0883: "Pain Rating"

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Comic JK
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0883: "Pain Rating"

Postby Comic JK » Fri Apr 08, 2011 4:14 am UTC

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"If it were a two or above I wouldn't be able to answer because it would mean a pause in the screaming."

(Compared to having all your brain's incoming nerves wired to a malicious arbitrary waveform generator, I guess you're fine.)
Last edited by Comic JK on Fri Apr 08, 2011 6:03 am UTC, edited 1 time in total.
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The Origamist
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Re: 0883: "Pain Rating"

Postby The Origamist » Fri Apr 08, 2011 4:15 am UTC

The doctor should have probably specified a log scale.
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Re: 0883: "Pain Rating"

Postby koreiryuu » Fri Apr 08, 2011 4:19 am UTC

I'm upset because I spent the last 10 minutes perfecting my post to have the honor of pinning this.. And was refused permission to use the [url] BBC code T_T

:sigh:

Anyway, this was priceless because I can totally relate <<;
Mums a nurse, and when one of her coworkers was tending to me once, asked me a similar question (with an emphasis on the "worst pain you can imagine" line), I thought about it and gave him a two for a stab wound <<;
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Comic JK
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Re: 0883: "Pain Rating"

Postby Comic JK » Fri Apr 08, 2011 4:19 am UTC

Or do it empirically, like with hearing tests.

Does it hurt as much as this?
ouch. No.
Does it hurt as much as this?
Ow! No.
Does it hurt as much as this?
YEAH. RIGHT ABOUT THERE.
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Re: 0883: "Pain Rating"

Postby Magnanimous » Fri Apr 08, 2011 4:23 am UTC

I'd say he's about a seven.

kioria
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Re: 0883: "Pain Rating"

Postby kioria » Fri Apr 08, 2011 4:24 am UTC

I had this problem when in labor with my child! It was painful but by far not the worst pain I could imagine, nor even the worst I'd felt. I was about at a 2 (a 3 at some moments) the whole time. The subjectivity of it was frustrating.

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ysth
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Re: 0883: "Pain Rating"

Postby ysth » Fri Apr 08, 2011 4:31 am UTC

So many choices, so little time: http://www.medscape.com/viewarticle/533939_5

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Re: 0883: "Pain Rating"

Postby mbklein » Fri Apr 08, 2011 4:33 am UTC

Comic JK wrote:Compared to having all your brain's incoming nerves wired to a malicious arbitrary waveform generator, I guess you're fine.


Is that the alt-text, or your commentary? 'Cause that's not the alt-text I see, which is "If it were a two or above I wouldn't be able to answer because it would mean a pause in the screaming."

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Re: 0883: "Pain Rating"

Postby phlip » Fri Apr 08, 2011 4:36 am UTC

Personally, I think the Hyperbole and a Half pain scale... much easier to figure out than a scale based on "the worst you can imagine"...

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enum ಠ_ಠ {°□°╰=1, °Д°╰, ಠ益ಠ╰};
void ┻━┻︵​╰(ಠ_ಠ ⚠) {exit((int)⚠);}
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mterpstra
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Re: 0883: "Pain Rating"

Postby mterpstra » Fri Apr 08, 2011 4:39 am UTC

Magnanimous wrote:I'd say he's about a seven.


Got beaten to the scrubs reference. First thought that came into my mind too.

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Plasma Mongoose
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Re: 0883: "Pain Rating"

Postby Plasma Mongoose » Fri Apr 08, 2011 4:47 am UTC

As far as I know, Irukandji syndrome is the worth pain ever, most sufferers beg for death after suffering it.
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Re: 0883: "Pain Rating"

Postby slightlydead » Fri Apr 08, 2011 4:51 am UTC

there's this pain scale where each subsequent level of pain is represented by a smiley face or unhappy face.

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Re: 0883: "Pain Rating"

Postby EvanED » Fri Apr 08, 2011 4:52 am UTC

kioria wrote:I had this problem when in labor with my child! It was painful but by far not the worst pain I could imagine, nor even the worst I'd felt. I was about at a 2 (a 3 at some moments) the whole time. The subjectivity of it was frustrating.

In a wilderness first aid course, we were told that the primary purpose of asking your pain rating is to get a sense of change over time. If you say it's a 5 now and an 8 in an hour, something is wrong. I'm not sure this applies to all versions of the pain scale, or in all situations, but it might be helpful to know that if a doctor asks you that question he or she may well not be trying to compare you to other people.

