Podcast appearances and mentions of Charles Bell

Today we're tackling the topic of high-stakes exams and board certification—a challenge that many physicians face. Struggling with these exams can lead to feelings of low self-esteem, test-taking anxiety, and even impact career opportunities. To lend their guidance and expertise, I'm joined by two wonderful guests, Dr. Rob Steele and Dr. Charles Bell, founders of Physician Test Prep Professionals. With decades of experience in physician assessment and remediation, they bring a wealth of knowledge to this important topic. In this episode, we discuss actionable strategies for exam preparation, managing anxiety, addressing knowledge gaps, and achieving success on high-stakes exams. In this episode we're talking about: Common missteps physicians make when preparing for board exams. Why creating a structured study plan is essential for success. Techniques for identifying and addressing knowledge gaps. The benefits of focusing on question-and-answer study formats. Strategies for managing anxiety and building confidence on test day. Tips for balancing study time with clinical responsibilities and personal life. Recognizing and avoiding burnout during intense study phases. Links for this episode: Physician Test Prep Professionals Email address: md.test.prep.ceb@gmail.com Text messages can be sent to: 512.442.6195 ⏰Time Management Resource - Download a list of books and apps that can help you with time management, procrastination, building successful habits and finding ways to focus.  

Send us a textCharles Bell joins us to share his incredible journey from a high school athlete in Newcomerstown, Ohio, to managing a family-owned business in Lisbon, Ohio. Charles reveals how his dreams of becoming a physical therapist shifted to engineering, all thanks to a chance encounter with college baseball and his future wife. I even share my own twist of fate—a career-ending injury that reshaped my path and led me to meet my significant other. Together, we reflect on the unexpected turns that have brought us gratitude for the lives we lead today.Our conversation with Charles also uncovers the complexities of running a family-owned niche manufacturing business. As Charles and his brother-in-law Jason take the helm from the founder, they navigate the world of labeling and laser coating equipment production. Charles paints a vivid picture of the challenges and rewards involved in growing a close-knit, community-driven enterprise without the looming influence of corporate giants. The discussion highlights the importance of patience, perseverance, and the enduring success of family businesses that contribute meaningfully to their communities.We round off the episode with spirited discussions on coaching, sports, and the ever-evolving landscape of college football. From first-year coaching memories to the excitement of the new college football playoff system, the episode is infused with humor, nostalgia, and valuable insights. The balancing act of coaching, family, and work is laid bare, with stories of late-night film studies and the camaraderie of the locker room. Whether you're here for the sports talk or intrigued by family business dynamics, there's a wealth of dedication, friendship, and life's unexpected paths waiting to entertain and inspire.Subscribe for exclusive content: https://www.buzzsprout.com/1530455/support Buzzsprout - Let's get your podcast launched!Start for FREEReaper Apparel Reaper Apparel Co was built for those who refuse to die slowly! Reaper isn't just clothing! Dubby EnergyFROM GAMERS TO GYM JUNKIES TO ENTREPRENEURS, OUR PRODUCT IS FOR ANYONE WHO WANTS TO BE BETTER.Tactical BrotherhoodThe Tactical Brotherhood is a movement to support America.ShankitgolfOur goal here at Shankitgolf is for everyone to have a great time on and off the golf courseSweet Hands SportsElevate your game with Sweet Hands Sports! Our sports gloves are designed for champions,Buddy's Beard CareBuddy's Beard Care provides premium men's grooming products at an affordable price.Deemed FitBe a part of our movement to instill confidence motivation and a willingness to keep pushing forwardDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showFollow us on all social mediaX: @mikebonocomedyInstagram: @mikebonocomedy@tiktok: @mikebono_comedianFacebook: @mikebonocomedy

Today's guest Chef Charles, President, and owner of Roux and Raw Perfection joins host Tommi A. Vincent on Radio Row during Super Bowl LVIII to discuss taking a career leap of faith from New Orleans to Las Vegas, his rich family heritage in Cajun and Creole cuisine, partnering with other chefs and more. Chef Charles Bell makes you feel right at home with his cooking. A few of Chef Charles Bell highlights: •Native of New Orleans Louisiana •A distinguished personal chef for celebrities and professional athletes •Dedicated to empowering fellow chefs to become successful entrepreneurs Host: Tommi A. Vincent Guests: Chef Charles Bell Produced by: Tommi A. Vincent, Dimitri Golden, and Motion Hue Productions Music By: Stichiz - Big T. Music / Roj & Twinkie #upongameSee omnystudio.com/listener for privacy information.

Today's guest Chef Charles, President, and owner of Roux and Raw Perfection joins host Tommi A. Vincent on Radio Row during Super Bowl LVIII to discuss taking a career leap of faith from New Orleans to Las Vegas, his rich family heritage in Cajun and Creole cuisine, partnering with other chefs and more. Chef Charles Bell makes you feel right at home with his cooking. A few of Chef Charles Bell highlights: •Native of New Orleans Louisiana •A distinguished personal chef for celebrities and professional athletes •Dedicated to empowering fellow chefs to become successful entrepreneurs Host: Tommi A. Vincent Guests: Chef Charles Bell Produced by: Tommi A. Vincent, Dimitri Golden, and Motion Hue Productions Music By: Stichiz - Big T. Music / Roj & Twinkie #upongameSupport the show: https://www.upongame.network/See omnystudio.com/listener for privacy information.

It is no secret that lots of marketers have been using AI to help with content generation. (I mean, you've only got to take a look on LinkedIn to spot a few)But content creation is only half of the battle. If you haven't got a smooth process for getting it in front of your prospects, then you're still stuck! This is where the V's of Content comes in.  Velocity, Volume, and Value.

Wake the Farm Up! Maintaining Ground Podcast Part two of the 1Year Anniversary Special of the Pod Squad Live Show Recordings  More Fya!Recorded Live at the Atwood Amphitheater • 10-5-2023Featuring:  Preston Charles Bell III, Nick Maurer, Crow, Obalaye of 144Farms, Torio Gkilla, Ande the ELf,  Stefin101, David Panther, Andy Stephen, and MoreGratitude to all who have supported the show with so much passionate enthusiasm, and especially all those who took it serious and seriously had fun contributing their voices.Special shout out goes to Liz Virgo, for her cohosting and voice has been a huge part of year one.after some teasers, we continue right into the show where we left off…(3:20) Nick Maurer The Electric Bike Wheel Jam with the PodsquadCheck out his songs in Part 1!Check out his music explorations!(6:48) Elf Crystals from the Earth never heard before…(8:40) David Panther, Roofs Up Top!(19:99) Obalaye Convo flows 144 Farmssupport 144 farms and the Historic Society (43:53) Grass Roots to Forest Gardens(45:15)Obalaye poetry freestyle(45:55)Obalaye, Crow, Preston(50:33)Torio Gkilla, (53:00)Elfkin, CrowStefin101, Torio, Preston more…Who needs the Money?(55:00) Torio, Elf tiny Coconuts into Keepin fresh with the Children(57:03) Crow's Tick Tack Freestyle(59:02) Obalaye comes in on the Wind of Truth, Torio inserts, Crow inserts(1:04:27)Torio Gkilla Elf Kush(1:06:02) Seed In - Podsquad (1:07:49)Crow deep drop(1:10:18)Torio Gkilla convo sessionLook up Torio Gkilla YouTube (1:16:16) Elf close out call(1:18:18) Elves, Robots, Amaranth and Venison Stew, Preston (1:20:35) Preston Bell Charles iiiFind his music!!! As ever... artists, farmers please report your links and the edit elves will work!Support the showLinks to Stefin101 and Doctor Bionic Check us out on instagram @wakethefarmup @maintaining_ground_podcast@kastle_369Ask how you could be involved in the show, Subscribe and Support the Show

