Episode Transcript
[00:00:03] Speaker A: Welcome to JBJS Ortho Corps. Listen as members of the ortho community, residents, surgeons, educators, staff and patients share their stories about the experiences and people most important in their lives and the lessons they learned along the way. OrthoCorps is an audio archive inspired by StoryCorps and independently organized by the Journal of Bone and Joint Surgery.
[00:00:28] Speaker B: All right, tell us, if you don't mind your name and where you're from and where you did your training.
[00:00:35] Speaker C: So my name is Andy Pollock.
I live in Baltimore, Maryland. I live in Maryland, outside of Baltimore. I've worked at the University of Maryland Medical Center System and School of Medicine for this is my 30th year there.
So I'm going to start with where.
[00:00:55] Speaker B: Are your medical school and residency?
[00:00:57] Speaker C: Medical school and residency. So I grew up in Pottstown, Pennsylvania. I went to college and medical school at Northwestern.
Then I left Chicago and went to Cleveland, did my residency at the Case Western Integrated Program there.
I left there and did a fellowship in orthopedic trauma with Mike Chapman at UC Davis for a year. And when I finished my fellowship, I went to Baltimore to join Andy Burgess at shock trauma.
And that's where I've been since.
[00:01:28] Speaker B: So how did you originally get interested in orthopedic surgery and orthopedic trauma in particular?
[00:01:34] Speaker C: Yeah, so it's an interesting story.
My father had a company that made pumps and home workshop power tools.
So I grew up, I'd go to work on the weekends at the factory store and I would be selling woodworking tools and kind of learned about power tools and woodworking tools and how those things worked. I was always interested in it, but everybody at the plant where he worked was, you know, the kids my age were all joining the volunteer fire companies. So I joined the volunteer fire company too, to fight fires. I wasn't really interested in the ambulance stuff, but the, but nonetheless, I thought it was kind of, kind of cool to ride around in a fire truck and put fires out.
And I quickly realized that the ambulance went out on a lot more calls and they didn't have a lot of people there who were able to pass the EMT and paramedic exams. So I did that, got involved in EMS and got tremendously interested. My father had always wanted me to be a doctor, go to medical school.
So I applied to the six year program and got in with this background in emergency medicine and this background in woodworking and home workshop power tools.
So I was, I, when I got to medical school, I thought emergency medicine was where I wanted to Be.
And it turned out I realized they don't really get to take care of patients. They get to take care of patients for a short period of time, an exciting period of time. Tremendous contribution. But I wanted the long term relationship with patients and their families that I saw in other specialties. And I had been exposed to an orthopedic surgeon in the town that I grew up in. I knew a lot about orthopedics, but I was a little worried about it because this guy had no home life. He was the only orthopedic, orthopedic surgeon in town. He was constantly working and not doing other things. And I, I don't know how much that worried me or not, but I, I had shied away from orthopedics initially because of that, but then I did my orthopedic rotation. I didn't do that till my fourth year.
And I realized this is, this is it. It brings everything together. You know, all the power tools, the stuff I already knew about. And then the emergency part and the, the emergency medicine part was attached to orthopedic trauma, the acute care of the injured patient. And I got the long term follow up of those patients too with that. And I think that as I look back on the career and all those decisions, those things just came together fortuitously for me. I was tremendously lucky to be involved in what I think is the greatest part of orthopedics and one of the greatest parts of medicine.
But the real great part about it is really that long term follow up piece. Because when I see patients back in the office today that I operated on 20 and 30 years ago and they come back to say hello, they come back for a different problem. They come back for things that aren't related to orthopedics and I don't really care. But it's so fantastic to see them, right? People who were on death's door when they walked in to your, when they came into your institution, didn't walk in, who now have kids and grandkids.
The rewards are fantastic. And to be part of a team that contributes to those rewards has been tremendously gratifying.
Perfect.
