Portal de Periódicos da CAPES

Dreams of the Future, Remembering the Past

2007; Elsevier BV; Volume: 23; Issue: 6 Linguagem: Inglês

10.1016/j.arthro.2007.04.012

1526-3231

Walter R. Shelton,

To my family, to my fellow AANA Board members, and to you the members of AANA, I would like to express my gratitude for having the honor and privilege to serve you as the 25th President of the Arthroscopy Association of North America. My duties with AANA have allowed me the opportunity to give something back to our profession, and I am appreciative of that opportunity.AANA has had significant accomplishments in the past several years. Recent upgrades at the Orthopaedic Learning Center have assured its continued position as the premiere hands-on surgical skills learning facility in the world. Our partnership with the Academy at the OLC sets us apart as an organization committed to education. The completion of the Building on Excellence Campaign will assure AANA the resources to plan and build for the future. Our Fall Course and OLC courses continue to attract both residents and practicing surgeons seeking to improve their skills and knowledge. While looking back is satisfying, I am looking forward with great anticipation to our future. Thomas Jefferson said, “I like the dreams of the future better than the history of the past.” I agree with Jefferson and as I look forward I see that AANA is financially strong and secure. We will remain committed to educating surgeons of the future in the discipline of arthroscopy and minimally invasive surgery.Our strength lies with you, the members of our organization. I have watched over the years as you have volunteered your time, resources, and efforts in teaching courses in Chicago, serving on committees, putting together instructional course lectures, and manning the labs at the fall course. We are truly a grass roots organization whose members are in the trenches. Should one seek the secret of our success, they need to look no further.Along with our members, we have the greatest staff in the world. Words cannot express what a great job Whit, Ed, Holly, Donna, Beatriz, Lauren, Tiffiny, Allison, and Marge do. They are truly devoted to AANA and I thank them for the effort they have made to make this past year successful.I would also like to thank my partners at Mississippi Sports Medicine. We started our dream small over 23 years ago. They have provided support and camaraderie for which I am thankful.I am humbled by the fact that so many of my family and friends have honored me by coming all the way to California for this special occasion. I appreciate your love and support more than I can express.I would like to leave you today with some personal reflections that have come from my experiences as a son, brother, husband, and father, and as an orthopaedic surgeon over the last 27 years. Certainly life has its way of testing, molding, and making us into the final products that we are. If someone years ago had told my future and predicted all the twists and turns my life would take leading to this stage, I might have thought them nuts.I grew up in the Mississippi Delta, a land rich in history and culture. It was the land of William Faulkner, Tennessee Williams, B. B. King, Morgan Freeman, and Charlie Pride. Yes, it was a great place to grow up, small town rural America. Probably not different from where many of you grew up. I thought it the center of the universe and am reminded of a trip that my cousin Bill and his father Dan, the Mayor of our small town of Lambert, took one day to our Courthouse in Marks, Mississippi, during the Cuban Missile Crisis. Bill and his dad happened upon the usual group of whittlers and political scientists who frequented the large shade tree on the Courthouse lawn. After the usual cordial greetings, Dan asked one of the men if he was worried about the crisis in Cuba. “Well, of course we are concerned” was the reply. “Those Russians are going to drop an atomic bomb on us here in Marks.” Dan was astounded. “Do you mean that you think the Russians consider us important enough to drop an atom bomb in Marks?” he asked. “Well of course, Dan” came the reply. “We are the county seat.”I had wonderful parents, a house full of brothers and one sister, and one special aunt who encouraged me at all times. I was a real-life Tom Sawyer. We worked hard but we also played hard, hunting, fishing, and camping with my friends, guys from varied backgrounds and cultures. Especially the hunting. God made a special place for duck hunting and he put me in the middle of it, in the heart of the Mississippi Delta. Fighting Bayou is located at the junction of Dugan and Rattlesnake Bayous in Booger Den, Mississippi. Specifically, it is located 3 miles east of Scared Man Brake and 2 miles south of Ignorant Ridge. It has truly blessed me as a place to relax with friends and colleagues.Of course, all of this outdoor activity convinced me that I was destined to be an All-American football player. I did not realize at the time that there was little demand for a slow, 175-lb quarterback. That honor would go to a buddy, Archie Manning, who lived 30 miles down the road. It did, however, account for a life-altering event, an ACL tear that influenced my ultimate decision to become an orthopaedic surgeon. An ACL repair by Marcus Stewart at the Campbell Clinic would also guide me back to the same institution for training years later.I went on to college at Mississippi State where all I did was study (that’s what I told Beverly) and then on to medical school in Jackson. Here I met and married Beverly, the love of my life, to whom I owe more than