Wake the Farm Up! Maintaining Ground Podcast 1Year Anniversary Special of the Pod Squad Live Show Recordings  Recorded Live at the Atwood Amphitheater • 10-5-2023This was a celebration, music rich adventure... This is Part 1.  Part 2 will be coming soon!Featuring:  Preston Charles Bell III, Nick Maurer, Crow, Obalaye of 144Farms, Torio Gkilla, Ande the Elf,  Stefin101, David Panther, Andy Stephen, Patrice Logan and MoreGratitude to all who have supported the show with so much passionate enthusiasm, and especially all those who took it serious and seriously had fun contributing their voices.Special shout out goes to Liz Virgo, for her cohosting and voice has been a huge part of year one.So, after some teasers, (Some from part 2!) we go right into the show.(4:08) Intro to the special show with your Host Ande the Elf(17:45) Preston Charles Bell III -Preston's Links - soundcloud link • facebook(22:10) Preston Jam1(33:33)Preston and Elf go to Space(42:40) Preston leads the pod into a journey with Elf on Banjo, Crow poetry, Stefin101 poetry, freestyle.(1:02:30) Elf Appreciation(1:03:25) Nick MaurerNick's Links -Spotify link  • Bandcamp(1:04:30) Nick Maurer "She's Gonna Get Polio"(1:07:37) Nick Maurer "Teeth and Stones" into "Dance in the Street!"(1:20:55) Nick Maurer "Old Mattress in a parking lot" with Preston(1:24:45) Nick Maurer “Jesus Christ Ain't Got Nothing On Jesús" (1:26:40) Nick Maurer “Bustelo” ...to be continued in Part 2... Support the showLinks to Stefin101 and Doctor Bionic Check us out on instagram @wakethefarmup @maintaining_ground_podcast@kastle_369Ask how you could be involved in the show, Subscribe and Support the Show

This Week in Pharmacy we talk to Dr. Charles Bell and Andrea Corner, PharmD with CereCore. These pharmacists work with EHR technology which provides healthcare IT services such as EHR implementation, staff augmentation, clinical and technical support to hospitals. This is an example who pharmacists are impacting all facets of healthcare, including electronic health record's technology, workflow, and implementation for better patient care.   

Host Jim Tate talks to Dr. Charles Bell of CereCore. He has over 40 years of experience in direct healthcare delivery and related technology. His unique perspective provides valuable insights into best practices building the bridge between of healthcare and technology. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

This week on Everyday Injustice, we talked with Charles Bell, an assistant professor in the Department of Criminal Justice at Illinois State University, whose work focuses on school discipline, suspensions and the school-to-prison pipeline. As Bell explains, his work focuses on how Black students and parents view school punishment, the disproportionate use of suspensions and criminal legal system solutions when dealing with Black and brown youth. Bell's book, Suspended: Punishment, Violence, and the Failure of School Safety, found that Black students made up 15% of the student population across the country, while being 39% of those who received one or more suspensions. The school-to-prison pipeline as Bell explains, “see a pipeline in which students enter school, and then school criminalizes their behavior. Increasingly, what we see is schools become a carceral space in which you have all these criminal justice elements.” The term, refers to the trend amongst school districts to enforce severe discipline policies that push students out of the classroom and into the criminal justice system. And as we discuss, this has a huge impact on the future of children of color.

The boys sit with esteemed Celebrity/Athlete/Dog Chef. The one and only, Chef Charles Bell. They talk about Chef Charles upbringing in New Orleans, Louisiana where they cover effects of Hurricane Katrina, origins in the kitchen, going to private school and his parents owning a Nightclub and restaurant down stairs. The boys touch on his crazy list of celebrities, professional athletes & coaches that have hired him to experience his culinary craft. Chef Charles lists his top-five fast food restaurants and his SHOCKING best-fast-food fried chicken and his wildest kitchen and dining experiences.   Thank you all for supporting the Still Friends Show and being a part of the family. Please support Chef Charles Bell by hiring him for his services and checking out & sharing his content from the link below. Don't forget to check out our show and cast on social media, links down below.    Chef Charles Instagram- https://www.instagram.com/chefcharlesbell/ Still Friends Show- https://www.instagram.com/stillfriendsshow/ Justin Hong- https://www.instagram.com/justinakonihong/ Jamari Smith- https://www.instagram.com/j_smitttyyy/ Still Friends Show LinkTree- https://linktr.ee/stillfriends?utm_source=linktree_profile_share<sid=b6663f31-aff9-45c8-893d-f7bc89f062b5  

The boys sit with esteemed Celebrity/Athlete/Dog Chef. The one and only, Chef Charles Bell. They talk about Chef Charles upbringing in New Orleans, Louisiana where they cover effects of Hurricane Katrina, origins in the kitchen, going to private school and his parents owning a Nightclub and restaurant down stairs. The boys touch on his crazy list of celebrities, professional athletes & coaches that have hired him to experience his culinary craft. Chef Charles lists his top-five fast food restaurants and his SHOCKING best-fast-food fried chicken and his wildest kitchen and dining experiences.   Thank you all for supporting the Still Friends Show and being a part of the family. Please support Chef Charles Bell by hiring him for his services and checking out & sharing his content from the link below. Don't forget to check out our show and cast on social media, links down below.    Chef Charles Instagram- https://www.instagram.com/chefcharlesbell/ Still Friends Show- https://www.instagram.com/stillfriendsshow/ Justin Hong- https://www.instagram.com/justinakonihong/ Jamari Smith- https://www.instagram.com/j_smitttyyy/ Still Friends Show LinkTree- https://linktr.ee/stillfriends?utm_source=linktree_profile_share<sid=b6663f31-aff9-45c8-893d-f7bc89f062b5  

Hosted by President Charles Bell and Vice President Michael Spencer

While I amputated one man's thigh, there lay at one time thirteen, all beseeching to be taken next… It was a strange thing to feel my clothes stiff with blood, and my arms powerless with the exertion of using the knife.” – Charles Bell, Surgeon at the Battle of Waterloo, 1815. Hippocrates said that ‘war is the only proper school for surgeons' and, throughout history, we have become experts at battlefield medicine. From swords and spears to ballistic missiles and machine guns, the destructive power of our weapons has increased exponentially, but so has our ability to manage injuries and save lives that extend beyond the battlefield. Our special guest is Dr Dan Pronk who is a qualified General Practitioner, completed Australian SAS selection and worked with Special Forces in the Army where he served five years including four tours of Afghanistan and awarded a Commendation for Distinguished Services. He is the author of ‘Average 70kg D**khead', ‘The Combat Doctor', and ‘The Resilience Shield. This is the story of war and medicine.Support the show: https://theadelaideshow.com.au/listen-or-download-the-podcast/adelaide-in-crowd/See omnystudio.com/listener for privacy information.

Hosted by President Charles Bell and Vice President Mike Spencer 

Hosted by President Charles Bell and Vice President 

Join us for a special presentation by Dr. Charles Bell titled "Exploring Students' and Parents' Perceptions of School Punishment and its Impact on Families."Charles Bell is a professor in the Department of Criminal Justice Sciences at Illinois State University and the author of Suspended: Punishment, Violence, and the Failure of School Safety. His research explores students', parents', and teachers' perceptions of out-of-school suspension, seclusion, restraint, and school safety measures. Professor Bell works with local and state politicians to improve school discipline transparency and establish laws that protect families from harmful disciplinary practices.Support the show

Charles Bell knows a thing or two about rock bottom.  He knows about cage fighting, broken noses, and massive hangovers.  He even operated an underground Subway shop by smuggling roast beef into Cellblock 7.  But, the power of this story is simply that Charles also knows all about that moment when enough is enough.  

A man goes missing, then turns into a homicide investigation, five years after his disappearance declared dead however no body is ever recovered. Sources: https://charleyproject.org/case/charles-dwayne-bell-jr https://abc17news.com/news/crime/2021/09/15/missing-boone-county-mans-family-seeks-answers-10-years-later/ https://www.columbiamissourian.com/news/informant-charles-bell-was-shot-at-home-by-someone-he-knew/article_2accb340-8a0e-5c3e-8c38-b33dd03ddea4.html https://krcgtv.com/amp/news/local/father-still-hopeful-years-after-sons-disappearance

The school-to-prison pipeline is a common talking point throughout urban centers. Dr. Charles Bell led research and studies exploring the impact suspension and expulsion have on students. Dr. Bell is a Detroit Public School graduate that is now a professor at Illinois State University with a critical focus on Child Development. His new book "SUSPENDED: Punishment, Violence & The Failure of School Safety" is one of Source Booksellers' most recent and insightful books. In this Riverwise interview, we talk about the studies from the book throughout Metro-Detroit and Michigan connecting students, parents, and teachers to this problem.   The Riverwise Podcast is bringing together Detroit citizens to consider new and forms of resistance to continuing economic and political marginalization in communities of color. For over three years now, the Riverwise collective has created media that depicts local activism and the profound new work being done in Detroit neighborhoods. Through the quarterly Riverwise magazine, Riverwise community conversations, and the Riverwise Writing Workshop, we're developing our collective voice.

Dr. Bell talks about his new book “Suspended: Punishment, Violence, and the Failure of School Safety." And Michigan artist and filmmaker Andy Kirshner talks about his new film "10 Questions for Henry Ford."