[00:04:41] Speaker B: Were there specific mentors who influenced you and how, what lessons did they teach you?
[00:04:47] Speaker C: Ton.
So I'll start off in, I guess in, in medical school. The two, the two mentors that really influenced me most were Bill Stromberg, who was a hand surgeon in Chicago.
And he taught me about the value of the relation, the special relationship. He has a physical with patients, who's a hand surgeon, but his his interactions with his patients and the way that they clearly loved. Loved him. They just, He. He just. He created such value in their lives that. That, to me, was important. That's a lesson I didn't. Didn't forget.
And Mike Schaefer in med school as well, who was the chair of orthopedics at Northwestern at the time and was chair there, I think, for the longest anybody's ever been chairman anywhere. Probably some exceptions to that, but maybe not far.
Mike taught me about the importance of the commitment to the program, to the group, and to your own leadership.
Then in residency, I had, again, a ton of mentors. Victor Goldberg was the one who really taught me about the importance of rigorous scientific methodology and research and bench research.
The. And then certainly Fred Behrens, who taught. Taught me a ton about orthopedic trauma. But the. I would say that the biggest mentor I had, and most of the folks who came out of Case Western, there's a bunch of people who came out of Case Western went into orthopedic trauma. That's a Jack Wilbur legacy. Without question. Jack was. Was so important in my decision to become an orthopedic surgeon. He just, you know, he made it look so easy. And again, his commitment to his patients and to quality of care and really to quality of surgical care was spectacular.
Mike Chapman was a tremendous mentor in fellowship again, around topics of how you put yourself second and the program and the work first, and then lots of others outside of orthopedics as my career evolved, but within orthopedics, the last one that I'll mention is probably the person who's had the most impact on my professional career, and that's Andy Burgess. Andy really gave me opportunity after opportunity after opportunity. I took advantage of a small fraction of the opportunity that he gave me, but he really had tremendous confidence in me and the willingness to let me try and fail sometimes. And sometimes we succeeded, too.
[00:07:36] Speaker B: So what lessons has your work life taught you?
[00:07:41] Speaker C: My work life has taught me about the importance of the work that we do and the gravity of it.
There's a quote that I will butcher and get wrong, but it's from Jim Mattis, former Secretary of Defense and lifelong career in the Marines. And he said winging it and filling body bags as.
We sort out what works reminds us of the cost of the moral certitude and the cost of incompetence in our profession.
He was talking about fighting wars. He wasn't talking about health care. But when you apply that back to healthcare and to what we do, Winging it is not okay.
And the message was so important that it's about being prepared. It's about reading.
You read the quote in the context of how he gave what he was talking about at the time, making sure you've read everything that there is to read about what you're doing and the lesson about the importance of preparedness and the work that we do and the consequences of inadequate preparedness for people.
[00:09:07] Speaker B: That's a good one.
What would you say you're proudest of in your career?
[00:09:16] Speaker C: You know, I answered that question differently last night that I'm going to answer right now.
Let me give you the last night answer in the today because I had a little bit of time to think about it in between. So the last night answer was that I was proudest of the work that I had been privileged to be part of the leadership of in developing the Extremity Warranties program and in particular the peer reviewed Orthopedic Research program, which has led to half a billion dollars in federal investment in musculoskeletal trauma research.
The outcomes of that work are absolutely ferocious. But when I say what I'm proudest of, really, I'm proudest of the success of the faculty in our department in graduating growing fantastic educational programs that will take the work that we've done and scale it to many parts of the rest of the country and the rest of the world. I'm proudest of the research accomplishments within the department that have happened as a result of our ability as a team to come together and help one another and really focus on where we wanted to get in terms of meaningful, sustainable lines of investigation and what that team has accomplished.
So that would, you know, I'm proud of a lot of the things that we've done in Maryland. But I'd say those are the two things that I'm proudest of, those two.
[00:10:38] Speaker B: What about. Do you have any regrets?
