Carpenter with an edge

And then God made an Orthopod. The surgeons looked upto the sky with disgust and called us carpenters. I say we are carpenters with an edge. The exact date when an orthopod evolved is still a mystery. Like every other pod the orthopod have evolved as pediatric pod, hip pod, knee pod, spine pod and above all the know it all “Orthopod”. Haven’t we seen enough of these already.
Hey, we are glorified carpenters, so what. We make people walk, kick and fight another day. Orthopods are reconstructive surgeons whether they do foot, paeds or any joint or bone right or Left superior or inferior. Unlike general surgeons, we do not remove body parts. Amputations are best done by general surgeons.

Orthopods are the the butt of many jokes. My cardiologist colleague once asked me to answer what a double blind study was, and proceeded to answer that it is two orthopods trying to read an ECG. But guys and girls, who else can ask a nurse for a screw without getting hit.

Who said girls can’t be good orthopods. I was taught that to sculpt the arch of the foot the anterior surface of thorax makes a perfect mold which few males can reproduce. Cut the bull about strength needed in orthopedics. It is the technique, the size doesn’t matter. May be a hip reduction needs a bit of biceps.
Like any profession life is tough. Look at the auto driver navigating the pot holes in Kochi in the monsoon rains. His job is as tough as any ones.
Getting a degree is just the beginning of ones orthopedic career. I do believe one needs to be at least 10 years in the speciality before one decides to set up independent shop. Any surgeon for that matter or any profession has about 10 years when one is at the top. It could ie; sleeping, drilling, screwing(cortical and cancellous), reading, removing sutures, k wires, implants, debriding and ball carrying your boss are for those 10 peak years. Some use you other are used by you. After which one rests on ones achievements and can prolong one's career at the peak depending on your ones genes and environmental influences.
Please differentiate information which is what one get from the net, books, journal, colleagues etc from knowledge which is where in you put the “correct” information to use and a few grey hairs if you have any with wisdom obtained by the time one retires. Wisdom is where you have learnt it all, done it all, using the knowledge and learning what works surgically and what was bull with your bare hands and mind. Unfortunately, you retire by the time one attains wisdom.
There is no perfect post op X-ray. One can always find something in the morning when you look at the Xray to criticize and improve next time. Read again the night after the surgery to correct what could be improved and not just the day before the surgery. Of course read the day before surgery too. In difficult cases have a plan B and sometimes plan C to cover intraop surprises.
Text books are 4 to 5 years old information, journals 2 years and cutting edge conferences one year old information. If one wants to be cutting the edge one should do the cutting edge work yourself or be in touch with the cutting edge guy.

Our exams and training appear to be focused on passing exams and amassing degrees all of the same subject. Not improving skills. Which other world has doctors with D orth. MS orth, Mch ortho. FRCS ortho and quacks with fellow of this and that. One should do allied subjects which will widen ones scope. A searching, researching questioning hat one should always wear.

Yes, it is difficult to criticize your boss even if you know he is wrong. But you could jot down what one should do if you think your boss does not have the knowledge or broadmindedness to accept a mistake. Keep a copy of the operation note in your laptop or file as some rare cases are rare and the experience of the case will help in years later when you head the team. When you read a topic search everywhere around and save the updated information, and keep updating it each time you read about it.
Never repeat the same mistake. If so, you are either to be punished, banished or send to our border. I hear patients getting blamed for rejection of implant when it is either infected or loose due to bad cementing. Every mistake is a learning process and corrective measures should be immediately taken. Do not get disheartened by the statements of your colleagues who are sometimes ignorant, jealous or just plain nasty.
Do not do a procedure because you know how to do it. I was taught that if you consider every patient your father, mother, brother, sister, son or daughter and decide whether one would do the same on them, then proceed. Otherwise stop. Move around and train under many different surgeons to learn from one and all before one decides your methodology. With some jobs one might learn what not to do.
All what I have mentioned is what I have learnt from my Gurus, colleagues and juniors. Above all ask for the Almighty’s blessings to help you help your patients. Signing of with a cardiac surgeon’s quote. What is the difference between God and a cardiac surgeon? The cardiac surgeon thinks he is God. Don’t ever make the mistake and talk to your patient about all the options(not just the option you know) and communicate the complications too. You are not God’s gift to mankind.
Jacob varghese