John Bonica

“John Bonica and the Pain Center @University of Washington”

“In Memoriam: John J. Bonica @International Association for the Study of Pain”

“The amazing story of the man who gave us modern pain relief by Latif Nasser @TED Talks”

“Bonica... was the first to treat pain as a disease all its own, using the multiple disciplines of neurology, orthopedics, psychology, and physical therapy, along with alternative therapies such as acupuncture. I was captivated by Bonica's ability to successfully treat a multitude of patients whose pain had previously confounded doctors for years. His book revealed how, with dedication and the proper tools, pain could be eiliminated, even if the primary illness remained. This was revolutionary in the 1940s, and it was still considered revolutionary, fifty years later.”

“In 1946, Dr. John Bonica began the first multidisciplinary pain center in Tacoma, Washington, based out of a private practice. It arose from his recognition that chronic pain was optimally treated by a team of specialists. For the first time, patients suffering pain were routinely evaluated by different medical specialties, physical therapists, and psychiatrists. ...Other multidisciplinary pain programs began to emerge around the country, carrying forward the original Bonica model.”

“It has been thirty years since John Bonica, the great anesthesia-based pain educator, expressed concern that pain was not well controlled because of the failure of physicians to apply available knowledge.”

“Bonica's years of wrestling caught up to him. ...Still in his mid-50s, he suffered severe osteoarthritis. Over the next 20 years he'd have 22 surgeries, including four spine operations, and hip replacement after hip replacement. He could barely raise his arm, turn his neck. He needed aluminum crutches to walk. His friends and former students became his doctors. ... Already a workaholic, he worked even more -- 15- to 18-hour days. Healing others became more than just his job, it was his own most effective form of relief.”

“Right around D-Day, Bonica showed up to Madigan Army Medical Center, near Tacoma. At 7,700 beds, it was one of the largest army hospitals in America. Bonica was in charge of all pain control there. He was only 27. ... Bonica tracked down all the specialists at his hospital -- surgeons, neurologists, psychiatrists, others. And he tried to get their opinions on his patients. It took too long, so he started organizing group meetings over lunch. It would be like a tag team of specialists going up against the patient's pain. No one had ever focused on pain this way before.”

“Willard Fordyce, working with physician John Bonica, reconceptualized subjective ( and therefore unreachable) "pain" into observable and measurable "pain behaviors," and showed that these respond to reinforcement contingencies just like all other behaviors. Fordyce and Bonica's program at the University of Washington was the first modern, interdisciplinary, and effective pain clinic.”

“John Bonica formalized the recognition of pain as a clinical entity; the work emphasized the pain syndrome's individualized consideration, as opposed to it being thought of as little more than an accompaniment of acute trauma, or an even worse myth, the miserable complaints of neurotic patients who stubbornly refuse to heal. Bonica's formal conceptualization of pain as a disease state within its own right stimulated an ever widening wave of research and clinical application culminating in the newest specialty recognized in Medicine...”

“Dr. John Bonica and I became good friends quickly, a great benefit to me then and much more later. ...John seemed to take an interest in my having trained in the surgery of children and in two weeks taught me many basic principles of anesthesiology. Little did I know at the time how useful this information would be for me—when I became chief of anesthesia at a hospital army unit in a strange country.”

“The full array of nociceptors is now deluging the nervous system with a blitz of chemical and electrical signals that the late American pain-management pioneer John Bonica called "the inflammatory soup of prostaglandins, protons, serotonin, histamine, bradykinin, pourines, cytokines, eicosanoids, and neuropeptides. Pain now echoes and amplifies itself as nociceptors form circuits and feedback loops, each link in the chain stimulating its neighbors to greater activity.”

“The challenge of managing chronic pain and suffering born of injuries to troops in WWII galvanized John Bonica and other pioneers, representing several specialties, into action. They refused to consider that their duty to these soldiers, and by extension their brethren in chronic pain of all causes, was finished once pain was controlled after an acute injury or during a surgical procedure.”

“Dr. John Bonica decided that the most effective way to combat pain is to treat the person as a whole.”

“Doctors practice in the isolation of their private offices, treating patients with the tools of their particular specialties. Compounding what John Bonica calls this "tubular vision" in the medical profession, the specialists don't compare notes or join forces; often they don't even realize whom else the patient has seen or what's already been done. ...sometimes they become impatient with pain—especially when there's no observable pathological reason for a person's complaint.”

“Dr. John Bonica, professor of anesthesiology at the University of Washington and founder of the Multidisplinary Pain Center, Seattle, spearheaded the movement to recognize pain as an entity unto itself. Bonica and other pain specialists are alarmed by an epidemic of pain throughout the industrialized world. ...He estimates that pain results in the loss of some 700 million workdays a year—in litigation, in compensation, and, mostly, in search for relief.”

“Some fragmentation of the principles espoused by Dr. Bonica more than forty years ago has occurred, and unidisciplinary "pain clinics" have become commonplace.”

“If I wasn't as busy as I am... I would be a completely disabled guy.”

“What the hell kind of conclusion can you come to there? The most important thing, from the patient's perspective, they don't talk about.”

“No medical school has a pain curriculum...”