October 2000 Bulletin

Love of orthopaedics: a family tradition

By Sandra Lee Breisch

When he was in the ninth grade, Richard L. Wixson, MD, recalls a "challenging" school project: "I had to identify what profession I would go into as an adult."

Timidly, the youngster asked his father, Richard C. Wixson, MD, "Do you think I could become a doctor like you?"

"It didn’t dawn on me that my son wanted to become a doctor, but from that point on, he had a goal and was focussed on a career," reflects the senior Dr. Wixson who practiced in Madison, Wis. "Naturally, I supported him."

"By example, my father mentored me by teaching me very early on how to act and behave like an orthopaedic surgeon, even though I didn’t know what an orthopaedic surgeon really did," says the younger Dr. Wixson, who specializes in total hip and knee replacements in Chicago. "Since my father put himself through college as a painter and carpenter, he taught me and my three non-physician brothers how to use tools, our hands and how to approach a problem and how to solve it—as well as ethics and values. We also learned that you could rely on yourself to do things."

In his junior year of medical school, the younger Dr. Wixson emulated some of his father’s surgical skills. "My father taught me how to tie knots one-handed—which is how many experienced surgeons tie knots," he says. "It was funny that I was over-prepared and I was told in the operating room to use two hands."

"Richard probably was advanced for his age, but it was a plus for him," notes the 86-year-old Dr. Wixson. "In knowing other orthopaedic surgeons whose fathers were orthopaedic surgeons, I think all of us feel it was a real strength and help in understanding what we have to do to be an orthopaedic surgeon."

The Wixson’s are just one of many families who have passed the love of orthopaedics from father to son or daughter.

Bess E. Brackett, MD, says when she was just 3 years old she was "fascinated" by the profession of her father, E. Boone Bracket III, MD. In elementary school, she’d bring plaster for show-and-tell, hoping to perfect her casting techniques on classmates. In the fifth grade, she authored a report entitled, "How our bones help us." "The report relied heavily on my father’s encyclopaedia," recalls Dr. Brackett. "It spoke of hydroxyapatite that is now routinely applied to total hip prosthesis to help bone growth—among other things."

As she grew older, she’d accompany her father on rounds and "play assistant" in the emergency room by holding the arm or leg that needed casting. "Because the legs were heavier than my body weight, I quickly learned the physics of orthopaedics intuitively," recalls Dr. Brackett. "I figured if I could rest my elbow on the anterior hip bone or the iliac spine, I really didn’t have to use my muscles to hold the leg up."

"She was a natural from the get-go," points out her father. "Although we probably broke the rules back when she was young, I wanted to show her about the profession at a very early age."

He also cautioned his daughter about the years of hard work, good grades and residency standards required for her aspiring career. "My father stressed, ‘It’s not like handing over a small business to you; you have to want it and be able to do it,’" recalls Dr. Brackett.

From 1993 to 1997, this father-daughter team practiced together in Oak Park, Ill. Today, Dr. Brackett practices in Greeley, Colo. and her father is still in Illinois.

A third generation orthopaedic surgeon, William J. Robb III, MD, doesn’t recall his father, W. John Robb II MD, taking an "active effort" to convince him to be a physician or an orthopaedic surgeon. In fact, he admits to wanting to be anything but an orthopaedic surgeon. "It wasn’t an active rebellion—just based on my other real interests," he says.

But at age seven on up, he "tagged around" with his father—an orthopaedist in Cedar Rapids, Iowa—and witnessed the "nuts and bolts" of what it meant to be an orthopaedic surgeon. "I saw my father’s dedication to his profession and patients by his willingness and capacity to work very hard and long hours, manage different problems and take on challenges," says Dr. Robb. "These values were instilled upon me very early on and are important values for an orthopaedic surgeon."

Years later, Dr. Robb pursued a medical education at the University of Iowa where his father practiced. "We shared my cadaver because at that time, in 1966, there were few psychomotor skills courses," recalls the 56-year-old orthopaedist, who specializes in adult reconstructive knee surgery in Glenview, Ill. "My father was interested in doing new anterior spine techniques and he did some dissections. He was interested in doing an anterior cervical fusion—a procedure that had just been developing. Observing him work on the cadaver and in the operating room was very impressive."

Proudly, his 83-year-old father says, "A man in my position that has a son that followed me and excelled—well, to think that I played a role in it ‘by example’ is even more important to me."

