Her 1935 appointment as instructor in pharmacology at the Cornell University Medical School led to a series of more than a dozen papers that were concerned with the pharmacology of cardiovascular disease. In 1930, Janet's 2nd scientific paper, “Importance of Differences in the Potency of Digitalis in Clinical Practice,” 2 set the tone for her initial focus on cardiology and pharmacology. Chapter 14, “My Standard of Comfort Was Raised,” is delightfully readable, with much enlightening insight into the MTrP enigmas that she studied and into the way that her brilliant and determined mind worked. Office Hours is a guide to Janet's pioneering spirit and to essentially all of her other publications. 1 The typescript of this book is among the treasures of George Washington University's Travell Collection. I eagerly collected and studied everything that she had written on MTrPs.ĭuring much of this time, she was still working on her autobiography, Office Hours: Day and Night. For nearly 4 years, much of our time was spent discussing her many pharmacologic and muscle-pain experiments to shed light on the pathophysiology of MTrPs and to determine the most effective treatments. One of the perks of this job was the regular opportunity to spend the afternoon talking with Janet in Washington before returning to Houston. My motor-control laboratory, newly computer-equipped, was located in Houston. At least once a month, I went to Washington, DC, from my home base in Houston for a few days, in order to communicate with other research coordinators and administrators. Two years later, in 1965, I retired from the US Air Force and joined the central office of the Veterans Administration (VA, now Veterans Affairs) as coordinator of research for physical medicine and rehabilitation throughout the 63-hospital system. Occasionally, she injected a refractory MTrP with 0.5% procaine.
TRAVELL AND SIMONS BOOK FULL
Her application of spray and stretch to that muscle (using Fluori-Methane) always produced immediate and impressive, if not complete, relief of pain and restored full range of motion. Her demonstrations were awe-inspiring: a focused medical history, a meticulous history of the onset of pain, a detailed identification of the pain pattern, a demonstration of the painfully restricted range of motion, and a finger placed unerringly on the exquisitely tender trigger point.
The cause of this myogenic pain was clearly overlooked in medical training and practice, but diagnosable and treatable by an expert. So this was the cause of most of my muscular aches and pains and those of my friends, family, and colleagues! Although I preferred research to general clinical practice, such an enigmatic yet common myogenic source of human suffering posed an irresistible challenge. Janet's lectures were a revelation to me. Stapp, the fastest man on earth via rocket sled-had identified a trigger point as the cause of an enigmatic shoulder pain in a staff member of the laboratory.
The only thing I knew about MTrPs was that years earlier my chief at the Space Medicine Laboratory in Alamogordo, New Mexico-Col. She was responding to an invitation by my chief, Larry Lamb, MD, who was the lead cardiologist in the USAF and who thought of Janet as a great pioneer in cardiology and myogenic pain. Travell, the White House physician to President Kennedy, delighted me, a staff flight surgeon at the United States Air Force's School of Aerospace Medicine. In 1963, the prospect of a 2-day lecture demonstration on myofascial trigger points (MTrPs) by Janet G.