When a physician enters the exam room, it’s usually to fix things. He or she dries a child’s tears, calms parents’ fears, and makes things right. But what happens when the doctor is a patient – when an orthopaedic surgeon who spends his days fixing broken bones finds himself on the examination table with a fracture? This happened to one of Los Angeles Orthopaedic Hospital’s own – Mauricio Silva, M.D., Associate Medical Director, and Medical Director of the Urgent Care Center. After recently suffering a fractured kneecap, Dr. Silva saw the process of fixing orthopaedic trauma from the patient’s point of view. He shares with us the understanding and insights gained from what he calls the “challenging and educational experience” of being a healer temporarily in need of healing.
Dr. Silva measures range of motion in a patient recovering from an elbow fracture. The crutches are the doctor’s.
I see sprains, strains and many broken bones nearly every day of my life. That’s the nature of being a surgeon specializing in children’s orthopaedic issues, especially here at Los Angeles Orthopaedic Hospital (LAOH), where we treat many thousands of kids each year. But I had never personally suffered a fracture until this summer.
I was walking with a small group of people when I slipped and landed hard on my left knee. I didn’t suspect the extent of the injury, initially - I just knew I wanted to get up immediately, stop feeling embarrassed, and continue on to work. When I still felt pain after about 20 minutes had passed, however, I knew something was wrong. I went to the Urgent Care for an X-ray, and the film showed that I had fractured my patella.
My reaction was actually relief. I could see that it was only a minor fracture, that it wasn’t displaced. This type of injury is relatively common in kids, and I have treated it here at LAOH. I knew it would take about four weeks altogether to heal, and that I wouldn’t need to have surgery and take time off to recuperate.
Dr. Scaduto (Anthony A. Scaduto, M.D., Los Angeles Orthopaedic Hospital President and CEO, and Medical Director) served as the treating physician. He ordered a long cast – from hip to ankle - put on to immobilize the leg. In pink! As they always do, our cast techs did a very good job applying it.
Naturally, as this was my first fracture as a patient, this was also my first cast. The experience of wearing it was awful! Mobility was difficult; it was hard to get out of the car, to shower and to keep the cast dry. It was a challenge to conduct surgery. It’s not a matter of balance, since you sit for the operation; but you have to make a place for it amongst all the equipment. Happily, we managed, and I was able to work through it.
With the doctor wearing an immobilizer, it requires a bit more room than usual to record a patient's notes.
One upside to this experience is that I learned how compassionate people are to someone struggling with a physical impairment. People opened doors for me. At Santa Monica-UCLA Medical Center and Orthopaedic Hospital, which is a spacious building, the staff would bring me a wheelchair when I arrived, and take me to the clinic, the OR, wherever I needed to be to see my patients.
In the clinics, the families’ reactions have been interesting. Everyone seems surprised, at first, to see the doctor in a cast or on crutches. There’s maybe even a bit of skepticism in their eyes: “Are you going to be able to help me heal?” Then, the kids will ask what happened. We begin to talk, and discover we’re going through the same thing, and that makes it seem a little more ordinary or bearable for them.
For example, patients would complain to me about their wrist or arm cast, and then compare it to my hip-to-ankle cast, and decide theirs was so much better! For my part, I appreciate gaining this additional perspective on what my patients are going through. It is tough! And knowing that from direct experience will enable me to be more sympathetic.
Apart from that lasting awareness, which is valuable, this will soon be behind me. The cast is off now, and, just as my patients would, I’ll continue with my treatment until healing is complete.
You keep going. I try to communicate that to my patients – that just because they have a fracture, they can’t lie on the couch waiting until it’s healed. The kids understand. Once they’re through their episode, it’s done. They’re on to the next thing, and life continues. It will be the same for me. It’s just a fracture.