Today, 39-year-old Douglas M. Cooper, MD, says he "understands the same orthopaedic topics and can talk to different generations of orthopaedists," as does his 68-year-old father, Reginald R. Cooper, MD, the 1987 Academy president.

But as a boy growing up in Iowa City, Iowa, he wasn’t exactly thinking about going into the same profession. "I had a strong interest in math and science," the younger Dr. Cooper recalls. "About the end of my third year, I thought I’d like to go into radiology or orthopaedics. But radiology didn’t have as much patient contact or the variety of work that orthopaedics did—so I chose orthopaedics as a career."

"I never did take my son on rounds or scrub in the operating room," says the elder Dr. Cooper. "And, no, I didn’t try to influence any of my kids to go into my profession. I just let them decide what they wanted to do and supported them as much as I could."

Surrounded by orthopaedists his entire life—and now married to orthopaedist Margaret Fehrle, MD—the younger Dr. Cooper admits, "It was a big influence for me just meeting other orthopaedic physicians at the University of Iowa. Almost all of the folks I met there I liked. They enjoyed what they did, were happy with their lifestyle, didn’t seem tired and were a friendly group who got along with others."

At the age of 2, James V. Luck Jr., MD, recalls adding two important words to his vocabulary: orthopaedic surgeon.

"I think that once I could pronounce the words—mostly because I was so proud of the fact that’s what my father was—I knew that’s what I wanted to be," says the son of the late J. Vernon Sr., MD, the 1961 Academy president. "My career goal never really varied from that."

"My father’s study was a hodgepodge of various reconstructive orthopaedic devices," he fondly recalls. "He had a variety of dry cadaver bones he was working on to try to develop better fixation devices for fractures of the proximal femur and on developing a hip prosthesis. He also had reams and reams of paper from the book he was writing, Bone and Joint Diseases. All of this was intriguing to me."

One of the young boy’s fondest memories was when his father was working on the prototype for the Luck Bone Saw. "He had me operate the power switch," he recalls. "It was a great thrill for me because I was 4 or 5 years old. Mother had a table that had uneven legs and dad said he’d ‘even it up’ by trimming off one of those legs with his invention. Suddenly, I saw the saw jump, grab his pants and go up his leg. Because I still had my hands on the power switch, father was yelling, ‘turn if off.’ I didn’t until he gave me a swift kick."

Dr. Luck, Jr., emulated his father in almost every way. They spent most of their careers at the Orthopaedic Hospital in Los Angeles practicing together from 1974 to 1985 and also worked on research projects related to bone tumors and osteoarthritis.

When orthopaedist Robert F. Smith, MD, saw signs that his teenage daughter, Stacia, had an interest in medicine—after getting her emergency medical technician (EMT) certificate while serving as a volunteer fireman in town—he realized, "that gave Stacia an avenue to the hospital." And it was also a great opportunity for him to mentor.

Stacia Smith, MD, got early exposure to medicine with her father, Robert F. Smith, MD, and followed him into orthopaedics.

"In those days, the hospitals used physician assistants," explains the elder Dr. Smith, who in 1968 was the only orthopaedist in Mount Vernon, Wash. (he retired last December). "But beyond that, we actually were using EMTs to assist in surgery, so we had people of varying medical training and backgrounds. I got her [Stacia] hospital privileges so she could assist in surgery for a couple of summers. She also worked at my office and that gave her an exposure and knowledge base so that she had some medical background."

The 39-year-old Dr. Smith admits that "parental influence" came into play in medical school after she told her father she planned to go into a different surgical specialty. "My father talked me into going into orthopaedics because it was very rewarding, had better outcomes and he actually had made a significant impact on people," she recalls. In 1995, she joined her father’s practice.

K. Robert Lang, MD, and daughter, Kaärstan Lang, MD, share the love of orthopaedics at their Mount Vernon, Wash. practice

A few years later, this father- daughter team welcomed Kaärstan Lang, MD, and K. Robert Lang, MD, to their practice—giving them a one-of-a-kind dual father-and-daughter status in Mount Vernon. They are part of a six member orthopaedic team.

The father recalls his daughter always had an "abiding interest" in orthopaedics. "I knew she was destined to be an orthopaedic surgeon when I did a fellowship with Sir John Charnley in England and she spent her time outside that glass theater watching us do joint replacements, he says. "Not many 16-year-old-kids would have loved that experience—but she did."

Says the 39-year-old Dr. Lang, "Orthopaedics had fun toys and everybody was having a good time—I just fell in love with it and it cemented my desire to follow in my father’s footsteps."