WCBU's On Deck has everything you need to know to start your day for Monday, November 1. Our top story is about the COVID-19 vaccination dose for 5 to 11-year-olds. You'll also hear from Charles Bell, an Illinois State University professor. Sarah Nardi interviewed Bell about his recent book, “Suspended: Punishment, Violence, and the Failure of School Safety.”

Charles Bell is the author of a new book that explores the disproportionate effects of suspensions on Black students.

When Aristotle first outlined the human senses, he listed five: sight, hearing, smell, taste, and touch. He excluded the existence of a sixth sense – what was later referred to as the muscle sense by surgeon and physiologist Charles Bell. It's our bodies ability to sense itself and its position in space. And there are even more beyond that. Let's explore those senses and how we can utilize them in our everyday lives.To learn more, and for the complete show notes, visit: lytyoga.com/blog/category/podcasts/Resources:Instagram: @lara.heimannVisit athleticgreens.com/lytyogaRedefining Yoga is a production of Crate Media See acast.com/privacy for privacy and opt-out information.

On the 100th Year of his Birth, Eric remembers his Father, Charles Bell (1921-1998).

Correspondent Tom Wilmer reports from U.S. Army Reserve Garrison Fort Hunter Liggett in Monterey County for a conversation with Commander Colonel Charles Bell. Bell shares recollections of his accomplishments and challenges at Fort Hunter Liggett as Garrison Commander for the past 24 months. He also shares insights about his new assignment in Salt Lake City, Utah as Chief of Staff for the 76 th Operational Response Command .

Correspondent Tom Wilmer reports from U.S. Army Reserve Garrison Fort Hunter Liggett in Monterey County for a conversation with Commander Colonel Charles Bell. Bell shares recollections of his accomplishments and challenges at Fort Hunter Liggett as Garrison Commander for the past 24 months. He also shares insights about his new assignment in Salt Lake City, Utah as Chief of Staff for the 76 th Operational Response Command .

The Middlesex Hospital was home to one of the world's first dedicated cancer wards and hosted the nineteenth-century surgeon Charles Bell.

The height of Mount Everest was first measured in 1850, but the closest any Westerner got to Everest during the next 71 years, until 1921, was 40 miles. The Hunt for Mount Everest tells the story of the 71-year quest to find the world's highest mountain. It's a tale of high drama, of larger-than-life characters - George Everest, Francis Younghusband, George Mallory, Lord Curzon, Edward Whymper - and a few quiet heroes: Alexander Kellas, the 13th Dalai Lama, Charles Bell. A story that traverses the Alps, the Himalayas, Nepal and Tibet, the British Empire (especially British India and the Raj), the Anglo-Russian rivalry known as The Great Game, the disastrous First Afghan War and the phenomenal Survey of India - it is far bigger than simply the tallest mountain in the world. Encountering spies, war, political intrigues and hundreds of mules, camels, bullocks, yaks and two zebrules, Craig Storti uncovers the fascinating and still largely overlooked saga of all that led up to that moment in late June of 1921 when two English climbers, George Mallory and Guy Bullock, became the first Westerners - and almost certainly the first human beings - to set foot on Mount Everest and thereby claimed the last remaining major prize in the history of exploration. With 2021 bringing the 100th anniversary of that year, most Everest chronicles have dealt with the climbing history of the mountain, with all that happened after 1921. The Hunt for Mount Everest is the seldom-told story of all that happened before.

Vous n'avez peut-être jamais entendu son nom, mais Joseph Bell est connu dans le monde entier à travers son alter ego littéraire. Ce chirurgien né au milieu du XIXe siècle est non seulement un praticien et un professeur talentueux, mais il est également un observateur hors pair.Ses capacités de déduction exceptionnelles, qui lui permettent de deviner les troubles et certains éléments de la vie de ses malades avant même que ceux-ci n'aient eu le temps d'ouvrir la bouche lui valent l'admiration de l'un de ses plus fervents étudiants : Arthur Conan Doyle. L'histoire de Joseph Bell, c'est celle du véritable Sherlock Holmes derrière celui de Baker Street, que nous vous proposons de découvrir aujourd'hui.

Vous n'avez peut-être jamais entendu son nom, mais Joseph Bell est connu dans le monde entier à travers son alter ego littéraire. Ce chirurgien né au milieu du XIXe siècle est non seulement un praticien et un professeur talentueux, mais il est également un observateur hors pair.Ses capacités de déduction exceptionnelles, qui lui permettent de deviner les troubles et certains éléments de la vie de ses malades avant même que ceux-ci n'aient eu le temps d'ouvrir la bouche lui valent l'admiration de l'un de ses plus fervents étudiants : Arthur Conan Doyle. L'histoire de Joseph Bell, c'est celle du véritable Sherlock Holmes derrière celui de Baker Street, que nous vous proposons de découvrir aujourd'hui.

The blast blew out windows and sent metal fragments flying, ripping through walls and wooden beams inside the Prince Edward Island courthouse, shattering the stillness of a fall Monday morning. It was Oct. 10, 1988, just after 6 a.m. The homemade pipe bomb had been hidden in a flower bed at the rear of the building. The force was so powerful it drove some pieces of metal into the judges’ chambers on the second floor. In such a comfortably rural society, where crime is largely an abstraction and the people are suspicious of mainland influences, something like Loki 7 was a homegrown horror. - Get exclusive access to additional content, suggest episode topics, talk sh*t, share dank memes and join our #Discord server here- www.patreon.com/carouselsnipervictim Donate to our beer and weed fund- www.carouselsnipervictim.com   Produced by Shaun Jeffery Additional research by Agent686 and Killah Tunes by- Psychosalad Follow us on all your finest social tubes: @CarouselSniperVictim @DeadGlassDesign Facebook, Instagram, Twitter Digital Bark by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4570-unwritten-return License: https://filmmusic.io/standard-license Magic Forest by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4349-shores-of-avalon License: https://filmmusic.io/standard-license Despair and triumph by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3895-i-knew-a-guy License: https://filmmusic.io/standard-license Drone in D by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3767-fluidscape License: https://filmmusic.io/standard-license Aftermath Mystery by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3531-comfortable-mystery License: https://filmmusic.io/standard-license Ossuary - Air by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4542-tranquility-base License: https://filmmusic.io/standard-license sources/ further reading: https://www.theguardian.pe.ca/news/local/convicted-bomber-roger-bells-reign-of-terror-began-30-years-ago-251945/ https://www.theguardian.pe.ca/opinion/local-perspectives/editorial-loki-7s-legacy-251842/ https://www.saltwire.com/news/local/how-loki-7-bomber-roger-bell-became-a-police-task-forces-top-priority-251954/ https://www.washingtonpost.com/archive/politics/1997/08/05/a-journey-into-violence/ae719985-9e3b-4eea-ae09-b1bc3fcfff35/ https://newsinteractives.cbc.ca/longform/pei-bombing

