“We Believe You”: The Moment That Changed Chronic Pain Care

Keith Meldrum: [00:00:00] So the most important thing ever is that you matter. Every single human life matters. And when you're at your darkest. And your lowest and you just feel like you can't do it anymore. That's when we have to have that conversation with ourselves and say, I, I've gotta take some of this energy that I'm burning into fighting this, and I have to turn it inwards to myself.

Mark Kargela: What if the most powerful pain intervention isn't a procedure or a pill, but three words that change everything? We believe you.

Welcome back to the Modern Pain Podcast.

This episode continues our series where we put the lived experience of people in pain front and center. Today we're joined by Keith Meldrum, who survived a devastating car crash at 16, and then spent decades navigating surgeries nerve blocks in a system that often dismissed him.

Keith shares what it was like to live in constant pain while fighting both his body and the healthcare system, and how a single moment of validation shifted his entire path. We will explore why pain is always biological, but rarely only biomedical. How stress and stigma can crank up the volume [00:01:00] and how moving from fighting to willingness opens the door to function and meaning again, if you work with complex pain or you live with it, this episode offers real world strategies powerful reframes and a story that proves recovery isn't just about eliminating pain, but reclaiming life. Now onto the episode.

This is the Modern Pain Podcast with Mark Kargela.

Mark Kargela: Keith, I know your story a bit, but I'm wondering if you could kinda share a bit of what it was like when pain was at its worst, where you felt like you were in that struggle with pain.

Keith Meldrum: maybe I'll just frame it a little bit of context is how I got there.

Everybody's story is different. Mine is just mine. But I think it helps to just paint a little picture of. You know what, what happens to get me in that? 'cause I believe, the precipitating event also caught was some of the causes of my challenges over a few years.

So I'll make it short. And many years ago now, it's almost 40 years ago now good thing I was sitting down and I said that. But in in August of 86 when I was young and didn't make good decisions at 16 years old, I [00:02:00] got behind the wheel of a car after drinking most of the night and got very little sleep. And found out in the hardest way possible that a combination of alcohol and lack of sleep will cause you to fall asleep behind the wheel. And then when you're trying to drive down a rural highway in the middle of British Columbia, in Canada when the highway bends on a big curve you don't, and you go straight over the bank and roll your car down and over end.

Did you have this? Rather in my mind, spectacular car accident. I don't really remember much of it and I was inside at the time, but that accident while I was wearing a lap belt it caused a significant internal trauma, tore me apart inside, just quite horrifically. And if the car accident wouldn't have been witnessed, then it just barely was.

Two people saw me leave the highway. You couldn't see the car down at the bottom of the bank, so that's where my life would've ended. That cool August morning, but fate intervened and two ladies saw this crazy guy driving down the wrong way right for them when I pitched her off the highway. So I, that, [00:03:00] that's what sort of entered me into a life of pain, and it was sudden.

But, I, what I also wanna acknowledge is that. That genesis is different for every person. It can be something as simple as waking up one morning and you have pain in your back that wasn't there when you went to bed. Or you can have a traumatic car accident like I had. So the how really isn't relevant except for, in my case and for others, it does paint a bit of the background color to a story.

So that's what happened in my. Wound up in a hospital for, I was in the hospital in the ICU for 10 days and had major surgery and I wound up having multiple surgeries after that 'cause there was just so much damage and trauma and. I was launched right into almost immediately a life full of pain.

And I remember once I was at a teaching event, a pain school in, in, in Quebec, and somebody had asked me when did they think my transition from acute to chronic pain occurred? And as we know, the golden rule is, three months and we can have a [00:04:00] conversation about that some other time.

But I said I think it happened while I was lying in the ICU. And the reason for that was I had no path other than where I went because the surgeons told my parents after my accident the words that my mother relayed to me was, she said, the surgeon said he's going to live, but he is gonna have a whole bunch of problems later. And it was just ended at that. It wasn't like, and when that occurs, here are the things that we can do to help him. It was like he's alive and it's gonna cause problems later. Full stop. And it did. And the years after my accident were just fraught with pain. Right from the time that I left the hospital, it was just, it was always there and it never went away. And I'm 16 years old and as we know it was males, the male brain doesn't fully develop till I think the day we die. And then maybe it's not still quite, but, so at 16, in my head I'm thinking. I'm young and I was fairly strong. Thank God back then. 'cause I think that helped get through what I did. But I'm like, when I was a kid playing [00:05:00] sports and I would break bones all the time, broke nose playing hockey and collarbone, and, but yet you broke something and it hurt. And then the hurt went away and the thing that got broken got better. So in my mind I'm like I got hurt, then I got broke and they fixed the broken thing and I'm gonna get better.

