Janet Travell and David Simons, True Medical Pioneers
By Virginia P. Street
In the historic letter below, Janet Travell, M.D. wrote to her friend and colleague, David G. Simons, M.D., in response to a letter that she had received from him, to tell him that he had "hit the nail on the head" with his outline about how the two of them could proceed in putting together a medical textbook about myofascial pain and trigger points [a trigger point manual] which, of course, they did.
November 12, 1974
David G. Simons, M.D.
Veterans Administration Hospital
5901 East Seventh Street
Long Beach, California 90801
Dear Dave:
Many thanks for returning the reprints that I left with you for photocopy and for the photos taken at the V.A. Hospital, and for your wonderful letter of November 5. The photos do not flatter me, but the best of them is the one of you and me together. I am glad to have that one.
Your extraordinary letter gives me a great shot in the arm, and I cannot tell you how much I look forward to spending some time with you next spring. I believe that you have the talent, interest, and opportunity to learn all the things about myofascial trigger mechanisms that I have not been able to do. Besides, you will pin down this knowledge into words in a usable, organized form: 1, 2, 3, and so forth, throughout the list.
You have hit the nail on the head with your outline, starting with anatomical relationships and action of the muscle, referred pain pattern, positioning of the patient to examine, and to stretch or inject the muscle. ...
I have made a list of referred pain patterns of muscles, which may be new to you. You asked only for the teres minor, but I will send you other goodies.
More to follow soon. I have not answered all the questions in your letter, but will do so presently. ...
Warm regards to you and Ute,
Sincerely,
Bobby
Janet G. Travell, M.D.
* * *
Below is a 1993 article by David Simons, JANET G. TRAVELL, M.D. AND DAVID G. SIMONS, M.D., from the Journal of Musculoskeletal Pain, (1) (now MYOPAIN):
In 1963 fate introduced me to Janet when she lectured on myofascial pain and demonstrated its relief on astronaut-candidate Neil Armstrong at the USAF School of Aerospace Medicine in Houston, Texas, where I was serving as a flight surgeon. Our relationship grew until, after I retired from the Air Force, we realized that her treasure of clinical experience must be published if others were to reap the full benefit it. The concept of The Trigger Point Manual was conceived in 1974 following a month that she spent seeing patients on my ward at the Long Beach Veterans Administration Hospital. That visit included non-stop demonstrations and a lecture schedule that covered muscles of the entire body. Her energy was inexhaustible. By the end of a day, I was barely able to keep up with her.
She agreed to provide information if I would do most of the writing. Her mind was a fountain of ideas that overflowed from muscle to muscle in rapid sequence. I quickly learned to tape record her speeches and conversations and then go back and sort out all the information on each muscle as I integrated other work through library research.
After a 9 year gestation period, in 1983, Volume 1 that covers the muscles in the upper half of the body was delivered. This included the first published presentation of her understanding of perpetuating factors. On the anniversary of her 90th birthday, in 1991, she had in hand a newly-printed copy of Volume 2 of The Trigger Point Manual, covering the muscles in the lower half of the body. By now Volume 1 has been printed in three languages and is being translated into three more. Myofascial pain, that scourge of humanity observed and tamed by Janet, is now becoming recognized and respected by the medical community for what it is.
This manual is the product of a remarkably close collaboration between the co-authors that evolved over nearly two decades. They brought together two very different backgrounds that were compatible and complementary. They learned to resolve their many differences of opinion by determining what was correct, not who was correct. (2)
In 1999, two years after the death of Janet Travell, the Second Edition of Volume 1 was published. Its title was changed so that David Simons was listed as the senior author. In the Foreword to that edition, their colleague, John V. Basmajian, M.D., wrote: "This is a gargantuan publishing effort that would have done Rabelais credit. ... It is not fantasy; it is hard-headed facts and a wise explication of many current ideas and new findings. ... Updating and expansion throughout the volume now make the two volumes together one of the most impressive medical publishing efforts of modern times." (3)
Notes:
(1) Vol. 1 (1) 1993, The Haworth Press, Inc., p. 20.
(2) "Myofascial Pain and Dysfunction. The Trigger Point Manual," Volume 1, The Upper Extremities by Janet G. Travell, M.D. and David G. Simons, M.D., Williams & Wilkins, Baltimore, 1983, pp. xi & xii.
(3) "Travell and Simons's Myofascial Pain and Dysfunction. The Trigger Point Manual," Volume 1, Second Edition, Upper Half of Body by David G. Simons, M.D., Janet G. Travell, M.D., and Lois S. Simons, P.T., Williams & Wilkins, Baltimore, 1999, p. vii.