October 2003 Bulletin

Now online: Orthopaedic aphorisms

You may already be aware that AAOS online private discussion groups can be a great resource if you’re looking for a few “pearls of wisdom” on a given technique, or need a little guidance on an unusual case.

What you might find surprising is that the site also serves as a showcase for aspiring orthopaedic surgeons/ comedians/wordsmiths.

One discussion thread in particular—“Orthopaedic Aphorisms”—has attracted dozens of clever contributors. Orthopaedic surgeon James D. Brodell, MD, kicked off the topic because he was curious how many “wise orthopaedic sayings” are floating around out there. The answer? More than 135 and counting…

The clever quips and astute adages appearing on this thread run the gamut from inspirational to irreverent; droll to deep; cynical to silly…but they’re all worth a read.
Do you have a memorable maxim to contribute? Then log on to the discussion and click on “Organizational Issues in the Practice of Orthopaedic Surgery.”

In the meantime, we’ve selected a few highlights for your reading pleasure. (Contributors’ names have been withheld to protect the innocent/guilty.)

• As it relates to the advent of new technology: “When you have a new hammer, everything begins to look like a nail.”
  
• “Bone is home. Never let a piece of skin stand between you and the diagnosis.”
  
• “Nothing will destroy your confidence like long-term follow-up.”
  
• All bleeding stops.......eventually.”
  
• During a faulty operative maneuver, an orthopaedist never says, “OOPS!” He/she says, “THERE!”
  
• A wise old orthopaedist observed, “A nonunion is usually perceived by the patient as an act of God, but a malunion is always seen as the fault of the physician.”
  
• “If at first you don’t succeed, get a bigger hammer.”
  
• “I did a hundred of those last year.”...This is most common line said by many orthopaedists, (who incidentally, are lyin’ like hound dogs), about any surgical procedure at the annual AAOS meeting.
  
• “Think twice...cut once.”
  
• “The case that starts botched stays botched.”
  
• George Dixon, one of my mentors, always said: “There’s no condition so terrible that it can’t be made worse by an orthopod!”
  
• “You can’t be too good looking, have too much money or have too much bone graft.”
  
• “When things are going real bad, take the pulse...yours first, then the patient’s.”
  
• “The solution to pollution is dilution.” (Used during infected cases - someone else’s, of course.)
  
• “I love the smell of fresh cautery in the morning.”
  
• “Taking out hardware never makes you look good.”
  
• “If it were easy, pediatricians (or whatever other specialty you choose to malign) would do it.”
  
• “Treat the patient, not the X-ray.”
  
• “Don’t just do something, stand there!”
  
• Under the general category:
  It’s tough to build a good reputation...“Your patient with a good surgical result will tell 10 people. Your patient with a poor surgical result will tell 100 people.”
  
• “Sight and touch together make the greatest clinical faculty of all, namely, common sense.”
  
• “Do no harm.”...The Big “H” (Hippocrates).
  
• More of a joke, but anyway: “How do you hide money from an Internist? Put it under a dressing. How do you hide money from a Surgeon? Put it in the chart. How do you hide money from an Orthopedic Surgeon? Put it in a book without pictures. How do you hide money from a Plastic Surgeon? You can’t.”
  
• “At retirement, no one ever laments having not spent enough time in the office and/or operating room.”
  
• “Good judgment comes from experience. Experience comes from BAD judgment.”
  
• Reference hip fx: “The bad results of pinning are the result of a bad pinning.”
  
• “Look for help from people with gray hair.”
  
• “Spread the grief.”...This relates to any situation where you would like a consensus of opinion. Usually before doing something in the operating room.
  
• “If you can’t tie good knots, tie lots of them.”
  
• “Surgery is not a race.”
  
• “If you’re a slow surgeon it doesn’t mean that you’re good, it just means you’re slow.”
  
• Another description of an orthopaedic surgeon: “Frequently wrong....Never in doubt.”