Friday, November 2, 2012


Today is a bittersweet day, the day we focus on remembering our dearly departed (as if they were ever out of our thoughts for even a moment, as if they weren't present with us, inside our hearts, our brains, our beings every moment, waking and sleeping, of every day...)....More......

My dear Mario was an amazing man.

Smart, caring, funny, warm, thoughtful, firm in his convictions, but open to honest dialogue and change, able to relate sincerely to popes, princes and paper boys.

He also made an enormous contribution to medicine in Milan, in Italy and in the whole world: he founded and chaired the world's first university chair for the physiopathology and therapy of pain, for which he was inducted into honorary membership (a "hall of fame") in the most important international association of pain specialists, IASP. This, for him, was his most prized award, rather, he used to say, like the Nobel prize in applied medicine (Nobel established a prize for researchers, not for doctors working with patients).

Then, among the gazillion other awards he received, his other most prized award he received in 2007: the Galen award for excellence throughout his medical and university career. He was the first to receive it.

Fascinated by the question 'What is pain?' and the need, as a caring physician, to relieve it, early in his career he defined pain in a Descartian way as an alarm bell that aids diagnosis, but, once it has served its purpose, which should be relieved. Sounds like the discovery of sliced bread? Not in Italy in the mid-20th century, and despite his efforts--including early and repeated seminars for general medicine doctors--traces of this acceptance of pain as atonement still linger.

He distinguished the phases of 'pain': stimulus, transit of the signal, arrival of the signal in the hypothalamus...up to which point, rapid though the progression is, it's still just a signal, it's not 'pain'...and then the arrival of the signal in the cortex, where it is processed, interpreted as 'pain.'

Fascinated by how the brain works and whether who we are is generated by something that survives the death of the physical body, or by the extreme complexity of the brain, itself, he closely followed the work of researchers such as Wall and Melzack, and developed the metaphor of Alice before a warped mirror to help non-specialists understand how the state of being of a person (which includes culture and ambiance) can modify pain perception, which takes place in the cortex: focusing on pain increases the perception of pain, distraction decreases the perception of pain.

Sweetheart, I just saw an article on a University of Southern California web site that would have thrilled you: how liking, or disliking, someone can modify how we perceive them, as seen in brain scans.

The more things change, the more they stay the same, just like Marcus Aurelius used to say, 'It's not the thing in itself, it's how we perceive it.'

Sweet dreams, sweet heart.

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