Medicine is in a constant state of change. Advances in biomedical research are changing medical knowledge on a daily basis. Over time, these advances lead to fundamental changes in our approaches to diagnosis, treatment and prevention.

The feature articles in this issue of UW Medicine portray two such paradigm shifts. Concussions in sports were once considered “part of the game” — inevitable and unavoidable in sports like football and wrestling. We now know that concussion is a traumatic brain injury that can result in long-term impairment. That shift in understanding is leading to increased research and clinical attention to treatment and prevention, as well as policies and laws to prevent and minimize the impact of concussions in sport and other settings.

Richard Ellenbogen, M.D., UW professor and chair in the Department of Neurological Surgery, and newly appointed co-chair of the National Football League’s Head, Neck and Spine Medical Committee, has been a vocal spokesperson for focusing attention on concussion. He and Stanley Herring, M.D., UW clinical professor in the Department of Rehabilitation Medicine, co-direct the Seattle Sports Concussion Program, a collaboration between UW Medicine and Seattle Children’s that is playing a key role in advancing treatment and understanding of concussion.

Likewise, for centuries, pain meant symptoms associated with disease or injury — to be controlled if possible, but often something to simply endure. UW Medicine faculty member John Bonica, M.D., introduced a new model for pain care when he started the world’s first pain clinic in 1961. Once again, UW Medicine is leading changes in care of patients with severe pain with a new Division of Pain Medicine, led by Alex Cahana, M.D., in the Department of Anesthesiology & Pain Medicine. Dr. Cahana and his colleagues are advancing the work that Bonica began nearly 50 years ago by focusing on the recognition that chronic pain is a disease rather than a set of symptoms. This deceptively small twist in meaning has profound implications for treatment and prevention. As a result, patients who suffer chronic pain can now experience hope at the UW Medicine Center for Pain Relief.

The work being done in these two areas is remarkable. While rapid change can be challenging, the results are frequently groundbreaking. It is a privilege and a pleasure to work with the scientists, educators and clinicians who make discoveries that lead to important changes in health care.


Paul G. Ramsey, M.D.
CEO, UW Medicine