And I never did get better. And that caused me to be on this focused path of they, they've just gotta fix me. It's great that they patched me up when I had my car accident, but, they've missed something. There's more that they can do. I didn't have the right surgeries and I was just, I was focused on making the pain go away.

'cause I thought they just didn't get it all or didn't do what they needed to do. And. Underlying all of that. And this is why I wanted to just share what caused the accident was in hindsight, and this is probably about 10 years ago, that I really came to realize maybe some of the challenges were also brought about by being 16, being a near fatal car accident lying on the ground.

And one of the few memories I have from that accident was begging to die. I had no will to live anymore. And the pain to this day is, I don't have [00:06:00] any words to describe it. It was just all encompassing and I just, I didn't wanna live anymore. So I have this, all of this, like I gave up and I wasn't strong and I wanted to die. Terrible car accident, all of this stuff. And at no time did somebody say This could be a bit of a problem for you. You might wanna talk to somebody about that. Never, ever offered an opportunity to talk through it. Having said that, if I was, I probably would've been too stubborn to say, I'll take it, because I just thought I needed to push my way through it and find somebody who could fix the pain. All of that to say 15 years, I chased down every intervention. I made decisions in my life to prove to myself and to what I thought was the world that this car accident and my injuries weren't gonna hold me back. That I was gonna be anything I wanted to do, and I kept making life decisions and trying things in my life that just made my pain worse and would cause me to wind up going into the hospital again.

And those interactions, and this is the late eighties, early [00:07:00] to mid nineties, we're challenged now with the stigma and the misunderstanding and the dismissiveness. The sideways glance cells of chronic pain or persistent pain, especially when you enter an er, go back 30 years. It was terrible. It was just like you were immediately suspected of being a faker. All sorts of other issues. I remember laying on er beds for hours before anybody did anything. 'cause they would just kinda let you there leave you there to sweat it out. 'cause they, I think they didn't believe you half the time. Life was just full of these terrible choices I made trying to push through believing in my mind that the pain had to go away because I couldn't believe that you could live with pain. Like I'd never, anytime I'd hurt myself as a kid, the pain went away and why wasn't it going away now? And I tried every intervention and if they could stick a needle in me, I had the needle done. I had multiple surgeries. They would go in sometimes and just. They don't do this as much anymore, not nearly as much back then, they'd be like, oh, maybe [00:08:00] we missed something. They cut me open again and go rooting around in there for I don't know what. And I would suggest all that did was actually cause more harm than any good.

But there were times when some doctors thought they were doing the right thing, but it was just a life consumed with pain and a lot of confusion and misunderstanding in my life as to what caused it. On top of all of that was an interaction I had when I was 19 with my family doctor. I'd had probably my third or fourth surgery by that point, and I'm in his office and I'm saying it still hurts, like I still have this pain.

My left side and my flank, it still hurts all the time, and he. I remember like very clear to this day. He just looked at me and he said, the surgeons have fixed everything that was broken. This is all in your head. So now I'm, and I'm 19 or 20 or whatever at this point. And I'm dealing with all of this trauma, physical trauma from the car accident, this underlying emotional, probably psychological trauma [00:09:00] that I pushed to the back of my head 'cause I didn't wanna have to deal with it. And then I'm told I'm making pain up and not just. It just screwed me right up because I kept thinking to myself how crazy must I be to keep doing this to myself pretending I have pain, putting myself through all this terrible interactions and needles and surgeries if it's not real? And it just created this knotted bald mess of emotion and pain and just not really knowing what to do and not finding anybody who could help me. I just kept getting dismissed or I would be told on numerous occasions, what do you want me to do?

Mark Kargela: I'm wondering if you could. Discuss a little bit of your relationship with pain as you were in the midst of that struggle. I know it's changed over time, but I'm wondering when you're in that struggle, like how did you view pain and was your relationship with it, as you were going through that difficult stretch.

Keith Meldrum: It was nothing short of adversarial. I viewed my thing as the enemy. And as I mentioned earlier, I viewed it as and again, it [00:10:00] kept in the back of my mind was my GP back then saying, this is all in your head. So I'm like then I just have to push harder. It hurt.

