Travell, Janet G. (1901–1997)

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Travell, Janet G. (1901–1997)

American physician, noted for her work in the field of neuromuscular pain, who was the first woman to serve as personal physician to a U.S. president. Name variations: Janet Powell. Born Janet Graeme Travell on December 17, 1901, in New York City; died on August 1, 1997, in Northampton, Massachusetts; daughter of Willard Travell (a physician) and Janet (Davidson) Travell; attended the Brearley School in New York City; Wellesley College, B.A., 1922; Cornell University Medical College, M.D., 1926; married John W.G. Powell (an investment counselor), in June 1929; children: Janet Powell McAlee; Virginia Powell Street.

Served as an ambulance surgeon while an intern and resident (1927–29); served as house physician at New York Hospital (1929–61); became expert in the use of digitalis to treat pneumonia, arterial disease, and pain; was an instructor, then associate professor in pharmacology, Cornell Medical College (1930–61); appointed to serve as personal physician to the president of the U.S. (1961–65); was known as a leader in the treatment and management of neuromuscular pain; published, with David G. Simons, Travell and Simons' Mysofascial Pain and Dysfunction: The Trigger Point Manual (2 vols., 1983, rep. 1998).

Known as a guiding light in the diagnosis and treatment of mysofascial pain, Janet G. Travell was born in 1901 in New York City, the daughter of Willard Travell, a physician, and Janet Davidson Travell . Willard specialized in relieving pain through physical medicine and in promoting exercise for good health, and his daughters Virginia and Janet followed his interests actively. He was to live to age 91, having practiced medicine for 60 years. Janet attended the Brearley School in New York City for both her primary and secondary education. She was an athlete who loved tennis and, during vacations at their summer home in Sheffield, Massachusetts, both Virginia and Janet caught turtles and frogs for informal anatomy lessons with their father. Virginia was later to become a pediatrician, practicing in Brooklyn. Their mother was a graduate of Wellesley College, and daughter Janet followed her there, winning three tennis championships and graduating Phi Beta Kappa in 1922. To study medicine, she returned to New York City and the Cornell University Medical College. She was granted an M.D. degree in 1926, was awarded the John Metcalf Polk Memorial Prize for academic excellence, and graduated at the top of her class.

Travell served her internship and residency from 1927 to 1929 at New York Hospital, an affiliate of the Cornell University Medical College. She also joined the New York City police force to serve as an ambulance surgeon. With the rank of lieutenant, she covered a rough area of the city that included the waterfront, subway stations on the West Side, and the area known as Hell's Kitchen. After completing her residency, she was named house physician at New York Hospital, where she was the only woman doctor on the staff. She remained with New York Hospital until 1961, except for a period in which she transferred to Bellevue Hospital for a special study of pneumonia patients. Travell won a fellowship enabling her to join specialists from Bellevue, Cornell, and the Rockefeller Institute in evaluating the common practice of giving digitalis to pneumonia patients. In an 18-month study, she tested 1,000 patients and concluded that the doses of digitalis should be smaller and given more selectively. As a result of this research, Cornell Medical College awarded her an instructorship in pharmacology in 1930. Her association with Cornell also continued until

1961, and she achieved the rank of associate professor of clinical pharmacology in 1952.

Travell held several positions as visiting physician. From 1936 to 1945, she was visiting assistant (later associate) in cardiology at Sea View Hospital in Staten Island. Receiving a fellowship from the Josiah Macy, Jr., Foundation in 1939, she used it to study arterial disease from 1939 to 1941 at Beth Israel Hospital in New York City. This assignment introduced her to new methods of relieving pain, and she studied these techniques, becoming a pioneer in the field. She later joined the staff of Beth Israel and, by 1961, was an associate physician in the hospital's unit for cardiovascular research. From the 1930s to 1961, Travell also kept up a private practice in offices she shared with her father. Because both had begun their medical practices as general practitioners but had specialized in pain relief, their private patients included a number of athletes, prize fighters, and John F. Kennedy, who would become Travell's patient in 1955, when he was a senator. Following her studies of arterial disease and cardiology, Travell expanded her interest in pain relief to include chest pain, and, from there to the field of orthopedics, in which she specialized in musculoskeletal pain and its relief. She was one of the first to understand the contribution of muscle "trigger points" to pain syndromes, and to develop treatment to manage and alleviate chronic and acute pain.

