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The amazing story of the man who gave us modern pain relief

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    A few years ago,
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    my mom developed rheumatoid arthritis.
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    Her wrists, knees and toes swelled up,
    causing crippling, chronic pain.
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    She had to file for disability.
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    She stopped attending our local mosque.
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    Some mornings it was too painful
    for her to brush her teeth.
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    I wanted to help.
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    But I didn't know how.
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    I'm not a doctor.
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    So, what I am is a historian of medicine.
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    So I started to research
    the history of chronic pain.
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    Turns out, UCLA has an entire
    history of pain collection
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    in their archives.
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    And I found a story --
    a fantastic story --
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    of a man who saved -- rescued --
    millions of people from pain;
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    people like my mom.
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    Yet, I had never heard of him.
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    There were no biographies
    of him, no Hollywood movies.
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    His name was John J. Bonica.
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    But when our story begins,
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    he was better known as
    Johnny "Bull" Walker.
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    It was a summer day in 1941.
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    The circus had just arrived
    in the tiny town of Brookfield, New York.
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    Spectators flocked to see
    the wire-walkers, the tramp clowns --
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    if they were lucky, the human cannonball.
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    They also came to see the strongman,
    Johnny "Bull" Walker,
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    a brawny bully who'd pin you for a dollar.
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    You know, on that particular day,
    a voice rang out
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    over the circus P.A. system.
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    They needed a doctor urgently,
    in the live animal tent.
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    Something had gone wrong
    with the lion tamer.
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    The climax of his act had gone wrong,
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    and his head was stuck
    inside the lion's mouth.
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    He was running out of air;
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    the crowd watched in horror
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    as he struggled and then passed out.
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    When the lion finally did relax its jaws,
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    the lion tamer just slumped
    to the ground, motionless.
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    When he came to a few minutes later,
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    he saw a familiar figure hunched over him.
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    It was Bull Walker.
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    The strongman had given the lion tamer
    mouth-to-mouth, and saved his life.
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    Now, the strongman hadn't told anyone,
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    but he was actually
    a third-year medical student.
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    He toured with the circus
    during summers to pay tuition,
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    but kept it a secret
    to protect his persona.
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    He was supposed to be
    a brute, a villain --
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    not a nerdy do-gooder.
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    His medical colleagues didn't
    know his secret, either.
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    As he put it, "If you were
    an athlete, you were a dumb dodo."
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    So he didn't tell them about the circus,
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    or about how he wrestled professionally
    on evenings and weekends.
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    He used a pseudonym like Bull Walker,
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    or later, The Masked Marvel.
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    He even kept it a secret that same year,
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    when he was crowned
    The Light Heavyweight Champion
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    of the World.
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    (Laughter)
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    Over the years, John J. Bonica
    lived these parallel lives.
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    He was a wrestler;
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    he was a doctor.
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    He was a heel;
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    he was a hero.
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    He inflicted pain,
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    and he treated it.
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    And he didn’t know it at the time,
    but over the next five decades,
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    he'd draw on these dueling identities
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    to forge a whole new way
    to think about pain.
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    It'd change modern medicine
    so much so, that decades later,
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    Time magazine would call him
    "Pain relief's founding father."
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    But that all happened later.
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    In 1942, Bonica graduated
    medical school and married Emma,
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    his sweetheart, whom he had met
    at one of his matches years before.
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    He still wrestled in secret -- he had to.
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    His internship at New York's
    St. Vincent's Hospital paid nothing.
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    With his championship belt,
    he wrestled in big-ticket venues,
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    like Madison Square Garden,
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    against big-time opponents,
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    like Everett "The Blonde Bear" Marshall,
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    or three-time world champion,
    Angelo Savoldi.
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    The matches took a toll on his body;
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    he tore hip joints, fractured ribs.
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    One night, The Terrible Turk's big toe
    scratched a scar like Capone's
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    down the side of his face.
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    The next morning at work,
    he had to wear a surgical mask to hide it.
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    Twice Bonica showed up to the O.R.
    with one eye so bruised,
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    he couldn't see out of it.
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    But worst of all were
    his mangled, cauliflower ears.
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    He said they felt like two baseballs
    on the sides of his head.
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    Pain just kept accumulating in his life.
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    Next, he watched his wife go
    into labor at his hospital.
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    She heaved and pushed, clearly in anguish.
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    Her obstetrician called
    out to the intern on duty
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    to give her a few drops of ether
    to ease her pain.
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    But the intern was a young guy,
    just three weeks on the job --
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    he was jittery, and in applying the ether,
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    irritated Emma's throat.
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    She vomited and choked,
    and started to turn blue.
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    Bonica, who was watching all this,
    pushed the intern out of the way,
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    cleared her airway,
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    and saved his wife
    and his unborn daughter.
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    At that moment, he decided
    to devote his life to anesthesiology.
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    Later, he'd even go on to help develop
    the epidural, for delivering mothers.
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    But before he could focus on obstetrics,
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    Bonica had to report for basic training.
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    Right around D-Day,
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    Bonica showed up
    to Madigan Army Medical Center,
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    near Tacoma.
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    At 7,700 beds, it was one of the largest
    army hospitals in America.
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    Bonica was in charge
    of all pain control there.
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    He was only 27.
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    Treating so many patients,
    Bonica started noticing cases
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    that contradicted everything