I could ever repay. She has been a companion, mother, adviser, and my best friend.Looking back on my life experiences I realize I was fortunate to be raised with the principles of God, country, and family. It would be this foundation that would get me through the really tough times. I thought it appropriate to use this address to share two extraordinary experiences with you. Perhaps you can draw parallels between these events in my life and your own experiences. I know that mine have led me to conclude that as I go through life there is a firm hand from above guiding me through.My first real challenge came after 1 year and 7 days of my orthopaedic residency at UMC. Our entire group of residents resigned en masse over an ethical dispute with our Chairman. Here we were, 11 guys who wanted to be orthopaedists, but with nowhere to go to finish training and the assurances from the administration that we would be black-listed from every training program in the country. As we searched our way through this uncertain time, the Mississippi Orthopaedic Society, in emergency session, voted us a unanimous resolution of support. With their support we were able to secure interviews at other programs. Unbeknownst to me, in June, 1 month prior to our resignation, two interns who were scheduled to start their residencies at the Campbell Clinic decided to go into other specialties. Suddenly two spots that had been committed for over a year were open at my level. I went to Memphis for an interview and who was one of the interviewers? Dr. Stewart, of course. My friend Bill Marshall and I were accepted into the program and it opened the door and allowed me to complete my dream of becoming an orthopaedic surgeon. Was this all luck or coincidence? I am convinced it was not. There had never been and has not been since, positions to open like this at Campbell’s. I feel it was God’s hand guiding me to where I was supposed to be.During my training, Beverly and I were blessed with four lovely daughters: Kristen, a speech therapist, Sarah Elizabeth, a registered nurse, Ellen, an orthopaedic rep for DePuy I-Orthopaedics, and Melissa, a registered nurse. One man could not be more blessed. At the same time it provided my second real test. Sarah was born with cystic fibrosis. It was a crushing weight to know that your daughter would struggle for life and breath. I can remember one day in what seemed like a nightmare with no way out, the words of my cousin, Bill Ashford, “We will love this child through the good times and the bad.” And love her we did. A special bond developed between father and daughter.At age 15, Sarah’s struggle for life reached a crisis. Again it was the firm guidance from God that led us through. With options running out, we discovered that Kristen’s pediatrician while we were in Dallas was now a CF specialist. After one trip to Dallas, Claude Prestage sent us to St. Louis Children’s Hospital for a double lung transplant. Beverly and Sarah moved to St. Louis for what was supposed to be at most a 1-month wait for a donor. After 2 years of waiting and no donor, Sarah became so ill she had to be placed on life support and we all knew she would never come off without new lungs.After 2 weeks in the ICU, we had a morning conference with her pulmonologist, George Mallory. He told us she might not survive the night and that there were still no prospects of a donor. At 6:00 pm, holding her unconscious hand, I made my peace with God and gave her back to him. At this instant I experienced a feeling that I can only describe as a peace that passes understanding. I had never experienced such a feeling of comfort and reassurance. “What is going on?” I thought. My daughter was in the last hours of life and yet I felt no anxiety. I was totally at peace.Thirty minutes later, as her heart and kidneys began to fail, the word came: “A possible donor.” Sarah’s miracle had arrived. After 2 years of waiting, and at literally one stroke before midnight, Sarah got her transplant. But after the transplant, Sarah developed ARDS. After all the treatment George Mallory knew to give, Sarah was near death again. Dr. Mallory sat on her bed and explained that ARDS was universally fatal in lung transplants and that she would not survive. She looked him back in the eye and said, “Don’t worry about me for I know I am going to heaven.” Such courage, such faith. I have never seen more in one human, especially a 16-year-old. Within 24 hours, the ARDS mysteriously began to clear. Dr. Mallory could not take credit because he had begun nothing different. Slowly Sarah recovered. God’s second miracle had arrived. On January 22, after 96 days in the ICU, Sarah Elizabeth and I walked out of St. Louis Children’s Hospital together.Sarah became the first successful pediatric lung transplant CF patient in the world. She lived 9 more wonderful years until we lost her from transplant complications. But what a great 9 years. She lived life to the fullest, graduated cum laude from nursing school and taught me more about life, love, and faith than can be imagined.These experiences have given me a perspective of medicine and life that I would not have had otherwise. Having been on the other side of the doctor/patient relationship, I would like to leave you with a few thoughts on what being a physician means to me.When I look at medicine today, I see how much has changed since I started 37 years ago. As we all know there is much more intervention from the government, third-party payers, and lawyers. All of these add to the stress of what we do, and if we allow them, they can dominate our lives. I would challenge each of you