"Two more spine injections and then I'm free."
That is not a text a writer typically receives before interviewing a musician, but there's nothing illicit about the message. The man sending it is Dr. Jay Kuchera. He plays guitar for the blues-jam-rock-bluegrass-melding band the String Assassins, which will rock the Ford Stage at SunFest this Saturday, May 5. The spinal injections are one element of his day job as a triple-board-certified physician in algiatry (the treatment of chronic pain), addiction medicine, and anesthesiology. As a pain management doctor in South Florida, Kuchera describes himself as being on the front lines of the opioid crisis that has become a national conversation but has proven to be deadly in Florida.
Reports of backlogged morgues and a plague of overdoses have dominated local news over the past couple of years, but Kuchera says he first suspected the state was headed for a crisis about seven or eight years ago. Florida was becoming a pill-mill state, he says. Indeed, according to the National Institute for Justice, more Floridians died from opioids than from cocaine in 2010.
Like many doctors in the field of algiatry, Kuchera is taking a more holistic approach to his patients' pain management these days.
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"The one thing that seems to be pretty sorely lacking in this country is a good, fundamental system for delivering pain psychology," he says. "The typical pain doctor and the typical pain clinic is focused on the biomedical model of treatment, which focuses on medication and injections and procedures, maybe even surgeries or spinal cord stimulators, manual therapy massage, and whatnot. We definitely are coming back to look at more abstract interventions like meditation and awareness therapy, acceptance therapy."
In the past, he says, doctors prescribed opioids as a well-intentioned quick fix to relieve patients' pain, but recent studies suggest they might not be as effective at relieving chronic pain over the long term. Awareness and acceptance therapy can help patients cope with the reality that doctors may never be able to completely heal their physical pain but that their condition can improve through a combination of pain management strategies unique to each patient.
Kuchera says he's unsure of how his career as a doctor and his role as a guitarist intersect and inform each other ("not everything needs to be understood in terms of everything else"), but he certainly thinks and speaks about his daily work in musical terms.
"Music is more than just enjoyment," he says. "One of the first human experiences, in utero, is the sound of a heartbeat, which is a rhythmic experience."
He adds, "You can't force somebody to like a genre of music — it isn't usually successful — just like you can't force someone to follow a particular path of recovery." Kuchera also likens the experience of creating music in a band to that of creating a holistic pain management plan for his patients.
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In preparation for his band's performance at the long-running SunFest, he's been thinking about the role community-building experiences play in the alleviation of pain. He and bandmate Mark Shubert, whom Kuchera calls "Mangrove," say they grew up hearing about SunFest and attended dozens of years ago.
"One of the hallmarks of addiction is isolation," Kuchera says. "One of the hallmarks of addiction is disruption of ties and connection with family, jobs, friends, and societies. One of the most powerful antidotes that we have is community and tying people together and bringing people back into the fold."
In that light, a gig like SunFest, which strives to include regional acts such as the String Assassins in the same lineup as some of music's top names, might just be its own form of public service.
The String Assassins at SunFest 2018. 1 p.m. Saturday, May 5, on the Ford Stage, on Flagler Drive between Banyan Boulevard and Lakeview Drive, West Palm Beach; sunfest.com. Tickets cost $49 to $92 via tickets.completeticketsolutions.com.