I knew it hurt. I could feel it, but I'm like maybe I'm. Making it up. Maybe I'm making it worse than it is. Maybe I'm attention seeking, or maybe I'm doing all these things. So I had, I just had this truly adversarial relationship with my pain and every day was a dance of it trying to knock me down and be trying to push it down. And that's what constantly led to these these decisions. And pushing myself to do things to, 'cause I just thought if I pushed harder, I could get past it. I could get on top of it because I obviously just wasn't trying hard enough. Or in my head, I just needed to think my way out of this pain and just bare, it, just bear down and push through it.

But it was always there, it was always in my mind. And those. Who are listening who live with pain. It's with you 24 7. You never get a break from it. And it was always right up front. I now refer to it back [00:11:00] then, as it was the shadow that used to walk ahead of me and trip me up all the time. It was always there and sometimes we could get along and a lot of the times it would just stick its foot out and trip me up and down I would go and we would just tumble. Our way through another mess.

Mark Kargela: You mentioned the fix it approach that you are after, and that a lot of people are after, right? We want it fixed, and I think healthcare maybe puts that message out there and not in a. Negative intentions. I think in the grand scheme, I think most healthcare people are you are looking to do their best for somebody.

But I'm wondering if you could speak to that for people who are like, struggling with why isn't healthcare fixing me? And where maybe you see the shortcomings of that kind of thought process from healthcare.

Keith Meldrum: That is probably for me, it turned out to be one of the biggest moments that took me a long time to get to because like you, I think I dealt with a number of healthcare providers who did wanna try and help. And so they would try these different interventions 'cause they were. They were physicians and they [00:12:00] wanted, they saw somebody who had a problem. They wanted to do their best to fix it. But it, it just never, it never worked. And I was focused on fix it because, as I said earlier, I remember I had a terrible, pretty good bike accident and I broke my collarbone and cracked my elbow as a 12-year-old. And I was fine. I didn't even, I got up, walked my bike home and I was fine until I came to the front door of the house and my mom went, oh my God, what happened? And then that's when I cried. But until then I was fine. It just tells you a little bit of the emotion and psychology of pain in there. But that collarbone and everything it healed and it got better. And I was just, I was focused in on this. I can't believe, I'm not willing to accept that you can live with pain every day. Like I had never. I'd never met any, I didn't know anybody who had, I probably interacted with them, but I didn't know it. So in my little brain that was still developing, I was like, it's not possible to live with pain every day. They've just not done enough and they need to fix it. And I kept pushing and I realized I was [00:13:00] probably a bit of a challenging patient at time. 'cause I was always looking for somebody to fix me. And I was like, you just gotta do something. And I'm sure that was sometimes I was a bit much to handle because I was just so focused on you have to fix this. I cannot believe that this can't be fixed. 'cause it's not humanly possible for somebody to live with pain 24 hours a day for the rest of your life. That just, that is just not humanly possible. But sometimes. What goes wrong in our body, whether it's, in my case it was this car accident or whatever is the sort of genesis of that pain. It there just sometimes there is not the magic bullet as much as we want it to be. And I did for nearly 20 years, I was seeking that magic bullet, that panacea, and it took me a long time to realize that everything I was doing, the pushing and the fighting. I joined the Canadian military when I was 21 'cause I was gonna show the world how tough I was. And I wound up having surgery in the military. 'cause in one physical training [00:14:00] class, I just had a terrible pain breakthrough and my gut didn't blow apart, but they went in and operated on me. I kept making terrible decisions to prove that I could make the pain go away.

And it took me a long time to finally realize everything that I was doing that I thought was the right thing to do, to push and to find somebody to fix it. It wasn't working and maybe I was wrong, but there was another it. It took another interaction for that to really land for me.

Mark Kargela: The view on pain. 'cause I think we're all taught, like your experience was, is I have pain, something's wrong. I go to healthcare. Healthcare takes care of it. My pain goes away. And that obviously got shaken for you because it was, a pursuit of trying to find that somebody to take it away and it wasn't there.

I'm wondering if you could reflect on how you view what pain is and how it's maybe a little bit more than that simple equation of damaged tissue, fixed tissue pain go away type things.

I'm wondering how your view on pain has changed over time and through this experience.

