Introduction by Philippa Tindle BSc MSCP (Louis’ partner and wife)
Thanks to the Physiotherapy Pain Association (PPA) for organising this lecture in honour of Louis. And a huge thank you to Mick and Kath Thacker for also making the journey – they have been with Louis and I all the way. They travelled to Falmouth in February 2014 and Mick fulfilled Louis’ request to speak at his farewell party. And in October 2014 Mick and Paul Watson presented The Head, Heart and Hands session for Louis at the PhysioUk conference in Birmingham. All these events have been possible because of Mick and Kath. I am very lucky to have their support both for these public lectures and for our private times. We all need friends like them.
But it wasn’t always like this! I remember my first encounter with Mick – listening as he challenged Louis at a lecture in London about the role of the sympathetic nervous system. Here was a passionate ( and quite ‘bolshy’) young man incensed by what Louis was saying. Luckily for us Mick was open minded enough to agree to spend sometime with Louis to hear far more than can be expressed in an hour’s lecture. A friendship and collaboration with mutual respect was forged.
Louis always liked to be reasonably critical, but he was also happy to be criticised, saying that was what good science was all about and no one should be fearful of criticising – just do it nicely!
So, I am delighted that Mick is still a little bolshy and is still prepared to constantly explore and challenge our current thinking about pain. Thank you Mick, on behalf of Louis, for presenting this lecture and allowing us all now to look to the future.
THANKS TO THE PPA FOR RECORDING THIS TWO HOUR LECTURE
Last Christmas I suggested that Louis’ new book Aches and Pains would make a great present! Thanks to everybody who has bought a copy, told their friends and supported getting Louis’ words out there. Thank you to those who have written to me and told me how much they have enjoyed it. We sold out of the first print run last week – awesome! The first re-print will be ready by December 17th – before Christmas!
In October 2014 Mick Thacker and Paul Watson presented the Head, Heart and Hands lecture at PhysiotherapyUK, Birmingham for Louis. There is a story behind this title but too long for here, but this summer Louis and Philippa’s niece Megan Henwood released her new album called Head, Heart, Hand for Louis.
Another great Christmas present! The last track is called ‘Painkiller’ and about Louis.
Head, Heart, Hand
‘This album is for Louis Gifford, who made me promise that I would keep on keeping on’ Megan Henwood, July 2015.
Proper Music http://www.propermusic.com/artist/Megan-Henwood-20153
Thanks Megan. A very special tribute.
Happy Christmas and a healthy and happy new year. Philippa Tindle
Louis Gifford – revolutionary: the Mature Organism Model, an embodied cognitive perspective of pain. Mick Thacker. In Touch Autumn 2015 No 152 p4-9
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Get booked now! – The Louis Gifford Lecture by Mick Thacker and PPA AGM 16th Ocotber 2015. Liverpool, PhysiotherapyUK conference
PPA Get booked now! – The Louis Gifford Lecture and AGM 16th Ocotber 2015
Mick Thacker is presenting the Louis Gifford Lecture with PPA AGM to follow.
To book :
Go to the website (www.physiotherapyuk.org.uk) and click ‘book now’.
When the booking form opens there are two places where they will be asked for their delegate type, and they should select the bottom one (PPA – AGM & LG ONLY).
· If you select this type and book for 16/10 they will be charged £5+VAT.
· If you book for just 17/10 they will be charged the normal one-day rate (£207).
· If you book for both days they will be charged the normal two-day rate (£207). (But don’t forget the PPA discount code which would take 10% off any bookings).
See you there!
Louis Gifford Aches and Pains
CNS Press Falmouth UK
ISBN 978 0 9533423 5 8
A Review: Paul J Watson PhD FCSP, Emeritus Professor of Pain Management and Rehabilitation, University of Leicester, UK. November 2014.
Most people reading this review will be familiar with the work of Louis Gifford who died in February 2014. Over many years Louis delivered a number of courses and these form the basis of these three volumes. I must declare that Louis was a friend who I admired greatly as a clinician, author and teacher so this review may lack some objectivity; however, both the author and the potential reader deserve a fair review so I will try my best.
This final publication from Louis Gifford is presented in a boxed set of three volumes: Aches and Pains, The Nerve Root, and Graded Exposure and Case Histories. This is a difficult series of books to review because they defy a traditional classification. They are part autobiography, part literature review with a focus on teaching through the use of the author’s own professional experience with clinical examples. Throughout the books the reader is impressed with the sense of wonder Louis had in the phenomenon of pain, how this presented itself clinically and how the patient’s presentation and response to treatment could be interpreted and understood through an in-depth appraisal of the research literature. The books are written in the author’s own witty and idiosyncratic style which I find easy to read, rather like chatting to an old friend, but those who want a dry and studious book may find the style frustrating but I encourage them to persevere; it will be worth it. The tone is frequently opinionated and outspoken about the short comings of the professions and approaches used in the management of pain especially chronic pain, although there are occasional apologies for this there is no doubting the author’s irritation at the lack of critical thinking which attends the management of many painful conditions.
