Given the ... multidisciplinary philosophy, I was surprised by the absence of alternative pain approaches - the whole spectrum of cranial-sacral massage, healing-touch therapy, and other hands-on skills that are a lifeline to many people with chronic pain. Alternative therapie are hard to evaluate, but that's no reason not to explore them.
If Jeff Mogil and Ron Melzack are right about genetics and pain, fifty years from now, generic Tylenol tablets will seem as quaint to us as a bottle of sarsaparilla tonic. Instead, we'll take our genotype ID bracely to the local genopharmacologist to order some bespoke pharmaceuticals. Or we may rise at four A.M. to meditate on the part of our nature that is painful and feel better for it. Along with social insurance, we'll carry geno-cards that list our predispositions: photosensitivity, osteoporosis, and poor response to codeine.
Addiction might be redefined not as a character flaw but as a "biochemical deficit management." Our emotional habits will become an accepted factor of good health, along with slogans like "Heartache can be harmful to your unborn children."
These doctors, who had long experience with people in pain in addition to their traditional training and schooling, had discovered that nothing happens without communication, treatment based on evidence of outcome, and what used to be called a good bedside manner.
Simple intervention - the time spent with a patient - is a very powerful ingredient of the patient-doctor contract. The evidence is against the traditions such as surgery for back pain being true - the evidence says it doesn't work.
Why are we, the most medicalized of societies, a culture in pain?
Hasn't anyone thought to look at outcomes as a logical way to figure out what really works? Not until recently. That tells you how far out of the picture the patient has been.
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