P.S. Hi. Haven't been here for a while. ;-)

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Re: 0883: "Pain Rating"

Postby Arancaytar » Fri Apr 08, 2011 5:01 am UTC

I know he's putting his hands to his mouth in a gesture of shock, but an alternate interpretation I like is that he's imagining a tooth infection. "Every minute of every hour. There is only the pain."
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pensive bosom
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Re: 0883: "Pain Rating"

Postby pensive bosom » Fri Apr 08, 2011 5:15 am UTC

A friend once tried to convince me that a certain sort of blow to the kidneys could be so painful that the brain would simply die in response to it. I don't know whether that's true.

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Re: 0883: "Pain Rating"

Postby Hughes » Fri Apr 08, 2011 5:21 am UTC

pensive bosom wrote:A friend once tried to convince me that a certain sort of blow to the kidneys could be so painful that the brain would simply die in response to it. I don't know whether that's true.

I severely doubt the validity of that.

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Re: 0883: "Pain Rating"

Postby rpgamer » Fri Apr 08, 2011 5:22 am UTC

pensive bosom wrote:A friend once tried to convince me that a certain sort of blow to the kidneys could be so painful that the brain would simply die in response to it. I don't know whether that's true.

I have been told that being stabbed in the kidneys is so painful, you can't even scream before you've died.

A fun idea, but not one I've actually looked into.
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Re: 0883: "Pain Rating"

Postby AndyS » Fri Apr 08, 2011 5:24 am UTC

I saw this color-coded chart in a hospital once:

0- No Pain
1- Awareness
2- Mild
3- Annoying
4- Uncomfortable
5- Nagging
6- Distressful
7- Dreadful
8- Horrible
9- Agonizing
10- Excruciating

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Mahou
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Re: 0883: "Pain Rating"

Postby Mahou » Fri Apr 08, 2011 5:25 am UTC

I was once thinking about the supposed rings of hell. Specifically, the one where you're frozen in ice, unable to move for all of eternity. I believe that's the one for non-belief. I somehow managed to grasp a small bit of what that would be like.

It was one of the most horrifying experiences I've ever had.

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Re: 0883: "Pain Rating"

Postby AndyS » Fri Apr 08, 2011 5:28 am UTC

After I went to the hospital with an unknown abdominal pain and rated it a "7" or so, I found out that it was a case of kidney stones. The admitting nurse said she'd had one patient in on two seperate occasions; once with kidney stones, and once because he had been shot in the abdomen with a .38 revolver. He said the kidney stones were worse. The nurse thought that maybe I needed to recalibrate my pain scale :-p

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Re: 0883: "Pain Rating"

Postby Noah1989 » Fri Apr 08, 2011 5:39 am UTC

phlip wrote:Personally, I think the Hyperbole and a Half pain scale... much easier to figure out than a scale based on "the worst you can imagine"...


That's what I was thinking, too.

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CorruptUser
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Re: 0883: "Pain Rating"

Postby CorruptUser » Fri Apr 08, 2011 5:42 am UTC

Maybe it's emotional pain?

I'd say the most painful thing imaginable (by myself) would be on your deathbed, looking back on your life, and realizing that your entire existence has not done one thing beneficial for the world.

The Ferengi had something similar; at the end of your life the grand Exchequer or something would evaluate your life, and determine whether you produced more than you consumed, and from there either sent you to heaven or hell.\

Also, I like Pratchett's version of hell. After centuries, physical pain becomes meaningless to an immortal soul. Rather than have to roll a boulder up a hill for it to fall back down each day, you had to first read the 20k page manual on "Safe Boulder Moving Techniques", and rather than have a vulture eat your liver each day, it would just talk about its hernia operation.
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Re: 0883: "Pain Rating"

Postby phlip » Fri Apr 08, 2011 5:46 am UTC

Mahou wrote:Specifically, the one where you're frozen in ice, unable to move for all of eternity. I believe that's the one for non-belief.

Wikipedia says Treachery. The one for Heresy (which isn't quite non-belief, but meh) is being trapped in flaming tombs. Which would also be pretty uncomfortable.

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enum ಠ_ಠ {°□°╰=1, °Д°╰, ಠ益ಠ╰};
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Re: 0883: "Pain Rating"

Postby Sheikh al-Majaneen » Fri Apr 08, 2011 5:55 am UTC

Mahou wrote:I was once thinking about the supposed rings of hell. Specifically, the one where you're frozen in ice, unable to move for all of eternity. I believe that's the one for non-belief. I somehow managed to grasp a small bit of what that would be like.

It was one of the most horrifying experiences I've ever had.

I remember the description of hell in the wishing well dream in House of Leaves. That honestly is probably the most terrifying thing I have ever read.

Eternity falling through the abyss with nothing but terror to keep you company. When he says that he knows instinctively that some people have been falling down the well for thousands of years.

