Written by, Keith Javery, D.O.
It was late summer, 1989. I was just a few months in to my internship (first few months of training after graduating from medical school). Green, medically naïve, but full of youth, eagerness and anticipation. I was ready to tackle the world! It was then that I had my first experience with “chronic pain”. However, this first experience wasn’t in one of my patients’. It was me!
I was a “semi-professional” bicycle road racer which meant I was only good enough to earn just enough money to pay for my equipment. After finishing my 12-hour shift at Grandview Hospital, in downtown Dayton, I wanted to make use of the very few hours of personal time that I had been trying to stay in racing shape and I hit the road on my racing bicycle for some hard training. It was that fateful day, when I went in to a hard curve, just a bit too fast. This fact, plus some sand on the road I didn’t notice, caused my bicycle to fly up in the air, and caused me to land squarely on my right hip and on my head with tremendous force.
I was spared a severe head injury, thanks to my now broken helmet, but when I tried to arise, equally embarrassed as well as stunned, I felt that severe bolt of pain in my right groin, thigh and upper leg the instant I tried to put any weight on my right leg.
I was transported by ambulance to the same hospital where I served as “low man on the totem pole.” After a few X-rays/CT scan, the diagnosis was obvious – fractured acetabulum/pelvis. I had a pelvic fracture. Luckily the bone was minimally displaced, which meant I didn’t require surgery, but the first thought I had on my mind wasn’t my bike racing, or my hip. My first thought was, “how am I going to complete my internship with a broken pelvis!?”
“No weight bearing! None!”, barked the order of the attending orthopedic specialist. “I concur” seconded the chief orthopedic resident.
I started to feel sorry for myself. I was offered the ability to take the year off, and start again next year, but anyone who knows post graduate medical training knows you don’t want to repeat any of your internship and residency. Once is more than enough to endure! But how could I see patients and perform the “scut work” that is demanded of the intern in an inner city hospital?
The pain from the fracture was as I expected but I rented a wheel chair and kept it locked up in the medical staff locker room. I crutched to and from my apartments across the street from the hospital but by the 4th week post fracture, I thought my pain should get better, but it didn’t?! I cornered the chief orthopedic resident again and I was still having a lot of pain. He responded almost in disbelief, “suck it up Javery!” “Besides, there is no way it could still be hurting that much!”
I actually started to doubt my own mental and physical “toughness”. “What was wrong with me?” Yet I knew that “it wasn’t in my head”. I WAS having this pain, and there WASN’T anything wrong with me!
It was that moment that I saw a glaring disparity in medicine. It wasn’t a fault in my mentors, or myself. This was (and sometimes still is) the state of medical thought and dogma. I shouldn’t have been in that much pain, yet I was.
Throughout my life I have always despised bullies. I felt I was being ‘bullied’ into denying my own trueness. I was having ongoing pain, and I was told I couldn’t be. I knew at that time what I wanted to do. It’s just that I had no idea how it could be accomplished.
In 1989, the idea of a “Pain Clinic” was as foreign to 99% of physicians as it was to everyone! The term “Pain Clinic” itself wasn’t even part of the medical lingo!
I loved surgery, but the fact that my father, Herbert A. Javery, D.O., was an anesthesiologist, probably had everything to do with me specializing in anesthesia. Maybe for the simple reason that he told me I would be better off specializing in something else. I thought to myself, “all the more reason for me to do it!” My father knew me well, I think.
I loved the operating room. The excitement and rigors of a trauma 1, major university medical center, at the University of Kentucky was truly a dream of mine! I was doing anesthesia for every kind of case I could imagine. The simple tonsillectomy to the most advanced cardiac heart and lung transplantation. I had hit the “bigtime”!
However, during training we were required to rotate 1 month for the 3 years of anesthesiology residency in the “pain clinic.” I didn’t even know what we did in that place. I even had to ask where it was!
“You’ll hate it!” said my co-residents. “No one ever gets better, and all they want is pain pills!” Sounded like an awful place I thought to myself.
I then reported for duty, and my attending at the time, George Colclough, MD. He himself altered my life course drastically and permanently! George became my closest mentor and teacher. He instilled in me the importance of the work we do for those suffering souls. I was immediately brought back to my own brush with chronic pain, and instantly, I KNEW my life’s work was at hand, and it was right in front of me!
Instead of a loathsome, depressive place, I saw the “Pain Clinic” as a place of hope and even joy! My patients’ lives were drastically improved, even if I was only able to reduce their pain modestly some times. It itself was an enigma, but it touched my soul and continues to do so!
I was honored when my chairman offered me directorship of the University of Kentucky Pain Management Center after my training was completed. I stayed for 3 years, but knew that academic medicine was not my destiny. I wanted to be even closer to my patients. I wanted private practice. I came to Grand Rapids in 1995 to join a small but growing pain practice and I have never looked back since! In 2009 I hung out my own “shingle” and started Javery Pain Institute.
Again, ever grateful for those mentors, and colleagues who helped me grow professionally, but again, following the call to be even closer to my patients. I felt I could do this better “with my own place”.
It’s been an incredible nearly seven plus years since the formation of Javery Pain Institute. I am grateful to those patients and referring sources who helped make my dream of “my kind of pain clinic” a reality. But it was mostly my wife, Lisa, who prompted me (and pushed at times) to make Javery Pain Institute a reality!