It's Not About The Biceps

Abstract

In the biomedical paradigm all symptoms and limitations are ascribed to discrete pathophysiology. However, a biopsychosocial health model that accounts for the important influence of mind-set and circumstances on illness may be preferable in the vast majority of cases. Some of the shortcomings of the biomedical model include an overreliance on tests and treatments. One major issue of the biomedical model is the raging epidemic of opioid misuse and opioid related overdose deaths as previously reported in North America. Emblematic of these issues is a 56-year-old male that had surgery for a rupture of the distal biceps in our clinic with psychosocial aspects of the illness that were underappreciated by the care team and had disastrous opioidcentric attempts at pain control leading to threats to hospital staff, and finally resulting in forcible removal by hospital security from the ward and national police from the hospital. One might argue that there is no higher priority than rejecting the biomedical model, understanding illness is its full complexity, and learning from the world's mistakes so that we don't repeat them.

Keywords: Elective surgical procedures; Misuse; Opioid; Postoperative pain; Upper extremity.

Figure 1a

Flexed Abducted Supinated View MRI T1.

Figure 1b

Flexed Abducted Supinated View MRI T2.

Figure 1c

Coronal View MRI T1.

Figure 1d

Sagittal View MRI T1.

Figure 1e

Water–fat MRI.