    he had learned.
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    Pain was supposed to be
    a kind of alarm bell -- in a good way --
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    a body's way of signaling an injury,
    like a broken arm.
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    But in some cases,
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    like after a patient had a leg amputated,
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    that patient might still complain
    of pain in that non-existent leg.
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    But if the injury had been treated, why
    would the alarm bell keep ringing?
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    There were other cases in which there
    was no evidence of an injury whatsoever,
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    and yet, still the patient...hurt.
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    Bonica tracked down all the specialists
    at his hospital -- surgeons,
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    neurologists, psychiatrists, others.
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    And he tried to get
    their opinions on his patients.
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    It took too long, so he started organizing
    group meetings over lunch.
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    It would be like a tag-team of specialists
    going up against the patient's pain.
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    No one had ever focused on pain
    this way before.
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    After that, he hit the books.
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    He read every medical textbook
    he could get his hands on,
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    carefully noting every mention
    of the word pain.
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    Out of the 14,000 pages he read,
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    the word "pain" was
    on 17 and a half of them.
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    Seventeen and a half.
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    For the most basic, most common,
    most frustrating part of being a patient.
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    Bonica was shocked -- I'm quoting him,
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    he said, "What the hell kind of conclusion
    can you come to there?
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    The most important thing
    from the patient's perspective,
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    they don't talk about."
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    So over the next eight years,
    Bonica would talk about it.
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    He'd write about it; he'd write
    those missing pages.
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    He wrote what would later be known
    as The Bible of Pain.
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    In it he proposed new strategies,
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    new treatments using
    nerve-block injections.
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    He proposed a new institution,
    The Pain Clinic,
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    based on those lunchtime meetings.
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    But the most important thing
    about his book,
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    was that it was kind of an emotional
    alarm bell for medicine.
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    A desperate plea to doctors
    to take pain seriously
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    in patients' lives.
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    He re-casts the very purpose of medicine.
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    The goal wasn't to make patients better;
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    it was to make patients feel better.
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    He pushed his pain agenda for decades,
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    before it finally took hold
    in the mid-70s.
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    Hundreds of pain clinics sprung up
    all over the world.
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    But as they did -- a tragic twist.
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    Bonica's years of wrestling
    caught up to him.
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    He had been out of the ring
    for over 20 years,
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    but those 1,500 professional bouts
    had left a mark on his body.
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    Still in his mid-50s, he suffered
    severe osteoarthritis.
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    Over the next 20 years
    he'd have 22 surgeries,
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    including four spine operations,
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    and hip replacement after hip replacement.
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    He could barely raise
    his arm, turn his neck.
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    He needed aluminum crutches to walk.
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    His friends and former students
    became his doctors.
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    One recalled that he probably
    had more nerve-block injections
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    than anyone else on the planet.
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    Already a workaholic,
    he worked even more --
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    15 to 18-hour days.
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    Healing others became more
    than just his job,
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    it was his own most effective
    form of relief.
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    "If I wasn't as busy as I am,"
    he told a reporter at the time,
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    "I would be a completely disabled guy."
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    On a business trip to Florida
    in the early 1980s,
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    Bonica got a former student to drive
    him to the Hyde Park area in Tampa.
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    They drove past palm trees
    and pulled up to an old mansion,
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    with giant silver Howitzer cannons
    hidden in the garage.
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    The house belonged to the Zacchini family,
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    who were something like
    American circus royalty.
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    Decades earlier, Bonica had watched them,
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    clad in silver jumpsuits and goggles,
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    doing the act they pioneered --
    The Human Cannonball.
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    But now they were like him: retired.
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    That generation is all dead
    now, including Bonica,
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    so there's no way to know exactly
    what they said that day.
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    But still, I love imagining it.
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    The strongman and the human
    cannonballs reunited,
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    showing off old scars, and new ones.
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    Maybe Bonica gave them medical advice.
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    Maybe he told them what he later
    said in an oral history,
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    which is that his time in the circus
    and wrestling deeply molded his life.
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    Bonica saw pain close up.
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    He felt it. He lived it.
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    And that made it impossible
    for him to ignore in others.
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    Out of that empathy, he spun
    a whole new field,
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    played a major role in getting
    medicine to acknowledge pain
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    in and of itself.
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    In that same oral history,
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    Bonica claimed that pain
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    is the most complex human experience.
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    That it involves your past life,
    your current life,
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    your interactions, your family.
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    That was definitely true for Bonica.
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    But it was also true for my mom.
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    It's easy for doctors to see my mom
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    as a kind of professional patient,
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    a woman who just spends her days
    in waiting rooms.
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    Sometimes I get stuck seeing her
    that same way.
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    But as I saw Bonica's pain --
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    a testament to his fully-lived life --
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    I started to remember all the things
    that my mom's pain holds.
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    Before they got swollen and arthritic,
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    my mom's fingers clacked away
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    in the hospital HR department
    where she worked.
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    They folded samosas for our entire mosque.
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    When I was a kid, they cut my hair,
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    wiped my nose...
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    tied my shoes.
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    Thank you.
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    (Applause)
Title:
The amazing story of the man who gave us modern pain relief
Speaker:
Latif Nasser
Description:

more » « less
Video Language:
English
Team:
closed TED
Project:
TEDTalks
Duration:
13:51

English subtitles

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