[00:10:41] Speaker C: Sure.
The, you know, I, as I said last night, the, the focusing on regrets is not something that I particularly do, or I would say actually even more than that. I focus. I specifically try not to do that because I think looking forward is far more valuable.
But if I had, I would say the biggest regret I have, it relates to projects that you start and don't finish.
And the one that we started and didn't finish, weren't able to finish, I would say not because we didn't, but because we weren't able, was the program to train surgeons from developing countries in musculoskeletal trauma and acute trauma care.
In a specialty that we had developed and sort of codified within a complete curriculum that defined how you develop a specialty for a developing country that doesn't necessarily match the silos of the specialties we have in the United States. We've got emergency medicine docs who do their thing, trauma surgeons who do their thing, orthopedic trauma surgeons who do their thing. But if you're working in a developing world environment with a big busy trauma emergency room, what you need is somebody who can take care of patients with friends fractures from beginning to end, because that's what comes in. The patients with, with life threatening abdominal hemorrhage, unfortunately, they don't survive. Patients with severe brain injuries, they unfortunately don't survive. But patients with musculoskeletal injuries are, they survive and they're permanently disabled if you don't take care of them. Right. And they can be absolutely normal if you do take care of them. Right. The femur fracture is the ultimate example of that.
And I regret that we weren't able to get that program funded, developed in gear because I think breaking away from those silos of specific specialties, trying to train traditional orthopedic surgeons how to do scopes for SLAP lesions is not really relevant to those environments. I'm not sure scopes for SLAP lesions are relevant anywhere, but certainly not in places like Haiti or South Sudan. Right.
And I guess my biggest regret is that we weren't able to take that program forward, get it funded through the CDC or through USAID or one of those agencies. There was always some other priority that the agencies had typically related to infectious disease.
[00:13:15] Speaker B: So if you could talk to a younger version of yourself, what would you say?
[00:13:20] Speaker C: Stop and smell the roses.
Things go by fast, particularly with your kids. Right. You know, you don't get those times over again.
And the good news is my kids seem to appreciate. They've come along for the ride and they seem to have appreciated it. But there are things that I missed along the way that they remind me of.
The.
It's so I think you have to be, be selective about what you do, what you take on. And I see younger versions of me in the department coming through and they're signing up for every international course and every board of director opportunity that comes by and you know, it's fantastic. And what I can't tell them not to I did it, but I also do tell them, be careful, be try and try and develop some semblance of balance.
But you know, the opportunities that you're presented in this line of Work, particularly academic orthopedic trauma, are ferocious and to not take advantage of them is too hard.
[00:14:20] Speaker B: So how has your life been different than you imagined?
[00:14:26] Speaker C: I don't know that I spent a lot of time imagining my life before. But I guess when I started med school, as I said, I thought I was going to be an emergency medicine doc and I thought I was going to be an emergency medicine doc in the town that I came from and go back and run the fire department there as a medical director.
I did run a fire department as a medical director for 20 years in Baltimore, but in Baltimore County.
But I thought I was going to do it in a small town as an emergency medicine doc. I never thought that I would be a leader of a health system, that I would effectively leave clinical orthopedics. And I still take call one weekend day a month and see patients. But I'm really not a full, full on orthopedic surgeon anymore. I'm more of a part time orthopedic surgeon.
But I really did not envision myself in this type of a leadership role. I really thought that I would, if I left medicine ever, it would be to go into business independently, to run the family business or to do something like that. But this was sort of the way things sort of laid out and happened.
[00:15:34] Speaker B: Are there any funny stories or characters from your career that you'd like to share?
[00:15:40] Speaker C: Funny stories or characters from my career that I'd like to share. Yeah. So one. So I'll tell it this way. So when we were finishing fellowship, when I was finishing my fellowship, I had an offer from Dave Helford to go to HSS with him and Joe Borelli. And we were going to be spending, Joe and I were going to be flipping time, half, big time between hss, half time between North Shore and my wife, who had been in the cosmetics industry and the modeling industry, definitely wanted to be in New York, and the Upper east side of Manhattan was perfect. That was exactly where we were going to go.