This is a repost from 2018, an article caled Wired Into Pain: a history of the science of pain. I hope you enjoy it. I’ve also recorded an audio version to go with it!I am a Physiotherapist. Almost every person I see in clinic is in pain, and most already have an idea about what has caused their pain. If they are old enough, they might say ‘overuse’, or ‘wear and tear’; if they are younger, they might say ‘bad posture’ or ‘tight muscles’; if they have had a scan, they might say a ‘slipped disc’ or a ‘bone spur’. We accept these explanations prima facie. We consider pain to be a readout on the state of the body’s tissues. Or, as one doctor wrote in 1917, it is “the unerring medical compass that serves as a guide to the pathological lesion”.But it is only very recently that we have come to understand our aches and pains in this way. Since medieval times, until surprisingly recently, people commonly understood their pains in terms of their relationship to God, often as punishment for sin. Physical and emotional pain were entangled, along with mind, body and soul. This was the grim logic of medieval torture and self-flagellation: the truth of the soul could be accessed through the pain of the body.But, as historian Joanna Bourke records in her book The Story of Pain, this mixture of mind, body, soul and God also allowed people to feel pain as comforting: a “vigilant sentinel […] stationed in the frail body by Providence”, as one writer put it in 1832. For others, pain was redemptive: take, for example, the early nineteenth-century labourer Joseph Townend, who resolved himself to God after undergoing surgery without anaesthetic, and reflected at the end of his life on his “sincere thanks to the Almighty God” for his agonising conversion.Pre-modern physicians had a different perspective. Most understood pain according to humoural theory. Hippocrates and his disciple Galen considered all illness to be caused by an imbalance of the body’s humours — phlegm, yellow bile, black bile and blood — which ebb and flow in response changes in the body or its environment. This notion endured for many centuries. To one 18th century writer, pain was a consequence of “viscid blood [stopping] at every narrow passage in its progress”; to another, it was a “Nature throw[ing] a Mischief” about his body. Humoural theory is pre-scientific and seems quaint to us now. But, as Bourke points out, it accounts for an abundance of influences, from our personal temperament and our relationships to the alignment of the planets above our heads, on the pain that we feel.Over the coming centuries, at great cost to people suffering from pain, this insight was lost. This is the story of that loss; of how we arrived at the strange, wrong idea that pain is a straightforward “guide to the pathological lesion”; and of how an emerging re-understanding of pain shows us that it is more complex and more astonishing than we have thought for centuries.Descartes, dualism and the labelled line“The ghost in the machine” — Gilbert RyleIt is in the sixteenth century that we find the beginnings of the dominant modern understanding of the body and its pains. The rise of Protestantism and, amongst secular thinkers, of humanism, contributed to an increased focus on the individual and an understanding of the body as a natural, rather than a supernatural entity. Medicine became more interested in anatomy and the physical laws of nature. Vesalius published his On the Fabric of the Human Body, a compendium of illustrations of dissected cadavers based on the author’s strict, first-hand observations at a time when doctors were not accustomed to performing their own dissections. Later, physicians like William Harvey took principles from physics and astronomy to show that in many ways, our bodies can be understood as machines: pumps, pulleys and levers. Slowly, the body became less sacred and more scientific.It was in this spirit that, in 1641, the French polymath Renes Descartes published his Meditations on First Philosophy. This work contains a drawing that became the seminal image of pain for the next three hundred years. The picture shows a kneeling boy with one foot perilously close to a small campfire. The heat of the flame sends a signal (an “animal spirit”) up a channel to the boy’s pituitary gland, which Descartes reckoned was the seat of consciousness. There, the signal elicits pain, “just as pulling one end of a cord rings the bell at the other end”.This picture makes sense to us, it seems intuitively correct. But this is because in matters of pain we are most of us now, in the Western world at least, the children of Descartes. For pain scientists on the other hand, who have fought in recent decades to emancipate themselves from Descartes, this picture has has come to represent the original sin, the first big lie of the Western world’s understanding of pain.It’s crimes are twofold. First, it is the essence of an idea called dualism, which holds that mind and body are separate. The body feels pain, and passes this information on to the mind. For Cartesian dualists, the body is a machine and we are a kind of ghost in the machine, receiving information about its status.Second, the picture represents pain as being felt by a specific detector in the body, and passed up a specific pathway, the long hollow tube, to a specific location in the boy’s brain. Pain detectors, at the end of a pain pathway, that leads to a pain centre. This idea is called specificity theory, but in this post I’m going to use the term labelled line theory because although it is less common, I think it is more descriptive — a labelled line for pain.As it happens, Descartes’ idea was more subtle than the picture and its subsequent interpretations made out. In his defence, the historians Jan Frans van Dijkhuizen and Karl A.E. Enenkel point out that Descartes knew that pain is not merely perceived, like a mariner perceives his ship, but felt, as if the mind and body are “nighly conjoin’d […] so that I and it make up one thing”. Descartes knew that we don’t just have a body; we are a body. But this subtlety was lost: the picture of the little boy with his foot in the fire has a memetic power that has carried it, along with dualism and the labelled line, through the centuries.The nineteenth century“Nothing less than the social transformation of Western medicine” — Daniel GoldbergThis change came gradually. It was not until the nineteenth century, two hundred years after Descartes’ Meditations, that dualism and the labelled line for pain finally established their authority in medicine.They set in as part of a wider change in the history of medicine following the French Revolution that is sometimes now called the ‘Paris School’. The physicians of the Paris School transformed large teaching hospitals in the city to dedicate them, for the first time, to furthering scientific knowledge through rigorous observation of patients and cadavers, and the classification of disease. They explicitly rejected humoural theory, which held that illnesses are processes that are distributed around the body through the movement of viscous humours. Rather, physicians of the Paris School considered diseases to be the result of lesions localised to a single, solid organ.Influenced by the Paris School, Victorian physicians across the Western world began to search their suffering patients’ bodies for a local, solid lesion to blame for their pain. As one New York physician wrote in 1880, “we fully agree that there can be no morbid manifestations without a change in the material structure of the organs involved”. For the first time, doctors began to think like detectives on the hunt for the smoking gun, following clues provided by the body and its sensations (it is no coincidence that Arthur Conan Doyle was a doctor before he wrote the Sherlock Holmes stories, or that he made his character Watson one, too).This approach has tremendous diagnostic power. But, as we will see, even modern researchers find that our pain, particularly our chronic pain, resists reduction by detective work. How did Victorian physicians respond when their investigations failed to turn up a local lesion to explain pain? According to historian and medical ethicist Daniel Goldberg, many doubled down, hunting for anything they could find. As one surgeon put it, “any lesion anywhere in the body will do to account for an otherwise inexplicable pain”. And that meant any lesion: the surgeon Joseph Swann, or example, baffled by a woman’s 11-year history of pain in an apparently healthy knee, eventually attributed it to an imperfection he found, after much searching, in a nerve in her hand.Those that could not find a lesion anywhere explained unexplained pain as one inevitably must if one subscribes to the logic of dualism: if it’s not in the body, it must be in the mind. Goldberg tells the story of the surgeon Josiah Nott who, in 1872, took on the care of an American soldier whose leg was crushed in a railway accident. The leg had already been amputated by another surgeon at a point about halfway up the calf, but the soldier had developed phantom limb pains. The original surgeon, assuming there must be a local lesion at the end of a labelled line, had then amputated the stump, but to no avail. Nott, making the same assumption, took still more from the stump the next year, and still the patient felt no relief. Later that year, Dr. Nott operated again, removing tissues from three major nerves in the shank. This pattern continued until Nott had removed the poor soldier’s leg up to four inches above the knee, and his sciatic nerve up to the pelvis. When the patient’s pain returned after this final operation, Dr. Nott reasoned that he must have acquired an addiction to opioids which was inciting him to malinger (to exaggerate or feign his disease). Nott had, horribly literally, followed the assumed cause of the disease up a labelled line through the body and, not catching it, decided it must therefore be in the mind.This logic played out on a broad scale in physicians’ understanding of the now-forgotten condition “railway spine”, the widespread and mysterious back pain felt by the victims of train accidents. Initially, physicians thought that the trauma of a crash caused compression of nerve filaments that in turn caused pain. But as time wore on and their investigations repeatedly failed to find a tissue lesion to explain railway spine, even in cadavers, their suspicion grew that railway spine was not a ‘real’ condition at all. After all, weren’t most victims also seeking compensation from railway companies? By the beginning of the twentieth century, railway spine was known instead as “hysterical spine […] merely a psychical condition”. Dualism dictated once more that if we can’t find it in the body, it must be in the mind.1900 to 1965Anomalies, non-anomalies, and opening the gateAnomalies“[Pain] reveals only a minute proportion of illnesses and often, when it is one of their accompaniments, is misleading. On the other hand, in certain chronic cases it seems to be the entire disorder which, without it, would not exist.” — Rene Leriche, 1937The break from Cartesianism began at the end of the nineteenth century, when the great neuroscientist Santiago Ramon y Cajal showed that our nerves, spinal cord and brain are not one thing but composed of many smaller things (which came to be called neurons) linked by gap junctions (which came to be called synapses). Decades earlier, the English neuroscientist Charles Bell had suggested that the function of the nervous system is less straightforward than the labelled line in Descartes’s picture, and Cajal’s work was proof.As we can see by his extraordinary drawings, Cajal meticulously mapped the peripheral neurons in our arms and legs, running to the spinal cord, and the neurons running up the cord, and many of those in our brain. But, according to pain scientist and writer Fernando Cervero, the terminus for incoming peripheral neurons, the foremost part of the spinal cord that we now call the dorsal horn, was so dense and chaotic that it resisted even Cajal’s fastidious eye. He called the dorsal horn a maremagnum, a Spanish word that means ‘confused and disorganised crowd’, as in the bustle of a busy railway station. Cajal’s vision of a network of individual cells, with nodes of incomprehensible complexity, opened up the possibility that signals aren’t simply passed upwards in a linear fashion as Descartes had assumed, but are modulated along the way.The idea that inputs to the nervous system are modulated before they ‘become’ our sensations hints at an explanation for the odd persistent pains for which Victorian physicians could find no lesion. It also begins to explain the opposite phenomenon, lesions that cause no pain, which became unignorable during the brutal first decades of the twentieth century. Doctors like Rene Leriche, on the front line in the Great War, found that soldiers with dreadful wounds often felt no pain and could undergo surgery without anaesthetic. Leriche knew this was not willpower but “certain movements of the hormones, or of the blood”, a presciently non-Cartesian thought.During the Second World War, the American anaesthesiologist Henry Beecher built on Leriche’s observations by conducting a more methodical study at his post in Italy. He found that as many as three quarters of wounded soldiers felt little pain at the time of their injury. As one doctor put it, it was as if wounds and diseases “carry for the most part — most mercifully — their own anaesthetics with them”.One might think that such cases would have alerted the scientific community to the fact that our nervous systems are doing something more than passively relaying pain into our brains, as labelled line theory implied. But for scientists and doctors at large, anomalies that defied labelled line went on hiding in plain sight, “discovered” periodically and then easily forgotten as they had been in the Victorian era. Phantom limb pain, for example, was unignorable during the American Civil War, and then slipped once more from popular consciousness. The doctor and writer Oliver Sacks called these periods of forgetting scotoma, dark gaps in the scientific awareness in which the prevailing theory cannot explain common phenomena and instead shoves them in the attic to think about another day. The progress of science, wrote Sacks, is faltering and haphazard, “very far from a majestic unfolding”.Non-anomalies“Pain is the physiological adjunct of a protective reflex” — Charles Sherrington, writing in 1900“Pain remains a biological enigma — so much of it is useless, a mere curse” — Charles Sherrington, writing forty years later.