Do we have pain killers that would stand up to things like the brazen bull, rack, crucifixion, Judas’ cradle, etc without suffering pain, but allow also one to be fully aware of what is happening and also that the pain killers would not hinder motor function ?
IANAD:
I don’t think so. There are limits. My sister is a nurse and my (former) BiL is a doctor and both have mentioned people in so much pain that pain killers were not sufficient (IIRC my BiL said it was a burn victim and they had to induce a coma…not 100% I remember that correctly…my sister said it was a motorcycle rider who got in an accident and had road rash to a ridiculous degree).
Anecdotally, I was in the hospital room with my wife’s uncle who was in his last hours dying from cancer (I forget what it was cancer of). He was in clear agony and tearing the bedsheets. His wife begged the doctors to do something but they said there was nothing left they could do. One doctor told her he was already on enough pain meds that it’d kill anyone else in the room if they had that much (he had developed a tolerance to the drugs over time).
IANAD, but my understanding is that when it comes to the more-extreme tortures like being burned by a red-hot iron, nothing short of flat-out general anesthesia would do the trick.
Bear in mind that it’s not just physical pain, but psychological distress. Suppose someone were using a chainsaw to lop off your fingers, then toes, then your limbs inch by inch. Even if you felt no pain, you’d be in extreme mental distress over the fact that such irreversible harm is being done to your body.
Need answer fast?
First, the OP: no, I don’t think we have painkillers sufficient to kill the pain of what you mention AND keep people fully aware.
Second, regarding dying in agony from cancer: I sometimes question that, despite not being a doctor. Few doctors are really experts in managing end-of-life pain. Yet my father-in-law died at home of bone cancer without the clawing-at-the-sheets agony even though bone cancer has a rep for being agonizing. My late spouse’s pain could not be managed at home, but he was also able to die relatively pain-free from cancer in a hospital setting focused on end-of-life. Too often doctors hesitate to increase pain dosages despite the fact cancer patients can develop enormous tolerances. Even if they dose someone into unconsciousness, that’s better than being awake and in agony. Yes, that can hasten death, but it’s an instance where that’s permitted if the primary concern is to relive terminal pain.
We can’t even cope with burn victims’ pain very effectively.
The story is basically as I described it above. I was in the room and witnessed this happen personally.
That said, I was not privy to everything medically that was happening to him. Maybe there was more I was unaware of. Maybe the doctors were not doing as much as they said they were regarding pain meds (although that would surprise me…it was apparent to everyone this man would be dead in minutes or hours). Maybe his tolerance to pain meds he had been taking for many months meant they simply were not effective on him any more. He was a VERY large man…maybe there was just more of him to be in pain. Or something else. I do not know except to say he was in agony and the doctors said he was as medicated as they were allowed to do.
Yes, I understand your viewpoint.
On the other hand, my sister is an end-of-life specialist and knows considerably more than most doctors about managing all types of suffering at the end of life. So who really knows?
oh - that is quite frequent that some “lower rank” person does know a lot more in practical terms than some “higher ranks, like Doctors” on very specific matter.
I recall our GYN/OBST consulting intensively with the (very experienced) midwife when the birth of our 2nd kid ran into problems. … Practically she was calling the shots and the doctor (who was younger, but a good teamplayer) covered her decisions with his OK, I agree - lets to it this way…
So, its not a surprise that a specialized nurse could do a better job of administrating drugs to an end-of-life patient
different thought on OP: how about those “disociative” pain meds? … I once got some and woke up during a leg operation, seeing the doc with a big powerdrill working on my leg that the whole operating theater shook and smelled the smell of burned bones where he drilled… and thought - wow - thats way cool … before the anastesic guy noticed this and “gave me more” to let me doze off
To address the motor function part of the question: after my c-section, I wasn’t in a lot of pain, but my movement was really limited. For the first day (or technically, second-- see below), I didn’t have a lot of control over my lower body, because of trauma to my abdominal muscles, and swelling-- I looked bigger the day after I’d had the baby than the day before, there was so much swelling. I had ice and anti-inflammatories, though, and by the third day, was much better.
Finally got out of bed, but walked like I had spinal cord damage.
Again, really not in much pain. I’d take a c-section over an adult tonsillectomy any day, if you are just talking about pain. Migraine headaches are also more painful in my experience, than a c-section.
It’s not just a matter of controlling the physical sensation of pain that allows for full motor function.
Also, even though I was on an epidural for pain relief, I didn’t sleep during the 27 hour labor that preceded the c-section.
I imagine that few people could sleep through torture, even with total pain control, so you are left with sleep deprivation, which is its own hell.
FTR: labor and delivery was such an ordeal, that my doctor talked my insurance company into giving me another day in the hospital for recovery, albeit, as far as the insurance company was concerned, it was technically 2 days, because the first day begins once the baby is out, and my son was delivered at 11:55pm.
Yeah; I actually had very good insurance, but it followed common practices sometimes, and so my first day was 5 minutes long-- I wasn’t even in my room until about 4am, and wasn’t awake from the c-section under GA because it was an emergency, until about 1am, but that was all happening on my second day.
No, we don’t have those types of painkillers.
And I oversaw hospice patients for over 10 years. I’d say over 90% of such dying patients can have their pain minimized and die in relative comfort. But it takes decent staffing and knowledgeable, assertive nurses, aides, and physicians. It is time and labor intensive.
My MIL died of lung cancer metastatic to the brain, with her final event being an uncal herniation (pressure inside the skull forced the brain down and out of the skull through the only exit available, the space for the brainstem and spinal cord). That’s incredibly painful without meds, but with great hospice staff she had a peaceful end.
Aside: Even the Catholic Church, with its firm stance against euthanasia, considers this acceptable.
I’m not sure why you assumed my sister was a nurse.
She is an MD specializing in end-of-life care, not a nurse.
As it happens, my spouse’s oncologist did consult with her regarding how to keep dying patients comfortable.
Obviously, because of the way you worded it. That also was my initial assumption, that she was some sort of doctor-adjacent professional.
“On the other hand” makes it sound like you’re introducing a contrast. Then you don’t mention that she’s in the same group your contrasting her with. Next time, try writing “knows considerably more than most other doctors”. Better to write clearly than to blame the reader.
You did say:
If she is a doctor then you could say the same about all doctors. Any doctor with a specialty knows more than most doctors do about that specialty. It’s a truism.
Odd phrasing.
Just wanted to add
Yup.
No way to temporarily snip/deactivate the nerves in the spine just below the skull?
Real question (I have no idea and kinda surprised it never occurred to me before):
Are the nerves that transmit pain signals different than nerves used for motor control (moving)? Can you snip one and not the other?
That’s more anesthesia (reduction/elimination of sensation) than analgesia (reduction/elimination of pain) but yes, sensory blocks can be placed at certain level (an arm, a leg, a foot etc.) to stop all sensation in that region of the body. But to eliminate sensation yet leave motor function intact starting above the Cervical spine vertebra #1 (i.e. from the neck down) is, I think, not currently feasible.
There’s a condition some people are born with that keeps them from experiencing pain. It’s dangerous, because they can be very injured or sick and have no idea.
Apparently, they have normal motor control, though.
I don’t know whether the condition is brain-based, though-- which is to say, they may have normal neurological pathways for pain, just no place in the brain to process them.