A traditional review would criticise the series for not using the most up to date references throughout the book to illustrate the many fundamental points made. This would be erroneous and misses the point of much of the book which is a reflection of the journey Louis took to come to his understanding of pain through his learning and clinical practice. Instead he encourages the reader to “read what I’ve read”. This does not make his conclusions and his interpretation any less valid, most of the references cited are seminal in our understanding of the current theories of pain. In taking this approach he invites us to see if we too would reach the same conclusions with this information and states early on in the book that the work represents his understanding of the literature and he ask us to “feel free to challenge it and offer an alternative explanation”. In doing so it is a call to use this as a basis for understanding and a stimulus to better our own knowledge and understanding rather than to accept something as the given dogma.
Personally I found the first two books the most satisfying maybe because I, like Louis have a deep and unending fascination with the neurophysiology of pain in all its guises. This is not, mercifully for the casual reader, a complex discourse full of detailed descriptions of neurotransmitters, brain areas and detailed neurophysiology, it is described with a lightness of touch which few authors can achieve. This is peppered with case histories to illustrate points which clinicians will find very close to home and will recognise in many of their own patients. It lets the reader understand that pain is a dynamic, ever changing process which evolves into a complex phenomenon and, I hope, will stop people seeing acute injury pain and chronic pain as two completely separate entities. Louis has tried to bring together the neurophysiology, psychology, behavioural and immune responses together with the social environment within which the pain is interpreted and shows how these alter the presentation in clinic and how a better understanding can make us more effective clinicians.
It is in this section that Louis expounds further on his Mature Organism Model of chronic pain which was a seminal advance in the understanding of pain for many physiotherapists. With the passage of time since the original model was published more information has come to light which helps to support the model and to develop it further. In conversations with Louis he always considered this a work in progress which was unlikely to ever be complete.
The third volume is increasingly clinical and gives much space to case histories to explain and illustrate clinical applications which come from the author’s vast experience. This is likely to be the section many physiotherapists will enjoy reading – how we can put much of the learning into clinical practice. It includes Louis “shopping basket approach” to patient management which puts rehabilitation at the forefront of the whole of patient management and presents a model of clinical reasoning which demands a broad mix of skills without declaring one is a ………. insert your guru/dogma of choice in here….. therapist, the focus instead is on the patient, their presenting problems, their social circumstances, psychological needs and the ultimate rehabilitation aim; from this stand point one chooses what is appropriate for the individual.
Some will argue that there is a lack of reference to some of the more recent developments in the management such as more focused use of screening, the recent developments in the use of values driven rehabilitation approaches and mindfulness in chronic pain programmes but to me these are to be forgiven.
Minor niggles are an occasional repetition of information from one section to another and a lack of indexing making it hard to find information quickly. I am not sure the poetry and song lyrics contribute to the chapters but these are examples of the idiosyncrasies of the author, I am sure in a lecture he would make them seem perfectly in place. There are incomplete sections which were not completed before Louis became unable to continue, the sections are completed by his wife Philippa suggesting what Louis would have written; this adds a poignancy to the books.
I found these books eminently readable and I have read all 450,000 words with ease and found greater clarity in them than in many other textbooks on the subject. Even though the books are aimed primarily at physiotherapists I would recommend these to all clinicians from all professions. For students and people new to the study of chronic pain it gives a context for the current views of pain and synthesises a vast area which one could not hope to cover as quickly as one will by reading this series. The books are a testament to the intelligence, wit and charm of the author and represent a fitting final tribute to an excellent teacher and communicator.
I am unashamedly promoting Louis’ book set – they make great Christmas presents! Our courier has advised us that overseas and UK delivery for Christmas is wisely by 19th December ( although we are happy to continue to dispatch over the holiday period).
Louis used to write notes all over every book he ever read – so don’t share, buy or give a copy and write all over it too!
Thanks to Irene and Glen Hunter from Welbeing CPD and Beck Davison for kindly allowing me to promote Louis’ books at their recent study day in Truro, Cornwall. Thanks for all your support.
ORDER VIA PAYPAL BELOW OR CONTACT ME DIRECTLY VIA email@example.com or 00 44 (0) 1326 312156
Thanks to Ian McMillan and Simon Hadley for reporting on Louis’ session at Birmingham on 10th October 2014.
Heather, Paul and Mick did a great job. Louis would have liked to have shared the platform with his good friends and colleagues. Thanks to all in the audience for your support. I thought we all held it together pretty well – until the end! Philippa x
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