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Essential Pain Management – Nizam’s Institute of Medical Sciences



Pain, and for that matter life, is too non-linear for a single-strand narrative to render it accurately. Pain, and for that matter life, is a complex bio-psychosocial challenge with a high prevalence in our society, but which is often poorly understood and not very well managed. Managing pain well, in particular, continues to have a limited role in the overall schema of medical education. When compared with other specialties it is like Charlie Chaplin, the little tramp who lets the world walk over him. Yet, it is a specialty which is deeply rooted in humanities; which could introduce healthcare professionals to diverse perspectives; and which could lend itself to interprofessional collaboration and innovative education strategies. Managing pain well, despite the challenges and barriers, by remaining undaunted like the little tramp, invariably makes the world more human. Like one feels when the credits start rolling after a Chaplin movie.

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The Essential Pain Management (EPM) programme for health sciences students was launched only a few weeks ago, but the faculty are already in great demand and have taken to teaching as fish to water. My guess is that when something is so simple, so greatly rewarded, and bears so many positive consequences, it’s a recipe for addiction. Addicted we were then, when the road show stopped at the prestigious Nizam’s Institute of Medical Sciences, Hyderabad. The physiotherapy students, who trickled in post-lunch, participated with full aplomb in the interactive lectures, clinical scenario discussions and brainstorming sessions. They were interested in everything and always had something ingenious to say about the different facets of pain. There were discussions on ethics, reflective practice, philosophy and arts, and how it could be all put together to alleviate the pain of the sufferer. And, that a singularly biological approach of medications or injections or physiotherapy would not only be a futile one-size-fits-all treatment of pain, but also doesn’t ring true against the psychological and social variables which influence pain. We are thankful to the department of physiotherapy for providing the best possible conditions for us to teach, and for the students to learn.


Hermann Hesse’s Siddhartha, after an unrelenting search, attains Nirvana by being at a necessary distance to take in all elements, which leads him to see the unity of the world. The unrelenting search in itself, he realised, was essential for achieving a harmonious relationship with the world. In this, the river plays an essential role in teaching him not only the physical and spiritual world but also time itself. And, the ferryman plays his part as a guide for both the river and the path to enlightenment. In our endeavour, the Traveling Pain School – by bringing in an understanding and coherence about the different ingredients of pain – has been the river. For the many Siddhartha’s (health sciences students) in search of pain knowledge and are open to guidance, the faculty has been the ferryman in whom they would find what they need. The ferryman points Siddhartha in the right direction, but the river – by dint of being the ideal union of polarities (read medical specialities) – is Siddhartha’s final instructor. Just like in Hesse’s novel, our ‘train-the-trainer’ programmes make sure that Siddhartha himself becomes a ferryman after he reaches enlightenment. And, in Siddhartha, only the ferrymen are able to help others find enlightenment.

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