“I believe you will marvel, as I constantly do now, at just how much a doctor can learn in four years.” — Robert T. Cochran Jr., M.D.

In Understanding Chronic Pain, Cochran’s first book, he spoke with patients about their experience with unrelenting pain, developing a “thesis that chronic pain was a form of mental illness, and that by understanding and treating the mental illness one could often cure chronic pain.” Cochran saw links between chronic pain and issues such as childhood trauma, depression, substance abuse and bipolar disorder.Cochran was available to sign books for his readers.

“I believe you will marvel, as I constantly do now, at just how much a doctor can learn in four years.” — Robert T. Cochran Jr., M.D.

In Understanding Chronic Pain, Cochran’s first book, he spoke with patients about their experience with unrelenting pain, developing a “thesis that chronic pain was a form of mental illness, and that by understanding and treating the mental illness one could often cure chronic pain.” Cochran saw links between chronic pain and issues such as childhood trauma, depression, substance abuse and bipolar disorder. In Curing Chronic Pain, that thesis has been developed with much more depth and refinement, and offers examples of dramatic cures obtained by the treatment of underlying mental illnesses, often with drugs not conventionally used for that purpose.

Curing Chronic Pain uses anecdotes to illustrate specific experiences of pain.

In explaining chronic pain, Cochran defines it as:

• Pain that persists beyond expected recovery time
• Pain that extends beyond the original scope of the injury
• Disordered sleep with worsening pain at night
• Disordered appetite with weight gains, cravings for sweets or, conversely, weight loss with disgust for food
• Disorders of mood (despondency, depression or its opposite, restless hyperactivity/angry irritability)
• Diminished energy and pervasive fatigue

Q: You have been practicing medicine for over 40 years. How did you come to focus on chronic pain?

Dr. Cochran: From early on, I developed great empathy for victims of chronic pain. I felt that their disease was misunderstood, and that they were often mis-served by the medical community because of the suspicion that their pain was an excuse for the use of addictive drugs. I found that by removing myself from this preconception and listening – in detail – to what my patients told me, I could better appreciate and understand their illness. That practice has served me well, for I have learned that only by skillful interview can one correctly diagnose and treat the victim of chronic pain.

Q: How is Curing Chronic Pain different from your first book, Understanding Chronic Pain?

Dr. Cochran: Understanding Chronic Pain was, in its way, a breakthrough book because it developed the thesis that chronic pain was a form of mental illness, and that by understanding and treating the mental illness one could often cure chronic pain. In Curing Chronic Pain, that thesis has been developed with much more depth and refinement, and I offer examples of dramatic cures obtained by the treatment of underlying mental illnesses, often with drugs not conventionally used for that purpose.

Q: For many, you are their last hope when it comes to treating their chronic pain. How is your approach different from a more traditionally minded doctor?

Dr. Cochran: General physicians are obligated to search for the cause of pain as some form of injury to the body. However in many, indeed most, cases, a precise cause cannot be identified. When such patients are referred to me, I search for the cause of chronic pain not as injury to the body but as injury to the mind. Therefore, I spend my time researching my patients’ personal, social, and emotional history in an effort to understand their pain, often with dramatically successful outcomes.

Q: What is your opinion regarding the use of addictive drugs such as opiates and stimulants?

Dr. Cochran: I am an enthusiast for their use in the appropriate circumstances (and there are many). I have learned that the risk of addiction is less than I originally thought and, most remarkably, I have learned that the judicious and careful use of addictive drugs can not only diminish pain, it can cure mental illness.

Q: What message would you like to convey in Curing Chronic Pain?

Dr. Cochran:There is hope. It is a logical hope, and it is a scientific hope, and it is a realistic hope. It is the hope that derives from realization that the victim suffers a biochemical disease of the mind that can be cured with pharmacy. That is my message.

Dr. Cochran is a graduate of Vanderbilt Medical School and completed residency in internal medicine and neurology at the University of Texas and Duke University. He founded a private medical practice in 1963 and had over the years treated thousands of patients with chronic pain.

He is co-director of the Pain Center at Centennial Hospital in Nashville. He lives in Nashville with his wife, Donna.

