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Reflections of an octogenarian skeletal trauma surgeon Christopher Colton
Last year, I was invited to write a letter to myself as a final year medical student exhorting me to consider a career in Trauma and Orthopaedics. I wrote: “Dear Chris,
Chris Colton is Professor Emeritus in Orthopaedic and Accident Surgery at the University of Nottingham and was a Consultant Orthopaedic, Trauma and Paediatric Orthopaedic Surgeon at Nottingham University Hospital for more than 20 years. He was an ABC Travelling fellow, BOA President, Founding Trustee and Lifetime Honorary Member of the Board of Trustees of the AO Foundation.
You are nearing the end of your time as a medical student, and I know that you will do well. Remember that it does not mean that you know everything, you simply knew enough! I warn you that this is not the top of the ladder, just a chance to stand on the bottom of the next one. There will always be another ladder, but that is the essence of medicine – a lifetime of learning and challenge. Never forget that you have a bounden duty of care to your patients, your colleagues, your profession, and to yourself. Your journey ahead can take many pathways and only you can choose which. My instinct is that you are more a surgeon than a physician; should you select a surgical route, remember that you are first and foremost a doctor… one who also operates. Surgery is fun, but the hallmark of a good surgeon is to know when not to operate. Permit me to dangle before you an enticing prospect. The specialty of Trauma and Orthopaedics is initially seductive by virtue of the drama, dare I say glamour, and immediacy of managing the injured. But, T&O is more than that and, whereas the trauma element is the portal of entry for
44 | JTO | Volume 09 | Issue 03 | September 2021 | boa.ac.uk
many a young surgeon, there is much to elective orthopaedics. In the past, orthopaedic surgeons were thought of as front-row forwards with a hammer in hand, but T&O has changed beyond all recognition in the last few decades. You would enjoy a firm scientific basis for musculoskeletal surgery, a massive expansion in our biomechanical understanding, an explosion of investigative techniques and there is now available a huge inventory of relevant instrumentation. Fifty years ago, an orthopaedic surgeon was expected to cover the whole field. With all the developments mentioned here, there has arisen an imperative to focus down to subspecialties. This academic diversification includes posttrauma reconstruction, hand and upper limb surgery, pelvic and acetabular surgery, foot and ankle, shoulder, spinal surgery, bone tumours – and who knows what in the future, in any of these areas? There are great opportunities for teaching and research. Chris, whatever you decide, always remember that surgery is not a science, it is a scientific art: the art is two-fold. The first is the art of handling tissues with biological finesse and delicacy; the second is the art of handling your patients and their near ones with respect, humanity and humility.”