Keith Meldrum: That is I think, one of. The sort of the most [00:15:00] important things that in my life that I've gone through. And we all have these very important moments in our life. And not to minimize any of 'em, but getting married was a pretty big moment for me. That was really important. But starting to understand what sort of the totality of pain is and what it means was really very, it was pretty defining for me because I was going down a path. Fighting, gotta fix it. In and outta hospitals, it was really disruptive to my life. It was causing lots of problems. And I don't think it's I don't think I'm wrong to say that if I didn't find a different path and if I didn't find a different relationship with my pain, the path that I was on I don't think it would've turned out very well.

I don't exactly know what would've happened, but I don't think it was gonna be, where my life went. Otherwise, it was just not a good path. It was not a good relationship. There were times early in my marriage when I would say to my wife, I just wish I hadn't lived through the car accident.

I just didn't wanna do it anymore. It's just so frustrating. I never had thoughts of suicidality, but there were a couple of times I just, I remember saying, I just [00:16:00] wish I hadn't have lived. 'cause this is too hard. And what was really important for me was when I started to learn that pain, you can have tissue damage but that's not just what pain is.

And often, especially for chronic pain, it actually never is just the tissue damage. All pain is biological, but not all pain is solely biomedical. And what I mean by that, and I didn't. I didn't understand this at the time and I did actually wanna fight against it, was that pain is influenced by our lives.

Everything around it the world that we enact within and that acts upon us. And when this was first introduced to me, I just thought it was a bunch of hippie garbage people trying to find a way to just dismiss me without saying I can't help you. So this is on your own. But it's true that pain is truly emotional, spiritual, psychological. Your day-to-day life, everything impacts your pain. So in my case, I still [00:17:00] have my pain is neuropathic. That's a damage to that nervous system. But that's not just it. It is the emotions and the psychology and the stressors that I'm under. All of those things. And once I started to see that and find ways to change my relationship with some of those stressors, so get moving away from the pushing and the fighting.

'cause let's face it, we live in an environment in North America where we're, see it's, we talk about battling your disease and fighting through something. So that was it. I had to put on my armor, I had to fight and that I wasn't gonna retreat 'cause retreating is giving up. By retreating, and I don't mean giving up, but I mean by stepping back and not pushing against it, but allowing it to come in a little more. Taking a look at it and saying, what is, what's going on today? Oh, I'm having a really stressful day, and if I can find ways to deal with that stress, guess what? My pain went down a little bit and when I started to see those connections, which at first when I was [00:18:00] told. Those emotions and psychology effect I thought was just bunk when I started to actually try it and see that it did have an effect.

That's when I realized pain is so much more than just the damage that I had for my car accidents. It's the life that I live and the life that is lived upon me that affects my pain.

Mark Kargela: People who will comment on stories like I've shared with people who've gone through some pretty difficult pain things, and you're speaking to this right now, but they say, but what about real tissue damage? What about real tissue damage? Like I'm wondering where you think the, because that's a struggle to switch that thought process.

I'm just wondering if you can speak to. Somebody who's having this difficulty where maybe this is Keith before he's ready to make this I got damage. This isn't my, I got damage. I know you're talking about all this psychosocial stuff and people get rightfully mad. I'm just, I'm wondering what you would say to somebody who's having a real difficult time to consider that it's more than their tissues.

Keith Meldrum: [00:19:00] That is I think one of the single, it probably the single hardest thing to get over. 'cause that was a nut that I just I struggled to, to crack and 25 years later, after adjusting my life. It still pokes me in the eye because I have tissue damage. I was torn in, literally torn in half. I don't have most of my left abdominal muscles.

I have a great big chunk of plastic that's in my left abdominal wall to hold me in there. Every time I had pain in my brain, every twinge, every torque, every twist in my brain was I'm tearing something apart. I'm damaging it, and it. It was just a matter of, and it just doesn't happen overnight. At least it didn't for me that I had to come to the realization that all of this trauma, all of this tissue damage that I had and still have, I, it wasn't getting more damaged.

So when I felt that pain and I would tense up and I would stop and I would just get all stressed out what I was doing was just. Adding to that pain through that stress. But I thought I was doing the [00:20:00] right thing by stopping and guarding and like holding tight. 'cause in my mind I was like, oh, I ripped something.

I, in my mind it was always, I ripped something, something's ripped and it's hard because it hurts. You can feel it. In my case, I can look down and see the multitude of scars that had been opened up numerous times and go they cut me open and they went in there and I'm missing stuff.

