Dr. William H. Harris looks back on his career advancing orthopedic surgery



To mark the exit of Vanishing bone, in Part 1 of our Q&A with Dr. William H. Harris, we discussed the fascinating story of how he came to identify, and later heal, the severe bone destruction affecting people who have had total hip replacement surgery.

In this second interview, Dr. Harris looks back on his remarkable career; including what inspired him to pursue orthopedic surgery, how he balances his two roles as surgeon and clinician-scientist, and his advice to future surgeons.

What made you decide to become a doctor and what later led you to specialize in orthopedic surgery?

I was inspired to become a doctor mainly by an unbounded admiration for my father. He had first been a general practitioner, then during the depression he received additional training in radiology. Even though he loved being a radiologist and, in fact, was an excellent radiologist, he never lost his original instincts to be a general practitioner. A striking example of this was his common practice of leaving the radiology department to go anywhere in the hospital to do his own examination of the patient in circumstances where he felt his ability to accurately interpret x-rays without seeing the patient was compromised. It was, then and remains today, a rarest attribute. He loved being a doctor and it showed in every aspect of his life. It also inspired me.

Dr William H Harris. Photo used with permission.

My initial interest in the field of orthopedic surgery arose from an unusual experience. My father had told intriguing stories of his time in World War I in France when he had a motorcycle at his disposal. My brother and I begged for a motorbike in our teens which were always rejected with an explanation of the high risks involved. To prove his point, Dad took me to the hospital on a Sunday afternoon and into the operating room to observe a patient severely damaged by a motorcycle accident. Among other things, the hand injury had torn off the skin of much of his wrist, hand and fingers. When I saw the intricate and intricate anatomy of the hand and could imagine the interplay between this anatomy and the function of the hand, I was hooked. Dedication to the details of human anatomy and its vast interrelationships with human function at all levels has sustained my career over all these decades.

You created the Harris Hip Score and performed the very first total hip replacement in a patient with congenital total hip dislocation – among many other accomplishments. What do you think are the most significant moments in your surgical career?

The development of the Harris Hip Score, which is used worldwide to assess hip function both preoperatively and postoperatively, arose out of the overwhelming need, if real progress were to be made, for a rigorous method to quantify the effects of hip and hip disease. surgery. There was substantial dissatisfaction with previous efforts in this direction, so I introduced the concept of the Harris Hip Score early in my career (1969), the same year I founded the Harris Orthopedic Laboratory. .

Another defining moment was the initiation and continuation (over six decades) of the prevention of fatal pulmonary embolism after hip surgery. At the start of total hip replacement surgery, 2% of all patients died from a fatal pulmonary embolism. It is really one patient in 50 operations. It is a terrible price to pay for the surgical solution to a non-malignant disease, arthritis of the hip. As a result of my initial efforts, thanks to the massive efforts of our research and the work of many researchers, this risk has been virtually eliminated. The current risk is very close to zero, three in 1,000 patients.

Another rewarding area of ​​contribution has been my work on the design of implants for total hip replacements. Of many of these advancements, the cementless hip socket design that Jorge Galante and I devised, now the global standard, adopted by all manufacturers, is particularly satisfactory.

But perhaps the most surprising answer to your question would be this: the training and inspirations transferred to a most remarkable group of 100 highly talented young hip surgeons, the Harris Hip Fellows. Their contributions and successes are my most enduring legacy.

Follow your dreams. Choose a career that both stimulates and challenges you. Get excited about what you’re doing and do exciting things.

In addition to being an orthopedic surgeon, you are also a researcher and the author of over 500 scientific articles and several books. How do you balance the very different characteristics needed to excel in a patient care environment, versus those needed in a research environment?

The rewards, both intellectual and emotional, of being a clinical researcher can be very rich, especially the potential rewards for a surgeon-researcher. The surgeon-scientist is both emotionally and intellectually motivated by his failures, but he also has the opportunity to take the limitations and failures that he sees his own patients in a laboratory to see if creative efforts can resolve those issues. But the key requirements for success in every business – surgery versus innovation – are very different. First, the surgeon must instill in the patient a deep sense of confidence and an important interpersonal attribute. Next, he or she must combine technical skills with precise decision-making ability and great serenity under intense pressure. The results of the work of surgeons are generally fully recognized at relatively short durations after operations. Society demands of the surgeon that only operations with a high probability of success be undertaken.

Compare that with the demands of successful innovation. If the investigator only does the things that have worked in the past, the whole adventure is a failure. The innovator, by definition, is only successful if things that have never been done before can be achieved. Unlike the surgeon, the innovator has the freedom to perform 100 different tests to see which route is most successful. The interplay of these two remarkably different and stimulating forms of human activity makes the role of the surgeon-scientist particularly intriguing.

Finally, what advice would you give to any new trainee surgeon?

Follow your dreams. Choose a career that both stimulates and challenges you. Get excited about what you’re doing and do exciting things.

A fundamental necessity is to seek and obtain the best possible surgical training in a very rigorous program dedicated to the highest possible standards. It is also essential to foster and maintain a constant interest in the continuous improvement of both the surgical profession itself and your skills in this profession. Finally, it is essential to maintain a deep commitment to each human being in your care. In these settings, follow your dream. Choose a career that both stimulates and challenges you. Get excited about what you’re doing and do exciting things.

Featured Image Credit: ‘xray’ by rawpixel.com. Public domain via Unsplash.



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