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Re: 0883: "Pain Rating"

Postby s0merand0mdude » Fri Apr 08, 2011 6:09 am UTC

I've always hated rating my pain, mostly because it's so arbitrary and varies wildly from one patient to another, but also because how much pain I'm in shouldn't affect anything all that much. I'm in pain. Fix it. Don't ask questions.

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Re: 0883: "Pain Rating"

Postby ijuin » Fri Apr 08, 2011 6:16 am UTC

AndyS wrote:After I went to the hospital with an unknown abdominal pain and rated it a "7" or so, I found out that it was a case of kidney stones. The admitting nurse said she'd had one patient in on two seperate occasions; once with kidney stones, and once because he had been shot in the abdomen with a .38 revolver. He said the kidney stones were worse. The nurse thought that maybe I needed to recalibrate my pain scale :-p

I've heard that a gunshot wound actually isn't as painful as one would expect unless it hits your most sensitive spots--after all, most of your pain receptors are in your skin and your gut lining, not in the fluid space between them, so a bullet that punches through skin and doesn't hit any major nerves is perceived only as "punched a hole in my skin" rather than "tore up my lung/liver/whatever". It's stuff that pinches nerves (a slipped disk or spinal injury, kidney/gall stones, a tumor, etc etc) that hurts worst of all.

Personally, the worst pain that I had that lasted for more than a few minutes was a toothache that happened to me over Christmas one year--the thing that sucked about it was that since it was Christmas, I had to wait two weeks before I could get any treatment OR get a prescription to get my hands on any painkillers stronger than aspirin/tylenol/ibuprofen. I'd say that any pain where you'd gladly render yourself unconscious (or dead) in order to escape from it counts as "extreme".

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Re: 0883: "Pain Rating"

Postby A_of_s_t » Fri Apr 08, 2011 6:24 am UTC

Magnanimous wrote:I'd say he's about a seven.

Does what hurt?
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Re: 0883: "Pain Rating"

Postby meh » Fri Apr 08, 2011 6:33 am UTC

AndyS wrote:After I went to the hospital with an unknown abdominal pain and rated it a "7" or so, I found out that it was a case of kidney stones. The admitting nurse said she'd had one patient in on two seperate occasions; once with kidney stones, and once because he had been shot in the abdomen with a .38 revolver. He said the kidney stones were worse. The nurse thought that maybe I needed to recalibrate my pain scale :-p


I had a similar experience with kidneystones. The pain scale had always bugged me; I'd been fortunate never even to have broken a bone, much less had any really traumatic injury. Now I know what real pain is like.

When the attacks first really got going, I said that it was an 8, thinking I could still imagine worse. Later on I had to say that what was an 8 an hour before was maybe a 4 now. And I had to recalibrate a few more times as I gradually got to the point where I couldn't even listen to them talking or respond to their questions because of the shivering and vomiting. That's a 10.

Relatedly: morphine is the shit.

Edit: grammar.

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Re: 0883: "Pain Rating"

Postby Randomness » Fri Apr 08, 2011 6:35 am UTC

What, No migraine sufferers? I'd say a bad one of those is a 7/8, where the only thing you can think of is how wonderful unconsciousness would be. A 9 you wouldn't be able to think even of that, and a 10 your body would automatically give you unconsciousness.
Of course at those levels you would be unable to communicate with a doctor.

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Re: 0883: "Pain Rating"

Postby vodka.cobra » Fri Apr 08, 2011 6:35 am UTC

phlip wrote:Personally, I think the Hyperbole and a Half pain scale... much easier to figure out than a scale based on "the worst you can imagine"...

I have never seen this before, and I laughed more at this than at Randall's comic.
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Re: 0883: "Pain Rating"

Postby Faranya » Fri Apr 08, 2011 6:35 am UTC

phlip wrote:
Mahou wrote:Specifically, the one where you're frozen in ice, unable to move for all of eternity. I believe that's the one for non-belief.

Wikipedia says Treachery. The one for Heresy (which isn't quite non-belief, but meh) is being trapped in flaming tombs. Which would also be pretty uncomfortable.

Actually, disbelief is the first circle, which is for the so-called "virtuous pagans," those who did not accept Christianity but otherwise were good people. If I recall my Dante correctly, it is a perfectly comfortable area in which all the great pagan minds may meet and live together, the only punishment being the knowledge of your own damnation (i.e. that there is in fact something better, but you may not attain it)

So...yeah, you get to hang out with Plato, Euclid, Socrates, et al. for eternity. Much better than either frozen in ice or entombed in fiery sarcophagi.
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Re: 0883: "Pain Rating"

Postby Aliquantic » Fri Apr 08, 2011 6:40 am UTC

Am I the only one who normally thinks of pain in terms of instruments or sounds rather than intensity, depending on how it's been caused? Though I suppose you could always rate it depending on how high the pitch "feels"...