And they put things in me. I had a colostomy. They took it out. Like my brain was so focused on all the biomedical issues, I was sure that all of my pain had to be related to that tissue damage. And only that. And I think it's normal. When it hurts, you're like, see, the thing that got damaged is what hurts. And it might. But all of the things in our lives amplify that hurt. And when I started. To take a step back and give myself some space and stop fighting it and stop being on top of it and stop just focusing on it as much as I did. I found that I could get that pain to modulate down [00:21:00] and back off a little bit.

I'd love for it to go away, mark. I'd give anything, just have it gone. But the life that I have now with pain that is less and that I understand more that. All the damage that I had is not getting further damaged. I'm not harming myself. It hurts, but I'm not harming myself. And if I control the things that I can to help on those days, when it starts to get pretty toy to help back that off, then that, that is something that I need to do to help manage that pain.

But it's really tough when you have physical damage to your body. To not believe that is the sole cause of your pain. And really all that I can offer is it's not it's affected by so many other things. And I'm not saying ignore it. 'Cause if I still, if I move the wrong way, if I try and lift my arms over my head, hold 'em upward, my head, that brings on a lot of pain just so I don't do that. I, that's actually biomedical, so I don't do that because it really hurts. So I've learned how to move and how to care [00:22:00] for my body in a way so that I don't exacerbate that pain. But I also understand when I do something and I move in, it hurts. I no longer go right to, something's tearing apart in me.

I'm just like, oh, that I tweaked it. And I just gotta take a breath, sit down, catch my breath, relax, and then the pain just backs down to its normal levels. And then away I go.

Mark Kargela: You've had a pretty difficult journey as you were navigating healthcare, and I remember you and we've taught, talked about this in the past, how it became very, your relationship almost was healthcare became very adversarial because of the frustrations you were having of difficulties to find anybody who was truly able to take this thing away for you.

But then you had an encounter and we spoke to this again, but I think it's just powerful to share for folks that maybe haven't heard this. I'd love if you could share a little bit of that turning point for you that kind of set you on a different path.

Keith Meldrum: It's a point that I realized after it happened just how important it was. And then as I got into my advocacy work and talked to many other people, I realized others had these same sort of [00:23:00] pivotal moments in their lives. So for me, I was in a little bit of the backstory again, why I was chasing down interventions.

I was having nerve blocks. I was having para vertu, para vertebral nerve blocks. And one of the one of the possible risks with those is you, it could possibly cause the lung collapse 'cause they're, I always thought the needle was about this long. It sure felt like it going in, but it's an uncomfortable procedure.

But I kept doing it 'cause I thought it might help and it never really did. But on one of the, one of the intervention sessions, but the doctor who was really trying his best he really wanted to do what he could. I had a partial left lung collapse, but a one third collapse. And so he was like, okay, that's it.

Like we're, it's happened. They're not really effective anyway. And he referred me to a specialized clinic in Vancouver, here in British Columbia and said, you might wanna try or consider something called neuromodulation. Which when I looked into it and it was connecting face to my spinal cord, I was like I just don't know about any of this, but. I was at a point I just didn't know what to do and I [00:24:00] was still looking for the fix and nothing else was working. So I talked to my wife 'cause I really wasn't too excited about somebody rooting around in my spinal cord. And I said to her like, I think I just have to try it. I just, this might be the last shot and I think I just gotta try it. So I went ahead with the referral and I went to the hospital in Vancouver and I was sitting in. A little dingy hospital room as every story goes. 'cause they're always little and dingy. And the doctor was doing the intake. And by this point in my life, so this is 2004, the accident's in 86, I'd probably related my medical history dozens of times to healthcare providers. And you get to a point where you're detached from your health and your medical history, you just, they ask a question, you just answer. And I wasn't even looking at him. He was sitting off to one side and I'm just. Staring ahead and he's asking questions and I'm just answering them by rote. And we're going through it. I don't know, maybe halfway through, I'm not sure. And he had just stopped asking questions and I looked over and what the hell? And he put his pen down and in my mind I'm [00:25:00] like, oh yeah, here we go. I didn't even make it through the intake. I'm such a loser. Like they, they figured out right at this point. So this isn't the right thing. It's not that bad. They can't help me. In that moment, I had just every thought go through my head as to why this was just gonna be an abject failure. And I was just, probably within seconds, I had just gone flat. But I looked at 'em, I was just waiting for the rejection. And his name is David Hunt. Talked to David Hunt and he just looked at me. And he held my look and he just said, it's okay. We believe you and I like I was expecting you have to leave. 'Cause we can't help you. And that was the first time in nearly 20 years I actually had somebody in healthcare truly with compassion and empathy.

