Tuesday, 27 May 2014

Life is pain

Posted by Jenni Remnant

To avoid only writing (read complaining) about the difficulties of care, and in contradiction to the misleading title, I thought I’d write something uplifting-ish about a couple of events I’ve attended over the last couple of weeks.

The first was ‘Communicating and understanding pain; a multidisciplinary approach’ and the other was ‘Applied qualitative research in health; where now?’.

Both, I’m glad to say, were great.

I’m a bit of a pessimist about these events, not because I think they’ll be naff, but because I don’t have a lot of faith in my ability to maintain my mojo and absorb/impart any quality information over an entire day, especially post-lunch. I also get pre-event guilt about having inconvenient dietary requirements, and pre-event nerves that I will have to make small talk. I’m even worse at small talk than I am at big talk.

And....sometimes I worry that events will be as boring as hell and exercises in back patting, navel gazing and academic out-rankery.

Fortunately these two were totally great. The one on pain was split across two days; first an evening event at Durham University with three speakers Clare Roques, Suzannah Biernoff and Rachael Gooberman-Hill, and then panel discussion. The three talks were totally different, but all really engaging – totally outside of my area of study, but at the same time useful and relevant in terms of ordering thoughts, and seeing the wider picture. It was followed with a day of discussion, discussion and more discussion, with a free lunch lobbed in the middle (thumbs up to a free lunch). The basic premise of the day was to find an ‘answer’ (or at least more questions) in response to the ‘problem’ that in the north east the prescription of analgesics is 5x that of the national average.

I was sat in a room discussing this with neuro-scientists, clinicians, pharmacists, students, social scientists and an art historian. How fantastic is that? I don’t know if it was a lucky collection of people, or whether my expectations had been unfairly low, but the collaborative aim of the process was totally achieved; the discussions were varied, as were the ontologies of the attendees – but somehow it worked.

One group discussion I was in did travel further into philosophical thinking than my brain usually lets me travel; whether representation is representation, or whether representation is reality...etc, but mostly we kept on task and kept it real – we talked about GP consultation, hospital treatment, where pain came from and what relationship un/employment has with pain.

We talked about the dehumanisation of patients, and then over lunch with a pharmacist and clinician, about the potential necessity of that practice sometimes to avoid dehumanising clinicians; for example, if someone witnesses a lot of pain and death in their line of work, there may be utility in being a ‘body mechanic’, rather than engaging in the reality of all that sadness.

By the end of the day I got the impression we all felt energised rather thant comatose, and had truly given our brains some exercise, while also beginning to contend with a pressing public health issue.

The second of the two events was the British Sociological Association applied qualitative research in health symposium. Back on home turf in the Research Beehive in Newcastle, which was a good start.

This one was predominantly presentations, but included break out groups in the afternoon and a key note talk by Carl May. Also, to my delight, tweeting was encouraged with the hashtag; #AQHR.

The presentations were fantastic, a moving presentation was delivered using videos of patient narratives, one on the use of qualitative research to support randomised controlled trials, in addition to fascinating presentations on linked-up interviews, researching sensitive and distressing topics and various ways in which applied qualitative research in health has filled in the gaps left by more traditional health research styles.

The day was also, at times, very funny, certainly the quotes from research conducted in Glasgow around sexually transmitted infections in middle-aged adults had most of the room smiling.

The hashtag was well used – and the keynote speech was fantastic. Though I lost track a couple of times, on winding, but ultimately entertaining tangents, it was a pleasantly natural and informal talk from Carl.

In the break out groups I joined a group that focused on PhD student specific issues and was reminded of all the challenging parts of completing a PhD, though our group was fairly pragmatic – we identified that things that we thought were huge and bowled us over (criticism from supervisors…etc) were likely to be forgotten instantly by busy academics who probably have to rush off to another meeting or to teach…etc. We also highlighted the excellent use of a managerial tool used in academia and no doubt more widely in public health; ‘the sh*t sandwich’, whereby your criticism is sandwiched by positives, only we decided that it was more akin to a ‘sh*t pitta’, in that the bread is very thin, and the filling fairly substantial.

Rather typically – having spent both events listening and scribbling down notes as I’d realised they were going to overflow my brain’s capacity – on beginning to type them up, I gestured slightly too emphatically when describing what a great week I’d had and sent my full cup of coffee cascading across said notes rendering them illegible (see image above).

So can we do them again please? ;)

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