(Quoted in Understanding Pain by Fernando Cervero)Rather than explaining anomalies, scientists studying pain at the beginning of the twentieth century focused on a series of discoveries that appeared, at first, to confirm labelled line theory. The British neuroscientist Charles Sherrington had coined the term “nociceptor” for the neurons that convey danger messages (elicited by things like heat, intense mechanical pressure or an incision to the skin) to the brain, and in the following decades researchers slowly but successfully identified and isolated these cells.Starting in 1912, American scientists performed the first anterolateral cordotomy, slicing through the part of the spinal cord that was theorized to carry danger messages to the brain and appearing to stop pain in its tracks. Later, the success of such operations would prove to be temporary, but the procedure did show that this part of the spinal cord houses Sherrington’s nociceptors. In 1927, the Americans Herbert Gasser and Joseph Erlanger established that different nerve fibers conduct signals at different velocities, and classified them according to their diameter as A, B and C fibers. A fibers were widest and conducted signals the quickest; C fibers were the most narrow and slow. They found that one sub-type of A fibers, A-delta fibers, conducted the relatively quick sensation of dull pain we feel when we stub our toe; and that C fibers conduct the slower, stinging pain that arrives later. Again, this neat distinction would later prove to be more complicated, but the discovery was further evidence for a labelled line of pain. Gasser and Erlanger were only able to look at conduction signals from a whole bundle of nerves and so it was not until 1958 that Ainsley Iggo was first to record individual A-delta and C fibers and isolate Sherrington’s nociceptors for the first time.Opening the gate“It may seem easy, but it was not” — Ronald MelzackDespite this series of discoveries in favour of labelled line, some researchers could not shake from their minds those confounding anomalies: pain without lesion, and lesion without pain. And so, at last, the science of pain began to wake from its scotoma. Some scientists began to propose a theory to compete with labelled line called pattern theory, which held that it is not the stimulation of specific nerves that causes the sensation of pain, but that the way in which nerves are stimulated, spatially and temporally. Pattern theory was vague, and had nowhere near the amount of evidence that supported labelled line theory, but it did hint at an answer to some of the anomalies that had been documented in the recent scientific literature, such as the way pain spreads beyond the site of an injury and the way rubbing a pain can make it temporarily feel better. Pattern theory was taken up in Oxford in the 1940s and 50s, where the brilliant British neuroscientist Pat Wall was beginning to develop ideas he would turn into gate control theory, a whole new model of pain.In 1959, Wall moved from Oxford to the Massachusetts Institute of Technology where he met Ronald Melzack. Melzack, a Canadian, had just arrived at M.I.T. to take up a post as assistant professor of Psychology, and found to his annoyance that he could not perform research on animals in the university’s Psychology building. So, Melzack decamped to Wall’s lab. The two quickly took up a discussion on the inadequacy of Cartesianism and decided to come up with a new theory to “entice spinal-cord physiologists away from [labelled line]”.From his previous research, Melzack knew the brain sends messages down the spinal cord to inhibit the messages coming up it, exerting a kind of ‘top-down’ control on incoming information. From his own experiments, inspired by pattern theory, Wall knew that different inputs into the nervous system are weighed against each other somehow in the spinal cord, competing to be ‘sent up’ to the brain. Despite their discussions, Melzack and Wall’s ideas remained inchoate until, in 1962, Melzack stumbled on the Dutchman Willem Noordenbos’s pattern-theory hypothesis that large A-fibers carrying touch signals might somehow inhibit small C-fibers carrying danger signals.Melzack calls this moment a “flash of insight”. Noordenbos had theorized that this modulation happened in the substantia gelatinosa, which is part of the terminus for incoming information at the spinal cord. Wall knew that large fibers and small fibers entered the substantia gelatinosa at opposite ends, and theorised that it was this setup that allowed the one to inhibit the other, like closing a figurative ‘gate’. The weight of signals from large and small fibers would determine what kind of message was allowed up to the brain.In 1963, Melzack moved to McGill University in Canada, but travelled South over the border when he could to visit Wall’s home in Boston where, over large amounts of duty free whiskey, the two put the finishing, definitive touches to their work. Their theory differed critically from Noordenbos’ because they proposed that the brain itself plays a role in processing at the substantia gelatinosa, by sending signals down the spinal cord to make the ‘gate’ more likely to open or close to danger signals. This was gate control theory.For the first time, science had a model that began to explain pain anomalies. According to gate control theory, for example, the brain of a soldier who has sustained an injury can send messages down the spinal cord to close the gate to incoming danger signals. Over fifty years have passed, and gate control theory has turned out to be wrong in lots of little ways, but right in one big way: it is modulation in the spinal cord and the brain, or the central nervous system, that explains why pain is so rarely the reliable sign of tissue status that Victorian scientists assumed it was.Neuromatrix theory“We need to go… to the brain” — Ronald Melzack“When you feel a pain in the leg that has been amputated, where is the pain? If you say it is in your head, would it be in your head if your leg had not been amputated? If you say yes, then what reason have you for ever thinking you have a leg?” — Bertrand RussellGate control theory was a great advance but Melzack and Wall knew their theory was incomplete. According to Oliver Sacks, it is by studying anomalies — phenomena not explained by the prevailing theory — that researchers wake from scotoma and begin revolutions in scientific understanding. So it was that Melzack’s interest in the anomaly of phantom limb pain led to neuromatrix theory, the next great boost that finally allowed pain science to escape to orbit of CartesianismIf people without limbs have phantom pain, Melzack reasoned, it follows that the origins of the pattern of pain lie not in the limb but in the brain. And not only pain, but the sensation of having a body in its entirety — its place in the world, its shape, its movements — is housed, in what Melzack came to understand as a series of loops and patterns of neurons, inside our brains. This brain architecture is the neuromatrix.Incoming information, then, is not what holds the essence of our sensations; it merely triggers the neuromatrix, already inscribed in the brain, to ‘produce’ the sensations we feel. If a boy puts his foot in a fire, the nerves do not tell a passive brain “here is pain”; the nerves simply say “here is an intense input”, and the neuromatrix does the rest.How do we get a neuromatrix? Melzack says it is inborn, but then shaped by experiences. So, your neuromatrix develops your own personal signatures for familiar pains, like the pain you might feel in your back when you bend. Crucially, the neuromatrix uses our thoughts and emotions to generate our sensations, as well as sensory information. This makes sense: think of a stroke on the leg from your partner and one from an unappealing stranger. The same sensory input feels different.So, if you believe the cause of your back pain is something threatening, like a suspected spinal cancer or a ‘slipped’ disc, it willfeelworse than if you believe it is something benign, like a muscle strain. If a conscripted soldier sustains a battlefield injury that means he will likely have to leave the trenches to convalesce behind the front lines, that wound may not feel as bad as it would for a factory worker, for whom it could mean a loss of livelihood. If you have just been made redundant, or become divorced, than the incoming danger signals from an incipiently arthritic hip might suddenly start triggering your neuromatrix to produce a deep aching pain in your joints.Pain is intimately integrated with meaning, and informed by the broader context of our lives. And there is no labelled line: pain is the output of a widely-distributed neural process that takes input from countless biological, psychological and social factors.The sensitive nervous system“Not under conditions of my choosing / Wired into pain / Rider on the slow train” — Adrienne RichResearchers have used the neuromatrix as a foundation to develop our understanding of pain. For example, towards the end of the 1970s, scientists began to establish that the endings of our danger messenger neurons, the ones Sherrington christened nociceptors, become more sensitive the more they are used, a process called peripheral sensitization. But perhaps the most remarkable development since Melzack proposed the neuromatrix was Clifford Woolf’s discovery of central sensitization.On completing his medical training in South Africa in the early 1980s, Clifford Woolf joined Pat Wall’s laboratory in London. He was not content with measuring the readouts from individual chains of neurons, and instead began to monitor broader bursts of activity which he thought would give him more insight into the pain system as a whole. He started to measure the output of the neurons that cause muscles to flex away from a dangerous stimulus (think of touching a hot stove and retracting your hand before you are even conscious of pain). Investigating on rats, he found that most of these cells responded to dangerous stimuli, such as heat and pinch, in a fairly narrow field — say, one toe. But, some cells had a very wide receptive field and would respond to even light, non-dangerous touch. Why would rats have neurons designed to elicit a withdrawal response to light touch?It took Woolf some months to realise that he was only finding these neurons at the end of the workday, when his rats had already been subjected to hours of pain-inducing stimuli. He calls this his “eureka moment”. He had not discovered that rats have certain neurons that are super sensitive across a wide receptive field: he had discovered that a rat’s nervous system becomes super sensitive across a wide receptive field when it has been exposed to prolonged danger. Woolf had discovered an ‘amplifier’ mechanism in the spinal cord. This phenomenon is central sensitization.Woolf was the first person to show that the nervous system is not hard-wired for pain but plastic. Prolonged nociception can change the behaviour and the architecture of the nervous system so that non-dangerous inputs (like light touch) are felt as painful, and dangerous inputs (like a pinprick) produce more pain than they otherwise would have done. To top it off, this whole pain experience also spreads beyond the original site of injury. The great physiotherapist Louis Gifford described central sensitization as like tapping X on your computer keyboard three times, and 10 X’s of different sizes and colours popping up on the screen.A mild and benign form of central sensitization is common and almost immediate after most injuries — after you burn your hand or sprain your ankle, it is your body’s way of protecting itself. But central sensitization can wear on and, in many cases, persist and get worse long after any injury has healed. If you or someone you know has widespread back pain that flares up with the slightest movement, or has osteoarthritis in their hip that seems to spread all the way down their leg, they might have central sensitization.Central sensitization can affect many different functions, not just pain. People with ongoing, maladaptive central sensitization can be tense and forgetful, and sensitive to bright lights, loud noises and chemicals. It is also a feature of irritable bowel syndrome, migraine and chronic fatigue syndrome, and often goes hand in hand with anxiety and depression.So long, labelled line: Grappling with complexity“Pain