ago we expected and witnessed pain on a regular basis, and not just in childbirth. I thought of paintings and drawings of surgery pre-1846, when anaesthesia was invented. The patients are being held down by multiple attendants, and their facial expressions are maniacal; some are struggling and trying to run away. Fanny Burney describes closing her eyes in horror during her 1811 mastectomy; you can smell the fear of death in her account.

In the delivery room, my sister had a terrified expression on her face and closed her eyes and roared to get through the pain. I thought I was going to faint so I sat on the sterile blue rocking chair behind my hardier brother-in-law. I stared under the bed at my sister's Josef Seibel shoes ("The European Comfort Shoe", I noted). The midwife kicked my sister's shoes towards me as they took the bed apart and put my sister's feet in stirrups. After a half-hour of serious pushing and an episiotomy the baby's head appeared, glistening with dark-gold hair. The extraordinary result - a boy! - came tumbling out into the world.

While my sister's experience was childbirth and Fanny Burney's surgery was a different case entirely, I got the closest glimpse I think I will ever get of what it would be like to endure surgery without pain relief. I'd not been at all worried about seeing anything bloody or unsightly during childbirth. I've stood in the operating theatre and watched my surgeon carry out a mastectomy. My stomach is strong. Yet I was surprised to find that being present in the delivery room watching a natural birth was harder than watching someone being cut open. It wasn't the blood that was difficult to watch. Seeing my sister in pain was frightful. Pain management, or the ability to control it, is such a given today. Before me was living proof that the invention of anaesthesia has transformed life beyond surgery. It has transformed our relationship with pain forever.