to take a stand against these forces that would destroy us, but do not let them dominate you or change who you are.Remember, each generation of physicians has had its challenges. Churchill said, “A pessimist sees the difficulty in every opportunity, and an optimist sees the opportunity in every difficulty.” Our predecessors lacked our modern technology, knowledge, and ability to cure terrible diseases. They often had to accept morbid and crippling illnesses which they were powerless to treat. Can you imagine the stress on a physician powerless to save a child dying with a ruptured appendix, or having to amputate a leg from a Civil War wound, conditions that we routinely treat and cure today?I have been amazed to hear physicians say that they would not recommend their child to follow their footsteps into medicine. I have to wonder what they see as the satisfaction of being a physician. If it is only money, country clubs, and big cars then they have indeed missed out on the greatest satisfaction in life.I would challenge all of you to first become your patient’s friend. Lois McMaster Bujold said, “If you make it plain you like people, it is hard for them to resist liking you back.” Interacting one on one with another human who is in need of your knowledge and expertise, and conveying to that person that you really care about them and healing their problem is truly a gift to be cherished. Observing them actually recover with your help provides a level of satisfaction that is unparalleled. It is one all the lawyers and bureaucrats can never take away from us unless we let them. All of my Fellows have surely tired of my advice to them. If you sit and spend time with a patient, listen to their problem, empathize with them and genuinely convey that you care about them and helping with their problem, you will not only get a loyal patient, but a friend.As I look back on all the paths my life could have taken, I realize that I have the best job in the best country on earth. I am reminded of a Mississippi family doctor, Joe Johnson, the editor of our State Medical Journal. He wrote very pertinent editorials and ended each one with these words, ”Thank God that I am a physician.”I would also encourage each of you to become involved in leaving a legacy to the next generation of physicians. Whether it is being involved with AANA or another society, the need to teach our successors and set examples for them is never ending. Remember, there are over 600 new orthopaedic surgeons in the United States alone each year who need to be taught arthroscopy and other skills. I would challenge each of you to find a place and contribute. It leads to a personal and professional satisfaction that money cannot buy.Thank you again for the privilege of serving you as the 25th President of the Arthroscopy Association of North America. May God also guide you, as he has me, through your life journey. To my family, to my fellow AANA Board members, and to you the members of AANA, I would like to express my gratitude for having the honor and privilege to serve you as the 25th President of the Arthroscopy Association of North America. My duties with AANA have allowed me the opportunity to give something back to our profession, and I am appreciative of that opportunity. AANA has had significant accomplishments in the past several years. Recent upgrades at the Orthopaedic Learning Center have assured its continued position as the premiere hands-on surgical skills learning facility in the world. Our partnership with the Academy at the OLC sets us apart as an organization committed to education. The completion of the Building on Excellence Campaign will assure AANA the resources to plan and build for the future. Our Fall Course and OLC courses continue to attract both residents and practicing surgeons seeking to improve their skills and knowledge. While looking back is satisfying, I am looking forward with great anticipation to our future. Thomas Jefferson said, “I like the dreams of the future better than the history of the past.” I agree with Jefferson and as I look forward I see that AANA is financially strong and secure. We will remain committed to educating surgeons of the future in the discipline of arthroscopy and minimally invasive surgery. Our strength lies with you, the members of our organization. I have watched over the years as you have volunteered your time, resources, and efforts in teaching courses in Chicago, serving on committees, putting together instructional course lectures, and manning the labs at the fall course. We are truly a grass roots organization whose members are in the trenches. Should one seek the secret of our success, they need to look no further. Along with our members, we have the greatest staff in the world. Words cannot express what a great job Whit, Ed, Holly, Donna, Beatriz, Lauren, Tiffiny, Allison, and Marge do. They are truly devoted to AANA and I thank them for the effort they have made to make this past year successful. I would also like to thank my partners at Mississippi Sports Medicine. We started our dream small over 23 years ago. They have provided support and camaraderie for which I am thankful. I am humbled by the fact that so many of my family and friends have honored me by coming all the way to California for this special occasion. I appreciate your love and support more than I can express. I would like to leave you today with some personal reflections that have come from my experiences as a son, brother, husband, and father, and as an orthopaedic surgeon over the last 27 years. Certainly life has its way of testing, molding, and making us into the