The JUNE 9 Statarticle by Seth Mnookin certainly shines a light on the difficulty of treating patients who are recovering from drug addiction when they present with a painful condition (“I have a drug history. The hospital didn’t seem to listen.’’).

As a urologist, I am quite familiar with the situation he describes.

And so it strains credulity that an individual so informed and articulate about drug addiction should feel that he was ill served by the physicians and institution that treated him for kidney stones.

It’s hard to believe that the standard warnings about opiate use would not have resonated strongly for Mnookin; that setting expectations about the use and duration of therapy would not be alien concepts for him; and that the prescribing practices he describes didn’t reflect keen awareness by caregivers of the need to prescribe these powerful medications with care and restraint in individuals with his history and the increased pain perception that accompanies it.

There is a subtle equilibrium between institutional and individual responsibility that exists and that this case spotlights.

Mnookin had two medical problems the night he arrived at Massachusetts General Hospital: I think his treatment reflected excellent care of both matters.

Dr. David Berman

Andover