Yes, it is excruciating pain
One of the major factors that hinders the results of rehabilitation is pain.
Since this pain is something the person themselves perceives,
if a patient says they are in pain, that is pain,
and even if you ask how much it hurts,
because there are individual differences in how strong or weak one is against pain,
the assessment is extremely ambiguous.
Therefore, based on the pain I have experienced in my own life so far
and the experience I have gained from working in rehabilitation,
I have no choice but to imagine the extent of the patient's pain.
This is quite difficult.
Come to think of it, my father used to say,
there are three types of pain that one cannot endure.
First, abdominal pain.
Second, toothache.
Third, headache.
Indeed, all of these are unbearable pains.
However, these are only for healthy people,
I suppose that caveat would be attached.
The people we deal with are sick or injured.
Moreover, when suffering from an illness, the degree and quality of the pain differ,
they may be taking painkillers or psychotropic drugs,
and factors like body position and posture
all intertwine to create a comprehensive pain,
making it even more complicated.
While working and being troubled by such patient pain,
very rarely, I encounter a mysterious kind of pain.
It is a pain that has benefits.
When in pain, others will help them.
When in pain, they get attention.
When in pain, they are treated kindly.
For some reason, this pain, which should be distressing,
has become a necessity in their lives.
I think the way it manifests varies depending on their past living environment
and human relationships, but in any case,
these pains are used
to manipulate others.
People who have become accustomed to this pain
are beyond the reach of a single physical therapist.
So, when I am in charge of such a patient,
I do not touch their body at all.
Because,
They will say, 'You did something to me (Yama-chan),'
'It got even more painful,'
and nine times out of ten, things will get complicated after that.
Because they vividly complain of pain,
they keep looking for causes outside of themselves,
so a profession like ours, which relies on touch,
becomes a perfect target.
Therefore, the rehabilitation content is
just walking,
just doing light exercises together,
and just watching from afar.
I simply repeat these three things.
Then, they become unsatisfied,
(I won't get better with this kind of rehab, right?)
and start asking for physical therapy using special machines
or for a massage.
It's strange, they almost certainly say 'massage'.
At such times, I refuse smoothly.
I come up with some reason and refuse smoothly.
I continue to refuse until they understand
that I will firmly not touch them.
Then, they will manifest pain in a different location
to try and get attention.
I suppose that is how they will go on to die.
Changing the subject,
there is a condition called malingering.
As the name suggests, it is pretending to be ill,
and rather than a symptom, it is nothing more than a habit of that person.
In some cases, people end up calling an ambulance,
undergo numerous tests,
and it becomes a serious matter.
When the doctor tells them,
“As a result, there is nothing wrong with your body,”
they let out a deep sigh,
and they don't give up, asking,
“It hurts this much, so why?”
It almost looks as if they are blaming the doctor,
as if to say, “Don't you even understand that?”
What will happen to them from here on?
They go from hospital to hospital,
collecting diagnoses of 'nothing wrong' from everywhere.
“My pain is special, and it cannot be cured.”
The pain eventually becomes sanctified,
and as if boasting to everyone they meet,
they continue to complain about how severe their pain is.
“Both my legs hurt so much that I can't walk alone.
I've been to many hospitals,
but none of them can figure out the cause.”
There are parallel bars, long and sturdy bars on both sides.
Inside the equipment used for gait training,
that is what she said.
When I watch her from nearby,
the performance of her faltering steps begins.
However, when Yama-chan pretends to have other business
and leaves the area,
she starts walking sluggishly without any expression of pain.
Even within her,
she knows at least this much:
she cannot let her natural muscle strength decline
by just continuing to say it hurts.
She cannot let her body get worse.
She only wants someone to pay attention to her.
Therefore, she starts walking sluggishly.
The staff all know it too.
They know she is malingering.
But since pain is ultimately subjective,
if they say it hurts, then it becomes pain.
She, too, will likely die that way.
Once again, I touched the painful area of another patient
and gave the muscle a direct, firm stretch.
“Is this where it hurts?”
When I asked that,
the patient turned their eyes toward me
and calmly
said, “Yes, it is excruciating.”