It is now widely understood that the concept of “Pain Unit” refers to specialized units for the care of patients with painful pathologies that do not respond to conventional treatments. This also includes diseases that require specific treatments, due to their dangerousness, or due to the need for the specialist to have specific experience in their administration, or a management that is not usual for general practitioners or other specialists.
Pain units are a reality in almost all hospitals.
The truth is that pain units are present in almost all general hospitals in developed countries. They usually work with specialists in Anesthesiology, Neurosurgery, Rehabilitation, Psychology and Psychiatry, with the aim of making the most comprehensive approach possible. But this has not always been the case and the pioneer in working in this way was John Bonica.
John Bonica, precursor of the Pain Units
John Bonica was the precursor of this type of Pain Units. He was born in 1917 in Filicudi, one of the Aeolian islands northeast of Sicily. Years later his father decided to emigrate to the United States, in search of a better future and education for his children. Thus, in 1927 they settled in Brooklyn, New York. His father died very soon, in 1922, which forced John to do all kinds of trades to support his family, in addition to continuing his high school studies and getting to study medicine, his dream.
Meanwhile, he started wrestling as a sport, reaching the professional category, going to several national and international championships, under the pseudonym of Johnny (Bull) Walker or the Masked Wonder. In fact, part of his life was influenced by the injuries of that stage.
In 1938 he began medical school at Marquette University and completed his training as an intern in Anesthesiology at Saint Vincent’s Hospital in New York. In 1942, at the end of his medical training, he married Emma Louis Baldetti.
In 1944 he began practicing at Tacoma Hospital, where soldiers evacuated from the World War were treated. Difficulties in managing breathing in General Anesthesia aided in the development of regional techniques, as well as pain procedures for patients with difficult gunshot or shrapnel wounds. It was then that the Anesthesia training program for physicians and nurses began, a pioneer in the United States and the world.
Creation of the first Pain Unit
His accumulated experience led him to pool his knowledge to treat patients with persistent pain. It was then that he founded the first Pain Unit, with the aim of providing better coverage for those war-wounded patients with incurable sequelae. Great advances in science and medicine, unfortunately, have been made by accumulating suffering and death.
The summary of this knowledge will be the first great treatise on pain, the “Bible” of pain, the Management of Pain, published in 1953 and which will be the reference book for physicians in this specialty. From this master and school will emerge names such as Dr. Madrid Arias, Dr. Batutell, Dr. González or Dr. Vidal, pioneers in Spain in the approach to pain.