Look me in the eye and say. We believe you. He, what he said was, your pain is real. Like he didn't say those words, but by saying, we believe you. He said, your pain is real. And I was like, in my head, I was like, [00:26:00] hallelujah. Somebody finally believes me. And I'd love to say 24 hours later I had a complete new relationship with my pain. Not so much, but that was the beginning. The change in my path from going down the one that was not a healthy relationship with it at all, and fighting and not having the best quality of life by any stretch, that allowed me to change that trajectory. Just even one degree. A one degree course correction over time.

That's a big change, and it took time. But he gave me that one degree change that day, and over time it moved me onto the path where I find myself today, which is having a better relationship with my pain and learning how to live the best life I can despite.

Mark Kargela: Speaking of relationships, I'm wondering how you. Could, how, if you could speak to a bit about how relationships were impacted by pain, and I know it sounds like your wife was very supportive throughout this as you've journeyed through it, but maybe not even just [00:27:00] relationships with your spouse, but I'm wondering like, just even relationships with coworkers, I'm wondering how you felt pain really impacted relationships that you had.

Keith Meldrum: that is it is something I've certainly learned and heard a lot from people over the years. That is one of the most challenging things. 'cause I would suggest, and thankfully this I didn't really experience this, and I think that's just through the grace of. Whomever you believe in. I had just an amazing support network and didn't realize it.

But pain can be an absolute relationship killer. And it can be your, if you have a partner, it can be that relationship. It can kill your relationship with your family, your friends, because over time, people just start to wanna disassociate with people because it's like you're always in pain, you don't wanna do things. You're irritable, man. I was an irritable guy. I was not fun to be around sometimes. And who wants to be around a guy who's just grumpy and snapping at people? I was fortunate that my wife, who I am prepared to nominate for sainthood never gave up. She always stuck by me. And I had a [00:28:00] group of friends who always supported me as well.

And I think there were times when, some space was given. They knew when it was time to just give me some space. But I was fortunate that I didn't suffer some of those, like crushing relationship. Sort of destructive moments, which could be just really soul crushing. And one of the things that just adds to people's pain because your social network is gone and that causes stress, and that stress then feeds back into your pain.

So for all the things that weren't going right for me throughout my entire pain journey, I was my parents supported me. And then when I got married, my, my wife supported me and the employers that I had supported me, I. So one thing I cannot complain about, I was just, I was so fortunate, but I could see how easily it is to have those relationships erode because pain just sucks to life and the soul out of people, and that just drives a wedge between them and the people close to them.

It's you don't want it to, but it [00:29:00] just does.

Mark Kargela: Often hearing those stories of. of those relationship challenges too, that can, obviously, supportive situations that can really help pull you through. And then some other ones where it's a struggle to maintain some of those good relationships when you're dealing with a struggle, a mighty struggle at that on your own.

I wanna move it over towards acceptance. 'cause that word has some connotations and some difficult interpretations from folks that hear that for the first time. And that's often, proposed as something that we want to help people work with. I know there's better words and maybe there's ones that you have that you prefer but I'm wondering if you could speak to.

Maybe acceptance in how you might have, how people might view it in a incorrectly, and maybe you did as you were first hearing it and what you thought maybe came to mind initially. And then as you've understood it and how it's applied to your own situation. I'm wondering if you could share that.

Keith Meldrum: I would say the word acceptance is probably one of the great big red hot buttons for a lot of people. Again, through my process, my. Sort of path and journey with pain was this really convoluted, twisted thing. And I actually never had anybody say to me you just need to accept this.

'cause when I was going [00:30:00] through pain at that time there were no there were no pain clinics like we see today. So I never had those kind of interactions. Nobody handed me a tattered trifold pamphlet that said, here's self-management. You need to accept your pain. I was just always told you just need to learn to live with it. Learn to live with it, which means to accept it. And that is, if you look at somebody who's in, in their darkest moment in pain, and the best advice that the healthcare provider or somebody can give to them is to look them in the eye and say, Hey, you just need to accept this. They're lucky if they don't get punched in the throat because it's not really the message that somebody wants to hear. But what they mean, and in some of the work that I do in being able to present to healthcare providers is to learn how to couch that presentation of that word. And there are different ways and Bronnie Lennox Thompson, our dear friend, she gave me the word years ago, willingness.

