John Bonica Quotes (1917-1994)

“The continuum—stretching from a pole of "healing through techniques" to the pole of "healing through management"—is not specific to France. ...the gate control theory of pain—had played a crucial role in the development of pain medicine as proposed by John Bonica. The proposals of this anesthetist date from as early as 1944, but only became widely accepted in 1974. ...with the concept of pain clinics launched in 1953 by John Bonica, physicians had access to an organizational model. By the end of the 1970s, this model was widely accepted in the world of pain medicine. It stipulated that lasting pain—chronic pain... should be treated in specific pain clinics or pain centers by multidisciplinary teams... The justification for such a grouping of people stems from Bonica's 1953 book The Management of Pain, where he analyzes the complexity of problems associated with intractable pain that has resisted any traditional treatment in a number of disciplines. ...any evaluation of pain must be carried out on both the physical and the psychological level.”

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

“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.”

“The practical turn in modern pain therapy is primarily traced back to American anesthesiologist John Bonica. In the early 1950s, he first tried to found the management of pain on the methods of regional anaesthesia. In 1953, he published a book... Focusing on regional anaesthesia, it was intended to list all known options for treating pain. ...regional anaesthesia alone is not the way to obtain regular therapeutic success in cases of chronic pain. However... it started a move toward detachment from the components of cultural theories that, while suitable for wordy explorations of chronic pain, only considered the statements of patients in a distanced manner, in practice leaving the patients to themselves with their pain.”

“Pioneering pain researcher John J. Bonica (1990) believed that being rewarded for pain behaviors is a key factor that transforms acute pain into chronic pain. According to Bonica, people who receive attention, sympathy, relief from normal responsibilities, and disability compensation for their injuries and pain behaviors are more likely to develop chronic pain than are people who have similar injury but receive fewer rewards. Consistent with Bonica's hypothesis, headache patients report more pain behaviors and greater pain intensity when their spouses or significant others respond to pain complaints with seemingly helpful responses, such as taking over chores, turning on the television, or encouraging the patient to rest (Pence, Thorn. Jensen & Romano, 2008)”

“It is... with perfect timing that Dr. Dermot Fitzgibbon... with the collaboration of Dr. John D. Loeser... have provided us with a comprehensive interdisciplinary, patient-centered, guide to the assessment, diagnosis, and management of cancer pain. With a combined experience of over 50 years in pain management and in the spirit of Dr. John Bonica, both Drs, Fitzgibbon and Loeser have composed a detailed treatise that covers not only pain (with a lower case p) as a symptom, but also Pain (with a capital P), as a disease, with all its physiologic, pathologic, emotional, social, and existential dimensions.”

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

“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.”

“The practice of pain rehabilitation increasingly developed during the twentieth century by evolving medical specialties of physical medicine and rehabiltitation, anesthesia, psychiatry, and occupational medicine. John Bonica, one of the fathers of pain medicine, championed a more comprehensive biopsychosocial multidisciplinary approach in the United States in 1947. This approach expanded to include a team of clinicians at the University of Washington in the 1960s. Bonica's collaboration with Wilbert Fordyce, a psychologist, incorporated operant conditioning and other behavioral approaches with more specialized, structured, and in-patient multi-week programs. In the 1980s, John Loeser formalized a more structured program at the University of Washington. This 3-week long, daily program became a model for interdisciplinary treatment.”

“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.”

“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.”

“John J. Bonica... recognized during his experience in World War II that he was unable to provide adequate pain relief for many of his patients if he utilized only the methods afforded to him by his training in anesthesiology. He realized that health care providers who had been trained in other specialties and had managed pain for their patients could add a new dimension to both the evaluation and treatment of complex pain conditions that did not respond to his particular treatment. Although perceived by some to be more complicated and more costly because of the intitial multispecialty evaluations and treatments, multidisciplinary team management of pain has proven to be more effective and less costly overall than when pain is managed by different specialists working independently.”