The orthopaedic intellectual (part 1)

Dr Wiltse confounds this unfair stereotyping

All this exponential growth. There was a time, it is said, when one educated person could reasonably attempt to ingest all the published knowledge in the world. In my youth there were professors of medicine who certainly gave that impression. When one was reading the orthopaedic journals  there would be the British and the American Journals of Bone and Joint Surgery, Clinical Orthopaedics, possibly the Journal of Trauma, Acta Orthopaedica Scandinavica - not that many more of note. You could easily keep up. Now there are hundreds.

Likewise, if you talked about the known experts in the fields there weren't that many really - there was a decent chance you might have actually met a lot of them at conferences. So at that time it was true, in surgery giants really did stalk the earth. Now there are many many more highly accomplished, highly experienced true experts. Exponential growth, powered by the uniquely successful nature of our elective interventions - compared to the rest of surgery in general - has made the orthopaedic world enormous.

Although I'm not a spine surgeon (apart from coccygectomy), I recognise the name of Leon Wiltse as one of these giants, and like many American surgeons, he practised for a very long time.  One of the purposes of this blog is to collate the published wisdom -as opposed to research - of men such as Wiltse, and his review of his life and career, published in 1995, is a gem. The last few pages contain numerous nuggets of clinical and professional gold. I particularly commend the advice (more elsewhere) to sit down when you're with a patient, and the point that if you read an hour of the literature a day, you'll be the best read orthopod in town. The heaps of journals under the beds and on the office floors suggest that not enough of us are heeding it, me included. Dr Wiltse really was a fount of wisdom.