final products that we are. If someone years ago had told my future and predicted all the twists and turns my life would take leading to this stage, I might have thought them nuts. I grew up in the Mississippi Delta, a land rich in history and culture. It was the land of William Faulkner, Tennessee Williams, B. B. King, Morgan Freeman, and Charlie Pride. Yes, it was a great place to grow up, small town rural America. Probably not different from where many of you grew up. I thought it the center of the universe and am reminded of a trip that my cousin Bill and his father Dan, the Mayor of our small town of Lambert, took one day to our Courthouse in Marks, Mississippi, during the Cuban Missile Crisis. Bill and his dad happened upon the usual group of whittlers and political scientists who frequented the large shade tree on the Courthouse lawn. After the usual cordial greetings, Dan asked one of the men if he was worried about the crisis in Cuba. “Well, of course we are concerned” was the reply. “Those Russians are going to drop an atomic bomb on us here in Marks.” Dan was astounded. “Do you mean that you think the Russians consider us important enough to drop an atom bomb in Marks?” he asked. “Well of course, Dan” came the reply. “We are the county seat.” I had wonderful parents, a house full of brothers and one sister, and one special aunt who encouraged me at all times. I was a real-life Tom Sawyer. We worked hard but we also played hard, hunting, fishing, and camping with my friends, guys from varied backgrounds and cultures. Especially the hunting. God made a special place for duck hunting and he put me in the middle of it, in the heart of the Mississippi Delta. Fighting Bayou is located at the junction of Dugan and Rattlesnake Bayous in Booger Den, Mississippi. Specifically, it is located 3 miles east of Scared Man Brake and 2 miles south of Ignorant Ridge. It has truly blessed me as a place to relax with friends and colleagues. Of course, all of this outdoor activity convinced me that I was destined to be an All-American football player. I did not realize at the time that there was little demand for a slow, 175-lb quarterback. That honor would go to a buddy, Archie Manning, who lived 30 miles down the road. It did, however, account for a life-altering event, an ACL tear that influenced my ultimate decision to become an orthopaedic surgeon. An ACL repair by Marcus Stewart at the Campbell Clinic would also guide me back to the same institution for training years later. I went on to college at Mississippi State where all I did was study (that’s what I told Beverly) and then on to medical school in Jackson. Here I met and married Beverly, the love of my life, to whom I owe more than I could ever repay. She has been a companion, mother, adviser, and my best friend. Looking back on my life experiences I realize I was fortunate to be raised with the principles of God, country, and family. It would be this foundation that would get me through the really tough times. I thought it appropriate to use this address to share two extraordinary experiences with you. Perhaps you can draw parallels between these events in my life and your own experiences. I know that mine have led me to conclude that as I go through life there is a firm hand from above guiding me through. My first real challenge came after 1 year and 7 days of my orthopaedic residency at UMC. Our entire group of residents resigned en masse over an ethical dispute with our Chairman. Here we were, 11 guys who wanted to be orthopaedists, but with nowhere to go to finish training and the assurances from the administration that we would be black-listed from every training program in the country. As we searched our way through this uncertain time, the Mississippi Orthopaedic Society, in emergency session, voted us a unanimous resolution of support. With their support we were able to secure interviews at other programs. Unbeknownst to me, in June, 1 month prior to our resignation, two interns who were scheduled to start their residencies at the Campbell Clinic decided to go into other specialties. Suddenly two spots that had been committed for over a year were open at my level. I went to Memphis for an interview and who was one of the interviewers? Dr. Stewart, of course. My friend Bill Marshall and I were accepted into the program and it opened the door and allowed me to complete my dream of becoming an orthopaedic surgeon. Was this all luck or coincidence? I am convinced it was not. There had never been and has not been since, positions to open like this at Campbell’s. I feel it was God’s hand guiding me to where I was supposed to be. During my training, Beverly and I were blessed with four lovely daughters: Kristen, a speech therapist, Sarah Elizabeth, a registered nurse, Ellen, an orthopaedic rep for DePuy I-Orthopaedics, and Melissa, a registered nurse. One man could not be more blessed. At the same time it provided my second real test. Sarah was born with cystic fibrosis. It was a crushing weight to know that your daughter would struggle for life and breath. I can remember one day in what seemed like a nightmare with no way out, the words of my cousin, Bill Ashford, “We will love this child through the good times and the bad.” And love her we did. A special bond developed between father and daughter. At age 15, Sarah’s struggle for life reached a crisis. Again it was the firm guidance from God that led us through. With options running out, we discovered that Kristen’s pediatrician while we were in Dallas was now a CF specialist. After one trip to Dallas, Claude Prestage sent us to St. Louis Children’s