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Edward H. Livingston, MD

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In reply

I agree with Dr Rousseau: pain control is a serious issue and education is of paramount importance. Dr Ferrell's response typifies the emotionalism that has driven the movement for pain as a fifth vital sign. Dr Kozol's point was that pain is not a vital sign—it is a symptom—and insisting that it can be accurately measured and, therefore, precisely treated is misleading and dangerous. Dr Ferrell is a research scientist with a PhD, meaning she cannot prescribe narcotic medications. She typifies what those of us in the trenches face: an armchair quarterback. Surgeons stand by a patient's bedside in the middle of the night and face the dilemma of treating a patient's pain and must balance that treatment against the potential complications posed by analgesic medications. The next morning, we are subject to intense criticism by those who never engage in this sort of . . . [Full Text of this Article]

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RELATED LETTER

Pain Assessment Is Vital—Reply
Robert Kozol and Anthony Voytovich
Arch Surg. 2008;143(1):99.
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