November 30, 2000

David A. Labosky, M.D.
American Society for Surgery of the Hand
Correspondence Newsletter
629 North Nevada Avenue
Colorado Springs, CO   80903
Dear Dr. Labosky:
After having been in a profession for a considerable amount of time, it is a natural tendency to step back and take the long view.  In hand surgery, we spend what amounts to the first half of our careers becoming fully technically competent.  This technical acumen is at the heart of what we do, and without these skills we cannot help our patients heal.
Now, as one starting on the second half of my career, I find my thoughts about medicine and treating patients shifting increasingly from the technical to the human dimension.  In a time of considerable challenges and frustrations in the business and economics of medicine, I believe that it is in the human arena of our work where the deepest satisfactions occur.  And it is this interest in people, both as members of specific groups and as individuals, which keeps so many of us genuinely excited about rising early and heading off to work year after year.
As hand surgeons, our mission is to treat working people.  We see the entire cross section of the American work force.  I find a deep satisfaction in being an integral part of working America.  Few others get such an inside view of the nuts and bolts of our society, an ever fascinating study.
It can be very gratifying to help high-profile workers such as professional athletes or musicians for the symphony get better so that they can continue to share their exceptional gifts with others.  I find an equal satisfaction in helping those less exalted folks who also depend upon their hands for their livelihoods.  The recent immigrant factory worker who does not have adequate English skills, the sign-language interpreter for the deaf who develops carpal tunnel, the truck driver, road worker, firefighter, telephone- or cable-line installer, whose hands have become impaired—these are just a "handful" of the craftspeople and professionals we all see on a daily basis.  These people need their hands to work, make a living, and make the vital contributions that permit our society to function.
While there are many who are skeptical about work injuries—and I am not naïve about those few patients who do abuse the system for secondary gain—in my experience, most patients genuinely want to get better so that they can return to their jobs and get on with their lives.  Part of our role as hand surgeons is to assist in the entire therapeutic process.  This involves overseeing and working collegially with therapists during the rehabilitation process.  We must also interact with the Workers' Compensation and legal systems as our patients navigate those often complex and confusing roads during their recovery.  All of this involves the human dimension—it involves understanding people and their needs on a human level much more than it involves technical prowess.
After more than 20 years in hand surgery, I find myself smiling more at my patients, holding their hands more, asking them more about their kids and their hobbies.  I've come to feel that this is important, perhaps even crucial, in the healing process.  When patients feel their doctors genuinely care and see them as whole human beings and understand their place in society, it makes a difference and I believe really aids in their care and recovery.  It may seem odd that I stress the value of "bedside manner," but in our era of highly technical medicine and economic instability, the human, caring component is too often treated as secondary.
I express these thoughts not in an effort to preach, but rather to share my own evolution as a hand surgeon and what keeps me genuinely enthused and fascinated in our craft.  I feel fortunate to practice a profession that allows me to interact with and help the entire fabric of working Americans, and to be in an occupation that has inspired me to grow on human as well as technical levels.  If our primary purpose on this earth is to develop as human beings and in turn help others reach their potential, I cannot imagine a more rewarding discipline.

Yours sincerely,


Leonard Gordon, M.D.