Hospital for a double lung transplant. Beverly and Sarah moved to St. Louis for what was supposed to be at most a 1-month wait for a donor. After 2 years of waiting and no donor, Sarah became so ill she had to be placed on life support and we all knew she would never come off without new lungs. After 2 weeks in the ICU, we had a morning conference with her pulmonologist, George Mallory. He told us she might not survive the night and that there were still no prospects of a donor. At 6:00 pm, holding her unconscious hand, I made my peace with God and gave her back to him. At this instant I experienced a feeling that I can only describe as a peace that passes understanding. I had never experienced such a feeling of comfort and reassurance. “What is going on?” I thought. My daughter was in the last hours of life and yet I felt no anxiety. I was totally at peace. Thirty minutes later, as her heart and kidneys began to fail, the word came: “A possible donor.” Sarah’s miracle had arrived. After 2 years of waiting, and at literally one stroke before midnight, Sarah got her transplant. But after the transplant, Sarah developed ARDS. After all the treatment George Mallory knew to give, Sarah was near death again. Dr. Mallory sat on her bed and explained that ARDS was universally fatal in lung transplants and that she would not survive. She looked him back in the eye and said, “Don’t worry about me for I know I am going to heaven.” Such courage, such faith. I have never seen more in one human, especially a 16-year-old. Within 24 hours, the ARDS mysteriously began to clear. Dr. Mallory could not take credit because he had begun nothing different. Slowly Sarah recovered. God’s second miracle had arrived. On January 22, after 96 days in the ICU, Sarah Elizabeth and I walked out of St. Louis Children’s Hospital together. Sarah became the first successful pediatric lung transplant CF patient in the world. She lived 9 more wonderful years until we lost her from transplant complications. But what a great 9 years. She lived life to the fullest, graduated cum laude from nursing school and taught me more about life, love, and faith than can be imagined. These experiences have given me a perspective of medicine and life that I would not have had otherwise. Having been on the other side of the doctor/patient relationship, I would like to leave you with a few thoughts on what being a physician means to me. When I look at medicine today, I see how much has changed since I started 37 years ago. As we all know there is much more intervention from the government, third-party payers, and lawyers. All of these add to the stress of what we do, and if we allow them, they can dominate our lives. I would challenge each of you to take a stand against these forces that would destroy us, but do not let them dominate you or change who you are. Remember, each generation of physicians has had its challenges. Churchill said, “A pessimist sees the difficulty in every opportunity, and an optimist sees the opportunity in every difficulty.” Our predecessors lacked our modern technology, knowledge, and ability to cure terrible diseases. They often had to accept morbid and crippling illnesses which they were powerless to treat. Can you imagine the stress on a physician powerless to save a child dying with a ruptured appendix, or having to amputate a leg from a Civil War wound, conditions that we routinely treat and cure today? I have been amazed to hear physicians say that they would not recommend their child to follow their footsteps into medicine. I have to wonder what they see as the satisfaction of being a physician. If it is only money, country clubs, and big cars then they have indeed missed out on the greatest satisfaction in life. I would challenge all of you to first become your patient’s friend. Lois McMaster Bujold said, “If you make it plain you like people, it is hard for them to resist liking you back.” Interacting one on one with another human who is in need of your knowledge and expertise, and conveying to that person that you really care about them and healing their problem is truly a gift to be cherished. Observing them actually recover with your help provides a level of satisfaction that is unparalleled. It is one all the lawyers and bureaucrats can never take away from us unless we let them. All of my Fellows have surely tired of my advice to them. If you sit and spend time with a patient, listen to their problem, empathize with them and genuinely convey that you care about them and helping with their problem, you will not only get a loyal patient, but a friend. As I look back on all the paths my life could have taken, I realize that I have the best job in the best country on earth. I am reminded of a Mississippi family doctor, Joe Johnson, the editor of our State Medical Journal. He wrote very pertinent editorials and ended each one with these words, ”Thank God that I am a physician.” I would also encourage each of you to become involved in leaving a legacy to the next generation of physicians. Whether it is being involved with AANA or another society, the need to teach our successors and set examples for them is never ending. Remember, there are over 600 new orthopaedic surgeons in the United States alone each year who need to be taught arthroscopy and other skills. I would challenge each of you to find a place and contribute. It leads to a personal and professional satisfaction that money cannot buy. Thank you again for the privilege of serving you as the 25th President of the Arthroscopy Association of North America. May God also guide you, as he has me, through your life journey.