Orthopedic Clinic Quotes

McKusick's belief in this paradigm-the focus on disability rather than abnormalcy-was actualized in the treatment of patients in his clinic. Patients with dwarfism, for instance, were treated by an interdisciplinary team of genetic counselors, neurologists, orthopedic surgeons, nurses, and psychiatrists trained to focus on specific disabilities of persons with short stature. Surgical interventions were reserved to correct specific deformities as they arose. The goal was not to restore "normalcy"-but vitality, joy, and function. McKusic had rediscovered the founding principles of modern genetics in the realm of human pathology. In humans as in wild flies, genetic variations abounded. Here too genetic variants, environments, and gene-environment interactions ultimately collaborated to cause phenotypes-except in this case, the "phenotype" in question was disease. Here too some genes had partial penetrance and widely variable expressivity. One gene could cause many diseases, and one disease could be caused by many genes. And here too "fitness" could not be judged in absolutes. Rather the lack of fitness-illness [italicized, sic] in colloquial terms- was defined by the relative mismatch between an organism and environment.

No doubt there are other inferior clinics out there. Poor care, overpricing, and rude staffers can be found in every medical field. But you don’t find people using examples of it to inveigh against an entire specialty—railing against the greed of orthopedic surgeons (average 2012 salary, $315,000) or calling for surprise inspections of dentists because every year a few people die from preventable errors during dental procedures.8 Only in abortion care do the few bad providers taint all the others—and taint them so much that opponents can pass laws that would virtually shut down the entire field in the name of patient safety. No

We fix things. Do you understand that? We don’t analyze things. We don’t discuss things. We don’t wring our hands and cry about things. We fix them! If somebody wants to be analyzed they can see a shrink. When they come to the Department of Orthopedics at the Mayo Clinic they want only one thing: they want to be fixed. “Now get the hell out of here and go fix things. And I better not get any more reports of touchy-wouchy, hand-holding sessions in this department.

etc. In the APA program abstract Dr. Jaeger wrote, “Regardless of the initial diagnosis, patients who underwent brain SPECT prior to, or during, psychiatric hospitalization had markedly shorter stays than controls. As demonstrated by this clinical database (two thousand patients), brain SPECT may lead to more effective, shorter, safer, and less expensive diagnostic and treatment modes in children and adolescents with suspected neuropsychiatric illness.” His experience completely dovetailed with mine. I wondered, “How can we not look at the brain?” Cardiologists look at the heart, orthopedic doctors have X-rays to examine bones, gastroenterologists look at the gut, pulmonologists look at the lungs, every other medical specialist looks at the particular organ they treat. And, we deal with the most complicated organ in the body. How can we treat it without having any information on how it functions? Psychiatrists are the only medical specialists who never look at the organ we treat!