2018 Distinguished Service Award
Christopher M. Herndon, PharmD CPE
I became involved in pain management during my residency at the University of New Mexico College of Pharmacy. It was here I began working with Walter Forman, a pioneer in the modern palliative care movement. Dr. Forman showed me the importance of relieving suffering as our most vital job in addressing pain and symptoms, regardless of the setting in which you encounter the patient. Having worked in practices including outpatient oncology, hospice, outpatient palliative care, industry, academia, and now in a chronic noncancer pain service within a primary care residency program, this philosophy of care has remained my highest priority. Unfortunately, pain is pain and suffering is suffering. The lines we draw every day between etiologies and the prognosis of the patient should not matter as we strive to relieve suffering, yet it increasingly does. Should the suffering experienced by a younger patient with no diagnosis of malignancy or life limiting disease be palliated any less aggressively than that of someone at the end life? Working with these patients, advocating for these patients, and ensuring that our students understand the importance of relieving suffering has guided my efforts. And there is still work to be done. I am blessed by the remarkable mentorship I have received and the brilliant colleagues I work with. I am incredibly grateful, humbled, and honored to receive this recognition from the American Pain Society. Thank you.
Jessica S. Merlin, MD MBA
How did you enter the field of pain?
As a medical student (and as a resident and fellow), I spent time in Botswana. I worked on an inpatient ward caring mostly for people with HIV and AIDS. I was drawn to taking care of these patients, and recognized that in addition to their high burden of disease, they also had a high burden of symptoms. This led me to pursue a medicine residency and fellowships in infectious diseases and palliative care. As I spent more time working in HIV primary care in the US, I saw how prevalent and disabling chronic pain in particular was in this patient population. Chronic pain in people living with HIV, and related issues such as the overlap of chronic pain and mental illness, addiction, and opioid misuse became the focus of my clinical practice and research.
How did you get to where you are in your career today?
I have benefited tremendously from amazing mentors and colleagues. I try to take calculated risks in my research and do things that make me uncomfortable. For example, public speaking with big audiences, which has helped me learn more about what front-line providers in diverse care settings are facing, while also allowing me to make new professional connections. And I really love the work. I’m fortunate that my clinical work and research are closely aligned. I love seeing patients who have chronic pain get better, and they teach me what things we need to study more.
Why do you work in pain?
I explained above how I got to pain, but the reason it drew me in is that I really enjoy working with patients and in situations that are a bit uncomfortable, where medicine is as much art as it is science, where there are controversies and the evidence base is shaky, and where patients and providers are frustrated. These things make pain really interesting to me, and something where I feel that even very early in my career, I can make a contribution.
What is your favorite part of your work, and why?
I love helping other physicians who are grappling with really difficult cases. I also love mentoring trainees and very early faculty scientifically and in how to navigate academia.
What was most surprising about working in the field of pain?
Maybe I’m naive, but I’m surprised by how much chronic pain (and addiction) stigma still exists within the medical community. Chronic pain is a challenge for clinicians, and one that many are not trained to address. This sometimes translates into stigmatizing language and in my anecdotal experience, pessimism about patients’ options. I often hear this from my colleagues.
What is the biggest challenge you’ve faced?
When I was a fellow and early junior faculty and expressed interest in HIV and pain, I faced a lot of skepticism from the HIV scientific community. They were uncertain as to the importance of pain in this population. I realized that the reason for this was the lack of literature in this area, which made me determined to add to the evidence base through my research. I don’t get very much skepticism anymore!