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Re: 0883: "Pain Rating"

Postby konkonsn » Fri Apr 08, 2011 6:51 am UTC

Plasma Mongoose wrote:As far as I know, Irukandji syndrome is the worth pain ever, most sufferers beg for death after suffering it.


I only read a few articles after a google search, but it seems the begging for death is less about the pain and more about some weird mental thing the poison does, making suffers feel a great sense of doom.

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Re: 0883: "Pain Rating"

Postby Nooseybear » Fri Apr 08, 2011 6:56 am UTC

AndyS wrote:I saw this color-coded chart in a hospital once:

0- No Pain
1- Awareness
2- Mild
3- Annoying
4- Uncomfortable
5- Nagging
6- Distressful
7- Dreadful
8- Horrible
9- Agonizing
10- Excruciating


Wow, that's quite a jump from 5 to 6. I'd say that a bad paper cut was uncomfortable, and scraped skin was wagging, but it'd take a lot more for something to be distressful...

pareidolon
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Re: 0883: "Pain Rating"

Postby pareidolon » Fri Apr 08, 2011 7:03 am UTC

When I was in the hospital after heart surgery my pain rating never went above "four" when I was unable to sit up. There was a guy across the room from me though who was a pain rating of "nine" and happily scarfing down food.

ChaosR
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Re: 0883: "Pain Rating"

Postby ChaosR » Fri Apr 08, 2011 7:22 am UTC

I'd opt for Cluster headache (http://en.wikipedia.org/wiki/Cluster_headache) as the most painful thing out there. From literature and experience, I got to say, those things hurt. They are said to hurt more than amputating a limb without anesthesia. I don't know about that, I just know that I once had an attack so severe I was rendered in a state agonizing pain, barely able to mumble a few words, for a few hours.

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Re: 0883: "Pain Rating"

Postby Evil Midnight Lurker » Fri Apr 08, 2011 7:31 am UTC

Plasma Mongoose wrote:As far as I know, Irukandji syndrome is the worth pain ever, most sufferers beg for death after suffering it.


The worst pain known is being heavily stung by the Australian box jellyfish.

You can be sedated up the wazoo, completely unconscious, and SCREAMING IN PAIN IN YOUR SLEEP. :shock:

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Re: 0883: "Pain Rating"

Postby Tenom » Fri Apr 08, 2011 7:52 am UTC

Child birth and kidney stones have been found to be the most painful (natural) events a person can undergo and the two are comparable to each other. I've also heard that cholelithiasis is up there.

Personally when assessing pain I give my patients a 0-10 scale saying that 0 is no pain and 10 is the worst pain you've ever had in your life. Thus I give them both a (fairly) objective value and something to compare their pain to right off the bat. If someone is telling me their pain is worse than when they slipped a disc I know right away that it is serious. This approach usually works except for those who maybe have not experienced much pain in their lifetime, those are few and far between however. If someone like that gives me a 10 and is carrying on conversation with me I weigh that into my assessment. To me 10 is hunched over in bed/wherever doing absolutely nothing, let alone speak, out of fear of making the pain worse.

But as already mentioned pain is a very subjective thing. A 4 for one person may not be a 4 for another. Thus we try and collect as much information regarding the pain as possible, this also aids in diagnosis. Questions can be like what kind of pain is it? Is it stabbing, burning, aching, tearing, crushing, dull, pinching, etc? Is it constant or does it come and go? What makes it better, what makes it worse? Is it associated with any kind of activity?

Pain is treated as the 5th vital sign as so many things can be affected by it. Controlling a patients pain can mean the difference between them getting up and walking and being discharged and being confined to bed and developing pressure ulcers.

Edit* Not including the dreaded jellyfish toxin things in terms of natural events. I once watched a documentary of someone who had been stung by one. It was horrifying to watch.

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Re: 0883: "Pain Rating"

Postby Nic the Man » Fri Apr 08, 2011 7:59 am UTC

Don't do this IRL. From my experience, hearing anything less than a 7 means that the doctor/nurse/whoever will laugh you all the way back to your car. So even if you think it's just a cut in the leg, IT'S AN 8 GODDAMMIT!

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Re: 0883: "Pain Rating"

Postby Technical Ben » Fri Apr 08, 2011 8:27 am UTC

Perhaps "the worse pain you have experienced".
Else it's usually subjective anyway. The doctor just needs to look at what kind of pain relief. If you say a "1" your rating the importance low. :?:
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