Those who do not know their pain-history will repeat previous errors in pain management

This title is a modified version of a famous statement of the Spanish-American George Santayana (1863–1952). He taught philosophy at Harvard from he was 26 years old and is famous for the saying: “Those who forget the past are condemned to repeat it”—known as Santayana's curse.

Scandinavian pain clinicians have been lucky to have among us for almost a decade one of the early disciples of the most influential pioneers in modern pain management. Stephen Butler was recruited by John J Bonica already in 1973 and worked with Bonica, learning the useful analgesic block techniques described in the first ever, major textbook on pain and pain management (Bonica, 1953). The first edition of Bonica's huge textbook had the telling title: The Management of Pain; With Special Emphasis on the Use of Analgesic Blocks in Diagnosis, Prognosis, and Therapy. That monumental textbook has since been updated in three editions with Stephen Butler as one of the co-editors (Loeser et al., 2001).

This was at the time when Bonica founded the International Association for the Study of Pain, an immensely important pain researcher and pain clinician network, and the first scientific journal with focus on pain research, Pain. Subsequently Stephen Butler worked closely with the psychologist William E. Fordyce, the founder of behavioural therapy for chronic pain patients. This was a major step forward for understanding pain behaviour and helping the most complex pain patients to better cope with their illness. He described his methods in the classical textbook: “Behavioral Methods in Chronic Pain and Illness” (Fordyce, 1976).

I had the good fortune of being able to visit and observe these two towering pioneers and Stephen Butler in 1975, when Stephen Butler was running Bonica's pain clinic, the first real multidisciplinary pain clinic in the world. I invited Stephen Butler to review what he learned in Seattle, and what he now believes are effective therapies, after almost four decades of pain clinic practice, the last years practicing at the Pain Centre of Torsten Gordh in Uppsala, Sweden. Stephen Butler is one of the teachers in the courses in advanced pain management organized by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine since 1999 (Breivik and Lindahl, 2001). He has impressed us all, teaching and discussing in a learned, civilized, and erudite style, for the benefit of the students, his co-teachers, as well as their future patients.

The scientific literature on pain has increased almost exponentially during the last 20 years: Stephen Butler knows most of the developments in the pain field. He is convinced that Bonica's and Fordyce's philosophies and practices of pain management still are valid: He has written a personal history, observing the development of science and practice of pain management during 40 years, from Seattle to Uppsala. A story worth reading and learning: A story told by an experienced pain specialist who have seen and experienced many “new and promising” pain therapies (Butler, 2010). I am sure you will enjoy this piece of philosophy, if not hard science, as much as I do. He has come a long way since he was taught analgesic blocks by John J Bonica (Bonica, 1953) in the early 1970s (Butler, 2005, Engel, 1977).