Dear House of Pain (aka Pain Management Resources),

I just opened your quality assurance envelope, and found Discharge Instructions for the Epidural Steroid Injection. The first two of the three paragraphs include "What is an epidural steroid injection? And “What happens during the procedure?”

Your pamphlet description outlines the procedure mostly as I imagined—from pantsing/positioning me on the table and cleansing the area, to the painful-but-bearable local anesthetic injection. Actually, cleaning between the seat cushions was a little more than I bargained for, I’ll admit, but I knew to expect some unpleasantness.

I had some idea that the procedure would prove painful. “I don’t want to scare you” and “excruciating” served as two examples of cautionary phrases from close friends. I did not press those friends for more information. Instead, I got plenty of assurances from acquaintances who never had the Epidural Steroid Injection that sedation was probably meant for people with intense needle phobias, and that surely a local would suffice. Even if I had received said pamphlet before the procedure, I don’t think “You may feel some pressure or re-creation of your pain symptoms during the procedure and after the procedure” would’ve changed my elected course of pain management.

I felt ready. Unafraid. I’m no hero, House of Pain, but I figured I could deal with a brief injection after numbing with an anesthetic. My last child’s linebacker shoulders brought him into the world at ten pounds, one ounce, and no amount of Pain Management Resources can ease a side of beef through sausage casing. So to speak.

In fairness, this injection was the first epidural I’d received that didn’t include the joy of a baby-chaser. During the throes of labor, a shot in the spine is of little consequence. In fact, I might’ve tried to open-mouth kiss my anesthesiologists in gratitude on both occasions. Thankfully, they wore surgical masks. I digress.

For those of you Pain Managers who’ve never experienced the Epidural Steroid Injection, whereas the epidural during labor feels like manna from heaven, a cortisone injection with only a local anesthetic on a typical Friday afternoon, feels like High tea with Hannibal Lecter—when he makes you his clotted cream.

Now, had your pamphlet described the process as “shooting flaming saganaki through your sciatic nerve” I might have chosen differently. If I’d known that Dr.Trapper John would quip, “Which is it? Is it an ooh or an aah? You must choose” in response to my OOOOOOOHHHH AAAAHHHHH OOOOOH AAAAHHH cries mid-procedure, I might have chosen a more convincing pain-phrase. Pain never caused me to speak in tongues before, so I can’t be certain. Maybe “OPA!” would’ve been more appropriate.

I soon realized that Dr. Trapper John’s lighthearted attempt at humor served as part of a staff-wide pain-distraction technique of ill-timed jolliness. Three different nurses employed this technique, assaulting me with “So are yer kids getteen excited fer Christmiss?!?” as they chiseled me off the table, as they wheeled me down the hallway to my recovery cubicle, and finally when they lowered me into my trendy green recliner for my fifteen minute recovery.

The nurses then suggested I fill out your customer satisfaction survey, and proceed directly to the lobby to make an appointment for a follow-up injection in two to four weeks. I was welcome to drive home given that I wasn’t sedated, if by “drive” they meant sob-clutch-brake-sob-accelerate-wince-clutch-shift-brake-writhe-sob.

I would not describe myself as a satisfied customer per se.

However, spending the afternoon at your clinic did provide me with an emotional catharsis unparalleled since 1992, when I cried—hyperventilating through my Milk Dud/Popcorn whippets—for all of inhumanity as personified by Rebecca De Mornay trying to frame Ernie Hudson in The Hand That Rocks The Cradle. Catharsis opportunity notwithstanding, If you’d like to know what you could improve? Strongly encourage sedation for all of your clients. Let them know they will spend three hours at your clinic in a hairnet, and for all that is holy stop asking the traumatized Jewess if her “kids er getteeen excited fer Christmas.”

Ann Imig