History as a tool in orthopaedic education

Abstract

International Orthopaedics proposes to present an historical vignette with each journal. The idea is to offer one strategy for teaching orthopaedic surgery through various historical vignettes with original documents. Given a spectrum of different aims, historians, philosophers of science, orthopaedic researchers and orthopaedic surgeons can contribute to the use of history to enhance teaching orthopaedic science. Perhaps the most common use of history of medicine is to celebrate landmark discoveries and medical practitioners. On one level, this connects scientific knowledge—often viewed as objective and impersonal—to specific names, faces, times and places. Orthopaedic surgery thus gains a “human” dimension. When we laud a discovery in orthopaedic surgery, we indirectly convey on a deeper level a value in science itself and in novel ideas. For example, when we establish a relationship between M. Urist and bone morphogenetic protein (BMP), we thereby convey implicit standards for the introduction of growth factors in orthopaedic surgery. Such images can be adopted as goals, and an historical vignette on this scientist may potentially establish a “role model”, and history may thus help broadly recruit more participants into science. But historians may also be concerned that an exclusive emphasis on “heroes” and dramatic discoveries may be misleading. Sometimes the role models we construct—of Ambroise Pare or Dupuytren, as “genius” or “superhuman”—may be biased portraits, and one challenge, then, is to make scientists seem “human” in scale, perhaps demystifying their achievements and openly recognising their flaws. We often find it convenient, for example, to credit single individuals, though achievements are rarely due to one person alone. Further, emphasising conceptual achievements rather than innovations in instrumentation or technology—or theoreticians rather than technicians or manufacturers —conveys a strong bias about the value of intellect versus labor. Plainly, we need to be more sensitive to the sometimes hidden lessons implicit in our explicit uses of history. Discoveries may also be addressed in the context of conceptual development. That is, the history of the emergence of a concept or a family of concepts over many decades or even centuries, say, about plaster, external fixation, internal fixation, arthroplasties or genetics today, may Fig. 1 Marko Pecina (with the journal International Orthopaedics) and Philippe Hernigou during the 87th SOFCOT Congress in Paris 2012