And then Andy Burgess finally answered my 14th call or whatever to ask if he had any jobs there. And he said, all right. He was just still upset with me, still had a, you know, a chip on his shoulder because I hadn't come there for the fellowship program and they had ranked me very high, apparently. I didn't know that, but I wanted to go to the west coast for a little while. So Andy. I finally went down and visited with Andy and I convinced him that I was actually genuine about my interest for the job. And I realized that shock trauma was everything I wanted. You know, I had a background in ems. This was completely linked to ems. And so I came back with Trish to look at that job, and Andy took her for a ride in the car and showed her the, you know, the. The Maryland suburbs, the horse country.
We went by Cal Ripken's house and. And really did the. The hardcore sell. And she said, all right, I got it. You need to be here for. Let's. Let's do this for five years, then we'll go to New York.
And I said, all right, you got a deal.
That was 30 years ago.
So we finally, you know, five years came and went, and then another five, another 10.
Finally it was about 2012.
And the.
I got.
I was.
I'd just been at a. At a medical system board retreat, and I was the interim chair of orthopedics at that time. Dr. Pellegrini had left about a year before, and the dean was trying to convince me to take the permanent job. And we had been negotiating for months over this about what I thought was necessary to make it successful. I get back from the board retreat, and I walk into my desk and the letters on my desk, and it has everything that I've asked for for six months in it.
So I got no choice. I gotta sign it. So I sign it, and then I flip over the next letters from a search firm saying, we're putting together a very short list of people that we would like to come look at. Tom Skulko's job, he was stepping down.
I didn't show it to Trish. I threw it out. I definitely wouldn't have been competitive for it.
And the idea of going into HSS as an outsider and an orthopedic trauma surgeon as chair would have been, would have been a heavy lift. But nonetheless, I still keep telling her we're going to go back to New York someday. Turns out we're looking for an apartment for four weekends because all of our kids live there now.
[00:18:51] Speaker B: It's a good compromise.
[00:18:52] Speaker C: Yeah.
[00:18:54] Speaker B: Is there a specific orthopedic trauma device, technique, procedure, or innovation that you have a connection with that that you'd like to share? We'll finish on this one.
[00:19:05] Speaker C: So I would say.
The one thing that I will attribute sort of to me is the use of the lateral position without the fracture table for femoral kneeling at shock trauma.
And the way it happened was, you know, when I was a resident at Metro, we used to nail all of our femurs in the supine position on a fracture table. And it was a fricking struggle. I mean, you know, getting the starting portal and getting things right and getting the thing set up no matter where you were, was always looking for parts.
And then I got to UC Davis, and Mike Chapman taught me how to nail laterally in the front of fracture tip. It requires the right fraction fracture table to be able to get patients in the lateral position. You couldn't do it with just the fracture, any fracture. Then I get back to shock trauma and their back supine on the fracture table. So I figured either way I can do it. But it was still such a struggle compared to the lateral position. But I couldn't use a lateral position fracture table shock trauma because they didn't have it. So I finally said, what the hell? I just tried one lateral on a regular operating table. I realized it was hard to image at parts. But then we moved the patient south on the table and that worked. And finally we started doing it on OSI tables. We haven't used a fracture table for anything in shock trauma in 25 years as a result of it. When I first did it, the other faculty members there, other than Burgess, who let me go, the other faculty members there told me, that's clearly malpractice. You're going to have mal rotation, you're going to have all sorts of things, whatever. And so we challenged the dogma. And as I said, For 25 years, nobody's used a fracture table for anything. So that's sort of thing that still attaches mine.
[00:20:52] Speaker B: Well, thank you. This has been great.
[00:20:55] Speaker C: Thank you.
