Obituaries Australia

Michael Cousins operating, no date

Supplied by Gabriella Kelly-Davies

Michael Cousins’s driving vision was to reduce suffering by improving the treatment of pain and he dedicated his life to achieving this vision despite the sacrifices it forced on him. His unique combination of skills as a kind, empathetic clinician, groundbreaking researcher, leader, political advocate, orator, reformer and formidable negotiator with health bureaucrats and politicians enabled him to move mountains to improve pain management. Michael’s tenacity and resilience in the face of failure enabled him to overcome seemingly insurmountable obstacles such as lack of funding for pain research and treatment, opposition from intransigent health bureaucrats and systemic inertia.

In 1976, Michael Cousins founded Australia’s first multidisciplinary pain centre at Flinders Medical School in Adelaide, a testament to his visionary leadership. His advocacy in the late 1980s as the President of the International Association for the Study of Pain marked a turning point in the field of pain medicine. In 1990, he further solidified his impact by establishing a world-class pain centre at Sydney’s Royal North Shore Hospital and the Pain Foundation, a crucial source of funding for pain research and treatment.

One of Michael’s most significant contributions was his role in pioneering groundbreaking scientific research, alongside Laurie Mather. His relentless pursuit of innovative approaches to pain medicine and his efforts to foster multidisciplinary pain research have left an indelible mark on the field and earned him the deep respect of his peers.

Michael was a prolific writer, and he published 180 journal articles, 17 letters to editors, 15 editorials, six textbooks, 114 reviews and chapters in textbooks, a Doctor of Medicine thesis and a Doctor of Science thesis. In 1980, he and his co-editor, Phillip Bridenbaugh, published Neural Blockade in Clinical Anesthesia and Management of Pain. It was the first comprehensive modern textbook on regional anaesthesia and pain and included chapters from 39 contributors on the basic pharmacology and physiology of neural blockade, clinical techniques, and their use in pain management. Neural Blockade in Clinical Anesthesia and Management of Pain, now in its fourth edition, is viewed as a leading text on anaesthesia and pain management internationally.

In the late 1990s, Michael established the Faculty of Pain Medicine to administer a single training and accreditation process for anaesthetists, surgeons, physicians, psychiatrists and rehabilitation specialists. The agreement to run a joint training program, examination, and specialist qualification for medical specialists was unique in the medical world. Michael recognised that if Australia had a respectable, well-organised professional body, pain would have a higher profile within medical circles and government. The Faculty’s launch marked the beginning of specialist pain medicine training and heralded a unique level of professionalism in pain medicine.

In 2010, Michael led the effort to create Australia’s National Pain Strategy, which America, England and several European nations replicated. He also established Painaustralia as the peak national advocacy body for people living with pain. The following year, he gained the agreement of representatives from 64 nations for the Declaration of Montreal, which states that access to pain management is a universal human right.

One aspect of Michael Cousins’s legacy might be considered as essential building blocks, the infrastructure required to construct a sustainable pain management system. He taught, mentored and inspired new generations of pain medicine professionals in Australia and overseas. This was crucial because a highly skilled pain medicine workforce is the cornerstone of pain medicine practice. Throughout his career, he trained dozens of Australians and more than 75 international pain medicine fellows. Remarkably, by 2013, he had trained pain medicine fellows from 20 countries. He also assisted in establishing pain medicine centres throughout the Asia Pacific region, Europe, Canada and America.

Michael was indefatigable and charismatic, enabling him to inspire others who shared his vision and bring them along with him to achieve the unachievable. Recognising he couldn’t do everything himself, he delegated ambitious projects to his equally dedicated colleagues, who, together with him, built the field of pain medicine in Australia. Many of his colleagues thought of him as captain of the ship and themselves as his willing lieutenants.

Michael emphasised excellence in patient care and insisted that team members continually improve their skills to ensure patients felt supported by an empathetic care team. He also encouraged team members to advance, assist and strengthen other team members.

Equally at home in the international arena and the pain clinic, Michael did everything possible to help his patients reduce the impact of pain in their lives; he truly listened to them. Patient after patient noticed and appreciated his habit of worrying about them until he found a solution to reduce their suffering. His tireless devotion to his patients was a crucial aspect of his character.

Michael Cousins set a high bar for patient care, pain research, pain education and the advancement of pain medicine globally. His legacy is clear in the pain management strategies of Australian states and the trove of pain centres and resources now available to improve the lives of people living with pain.