Via Basel: Insights from 50 Years…

Maysey Craddock, the light that traveled the shore

Via Basel: Insights from 50 Years of Orthopedic Practice

Recently I was approached by a young family member in his final year of college to give an informal lecture to a club in his university dedicated to students aspiring to be physicians. Telling them about my journey and experience as a physician/orthopedic surgeon can inform them and help to decide if they want to continue to pursue a similar career and vocation. That prompted me to reflect on my 50+ years of training in, and practicing Orthopedics, as well as teaching it. I soon realized that certain repetitive themes, lessons, quirks, insights, or whatever they are called were in plain sight. These insights are not unique to me or even my profession but I believe are embedded in human experience, universal, and in some ways timeless, too. Allow me please to  share a few with you, dear reader.

My patients were my best teachers. To study the tools of the trade, any trade, gathering information from various sources, teachers, and professors is only the beginning of mastering your profession, to be followed by practicing it under mentor supervision. I was honored and humbled when my patients gave me permission to treat them medically or surgically. Learning from the subjects themselves, patients in my case, plants for a biologist, animals for a zoologist, is more comprehensive, effective, and practical. It is also more accurate because of the diversity and complexity in living beings. But this learning requires constant attention and patience, both of which are uncommon attributes these days. Listening well, and being open minded is the key to correct diagnosis and treatment. Tests and imaging are great but also need personalized interpretation and context, just as medical or surgical intervention requires compassion and emotional support as well. 

Life is hard. Upon evaluation and diagnosis of common ailments, arthritis, tendinitis, etc., my recommendation inevitably includes lifestyle advice, activity, diet in addition to definitive treatments. “But doc, it’s hard” or some version of that, is a common response and it baffles me. Not sure how the concept of minimal effort and easy solutions to our life problems became so pervasive. Maybe our expectations are out of line with reality, and the comforts we have in contrast to our ancestors have made us complacent. The first sentence in his seminal, groundbreaking book in psychology and personal growth, M. Scott Peck writes, “Life is difficult.” First published in 1978, a best seller for over a decade, it remains as relevant as ever. If you haven’t read it, read it, and if you have years ago, then re-read it.  

All phenomena have a beginning. Once I tell my patients what I believe is the cause of their problem, such as degenerative disc disease in the spine or rotator cuff tears in the shoulder, some exclaim astonishingly, “But doc, I never had this before.” Tempted to respond sarcastically, “Well, you do now,” I don’t, but then elaborate that some chronic pathologies have been there all along, but were not symptomatic for a variety of reasons and sometimes no reason at all. Our minds are not good at accepting novelty, especially with negative connotations. However, we totally embrace unexpected good news and believe in our core that we are worthy of it, a hypocrisy of sorts.

Priorities, priorities, and you are not #1. On my late son’s desk under the glass top is his handwritten sentence, no author named: “To know the order of precedence is the beginning of wisdom.” I have wondered over the years over its exact interpretation and meaning. In the real world  we act out what priorities our minds dictate to us. Some value, ethical principle, moral guide, or interest has to rise to the top followed by others. Unconsciously we act according to the values on top of this list. Most of us do this by default, without a clear reflective attitude, and get in trouble. In the Hippocratic oath physicians take, the patient’s health and well-being is our first priority, with doing no harm a close second. Constantly reminding myself of that, and not efficiency, financial, or ego incentives, has been a guiding principle in my career. It is not easy or comfortable, and modern medicine technology’s effect on patient/physician interaction has not helped either. In technical or legal jargon it’s called “conflict of interest.” Any action, test, procedure in medicine should be performed according to these stated priorities with patients well-being number one. Our profession has suffered from not always adhering to the priorities of the Hippocratic oath. This conscious and deliberate effort to repeatedly remind ourselves of these priorities of helping patients, customers, consumers is relevant in any profession. It also helps in our daily decisions when we have multiple and competing choices. For this to happen we have to Pause, Reflect, and Remember. Again another reason to cultivate mindfulness. I should stop now before getting too preachy.

Basel Al-Aswad, father of EIL founder Christopher Al-Aswad, is a yogi trapped in an Orthopedic Surgeon’s body. His loves in life include reading, writing, hiking, enjoying nature, meditation, and spending time with his large Iraqi family, and now, semi-retired, he is exploring new avenues in medicine, education, public speaking, teaching, and social engagement.

Order of Precedence, ceremonial

Order of Precedence, definition and examples

Proverbs 9:10  (a list for comparison)

M. Scott Peck at Wikipedia, The Road Less Travelled…and beyond!

3 responses to “Via Basel: Insights from 50 Years…”

  1. Mary Madden says:

    Gretchen Rubin, author of The Happiness Project, invented an often used expression, “the days are long but the years are short.” 50+ years of practice! Wow, so hard to believe! Congratulations to you! Years ago as I recall, you exemplified your altruistic characteristics from early on in your career. Your appreciation of the diversity and complexity of each of your patients and allowing yourself to learn from them only enhanced your focus, patience, compassion and emotional support. All of which are priceless to frightened, anxious, even stoic patients and their families. Your patients were more than just “the total knee in pre-op,” “the hip in O.R. 3,” etc. Their health and well-being were your priority and that was a huge comfort to them in knowing that. Unfortunately, as anyone in medical careers today knows, these important traits are sadly prioritized to a lesser degree than they were in the past. How wonderful it would be to inspire these students you’ve been asked to speak to, to reflect on what you have received from your patients not only as a stellar orthopedic surgeon but as a human serving others with dignity and respect! Pause, Reflect, Remember…your mindfulness flag is showing. Wave it proudly! It has served you well.

  2. Mark Naom says:

    Thank you again for coming to speak, you had some wonderful unique insights that could not have got from anyone else. We always invite professionals to come in to talk about the profession, but life is about so much more than just medical school and performing procedures. I’m glad you could shed some light on the true life of a physician and give advice to those who want to follow in your footsteps. I hope everyone who was present came with an open mind!

  3. basela says:

    Thank you both Mary and Mark for your most generous comments. I promise to continue my mindfulness quest and be a mentor to young adults, Marks generation.

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