Emotional and regulatory balance in clinical practice and spinal cord stimulation

(Jim, my patient who is photographed with me, has approved the words in this article).

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It is often said that the personal qualities that we have as humans can be both our greatest assets and our areas of vulnerability as doctors.

For me, I think it is essential that surgeons are able to understand and “feel” the pain of our patients in order to be able to empathise and have our patients know that we understand their journey and care for them.? The downside of this quality is that most of my clinical professional life is feeling the pain of others because every new patient has a problem.? Some patients are subconsciously very good at seeking to transfer their problems to me and I continue to work on my strategies to avoid taking on the problems of my patients.

On the flip side of this is the joy that we can experience when we are able to use our skills and knowledge to help people and make a real difference to their lives.? So the purpose of this post is to support and validate fellow “heart centred” doctors while sharing the joy of a beautiful success story to start the year and making a public call-out.

In 2017, I was asked to surgically place a thoracic spinal cord stimulator system, supplied by Abbott, within Jim’s body.? After successfully placing the paddle based system without complications, Jim returned to the care of his treating Pain Specialist.? He returned to see me in October 2024 as the battery of his system needed replacing.? We took this photo at the October consultation.? His battery has been replaced and his satisfaction continues.

It was wonderful to hear how spinal cord stimulation had changed his life.? I acknowledge Jim's Pain Medicine Specialist, Dr O’Callaghan, who made the diagnosis of neuropathic pain and recommended the treatment.? Jim told me that he went from having no hope and no quality of life to being active, healthy and happy.? He again became a contributing member of the community.? He said that the treatment saved his marriage as “I wouldn’t have stayed with the angry, negative and depressed man in pain that I was”.

Sadly, our patients who do well with our care pass through our rooms temporarily while those who don’t have a great outcome require our regular attention.? It is important therefore to hold onto these precious moments that people like Jim share with us and “let them in” to give us strength to help others and maintain our own emotional balance.

One final comment to those who are leading the campaign to deny Australian patients, like Jim, the chance to get their life back through spinal cord stimulation.? Please be fair, moderate and balanced in your thinking and move away from whatever ideology is driving your behaviour.?

Spinal cord stimulation technology is not perfect, has its risks, is expensive and should be used in a responsible manner befitting its "big end of town" status.? It works for many people, as it did for Jim. Some patients are unfortunately worst off from undergoing any medical intervention, including spinal cord stimulation.?

Please remember that these fellow community members usually have no alternative to add to their previous and current treatments.? The outcome of your campaign, if successful, is for them to have little hope and chance of a change in trajectory from their current state. Neuropathic pain seems awful to experience - you wouldn't wish it on your worst enemy.

You are correct in shining the light on the medical profession and our colleagues whose behaviour is also driven in ways that we as a professional community should not accept.? In my view, the lack of a compulsory clinical register for this treatment is a deficit in our regulatory framework. But please do not use the media tactics that you are using, such as hysteria, reporting that tells part of a story and calls for absolute bans. Together, let's find regulatory balance.

I acknowledge that if you are successful then you will save some patients from poor quality practitioners and you will save money for insurers.? But you will deny quality of life for so many more patients of good quality practitioners.?

Let’s work together to create a better system that focuses on delivering technology advances to those who will benefit most, keeps costs down as much as possible and removes from practice those who should not be using this capability.

Private Healthcare Australia Rachel David Adele Ferguson 雅培 Therapeutic Goods Administration Mark Butler #neuromodulation #spinal cord stimulation #neuropathic pain

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