Treating Pain and Those Who Suffer

More from our inbox:

• Strolling in the City Just Isn’t What It Used to Be
• Food Aid at Risk
• The Threat to Beech Trees

To the Editor:

Re “We’re Thinking About Pain All Wrong,” by Maia Szalavitz (Opinion guest essay, Dec. 26):

Millions of people suffer from pain, which is by far the major symptom about which patients complain.

Despite the fact that most pain can be effectively controlled, too many suffer unnecessarily, many intolerably, because of the undertreatment of pain. This has been a serious problem in the United States for decades, according to a 2011 Institute of Medicine report, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research.”

Medical and nursing schools have not done a good job training students to treat pain effectively. The vast majority of schools, inexplicably, do not have elective courses in pain management, and only a small percentage have required courses. Such courses should be mandated. And there needs to be a serious focus in these courses and continuing education courses on eliminating bias and disparities in the treatment of people of color and women.

Our health care system has failed to provide the good pain management to which patients are entitled. Ms. Szalavitz’s article should be another call to action to the federal and state governments, medical and nursing schools, and health care systems to make urgent, major improvements.

David C. Leven
Pelham, N.Y.
The writer is emeritus executive director of and senior consultant to End of Life Choices New York.

To the Editor:

Another factor contributing to the stigma of pain, as mentioned in this essay, is the value placed on stoicism in some quarters of our culture, as if toughing through and stowing away pain are good things, and as if being overwhelmed by intense and intractable pain is a form of giving in and hence a moral failing.

Pain is a part of living. It is omnipresent. Some people can cope with their pains better than others. But when pain is chronic and unbearable and the cause impossible to alleviate, as in the examples cited by the author, it is unreasonable to expect that those afflicted can do anything but suffer helplessly and intensely.

As a physician and a compassionate human being, I think the only proper and ethical response from doctors is to give due respect to their patients who are afflicted with such pain and to adequately treat it.

Paul Rosenberg
Palm Beach, Fla.
The writer is a retired psychiatrist.

Strolling in the City Just Isn’t What It Used to Be

To the Editor:

Re “The Price When Wanderers Cannot Wander,” by Shaan Sachdev (Opinion guest essay, Jan. 9):

I was disheartened but also oddly relieved to see Mr. Sachdev’s essay about strolling in New York City. After 13 years in the city I’ve been troubled lately that it feels much less pleasant to take a stroll than I recall before the pandemic.

I thought that I might be making it up, or that I had lost my love for big city living. But his words ring true: Something has changed in the relationship between walkers and vehicles in our city. Drivers are more aggressive and more distracted. Enforcement is very noticeably down.

Like him, I now find myself limiting my time outside, largely because of the hazardous nature of our city streets when outside a vehicle. Walking New York’s streets is no longer a pleasant diversion but is akin to traversing a dangerous and harried obstacle course.

Limited dependence on cars and equitable access to transportation are crucial to the long-term health of any large city. But our current crop of politicians, and in particular our mayor, remain, sadly, too fearful and too beholden to special interests to quickly make the bold, necessary changes to our streetscapes, like improved visibility at intersections.

Here’s hoping they find the courage to simultaneously save lives and help our city rediscover one of its greatest assets: its walkability.

Kenneth Lay
Brooklyn

To the Editor:

Shaan Sachdev is surely correct to blame the loutishness of certain cyclists and drivers for the increasing difficulty of being a proper flâneur in New York. But there is another important contributing factor: pedestrians who pay more attention to their mobile phones than to their fellow sidewalk strollers.

It isn’t just in crossing streets or bike lanes that one now must weave and dodge to avoid collisions. The solipsistic cellphone user may not endanger life and limb of other pedestrians. But their behavior often proves an obstacle to those who would just like to walk down a block without having to worry about whether the person coming toward them is likely to lunge left or right in the next few steps.

Mark Siderits
New York

Food Aid at Risk

To the Editor:

Re “Food Aid to Mothers and Children Is at Risk” (news article, Jan. 12):

When will the Republican Party understand that innocent children who cannot vote will be irreparably harmed by budget cutbacks to the Special Supplemental Nutrition Program for Women, Infants and Children, or WIC? An undernourished, hungry child cannot learn or grow properly.

This fight (yet again) over providing basics to those who cannot, by virtue of their age, provide for themselves must sicken all people who care about kids (and women).

Let’s hope the Democrats stress this loudly and clearly.

Barbara Gold
Philadelphia
The writer is a retired pediatrician.

To the Editor:

It is shameful that food aid in this country should ever be at risk. Our policy should be food aid to anyone anywhere anytime. It’s food.

Ellen Schaffer
Palm Coast, Fla.

The Threat to Beech Trees

To the Editor:

I enjoyed Jesse Wegman’s deeply felt commentary on the meaning of trees in his life and in ours as well (“In the Shelter of a Weeping Beech,” Opinion, nytimes.com, Dec. 25). Sadly, the beech trees he refers to may be doomed. An invasive nematode is attacking the species in a widening range from Ohio to New England and beyond.

From the kitchen overlooking our woods in eastern Connecticut, a pair of vigorous and graceful beech trees has been a treasured view. Last year the leaves emerged dark, striped, brittle and misshapen, and began falling early in the season. Our arborist offered little hope.

As December waned, our beeches and others in the neighborhood no longer carried their corona of pale winter leaves that lend a bright touch to the season in all weathers. We’re preparing ourselves to say goodbye to these lovely companions in another year or two.

Unfortunately, the beech is just the latest in a line of beautiful and majestic tree species, including the elm and most recently the ash, to fall to invasive infections and complications of climate change.

As Mr. Wegman said, trees create a “shelter for whatever or whoever might need it.” I deeply wish I could do the same for them.

Howard Drescher
Mansfield, Conn.