cannot easily be divided from the emotions surrounding it. Apprehension sharpens it, hopelessness intensifies it, loneliness protracts it by making hours seem like days. The worst pain is unexplained pain” — Hilary Mantel“The basic idea of pain modulation implies that the output can be different to the input at every stage in the transmission of pain signals throughout the brain” — Fernando CerveroCentral sensitization is just one discovery that has enhanced our understanding of pain. There are many more examples. Descending modulation is the ongoing process by which the brain sends signals down the spinal cord to simultaneously inhibit and facilitate incoming danger signals, a mechanism Leriche anticipated when he observed that battlefield wounds “carry […] their own anaesthetics with them”. In people with persistent pain, descending modulation may be set for a net facilitation of incoming danger messages. Researchers have also expanded our understanding to include the immune system, which aids and abets the nervous system as it produces pain. They have found out that nociceptors, far from lying waiting for an intense stimulus as Sherrington imagined, are actually firing regularly throughout the day, every time we use a pair of scissors, ride a bike or go on a long walk, without (if we are lucky) our neuromatrix producing the experience of pain. Conversely, clever experiments have shown that nociception is not even necessary for pain, giving credence to the stories of people who narrowly escape injury but, believing they have been hurt, writhe in agony. And, we know that stress, even the stress of early life events, plays a vital role in ongoing pain, and that our stress system and pain production system are intimately linked.The contrast between the byzantine, distributed complexity of the mechanisms of pain and the singular experience of pain — I feel it here — is remarkable. Scientists have made various attempts to simplify the mechanisms into something more understandable and more useful to lay people. The neuroscientist VS Ramachandran has said that “pain is an opinion on the organism’s state of health rather than a mere reflective response to an injury”, a stark contrast to the old-fashioned idea of pain as “the unerring medical compass that serves as a guide to the pathological lesion”.The scientists and physiotherapists Dave Butler and Lorimer Moseley put it elegantly:“We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body. Equally we won’t have pain when our credible evidence of safety is greater than our credible evidence of danger.”In other words, pain is not measuring damage, it is a protective strategy, just one of many (along with local and systemic inflammation, changes in movement like tensing or bracing, the feeling of stiffness, and so on) that the body enacts in response to credible evidence of danger.This evidence of danger often includes nociception (signals from tissue damage), but the neuromatrix uses many other sources, too. For example, if someone has back pain and a doctor tells you your x-ray shows “wear and tear” or “degeneration” in your spine, they have received a clear message of danger related to your body that is likely to make their pain worse. Indeed, people with back pain who get an MRI actually reduce their chances of recovery. On the other hand, if that person’s doctor (or physiotherapist!) tells them that the findings on their scan are normal age-related changes (or, better yet, doesn’t order a scan at all), that is a clear safety message. Safety messages can come from anywhere. Exercise can send safety messages to your neuromatrix, and so can a supportive workplace or having a friend around to talk to.ReflectionsSlow progress, hopes for the future and a note of cautionSlow progress“I am still not happy with what has been accepted” — Pat Wall, 1999Danger sharpens pain; safety soothes it. Why, then, do health professionals continue to give people with persistent pain credible evidence of danger? Apart from the obvious — that there is money in telling people their spines are crumbling and their pelvises are out of line, that they have muscle knots that need releasing and cores that need stabilizing — it is because, just as Descartes’ model of pain took almost three centuries to reach its zenith in Western culture, the neuromatrix, still only forty years old, has been accepted only falteringly even in medical circles, and hardly at all in the wider culture.Indeed, in many ways the twentieth century has doubled down on labelled line. Take, for example, the dominance of the orthopaedic understanding of low back pain, which the late Scottish doctor and historian Gordon Waddell called “the dynasty of the disc”. Waddell traces the tenuous association of the lumbar disc with low back pain to a fateful cluster of papers published at the beginning of the century by orthopods searching, like Victorian physicians had done before them, for a pot of gold at the (wrong) end of the labelled line. Even today, routine orthopaedic surgeries like lumbar fusion, knee arthroscopy and shoulder decompression are amongst the most low-value, least evidence-based treatments in healthcare, still performed largely because of inertia and unexamined Cartesianism.Many physiotherapists practice with the same habits. Like Joseph Swann, we might conduct a questionable root-cause analysis up or down a kinetic chain to find an ‘issue in the tissues’, settling on a pronated foot, a slumped posture or a valgus (in-falling) knee. Like Josiah Nott, when a patient has failed a course of ‘corrective’ exercise to ‘fix’ their body we might decide their problem is primarily ‘psycho-social’, a euphemism for in-their-mind. This is understandable, it takes great effort to shift from Cartesianism to the neuromatrix; I have been trying for years and I am still astonished when a new study is published showing, for example, that there are no major physical risk factors for a first episode of neck pain, but multiple psychological ones, like depression, and social ones, like role conflict. Still, it is imperative that medical professionals of all stripes challenge their colleagues who promote themselves as experts but who practice with unreconstructed Cartesianism.Hopes for the Future“While pain sufferers do not have the luxury of denying the reality of their pain, they can and do deny its legitimacy, thereby internalising the stigma so frequently directed at people in pain.” — Daniel GoldbergThe neuromatrix model has the potential to be immensely liberating for patients. For people with everyday predicaments of life like the back or shoulder pain we all get from time to time, there is the reassuring message that pain is not an indicator of damage and they are safe to move. In fact, movement, as opposed to protecting the painful joint, is the way to go in the long run. For people with more profound, widespread and recalcitrant pain, understanding why their pain is the way it is can help with the process of acceptance, and knowing pain is multifactorial can open up new therapeutic options to help calm down a sensitive nervous system.The neuromatrix could also militate against the way Cartesian thinking drives stigmatization of people with chronic pain. Cartesian dualism casts pain as a two-step sequence of events: the body senses pain, then the mind reacts. As recently as the 1980s, words like “hysterical” or “psychogenic” were used to describe people who appeared to be ‘over-reacting’ to their pain. It is this thinking that allows us to sort people into those who are responding appropriately to their pain, and those who are ‘being dramatic’. The saddest effect of this stigma is when patients internalise it, believing that they are not ‘coping’ properly with ‘a bit of back pain’.So patients and health professionals need to know that dualism is bogus: as Pat Wall himself put it, “the separation of sensation from perception was quite artificial… sensory and cognitive mechanisms operate as a whole”. Or, in the words of neuroscientist Fernando Cervero, “emotional, sensory and cognitive elements aren’t organised in a hierarchical way, but in a cooperative way […] interacting to generate the final pain experience”.A note of caution“Nineteenth century physicians drain[ed] pain of any intrinsic meaning altogether, making it little more than a sign or symptom of something else” — Joanna Burke“[The challenge is] to allow a rapprochement between the world of the clinician and the world of the person in pain” — Quinter et. al (2008).The neuromatrix and all its attendant discoveries have revolutionised how medical and health professionals should approach people in pain. It is a rare true paradigm shift. But there is danger in complacency. “Now is not a time for professional hubris or the proclamation of truth by a few”, warn the rheumatologists John Quintner and Milton Cohen. The battle to understand pain is only half won. It is all too easy to be drawn back into the orbit of dualism, not only between the mind and body, but between the clinician and the patient, or the researcher and the sufferer. Centuries-old habits die hard, and we have long made the person-in-pain an object of enquiry. But this can only take us so far; as Quinter and Cohen assert, “the pain of another person is irreducible to its neuronal correlates”. We can only really know pain through dialogue.It is difficult to talk properly about pain. Being in deep pain can be a harrowing, abject, solitary experience. And apart from anything else, often we just don’t have the words: Virginia Woolf, no stranger to pain, lamented that English has a rich vocabulary for love, but a meagre one for pain. The poet Emily Dickinson said that pain “has an element of blank”.But it can be done. Joletta Belton, a blogger with persistent pain, recently tweeted about the two clinicians who had helped her the most. “It wasn’t just their words” she wrote, “it was that they listened first. And understood. Listening matters […] I wasn’t interrupted or lectured, they didn’t try to ‘educate’ me or alter my narrative to suit their own […] I felt what I said was of value. I felt human, of worth. That’s invaluable.”It may seem strange to end a post about science with a note on the importance of listening, but in the context of the neuromatrix it makes perfect sense. Listening to people in pain is what’s needed to undo the damage that has been done, and take the progress that’s been made to the next level.Belton’s experience echoes a vignette reported by Joanna Bourke in The Story of Pain.During a medical consultation in 1730, an embarrassed patient found himself apologising to his physician for boring him with “so tedious a Tale”. The patient’s physician protested: “Your Story is so diverting, that I take abundance of delight in it, and your Ingenious way of telling it, gives me a greater insight into your distemper, than you imagine. Wherefore, let me beg of you to go on, Sir: I am all attention, and shall not interrupt you.”Selected bibliographyJournal ArticlesAllan, D. and Waddell, G. (1989). An historical perspective on low back pain and disability. Acta Orthopaedica Scandinavica, 60(sup234), pp.1–23.Arnaudo, E. (2017). Pain and dualism: Which dualism?. Journal of Evaluation in Clinical Practice, 23(5), pp.1081–1086.Baliki, M. and Apkarian, A. (2015). Nociception, pain, negative moods, and behavior selection. Neuron, 87(3), pp.474–491.Bourke, J. (2014). Pain sensitivity: an unnatural history from 1800 to 1965. Journal of Medical Humanities, 35(3), pp.301–319.Brodal, P. (2017). A neurobiologist’s attempt to understand persistent pain. 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Journal of Neurophysiology, 109(1), pp.5–12.Moseley, G. and Butler, D. (2015). Fifteen years of explaining pain: the past, present, and future. The Journal of Pain, 16(9), pp.807–813.Moseley, G. (2007). Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12(3), pp.169–178.Neilson, S. (2015). Pain as metaphor: metaphor and medicine. Medical Humanities, 42(1), pp.3–10.O’Sullivan, P., Caneiro, J., O’Keeffe, M. and O’Sullivan, K. (2016). Unraveling the complexity of low back pain. Journal of Orthopaedic & Sports Physical Therapy, 46(11), pp.932–937.Perl, E. (2007). Ideas about pain, a historical view. Nature Reviews Neuroscience, 8(1), pp.71–80.Quintner, J., Cohen, M., Buchanan, D., Katz, J. and Williamson, O. (2008). Pain Medicine and Its Models: Helping or Hindering?. Pain Medicine, 9(7), pp.824–834.Thacker, M. and Moseley, G. (2012). First-person neuroscience and the understanding of pain. The Medical Journal of Australia, 196(6), pp.410–411.Wiech, K. (2016). Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science, 354(6312), pp.584–587.Woolf, C. (2007). Central sensitization. Anesthesiology, 106(4), pp.864–867.BooksCervero, F. (2014). Understanding pain. Boston: Mit Press.Butler, D. and Moseley, G. (2015). Explain pain. Adelaide: Noigroup Publications.Bourke, J. (2014). The story of pain. Oxford: Oxford Univ. Press.Moseley, G. and Butler, D. (2017). Explain pain supercharged. Adelaide: Noigroup Publications.Blog postsPain is weird by Paul IngrahamPain really is in the mind, but not in the way you think by Lorimer MoseleyCentral sensitization in chronic pain by Paul IngrahamMy own chronic pain story by Paul IngrahamEasing musculoskeletal pain Information leafletTell me your story by Joletta BeltonPodcasts and lecturesThe Pain Revolution by Lorimer MoseleyPain: past, present and future with Mick ThackerUnderstanding Pain in 2025 by Mick Thacker Subscribe at tomjesson.substack.com

