Recording - 08-17-2023 21:50:41

00:02 Good evening, this is Mark Swiontkowski I am in Albuquerque, New Mexico, at the annual meeting of the 20th Century Orthopedic Association. And we are speaking with select members of the group who are remembering key people who worked very hard for this organization and loved it. And I'm speaking with my former partner, Herb Schwartz, who I worked with for three and a half years at Vanderbilt. And Herb has spent his whole career at Vanderbilt as a musculoskeletal oncologist and by the way, is an outstanding reviewer for the Journal of Bone and Joint Surgery. And Herb, as well as myself, were brought into the organization by Dr. Neil Green, who was a renowned pediatric orthopedist and was the executive leader of this organization for a five year period of time. We lost him not so long ago to lung cancer. And Neil has a very special and warm place in our hearts. So let me just start. Herb, when did you first meet Neil? Can you recall the details?

01:17 Yeah, I think I met him at the graduation party at his house, which was the chief resident's skit because interestingly, my first day when I become a practicing muscular scout, oncologist, faculty member at the Vanderbilt was in beginning July at that time and graduation party was in end of June.

01:52 This was 85.

01:53 No, it was in 87.

01:57 87.

01:57 87, yeah. And you, Mark Swiontkowski had a patient admitted under my name on the. Actually the children's floor, the 12, the 11th floor, 11 north. So she was an adolescent. Her. I could tell you her name. She still sends me notes. She had a distal femoral osteosarcoma and was in her first trimester of pregnancy, my first case.

02:25 Oh my.

02:26 Ever. And you admitted her under my name. So Neil was involved in that because it was, you know, under 18 and a very complicated case what to do with anesthesia, whether or not to give chemotherapy. The diagnosis was in question. It was a variant of an osteosarcoma. So I met Neil after. Through that. But the first time we actually met, Susan and I was. He held the annual chief resident skit at his house.

03:00 Right.

03:00 And it was a roast and the chief residence roasted the faculty and vice versa and a lot of memories. And actually this year I video. I got video clips of as many old skits and I actually have some with Neil and Mike Millick doing the Macarena and things like that. So the point of. So I met Neil, I didn't know of his presence in the pediatric orthopedic world. I didn't appreciate it. I was in my own little fiefdom and I was trying to figure out, you know, what to do next. But I knew him as a leader of the department and the residency director and the residency director and really the spiritual cultural foundation block of the program. And Dan Spangler was our chair. And Dan was excellent in his own way and administrative in organizing the resources for us to continue to grow, which he did. He moved us from town into gown and so on and so forth. Recruited you. But that's how I first met Neil. And he was a great partygoer and a fantastic dancer.

04:25 Yes.

04:25 And Leslie, his wife, was always tremendously warm and hospitable to Susan and I. So that was my first experiences with Neil. My professional exposure to Neil was not quite as warm because he was feared by the residents. They called him the King. And there was no question that he was the king. He took full call, was in the foxhole and, you know, did so many things in pediatric orthopedics like nailing adolescent femurs and even younger and before age 9 and did so many great things. But. So I was the tumor guy. I thought I'd do tumors. Well, I did all the adult tumors and everything sort of related, including a lot of trauma. But Neil wasn't ready to give up his children to an unknown at the time, and it took several years. I championed a lot of our faculty skits, which I think swayed him a little bit. And we talked a lot of cases because our offices were so close in those days. And he was the first one to introduce me to Google. I remember because he was kind of technologically advanced and I wasn't. And so we developed a great relationship and a great bond. And soon he felt confident enough in me to begin giving me first benign tumors and then finally the malignant ones.

06:14 And so you got the unicameral bone cysts first and the ABCs.

