Vol 35 | Issue 3 | September-December 2020 | page: 1- 2 | Kumar Keshav
Authors: Kumar Keshav 
¹Department of Orthopaedics, SGPGI, Apex Trauma Centre, Luknow, UP, India.
Address of Correspondence:
Dr. Kumar Keshav,
Assistant Professor, SGPGI, Apex Trauma Centre, Luknow, UP, India.
Starvation in The Midst of Plenty: Are we Orthopaedic Surgeons Smart Enough?
“Water water everywhere, nor any drop to drink”, lines from the classic poem ‘The rime of the ancient mariner’ by Samuel Taylor Coleridge can be compared to the present scenario of orthopaedic surgeons in large parts of the world. Many amongst us are currently having ample amount of time at our disposal, but do not know how to utilize it.
Before the onset of COVID 19 pandemic, we were, generally speaking, quite a busy lot looking at the broken bones or an arthritic joint or a torn ligament or a prolapsed disc – and fixing them up. We had forgotten that other domains of medicine too exist (pun intended), a trait due to which we have often been hilariously labelled as Arjuna, who saw nothing but the eye of the bird. The pandemic and the measures taken thereafter to channelize the resources towards COVID care has brought severe disruption of orthopaedic and trauma services . We are doing our best to tide over the pandemic. Some amongst us, who are at managerial positions of the hospitals/institutes, are looking after the logistics of COVID care while others are taking clinical care of the COVID-19 patients when their turn comes as per rotation policy. If we talk of orthopaedic services, it has resumed partially at some places. Even after resumption of orthopaedic clinical services in many hospitals, it is still far from what it was pre-pandemic . Consequently, most amongst us are having a feeling that we have become less productive. The management of patients have become a bit tedious starting from changing the hospital set-up, creating different teams, getting COVID RT-PCR before any surgery, use of special protective equipments and despite all these, we are not getting the satisfaction that we were used to. Satisfaction is, no doubt, the greatest pleasure. So, the big question is how to feel most satisfied in the present scenario. There are three aspects which gives us orthopaedicians ‘Ikigai’ (reason for being)- clinical work, academics (teaching and training) and research . But, the majority of us, especially in India are focused on the clinical orthopaedic work only- again something akin to Arjuna and the parrot’s eye. It’s high time to ask ourselves the question- “Have we moved too close to the tree that we have lost sight of the forest?”
If we zoom out a bit, we can see that the orthopaedic surgery, as a speciality stands on the three pillars, as mentioned above. But, this whole structure rests on the survival of the humankind (human beings considered collectively) itself (Figure 1). So, at this time, our first responsibility is to protect the base of our building which is being threatened by the COVID-19. We should not shun away from our responsibilities and hence get involved in the management of COVID-19 patients to the extent of our training and competence. We need to change the hospital infrastructure based on the guidelines given by major orthopaedic associations to improve the clinical services- the pillar, hitherto we were most focused at . And despite that, if we have plenty of time at our disposal, rather than wasting it in contemplating about the future, we should utilize it to strengthen the other two pillars of academics and research. No doubt, we are trying our best to act smartly. The daily webinars related to orthopaedics and COVID-19 from various platforms can indeed be a great substitute of the conventional classrooms and meeting halls that we are used to. The publications have seen a tremendous rise in these times . It’s high time to update ourselves in orthopaedic knowledge, gain insights into some related fields like biostatistics, technology, computing, etc and develop new skills from the confines of home. We can involve ourselves in research, which has often been neglected and that which is not allowing us to gain orthopaedic excellence and leadership. Contrary to what most of the Indian orthopaedicians think, not all the research has to be original clinical research. Secondary research like systematic review and meta-analysis, or primary research from the pool of data that we already have can be best done to quench our thirst of Orthopaedic Ikigai. Of course, there is water (time) everywhere and it can be used to quench our thirst, provided we know how to desalinate and purify it (do our part with responsibility to contain the pandemic and focus on academics and research).
1. Rolling updates on coronavirus disease (COVID-19). Updated 01 June 2020. Accessed on 06 June 2020. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
2. Keshav K, Kumar A, Sharma P, Baghel A, Mishra P, Huda N. How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey. [published online ahead of print, 2020 Aug 4]. Indian J Orthop. 2020;1‐10. https://doi.org/10.1007/s43465-020-00218-z
3. Alliance of International Organizations of Orthopaedics and traumatology. COVID-19 Best Practices Joint Statement. Accessed on April 27, 2020. Available at: https://www.apoaonline.com/pdf/aiot-jointstatement.pdf
4. Chhabra HS, Bagaraia V, Keny S, et al. COVID-19: Current Knowledge and Best Practices for Orthopaedic Surgeons [published online ahead of print, 2020 May 18]. Indian J Orthop. 2020;1‐15.
5. D’Ambrosi R. Orthopedics and COVID-19: Scientific Publications Rush [published online ahead of print, 2020 May 25]. Indian J Orthop. 2020;1-7. doi:10.1007/s43465-020-00141-3.
|How to Cite this Article: Keshav K | Starvation in The Midst of Plenty: Are we Orthopaedic Surgeons Smart Enough? | Journal of Bone and Joint Diseases | September-December 2020; 35(3): 1-2.|