Mini Blog: 2 minutes with… John Alchin

Dr John Alchin, the previous hand behind the editors pen of Ngau Mamae is the next of our guest bloggers...

1. What is your current role/job/position?  

I am a consultant at the Pain Management Centre, Burwood Hospital, Christchurch.  This entails:

• Seeing patients referred to us, both as new patients (as part of a Comprehensive Pain Assessment), and follow-ups. 
• I also take several sessions on our CHOICES program.  CHOICES is a 3 week full-time (9am - 4 pm, Monday - Friday), interdisciplinary group (5-8 pain patients in each group) cognitive-behavioural Pain Management Program.
• Other tasks include triaging patients referred to us; taking phone calls from other doctors (GPs, other hospital doctors) about their pain patients. 

2. How did you get into working in Pain Management?  

I got fascinated by pain through my primary specialty of Occupational Medicine, in which I trained in the last half of the 1980s.  I became increasingly interested in chronic pain as a problem in it's own right, from the late 19809s on.  In the 1990s, working in this field, it became clear that the many patients I saw with chronic musculoskeletal pain (primarily low back, upper limb & neck) were presenting a complex problem, not a simple one, for which there was no quick and easy mechanical fix.  Then in 1997 I was asked if I wanted to take a position at the Burwood Pain Management Centre.  As that coincided with my being made redundant from Air NZ in mid 1997, in one of their periodic "Re-Organisations" (all the occupational medical units were closed, but were later reinstated), I took up the offer.   

But in fact pain fits in with my life-long interests in biological medicine - after school I went into medical school, not so much for the clinical work, but for the training in human biology, which is what particularly interested me: at high school my favourite branches of biology were genetics, cell structure and function, evolution, and human behaviour/psychology.  And now, in pain, I have come full circle back to these underlying interests.  Because to (try to!) understand the phenomenon of pain requires a familiarity with a broad range of biological subjects - it ranges from the genetics of pain and molecular processes in cells including neurons, through to larger structures, including the structure and function of the nervous system & brain; to human behaviour, psychology and psychiatry; and to social factors - the epidemiology, including role of social class, deprivation, the social welfare & medicolegal systems, and the news media in the clinical presentation of patients we see with pain.

3. If you weren't working in Pain Management what would you be doing? 

My other favourite fields of medicine now are neurology, general internal medicine, psychiatry, epidemiology.  If I had my time over, these are also fields I could have gone into, in terms of my interests.

4. If you could invite any 3 people to have dinner, who would you choose and why? 

Hard question!  Who to choose?

From the medical/pain world, for their huge knowledge & wisdom about pain, and their nice personalities (but leaving out my NZ colleagues in chronic pain, as there are too many to list): Montreal's Serge Marchand, Australians Michael Nicholas and Lorimer Moseley, Americans Norton Hadler & John Loeser.  And especially the British psychiatrist Professor Sir Simon Wessely, a wonderful researcher and writer.  

From the non-medical world, for their knowledge, wisdom & (in some cases) their personalities: Radio NZ's Kim Hill.  NZ poet Sam Hunt.  Clive James.  Political Philosopher Michael Sandel.  Scottish ethicist Alastair McIntyre.  Wonderful British novelist (& chronic pain sufferer) Hilary Mantel.  Leonard Cohen.  Bob Dylan (in theory - as I gather he may not be particularly genial).   Woody Allan.  Kate Blanchet.  A lot of old white men (except for Kim, Hilary & Kate) 

5. What is the most important advance you hope will be made in Pain in the next ten years?

Now an easy question!  Development and clinical availability of some more effective, more targeted analgesics for chronic non-malignant pain.  That would make my patients lives, and mine, a lot more pleasant.  It is very difficult, day after day, to tell patients that we cannot abolish their awful pain, and that there is a good chance that we won't even be able to reduce it by a significant amount.