Surgeon Sir Charles Bell, on the aftermath of the battle of Waterloo

The body brings together a number of vexing questions: it is ‘animal’ yet ‘human’; ‘natural’ yet the ultimate object of cultural inscription? The part of the body that most represents us to others is its surface: for Victorians, skin, especially of the face and hands, was an important medium through which to read character and selfhood, a membrane that both divided the inner and outer worlds and served as a medium for the projection and interpretation of interiority. In this talk, Gilbert discusses Charles Bell, Charles Darwin and Cesare Lombroso’s discussions of blushing and the emotions. She surveys examples from both literary and visual culture to show how Victorian perspectives on the skin aid our understanding of representations of the relation between selfhood, the material body and the emotions. Speaker: Professor Pamela Gilbert (University of Florida)

The body brings together a number of vexing questions: it is ‘animal' yet ‘human'; ‘natural' yet the ultimate object of cultural inscription? The part of the body that most represents us to others is its surface: for Victorians, skin, especially of the face and hands, was an important medium through which to read character and selfhood, a membrane that both divided the inner and outer worlds and served as a medium for the projection and interpretation of interiority. In this talk, Gilbert discusses Charles Bell, Charles Darwin and Cesare Lombroso's discussions of blushing and the emotions. She surveys examples from both literary and visual culture to show how Victorian perspectives on the skin aid our understanding of representations of the relation between selfhood, the material body and the emotions. Speaker: Professor Pamela Gilbert (University of Florida)

This is the first episode of the long awaited Season 3 of Discovering Darwin. In this season we will be exploring Charles Darwin's 14th original published book entitled The Expression of the Emotions in Man and Animals. We are reading the 3rd Edition of the book that has been edited by Paul Ekman. Dr. Mark Jackson, Psychology professor at Transylvania University is joining us this season as we tackle this unusual book by Charles Darwin.One of things that makes this book so unusual is that it is considered the first scientific book to utilize photographs. The French neurologist Guillaume-Benjamin-Amand Duchenne had found a man who seemed to lack the ability to feel pain so Duchenne was able to apply electrical probes to stimulate muscle contractions. By carefully stimulating certain muscle groups, Duchenne was able to get his "Old Man" to hold an expression long enough to be captured in a photograph using the early camera system of the times that required long exposure times.  We discussed how Charles began taking notes for this book 33 years earlier when his first child , William Erasmus Darwin, was born. Here is the sweet photograph of a proud father, Charles Darwin, sits with his son William. We discussed the functionality of dressing all young children, regardless of their gender, in dresses.   One of the people that Darwin was reacting to as he wrote his Expression and Emotions of Man and Animals was Charles Bell, a talented artist and anatomist. One of Bell's hypothesis was that emotions are a uniquely human trait that were given to us by our creator and he would show muscle sets that were "unique" to humans for expressing emotions. Darwin, opposed that creation view, and worked to adopt his idea of evolution by descent with modification to explain how emotions, like other traits, in humans when compared to other animals "...do not differ in kind, although immensely in degree." [Descent of Man 1871].James described how beautiful the drawings of Bell were and mentioned the hand on the book illustration as represented below.So what expression do you think this image represents?The opening and closing theme to Discovering Darwin is "May" by Jared C. Balogh.

