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Only after she had knowledge of her cancer, or maybe its implications, did she report pain. Maybe losing her role as the caretaker, or leaving her home, full of cues to be the caretaker, caused her to experience more clearly what was happening in her body. Or maybe we just pushed opioids on her. Treating pain is rife with uncertainties like this. There is no biomarker for pain. Assessing pain is dependent on the communication skills of the patient and doctor. Pain is not one thing but many, and all are in interplay. Opioids complicate, not simplify, the treatment of pain. Opioids powerfully relieve psychiatric symptoms, but they are not indicated for any such conditions.

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