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Berde and his colleagues inserted a spinal catheter and gave the boy a local anesthetic and an opiate. The patient had been screaming; now he became comfortable and alert and was able to go home. Although that treatment had been used to control pain in adults, Berde says, "I don't know if it had been used much in kids. We had no protocol for it. But he clearly was terminal and not relieved by massive amounts of morphine...

Author: /time Magazine | Title: A CHILD'S PAIN | 10/1/1997 | See Source »

...Berde's research interests is developing local anesthetics that will work for days or a week after surgery instead of for six hours, as existing drugs do. Prolonged pain after chest or abdominal surgery is not just unpleasant; it can be harmful as well, keeping a patient from taking deep breaths or coughing--things they need to do. Pain can also keep people bedridden, impeding their recovery. "Our major aim is to get people up quickly," Berde says. "They're less likely to develop pneumonia, lose muscle mass and have trouble sleeping." Ambulatory adults are also less prone to blood...

Author: /time Magazine | Title: A CHILD'S PAIN | 10/1/1997 | See Source »

...pain killers now in use have drawbacks. Morphine, codeine and related drugs, given by mouth or intravenously, can cause such side effects as nausea, constipation and itching. Epidural blocks can lead to similar problems. In addition, they must usually be removed before the patient goes home, even though he or she may still be in pain. Berde has found that many people are reluctant to take pain medication at home, or give it to their children, in the mistaken fear that they will become addicts...

Author: /time Magazine | Title: A CHILD'S PAIN | 10/1/1997 | See Source »

...then return to the hospital to take care of a child who needs help, particularly one who is dying of cancer and in great pain. It is also not rare for him to get a 3 a.m. phone call from, say, India for a consultation about some young patient in pain. "He has worked almost every day of the week almost since I've known him," says his wife Evelyn...

Author: /time Magazine | Title: A CHILD'S PAIN | 10/1/1997 | See Source »

...conditions under which Batista, 50, operates when he is in Brazil are spartan at best. There is little modern monitoring equipment at his Curitiba hospital. Instead, his technicians are instructed to look for three things: the patient's feet should be pink, to demonstrate adequate blood pressure; there should be urine output, to indicate that the patient has not lost kidney function; and the surgical drain should be clear, to show no internal bleeding. Surgeons depend on large windows in the operating room to provide adequate light for operations...

Author: /time Magazine | Title: TOO BIG A HEART | 10/1/1997 | See Source »

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