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Indeed, health care has been a major source of new jobs. The 63-year-old Cleveland Clinic has become one of that city's largest private employers. Surgeons at the hospital perform some 4,000 coronary bypasses a year, and a $500 million building program is under way to expand the 1,000-bed facility. The hospital's payroll has almost tripled during the past ten years, to 7,400 professional and hourly workers, including 2,000 residents of the largely black Hough district that surrounds the clinic...
However, in general, pain clinic patients have less concrete causes for their suffering. For them, the first step often is to be weaned from whatever narcotics they have been taking for relief, substituting methadone if necessary and offering psychological counseling. Doctors tend to frown upon the use of narcotics and muscle relaxants like Valium because they may add to a pain sufferer's debilitation...
...helpful not only in relieving pain, but in helping patients get on with their lives despite it. Such treatments, including exercise, whirlpool and massage, are particularly useful for back pain, which is often compounded by muscular weakness. Before Maureen Brennan, 37, of Helena, Mont., arrived at the Seattle pain clinic for treatment of her back problem, she was confined to a wheelchair and was spending $180 a week on narcotics, sleeping pills and antidepressants. An accident four years earlier had ruptured five discs in her spine. Seven operations had failed to relieve the pain, and her weight had dropped from...
Hypnosis, biofeedback and TENS stimulation, once considered "fringe" methods of treatment, have earned respectable places in the pain clinic arsenal. Acupuncture, which tends to give only temporary analgesia, has a smaller following. According to Bonica, TENS provides significant short-term relief for 65% to 80% of patients and long-term relief for 30% to 35%. The electrical stimulating devices are widely available at costs ranging from $60 to $400. Biofeedback...
...seen patients and I've cried," he admits. "It stresses me emotionally to see a patient in severe pain who could be relieved and is not." And yet, according to his asso ciates, Bonica never discusses his own pain. Says Bill Fordyce, a psychologist at the Seattle clinic: "He's a tough...