Series of theme Facing Death – Part 12: Dr. Louis Brasseur: Being humble to listen to patients

 
“I understand the painfulness very well, not only because I am a doctor with decades of experience in pain control but also because my wife was a cancer patient…”

Dr. Louis Brasseur is a leading pain management specialist in France. His whole life has been connected with this homeland as he graduated from a medical university and received intensive training in France. He had 40 years working in many hospitals across France including being the Director of Pain Management and Inserm Research Unit (Hospital Ambroise Pare) for many years, as well as Director of Pain Management & Supportive Care Unit, René Huguenin Hospital (Curie cancer group), and Director of Pain Management Centre (Anaesthesiology Department) at Bichat Hospital, all units located in Paris area.

He, however, quickly accepts the invitation to work at FVH in a faraway nation where there are so many differences in the environment, climate and people… Only he knows that the place has similar working culture to France where he was working at. He knows that FV Hospital has achieved two rigorous international certification from HAS (France) and subsequently the JCI International Certificate in Quality and Patient Safety.

Pain control is as important as disease treatment

Becoming the head of the FV Hospital Pain clinic, Dr. Louis Brasseur eagerly brought in and shared the knowledge of pain control to the country which still has lack experience in this field. He quickly developed a training program for the medical team, expecting all the prescriptions containing painkiller medication are at most effective and accurate along with the minimum amount medication entering the patients’ body – according to pain mechanisms. This job is very familiar to him as he used to be a lecturer in pain control in France. The challenge is that he must compete with other training programs at FVH since the hospital consecutively organizes training courses to update professional knowledge for medical staffs in various fields. The enthusiasm and energy have never been missing in the old doctor simply because he understands the important of pain management for the patient. It improves the patient life quality at the time of treatment as well as helps patients to recover and minimize dangerous complications.

He gives the example of a postoperative pain that can raise blood pressure, heart rate, causing the patient to lie still thereby increasing the risk of pulmonary embolism. Pain can also increase the size of cancerous tumors, impaired immunity, willpower and the ability of the patient to cope with the illness. “Pain control is in some way as important as disease treatment itself,” concluded Dr. Louis Brasseur.

Responsibility for the memory

Starting his career in anesthesia & resuscitation field, the French doctor had many opportunities to work with chronic pain caring patients such as bone pain, neuropathic pain, and pain from cancer, etc. Everyday seeing the pain that swirled to the bone marrow or looking at the broken bodies that lost strength when struggling to withstand the pain, Dr. Louis Brasseur determined to spread his arms to support. He concentrated in deepening his studies, studying day and night about pain management. Then as a fate, his beloved wife suffered from breast cancer and died. For several years fighting bravely in this battle field between life and death, he had moments of weakness, fierce but full of desperation, strong but greatly painful, as the result Dr. Louis Brasseur further strengthened his determination to endure his journey in relieving both physical and mental pain. He assigned that responsibility on himself: “Having a loved one suffering cancer, family members are often very anxious, fearful and that affected to the patient, too. Having pain and anxiety at the same time would cause the pain itself more intensive.” Therefore talking with the family, reassuring and soothing them become the routine procedures at the FV Hospital pain clinic.

The doctor also attaches another responsibility for himself, the duty that only those who actually experienced are able to understand. That’s the responsibility for the memories. “I had a rectal cancer patient who barely walked normally because of the pain. He dreamed of having a memorable holiday with his family before his death. That is why we used intraspinal drug injected as an infusion straight close to the spinal cord through a tube inserted under the abdominal cavity and connected to an inserted pump. This method is more effective in reducing pain than taking pills. The patient was able to run, swim and had the happy end of life. That has great significance, not just for the patient. Remembering a happy, well-treated, contented husband/father leaves a nice memory for the family so that they can smile whenever they remember him. To a doctor, that is a huge reward. On the contrary, the image of a person suffers and struggles in great painful before death could haunt the living forever.

Simple, modesy and humble

Surely, the responsibility for the patient of one doctor is at most important. Not many FVH patients could hide their amazement from the “strange” questions of the French doctor when he asks about their career, family, children, the frequency of their exercise, even the way they carry their babies. Dr. Louis Brasseur explained that pain is often a result of long-term accumulation of lifestyle, and also related to other pathologies… so he needs to look at the whole picture to find the most accurate solution. The treatment of physical pain is also closely related to mental pain, because when the patient is depressed and suffers from insomnia, treatment for physical pain shall be more difficult.

Being asked about his treatment trick, the doctor did not talk about the profound knowledge he had worked on, or the machines that supported FV Hospital’s modern pain treatment. He only said that:

 
“I try to become as simplest, modest and humblest as possible, to be trusted with patient’s issues.”

Box: A female patient at FV Hospital woke up at 2 A.M in great pain and panic. She only wanted to be examined by Dr. Louis Brasseur. “Seeing a pain treating doctor at 2 A.M?” For my surprise Dr. Louis Brasseur explained: “It was necessary because I knew well her condition and she trusted me, too. The nurse suggested that the patient should see the doctor on duty, but she did not want to. Cancer patients were often afraid of dying, so their panic was terrible and this state would be harmful to the process of treating the pain. I can always come back home and get back to sleep, but the pain and panic of our patients and family members should be stopped as quickly as possible, so I went to the hospital immediately after receiving the phone call from the paramedics.”