So instead of acceptance, willingness, and willingness in that, what am I willing to do to help myself live better with my pain? And that's a little less sharp than you need to [00:31:00] accept it. 'cause acceptance feels like somebody's telling you it's all you. You're on your own. We're abandoning you. We're gonna be over here and you're just going on your way. But regardless, there needs to be people. I had to and others. You have to come to that point. You have to have that moment where you. Look yourself in the mirror. And I actually remember a day having a conversation in my head where I talked about I need to just figure out what to do differently because what I'm doing isn't working, it's making it worse, and maybe I don't know what I'm doing. And so that was my own internal acceptance speech, which was maybe this. And I, at that time, I wasn't, still, wasn't prepared to say it's gonna be with me for the rest of my life. But I was like maybe this is gonna be around for a lot longer than I want it to be. So what can I do to help myself just live a little bit better with this?

Because everything I've done for the last 18 years is making it worse, and I don't want I just didn't wanna do it anymore, mark. It was just [00:32:00] too hard and it was too tiring and. I often believe, and I've had a few conversations with people, actually, sometimes people actually have to be almost at that bottom point where they're like, nothing else is working. So I need to be willing to look outward a little bit and then inward it myself and say, what can I do to just help myself just live like a little bit better tomorrow? If I just a little bit better tomorrow, then I can worry about the day after that. 'cause you're not gonna change it overnight.

It takes a long time. To retool your life from the fighting and all the things that you've been doing. You don't just 24 hours later go off, I got this, I got it all figured out. Hell no. But if you do a little bit today and then a little bit next week and some more next month, and again, it's that trajectory change that one degree course check change over time, you will find it.

It is a big change. But it's a moment. And I did I remember I was sitting on the couch in my living room in my head and I was having a conversation about, I can't do this anymore. It's not working. I need [00:33:00] to find ways to learn to live with my pain somehow. 'cause it's obviously gonna be with me for a while. Acceptance is a tough word. I like willingness. I like conversations about. Talking to people about what is it that's important to you, even if there's one thing. 'cause ultimately what we wanna do is we wanna regain function. We've lost a lot of the things in our lives that are important to us. We've lost function. The things that we like to do, we can't do 'em anymore. Somebody they like to walk and now they can't walk anymore. These, then what? What can they do? What are they willing to do to maybe start walking just a little bit? Oh, look, I walked a hundred meters today. I used to walk five kilometers. I can't do that, but I walked a hundred meters.

Oh, look at that. And then over time, that hundred becomes 200 and a thousand. And, but it's about regaining function, about regaining control, that getting that locus of control back and just regaining their life a little bit. So acceptance can be a little bit harsh, it can come across a little knife edgy. But it's about. That willingness to change and that has to come from within. Nobody [00:34:00] could make me do that. That had to come from me and again, as I've said, probably too many times it was because I just couldn't do it anymore.

Mark Kargela: You had mentioned the adversarial fight and battle in healthcare and the cultural narrative is pain's, weakness, leaving the body, we gotta fight.

I'm wondering if you can tie that to willingness, do you think there was a willingness to drop that fight to, to and not in a surrendering fashion, right?

I'm wondering if you could discuss where willingness and that struggle and how that relationship with pain may maybe changed as you showed that willingness to maybe not have to fight this passenger that we're not really fans of that are part of our journey anymore, but maybe something that you could tolerate or had a willingness to have that still be present.

But man, I'm willing to. Do some things in life that are meaningful and matter to me. I'm just wondering if you could share that in your experience.

Keith Meldrum: that was hard because at least I was. I was wired that way and I still think it's a little bit prevalent in healthcare, so we still talk about it, fight. I have another unrelated disease and, talk about fighting that disease. I'm like, that's not, it's not really helpful words 'cause I have [00:35:00] a certain amount of energy capital and I don't need to be burning it up on things I don't need to be fighting. But what I had to learn was I was in my mind, the fight showed my strength. If I fought against this, I would rise up. Literally in my mind, I was rising up every day and I was battling against it. 'cause that's what you do. You're strong and you fight against it. And I had to learn that my, that the greater strength was coming from stepping back.

