Q&A With Dr. Banez

As the Program Director of the Pediatric Pain Rehabilitation Program in Cleveland Clinic Children's Hospital, Dr. Gerard A. Banez works with children each and every day. He watches them heal, helping them (and their parents) learn to deal with the pain and how to improve. I've recently interviewed him to get a better look at what he does and how he does it.

Dr. Banez, where exactly do you work?

Cleveland Clinic Children's Hospital

What is the average age range of the patients you see daily?

With our pain rehab program, which is what i do most of my time, i typically see kids who are in the junior high to high school age range. I do, however, continue to see some outputs, mostly kids with physical problems or psychological problems. These patients have an age range of 3 up to 21.

What is the protocol that you go through on an average work day?

Each day is different, but most days consist of some combination of clinical work (assessing and treating kids and families), teaching (I teach a lot of psychology, pediatrics, and pain management trainees), research (mostly on kids and pain), and administrative duties.

When working with your patients, what is the first thing you do?

The first things I do are (1) try to understand what the child''s primary problems are, (2) identify possible causes/reasons (biological, psychological, social) for these problems, and (3) determine what kind of help the child and his/her parents are looking for.

With kids, to be successful at these things, I think that establishing trust and support is key. Being respectful, sensitive, and taking the time to listen is huge.

These things are also very important when working with parents. With parents, I try to convey that they are the "experts" of their children and that my role is to use my experience to collaborate with them.

I see that you work in a Pain Rehabilitation Program. What is a younger patient's reaction to pain as compared to an older patient's reaction?

A young child's reaction to pain is more simple and basic than an older child's For young kids, pain hurts. They don't like it and will do anything they can to avoid it. Young kids are often dependent on their parents to make pain go away. They don't think about how they can help themselves.

For an older child, the reaction and possible outcomes are a lot more involved. For example, if an older girl hurts herself playing soccer, she may start thinking and feeling all kinds of things about the pain and its consequences - "Is it serious?" "What if I can't play soccer again...soccer is my life!" "All my friends play soccer, what will happen if I can't play with them anymore?" and so on.

The increased complexity can make dealing with pain more challenging because the more that kids think and worry about their pain, the worse it feels and the harder it is for them to deal with.