By 1955, Senator Kennedy had had two operations on his spine and was suffering from severe back pain. His orthopedic surgeon, Dr. Philip D. Wilson, referred Kennedy to Travell. To relieve the muscle spasms causing his back pain, Travell injected low-strength procaine (a form of Novocaine) directly into the muscle, causing it to relax and receive a normal supply of blood. Travell also discovered that Kennedy's left leg was slightly shorter than the right, causing added strain to his lower back muscles. The simple addition of a quarter-inch lift to his left shoe helped eliminate this additional strain. On Kennedy's recommendation, other members of his family, including both his parents and his brother Robert F. Kennedy, also sought treatment from Travell. Travell had also recommended that Senator Kennedy use a rocking chair to provide mild muscular activity. Kennedy bought an old-fashioned rocker for $24.95 and, when he became president, had it stained mahogany and moved into the White House. Photos of the president in his rocking chair popularized the "Kennedy rocker," and the manufacturer of the chair saw its production increase several hundred percent.

On January 26, 1961, Travell's ministrations to John F. Kennedy put her in the record books when she became the first woman to serve as personal physician to the president and the first civilian to hold that post since Warren G. Harding's administration. On that date, she was appointed to succeed Major General Howard McC. Snyder, who had served President Dwight D. Eisenhower as the White House doctor. Her White House assignment forced Travell to stop her practice and "half a dozen full time jobs" to assume sole responsibility for the health of the president. A registered Republican before the 1960 presidential election, she had crossed party lines to support her patient and to work for the "Doctors for Kennedy" campaign; however, one of her other patients was Kennedy's opponent, Senator Barry M. Goldwater (whom Kennedy had referred to Travell when both men were senators). Travell described Kennedy's physical condition as excellent. As part of her job, she insisted on seeing the president every day for a brief period in the morning and in accompanying him on all trips. She also supervised the White House dispensary, open to the president's family and staff, which was staffed by a Navy captain, two corpsmen, and a nurse. Travell's recommendations to Kennedy included regular exercise suited to his previous training. Because the president was an excellent swimmer, she advocated swimming daily in the White House pool and supplementing this exercise with golf and tennis. She often joined him on the tennis court.

Travell's recommendation to the president for the rocking chair grew out of studies of muscle strain that made her an authority on all types of chairs and seating. She expressed the belief that chairs should be chosen for particular uses and to fit their occupants. Many firms, including the industrial designer Henry Dreyfuss, hired her as a consultant to help design more comfortable seats. Dreyfuss actually regretted having hired her at one point, because she suggested so many costly changes to the manufacture of seats for farm tractors. She also designed airplane seats, notably the tilt-back seat for the Lockheed Electra turbojet.

Travell wrote many technical articles and professional papers that were published in the American Journal of Physical Medicine, the New York Journal of Medicine, the Journal of the American Medical Association, and other medical journals. Her work on pain relief is cited extensively in the book The Management of Pain, which is considered a definitive work on the subject and was written by Dr. John J. Bonica in 1953. With Dr. David G. Simons, she wrote what is considered the bible of neuromuscular pain diagnosis and treatment, Travell and Simons' Mysofascial Pain and Dysfunction: The Trigger Point Manual, a two-volume set originally published in 1983 and reissued in 1998. She received grants for pain research from the National Heart Institute of the National Institutes of Health and the Lieutenant Joseph P. Kennedy, Jr., Foundation. Travell received an achievement award in August 1961 from the women's division of the Albert Einstein College of Medicine of Yeshiva University. Her memberships included the medical societies of New York City, New York State, Westchester, the American Medical Association, the New York Academy of Medicine, the American Geriatrics Society, the New York Academy of Sciences, and the American Association for the Advancement of Science. She was also a diplomate of the National Board of Medical Examiners.

Travell's personal life was equally full. A tall, trim woman with hazel eyes, she had married John W.G. Powell in June 1929. Powell, an investment counselor with Trainer Wortham & Company, had turned down contracts offered by three major league baseball teams to pursue a career in finance. The Powells had two daughters; Janet Powell McAlee , an operatic soprano, and Virginia Powell Street , a painter and sculptor whose works were displayed in Travell's White House office. Travell followed her own advice regarding exercise; she swam, skated, rode horseback, and chopped trees at the family's summer home in Sheffield, Massachusetts. She remained White House physician after Kennedy's assassination, serving until 1965, and continued to work extensively in the field of pain management in the following years. In 1996, the American Academy of Pain Management bestowed its first annual Janet G. Travell Soft Tissue Pain Management Award. She died the following year, having lived, like her father, past 90.