Abstract
In this unprecedented time, most of us probably have a lot more free time than usual. The corona virus has imprisoned us, with little room to escape. Most of us have probably done things that they would not normally do, simply to avoid monotony. I would speculate that many of these new-found adventures would have never been realized without the viral load.
With only a handful of operations to perform in the past few months, I find that I do not miss the operating room as much as I thought. To date, it was one of my prevalent trepidations and fueled my zeal to venture further into the unknown part of the world of foot and ankle surgery. There are still a lot of things on my professional bucket list, but somehow, with the forced hiatus, they do not seem so important. Perhaps this is the mirror of retirement, whereby I would never pick up another journal, never have to log onto the network, or wonder about the cause of osteolysis after total ankle replacement.
But wait… something does not feel entirely right. Even though I have taken on lots of house projects I once vowed I would never do again, I find myself unable to detach from my research and the papers that have sat on the hard drive for years. I have gotten more engaged with resident education, giving more talks than normal, and tuning in to virtual academic sessions more than ever!
As a engaged student of orthopedic history, or folklore for that matter, I have often wondered how some of the things we commonly accept in clinical practice actually came into being. In these obligate virtual academic sessions, I have heard colleagues and residents profess opinions that are astounding, and often, completely dichotomous from what I “learned”. Now I am sure that these dictums are well intended, but it is difficult to remain on mute, particularly when I “know” that they more closely resemble a fairy tale than the bible. In the past, my usual response of “You don’t actually believe that do you” was met with the typical defense mechanisms endemic to human nature and served only to embarrass the perpetrator. Clearly, a new strategy was in order. Hold that thought.
As one gains clinical experience, it comes with an obligate dose of confidence. Yet I have often wondered about the validity of the bravado. Along this journey, that confidence becomes over confidence and probably more exponential than we would expect. Looking up to the sky, you think you can look right past the crimson sun, into infinity with a vast wealth of knowledge and unbridled ability. And in fact, as you look up every successive day, it seems you can see farther and farther, and even challenge infinity. You start to believe everything you say, and the speed of the vortex escalates, and you think you will never be expelled. Hold that thought as well.
To explore the genesis of the some of these imaginary clinical concepts, there are several possibilities. First, there is generational passthroughs whereby certain concepts are taught in specific residency programs. This is most prevalent in programs that have a certain amount of inbreeding. Second, there are these educational programs with speakers without academic pedigree or publishing experience. And the third, seemingly ubiquitous cause, is the poorly veiled, industry presentation. The disguise of the “unrestricted educational grant” is translucent at best. Perhaps the best strategy is to remain on mute, and accept this as the new reality.
What is the point of all of this? At one point in your career you will realize that none of these clinical pieces of fiction are borne by repeated doses of humility. The lucky ones finally realize humility is a good thing, not a harbinger of ineptitude. Some have the epiphany early, some late, but at least it is realized. At that point, you begin to challenge everything you hear, and stop hiding your problems, asking for help, even though you are “experienced”. You will also learn that if you solicit advice, it is probably best to heed it, or have a sound scientific basis to refute it.
Hopefully, there will be one momentous day that when you gaze up into the sky expecting to see professional nirvana, you will realize that what you thought was the infinite horizon, is only the bottom of the clouds.