Our objective was the Governors Square complex, where one finds several of the largest retailers in our community: Target, Circuit City, JC Penny’s, Dillard’s, Old Navy, Sears, Toys ‘R Us, to name a few. Driving through the various parking lots, we found them — unlike last year — disappointingly bare of overnight campers. Target, Dilliard’s, and JC Penny were completely empty, and Toys ‘R Us and Sears had only one car each.

The first stop on our survey tour was the Best Buy Store. At 2:02 a.m. there was a line of approximately 60 to 75 people camped out at the store. Sleeping bags, tents, lawn chairs, blankets filled the sidewalk along and past Premiere Medical Center and wrapped around the corner. This proved to be the largest gathering we encountered in our city tour. Best Buy had set out Port-a-Potties, lighting and recorded outdoor music for the campers. Speaking with a few of the hearty souls gathered revealed the following:

• Having arrived at 5 a.m. Thursday morning, Dan Stafford was looking to save money on a laptop
• Aaron Watts said he started his vigil at 1:30 p.m. Thursday and was looking for computers, both a laptop and a desktop
• Souette Quinn took up her post at 4 p.m. Thursday. She was looking to save $500 and buy a laptop and software.

Next we traveled to Circuit City. At 2:11 p.m. there were considerably fewer campers awaiting the Black Friday savings. Daniel Lockwood was there with his friend Raphael Alexander, looking to save money on cellphones, DVDs and video games. They had began their vigil at 6 p.m. Thursday. Quentin McLaughlin was interested in MP3 players, the Samsung Fuse, a Nintendo DS and was looking to spend about $250. There were also two good friends from Trigg County in the small group of about 15 people.

From Circuit City, we traveled to the front entrance of Governors Square Mall, where an even smaller group of die-hard shoppers stood their ground in the silent dark. Mitchell said he had been there since 11 a.m.. Ashley and Amber came on the scene at 11 p.m. with their Uncle Roger as guardian. They were looking for anything from Hot Topic and getting something to eat. Ashley admitted her funds were rather meager but she was hoping to find good bargains. There were about eight people camped out at the entrance and maybe four more in parked cars. At this point, we drove around the mall, finding the parking lot barren at JC Penny, Belk, Dillards, Old Navy and Sears. Toys ‘R Us was likewise forlorn, as was the lot at H.H. Gregg.

There were about 15 cars parked awaiting the specials at Kohl’s. K-mart employees seemed to be only cars in that parking lot- there was no one inside the six cars parked there and TJ Maxx was even more so vacant. However, Office Depot did have a hearty bunch awaiting their door opening. Wendy Kostenbawder and Jenny Shulze had arrived at 2:30. Wendy was looking for a laptop. Drew Jeffrey said he was also looking for the laptop special. The sales flier said there would be a minimum of six at each store and there were seven shoppers in this group. Right next door at Electronic Express, Dakota said he had been posted since 6 a.m. Thursday and was looking for a laptop. Other locations scoured included Borders, Pier 1, Books-A-Million, Hastings, Radio Shack, Hollywood Video, Big Lots, Grandpa’s, Riner’s and Chuck’s Furniture Stores, and both the Wilma Rudolph Boulevard and Fort Campbell Boulevard Wal-Mart Super Centers. Except for the Wal-Marts, businesses were all closed, with no indicated activity inside and no shoppers camping out for specials. The Wal-Marts were open but with no appreciable volume in their parking lots.

This little tour ended at 3:40 a.m.. It is hoped that shoppers did arrive after our drive-through, but the feeling from most the people we talked with indicated that while they were intending to spend some money, they had specific objectives and were not looking to be extravagant or deviate from their shopping lists. Everyone referred to being practical in some sense or another. This does not bode well for merchants. Last year early bird shoppers numbered in the thousands at the various retail outlets. What we saw would barely break the 130 mark. Our conclusion: the economy is having a definite impact on consumer shopping. Merchants are going to have to keep bargains in front of the public and have sufficient staff to insure quick processing at the check-outs. Best of luck to us all.

Share your Black Friday experiences. Did you shop online, go to Nashville, Bowling Green, Memphis, Atlanta, Louisville or not bother at all? Or are you looking for specials on Franklin Street or other local venues? Maybe you went shopping on Thanksgiving Day. How will you spend your holiday dollars this year?