Pain Doctor, Pain Patient
How chronic pain changed one doctor's career -- and life.
On the night of March 28, 1986, Howard Heit's car was struck in a head-on collision. He left the scene of the serious crash thinking how lucky he was that he hadn't been hurt. "And then four to six weeks later, I started noticing twitches in the muscles of my neck and upper back. These progressed to marked spasms of my neck, shoulders, and upper back," he recalls.
The pain never ceased. All day, every day it plagued him. It became difficult for him to walk -- and almost impossible for him to work. He had to rely on a wheelchair and brace to get around.
Heit went to several doctors in the Washington, D.C., area. None of them could figure out what was wrong with him. His doctors tried a variety of treatments -- massage, physical therapy, and muscle relaxants -- yet not one of them offered him pain medicine to relieve his constant agony. "Nobody, despite this tremendous pain, offered me a pain pill, even though I wasn't sleeping and I was losing weight," he says.
Even worse, his doctors didn't seem to take his pain seriously. "I had silly things said to me, like, 'The pain is all in your head.'"
Heit wasn't just any patient -- he was also a practicing doctor. A board-certified internist and gastroenterologist, he served as chief of the Gastrointestinal Lab at Fairfax Hospital in Fairfax, Va., and as an assistant clinical professor of medicine at the Georgetown University School of Medicine. And Heit knew that if the medical community was disregarding his pain, there was no way patients who didn't have the benefit of his medical expertise were getting the pain relief they needed.
"I started thinking that if this was happening to me ... nobody offering to at least discuss pain management with me ... the average person didn't have a chance out there to get appropriate treatment," he says.
(Read WebMD expert blogs "A Different Normal: Living with a Chronic Condition".)
Heit decided that he would become a pain management specialist and an advocate for people living with chronic pain. He realized that to become a pain specialist, he had to understand not only pain management, but addiction, as well, because painkillers can be habit forming.
He earned his Diplomate in Addiction Medicine from the American Board of Addiction Medicine and attended continuing medical education (CME) meetings to learn about both specialties. At his former employer, Fairfax Hospital, he bartered his services -- educating doctors there about gastrointestinal care in exchange for hands-on training in addiction medicine.
"And I set up a practice at the time that was very unusual. Patients who had pain only, patients who had addiction only, and patients who had both," he says.