Views & Reviews Medical Classics

The Broken Column

BMJ 2011; 342 doi: (Published 04 May 2011) Cite this as: BMJ 2011;342:d2419
  1. Desmond O’Neill, consultant physician in geriatric and stroke medicine, Dublin
  1. doneill{at}

It is a sad reality that pain, one of the most common and distressing symptoms of illness, is all too often neglected by doctors and nurses. Detection and measurement of pain in our patients is often shockingly deficient and unsystematic, and the problem is compounded by routine undertreatment.

How can it be that large groups of generally well intentioned, educated, and motivated people are insensitive to this aspect of their vocation? Among the possible explanations is, of course, that pain, unlike broken bones or cancerous masses, is invisible. In addition, the mean age of healthcare workers is considerably lower than that …

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