From the Executive Editor

JTO Editorial Team

Bob Handley (Executive Editor) Rhidian Morgan-Jones (Editor) David Warwick (Medico-Legal Editor) Tricia Campbell (Trainee Section Editor)

BOA Executive

Don McBride (President) Phil Turner (Immediate Past President) Bob Handley (Vice President) John Skinner (Vice President Elect) (Honorary Treasurer) Simon Hodkinson (Honorary Secretary) Deborah Eastwood

BOA Elected Trustees

Don McBride (President) Phil Turner (Immediate Past President) Bob Handley (Vice President) John Skinner (Vice President Elect) (Honorary Treasurer) Simon Hodkinson (Honorary Secretary) Deborah Eastwood Colin Esler Peter Giannoudis Grey Giddins Robert Gregory Anthony Hui Andrew Manktelow Ian McNab Fergal Monsell Rhidian Morgan-Jones Hamish Simpson Arthur Stephen Duncan Tennent

BOA Staff

Executive Office Chief Operating Officer - Justine Clarke Personal Assistant to the Executive - Celia Jones Education Advisor - Lisa Hadfield-Law

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From the Executive Editor

Bob Handley S trange and strained times. Writing an editorial that will be read a few weeks later is always risky business but even more so when surrounded by such volatility. It is, however, the essence of so much of what we do; we make the best judgement we can in the circumstances that prevail and proceed. Whether those circumstances be a tricky problem in theatre or the fallout from a pandemic we carry on. This special edition of the JTO charts some of our efforts. The normal printed JTO had been cancelled but then an opportunity arose to partially resurrect it as special on-line PDF version. To keep up with the ever changing world of COVID-19 we had already started publishing articles in a rapid turn-around Journal called the TJTO&C or the Transient Journal of Trauma Orthopaedics and the Coronavirus. This PDF version of JTO is in the main a compilation of those articles, with some updates and commentaries. The swing in the pervading mood over the last eight weeks has been extraordinary; an acute fear of being overwhelmed by pandemic respiratory failure morphing into a pervasive threat of endemic Coronavirus. The articles we have chosen reflect this mood swing. Some document the redeployment and experiences of individuals in the acute phase. ‘An orthopaedic surgeon’s diary at the Nightingale Critical Care Unit’ page 18 will be read in the future in a way similar to how I heard my parents describe the Blitz. A personal story of ‘Coronavirus (COVID-19): My experience of testing positive’ page 16 will hopefully soon seem like a relic of a bygone age. They are a record of what happened, a Pepys diary of 2020. There are more philosophical issues that arose. The article that promoted the most debate was that detailing SHiFT, a potential response to the anticipated collapse in resources which threatened. What would be the consequences of this on managing our normal urgencies, the exemplar for T&O being the hip fracture. It confronts triage of a condition with a risk of mortality, which for most of us has only ever been role play. We did it on our ATLS course but there was now the prospect of it happening for real. The Armageddon that was feared did not materialise but chronicling the planning exercise is of value. The acute loss of resource may now be replaced by a chronic one. With a morass of unpredictability awaiting; slower operating, fewer beds, PPE, staff testing, patient testing, consent, residual fear, the list could go on. This continues to generate noise in the unending health dilemma of whether we need central diktat or local solutions; one with its inflexibility the other risking a postcode lottery. A full retrospective can be had in a future bumper edition of JTO or a component of a Congress, but we have no idea when. Until then the TJTO&C will provide a forum. It is now customary to sign off with the invitation or encouragement to keep safe, the inference often being to hunker down to stay alive. I like the adage that “Life is movement and movement is life.” I don’t think that this was intended to apply only to the muscles used in breathing. In T&O our most common objective is restoration of function, this should now be the objective for both society and the individual. Phase one of COVID-19 could be summed up as “Be safe, don’t do anything” now we need “Do something but safely!” Those could just be hollow words but what better example could we have of the benefits of restoring function than Sir Tom. The raw statistics don’t look that good for a man in his late 90s with a hip fracture, but a broad smile and £33 million for the NHS is quite a result. We salute you Sir! n

Our cover image for this issue of JTO is a painting of Captain Sir Thomas Moore, who has captured the hearts of the nation during the COVID-19 pandemic and become Britain’s greatest

Story of the front cover

ever fundraiser. The painting by Elstreebased artist Mike Dawson was donated to Watford General Hospital.

Former British soldier Captain Tom, who reached the milestone of his 100th birthday on Thursday 30 April, took on the challenge of walking 100 laps of his 25-metre garden in Bedfordshire. His initial aim was to raise £1,000 for NHS Charities Together as a ‘thank you’ to the staff who had helped him recover from cancer and a broken hip. When his walk generated media interest, hundreds of thousands of people from all over the world began to contribute to his fund. By the time his fundraising campaign had closed he had raised in excess of £33 million!

In recognition of Captain Tom’s extraordinary fundraising efforts, his hundredth birthday was marked in a

number of ways, including flypasts by the Royal Air Force and the British Army. He received over 150,000 cards, and was appointed as honorary colonel of the Army Foundation College and his knighthood was announced on 19 May.

Mike Dawson, who specialises in ‘pop art’, painted Captain Tom wearing his blazer and medals, backed by the NHS rainbow. Mike said: “Like everyone else, I’ve been fascinated by Captain Tom’s story and I’ve been hugely impressed by his pluck, his humility and his charm. He’s been a breath of fresh air and he’s lifted the nation’s spirits. It’s an honour to paint him and I’m delighted that the wonderful staff at Watford General Hospital are happy to receive the end result.”

Images and videos of Mike’s paintings can be seen on Facebook.com/MikeDawsonArt or mike.dawson.art.

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