Sometimes an army has to retreat in order to win, and our greatest strength can come from taking that step back and saying. I can't fight this anymore. I need to find a way to, to live with it. Like we, we just, we gotta find peace. You gotta if it's a battle, we're finding a truce because the battle's never gonna end and it's just gonna wear everybody down and in the end, you're just gonna be a shell of yourself. So the greatest strength, and it was really hard for me to accept and to understand, [00:36:00] was. My greatest strength came from not fighting anymore, which is really counterintuitive because you're wired in your brain to fight 'cause that's what you do. And, I go back to having my car accident, 16 years old, lying at the bottom of the bank, pawing at the dirt.

I remember that as clear as day, begging, pleading to die and afterwards. After I got outta the hospital and months later, I was so ashamed because in my mind I had given up, I was weak and I wasn't strong enough, and I didn't try to fight through it. In that moment, that defining moment in my life, I felt just, I just felt so much less than a human being because I just gave up. But the greatest strength comes from recognizing that you can't always fight and life will be better when we just take that step back and as you said, look at the things that we can do to regain some function in the meaning in our life. And that's when you can start moving forward again. And at that point you're gonna move around what you're fighting with, like 'cause, but butting up against it isn't working. So you [00:37:00] just gotta find a way to flank it and get around it. Nice. You gotta move back, re-strategize, and then find your way around.

Mark Kargela: Some great advice. I'm wondering if you could, if you're somebody here listening to this, is in the, some of the dark times, some of the difficult times. Where you mentioned as part of your journey, you've you hit that bottom, but I'm wondering what you'd want to somebody here who's going through that right now.

Keith Meldrum: So the most important thing ever is that you matter. Every single human life matters. And when you're at your darkest. And your lowest and you just feel like you can't do it anymore. That's when we have to have that conversation with ourselves and say, I, I've gotta take some of this energy that I'm burning into fighting this, and I have to turn it inwards to myself.

'cause it also requires some self-compassion. I personally I never wanted to. Have any self-compassion. I was mad at myself. I had felt this was all my fault and I had this terrible fight with the healthcare system. I had a terrible fight with myself. But we [00:38:00] need to have some self-compassion and say I am worth being here and worth living.

And if I'm burning up all my energy by fighting these external forces, and I'm just not gonna win. I'm gonna channel some of that energy back on myself, and it actually takes energies. This might sound weird, but it takes energy and strength to not fight to, to re-channel that into yourself and to love yourself and to care for yourself, and to give yourself space to say I am worth it, and I can do this, and I just need to find a different path. The one that you're on, I have yet to find anybody, and maybe they're out there. I have yet to find anybody who has gone down the path of just hitting it head on and beating their head against it, that it's worked. If they're out there, I just, I haven't met them.

Mark Kargela: If that makes two of us Keith, we could talk forever. 'cause I always enjoy your perspective and as we're huge fans of making sure stories like yours. Are told so people can see what some people who may look [00:39:00] like the situation they may be going through or some of the deep dark struggles that folks in pain go through.

So I wanted to thank you personally, but also those listening I'm sure want to thank you for all the work you're doing to tell your story, but also to advocate for healthcare professionals to listen and to have more people. Tell people I believe you, which is a shame that still isn't front and center for most of our healthcare encounters.

So again, thank you so much for what you're doing and hope to, we're gonna hopefully get you here and talking to us soon and look forward to projects in the future. I.

Keith Meldrum: I appreciate that. Mark and I'll just leave this there's a quote that I use all too often and this is, this goes for healthcare providers a little more, but it goes to the, there's not enough compassion in humanity in healthcare. I'm not saying none, but over. It's just there's not enough.

And William Osler, who is a Canadian physician, 1849 to 19 19, 1 of his I just love this quote. A good physician treats the disease, the great [00:40:00] physician treats the person who has the disease. We need to treat people first as human beings, and that compassion and that humanity will give them the runway they need to be able to move forward.

Mark Kargela: great quote. We're gonna leave it there this week. For those of you listening, we'd love if you could subscribe to the podcast. If you know somebody who's struggling with pain, share this episode to them so they can hopefully get some words of wisdom from Keith and maybe a new direction to take with their pain.

Love, if you could share the episode, we will leave it there this week. We'll talk to you all next week.

Speaker: This has been another episode of The Modern Pain Podcast with Dr. Mark Kargela. Join us next time as we continue our journey to help change the story around pain. For more information on the show, visit modern pain care.com. This podcast is for educational and informational purposes only. It is not a substitute for medical advice or treatment.

Please consult a licensed professional for your specific medical needs, changing the story around pain. This is the Modern Pain Podcast.