Le médecin doit penser à : fracture du rocher, zona, maladie de Lyme, les tumeurs (de l'angle ponto-cérébelleux, du nerf acoustique, de la parotide), en fin une paralysie faciale idiopathique. Signe de Charles Bell.

Speaker: Professor Pamela Gilbert (University of Florida) The body brings together a number of vexing questions: it is ‘animal’ yet ‘human’; ‘natural’ yet the ultimate object of cultural inscription? The part of the body that most represents us to others is its surface: for Victorians, skin, especially of the face and hands, was an important medium through which to read character and selfhood, a membrane that both divided the inner and outer worlds and served as a medium for the projection and interpretation of interiority. In this talk, Gilbert discusses Charles Bell, Charles Darwin and Cesare Lombroso’s discussions of blushing and the emotions. She surveys examples from both literary and visual culture to show how Victorian perspectives on the skin aid our understanding of representations of the relation between selfhood, the material body and the emotions.

Paralysie Faciale Périphérique (PFP : complète avec signes de Charles Bell et de Souques). Paralysie Faciale centrale (PFC, uniquement territoire inférieur du nerf VII). AVC, facture rocher, plaie de la face, fracture mandibule, zona du 7 (ganglion géniculé), tumeurs (tronc cérébral, angle pontocérébelleux) parotide, SEP, polyradiculonévrite, Syndrome de Guillain Barré, intoxication par le plomb, neuropathie diabétique, porphyrie aiguë, Sarcoïdose et Paralysie facial idiopathique a FRIGORE. Attention AVC... urgence vasculaire.

Josh Kantor on being the Red Sox organist. Charles Bell of Illinois State University on school suspensions. Herman Pontzer of Duke University on the real paleo diet. Literary critic and editor Deborah Plant on Kossula's story of enslavement. Lego master builder Noel Straatsma on being paid to play with LEGO. Amber Rollins and Whitney Rodden of Kids and Cars on childproofing your ride.

Laura Gutierrez of Utah State University on Venezuelan crisis escalating. Charles Bell of Illinois State University on school suspension. Author Tommy Tomlinson on fat. Sam Payne of the Apple Seed shares a story. Michael Kugelman of Woodrow Wilson International Center on India vs Pakistan. Ken Alder of Northwestern University on lie detectors.

Austin, Texas has a reputation for being weird, and it’s about to get even weirder because Travis and I have arrived. We’re live on location at the Blokhaus, a venue where blockchain leaders are imagining the future together. In the news we’ll share what some fool said on Bloomberg, and you’ll discover a way to heat your home and mine bitcoin. You’ll meet Charles Bell, one of the top blockchain designers in the world, and we’ll have a sitdown with Chris Snook, the founder of The World Tokenomic Forum and this very Blokhaus. For reasons beyond reason, we’ve been invited to do the show live before an audience, and we intend to deliver all kinds of crypto goodness. So buckle up Austin, it’s episode #96 of The Bad Crypto Podcast. Full Show Notes at: http://badco.in/096 Ways to connect with Bad Crypto Facebook page - facebook.com/badcrypto Email to badcryptopodcast@gmail.com Join the Bad Crypto Mastermind badco.in/mastermind Join our TELEGRAM group! - badco.in/telegram Subscribe to our Newsletter badco.in/newsletter Call us at 708-885-9030 DONATE CRYPTO TO THE SHOW:If you'd like to donate a bit of cryptocurrency to The Bad Crypto Podcast, feel free to send copious amounts to the following locations: Bitcoin: 3HgKzHs3hB9oxqVLkBqmBXnkvmmVDSXuth Ethereum: 0x1cc3335e292fd9a956746f1467046e2198a8c69d Litecoin: LchSx4xHwXY5JBXVB72bf86VHEBgSmjTbC Dogecoin:  DPTjFZS4z9xPqfnCY8XrPNpMinYFZ9WsxK GET STARTED WITH CRYPTO WITH $10 BITCOIN FREE:We have an affiliate code with Coinbase.  If you decide to buy some crypto on Coinbase, you get $10 of free BTC, when you spend at least $100 in crypto.  The Bad Crypto Podcast also gets $10 BTC, as well. Win-Win. Coinbase is one of the most popular and well-known brokers and trading platforms in the world. Their platform makes it easy to securely buy, use, store and trade digital currency. Users can purchase bitcoins, Ether and now Litecoin from Coinbase through a digital wallet available on Android & iPhone. Do your own due diligence, some people have had some customer support issues.  Neither Joel nor Travis can attest to that.  If you do use Coinbase, once your coins clear, move it to an offline wallet or if you choose, move them over to another exchange. Here is a list of all of the top crypto-currency exchanges.  Choose one that you like. DISCLAIMER:Do your own due diligence and research. Joel Comm and Travis Wright are NOT FINANCIAL ADVISORS.We are sharing our journey with you as we learn more about this crazy little thing called cryptocurrency. We make NO RECOMMENDATIONS.  Don't take anything we say as gospel. Do not come to our homes with pitchforks because you lost money by listening to us. We only share with you what we are learning and what we are investing it. We will never "pump or dump" any cryptocurrencies. Take what we say with a grain of salt.  You must research this stuff on your own! Just know that we will always strive for RADICAL TRANSPARENCY with any show associations. Edited By: Aaron The Tech (http://aaronthe.tech) Support the show: https://badcryptopodcast.com See omnystudio.com/listener for privacy information.

“Lose belly fat.” “Build muscle.” “Lower your cholesterol.” “Improve your sex drive.” Browse the shelves of any supermarket or pharmacy, and you will find dietary supplements that promise to do all this, and more. Supplements are a multi-billion-dollar business, and today more than half of American adults take them, many at the advice of their doctors. But dietary supplements can have real risks. They are not required by federal law to be proven safe “to the FDA's satisfaction” before hitting the market, raising concern among critics about a perceived lack of safety oversight and consumer education. Using the latest science as the basis for discussion, Forum experts examined the risks and benefits of supplements. How effective are they? What about dosages — or interactions with prescription medications? Should supplements be subject to more stringent rules and tests? What role should doctors, pharmacists, and drugstores have in helping consumers make safe, educated choices about supplements? This panel attempted to help sort the facts about supplements and health. Part of The Dr. Lawrence H. and Roberta Cohn Forums, this event was presented jointly with PRI's The World & WGBH on May 11, 2017. Watch the entire series at ForumHSPH.org.

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell's lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell’s lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell's lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell’s lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell’s lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell’s lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Carin Berkowitz‘s new book takes readers into the world of nineteenth century London to explore the landscape of medicine and surgery along with Charles Bell, artist-anatomist-teacher-natural philosopher. Charles Bell and the Anatomy of Reform (University of Chicago Press, 2015) looks closely at the involvement of Bell and others in a project of conservative reform in nineteenth century British medical education. We follow Berkowitz not only into the pages of the works that made Bell famous, but also into the classrooms in which Bell advocated a pedagogy that trained hand and eye together and developed his interest in systems of all sorts, including the nerves, education, and display. Readers will learn about the growth of a new genre of medical weeklies that changed the public face of medicine, the founding of new institutions that changed the teaching of medicine, and the controversy over motor and sensory nerves that accompanied major transformations in the medical science of Bell’s lifetime. It is a fascinating story that honors the importance of the history of education in shaping the histories of science and medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices

Rod and Karen are joined by Randolph and Andy of the Three Guys On Podcast to discuss Last Comic Standing auditions, Dave Chappelle, Shaming, nudes being a sex crime, lab penis, gun robbery, engagement ring prices, Jay-Z, Ebola, 7th Heathen, Obama, Charles Bell, Ty Turner, Elle magazine, porsche test drive, car seat cop, baby puncher, heroine dealer and sword ratchetness. Twitter: @rodimusprime @SayDatAgain @TBGWT @threeguyson @AndyKline74, @realtalkforyou Blog: www.theblackguywhotips.com Voice Mail: 704-557-0186 Guest Website: http://www.threeguyson.com/ Sponsors: www.tweakedaudio.com Code: TBGWT