06:19 Yeah, because, you know, I couldn't screw them up. And I don't know if I told you this, I told somebody else just the other night we were talking about Neil, and I had a tough case that I went to ask his advice on. And it was eosinophilic granuloma, histiocytosis, vertebra plana in a, I don't know, 8 year old. And they had a. Literally a pancaked vertebrae. And. Well, Neil, what do you think? There's no room to biopsy that. It's all squished. What? I mean, it's going to look like fracture. It'll be. He said, just leave it alone. And he showed me this case that he had in those two by two slides that you stuck in a carousel. And he showed me the case, which I still use in my presentations for benign bone tumors of a particular case where it was vertebra plana. And then two years later it was 50% height was restored. And then four or five years later, and I have all the dates and all the old X rays, the vertebrae looked normal. The kid was approaching skeletal maturity. Totally healed. Never touched him. Yeah, a lot of lesson from his experience and I don't know, I. Tremendous memories of him. I don't know where you want to go after that.

07:44 Well, I just would be curious about the time when he approached you about becoming a member of the 20th Century Orthopedic Association.

07:54 Yeah, so I was chair at the time of our. Of our program. And I was prior, actually, I took over from Neil, the residency program director. So he gained enough confidence in me to gave. To get. To turn over. Really his baby, his prized possession.

08:16 Yeah, right.

08:17 What he. The legacy that he built for our program and the. And the residents that were so fond of him and all the alumni as well. And so I was the program director. And then I handed it off when I became chair. And then after a few years, I didn't know much about the 20th century. He approached me and asked and I said sure. So he was my sponsor. And he had just stepped down as the president of the association of 20th century. And I, not only I, but the key to the 20th century was something that Neil espoused and Leslie is the family relationships and how important that is not only in balancing your career, but in balancing your life, but in the experiences that we all learn and learn from. And it's been a great move. We welcomed it. We enjoyed meeting so many new people and continuing our friendship with others. And, you know, it kind of ended in a way when Neil died. He had familial lung cancer. No smokers. And several of his brothers died of similar disease. And we went to the funeral and we tried to, you know, be a member of Leslie's support group. They have a very close group of pediatric orthopedic surgeons that still meet and still take care of each other, including Leslie. And Leslie still comes the 20th century. We, in Neil's honor at Vanderbilt, we began. We're getting close.

10:10 No, no, no, we're good. We're good.

10:13 We wanted to create an endowed chair in Neil's honor. And many times these days it takes a lot of money to get an endowed chair. It's usually. It can be university specific, but it's usually a lot of money, and typically it comes from a single. A grateful patient or whatever. We didn't have a grateful patient at that time. And that was some of the politics unique to our university. I mean, Neil started the children's orthopedics program at Vanderbilt and really got little or no, I think he got less support than the trauma than the adult trauma did over the years. But we put out flyers and calls to our Vanderbilt orthopedic alumni, and that was the easiest chair I ever raised because there were so many donors. But there were several key donors who were really just Vanderbilt residents. They didn't necessarily go into pediatric orthopedics, but they were immediately philanthropic and charitable and giving their money in Neil's honor to support the chair. And it went to Neil's successor, Greg Mencio. And we had a, you know, a picture and we had the whole ceremonies in his honor. I got to meet Bruce. His son was always involved in orthopedics, and in many of our meetings, he had a charitable ride in Neil's honor, rode across the country, raised a little bit money and was on WhatsApp or something like that. And I don't know, they just had a wonderful family. And we still talk about Neil as if he was here tonight with the rest of us.

12:13 Yeah. So there will likely be people who are listening to this that have really no familiarity at all with the 20th Century Orthopedic Association. And my last question for you is, what do you find that's special about this meeting or valuable to you and your wife?

12:37 It's interesting that the only two meetings that my wife will attend, orthopedic meetings that my wife will attend with me were first, the Vanderbilt alumni meetings and 20th century. And the common denominator, I mean, AOS, maybe so on and so forth. The other meetings, specialty meetings, yada, yada, yada. No, she had other interests, responsibilities. She works. The common denominator between the Vanderbilt alums and 20th century, I think, is the importance of the family. Inviting family, encouraging family, having spouses involved as much as possible in the program, inviting them to guest lectures. The interaction between the entire family. And there are probably a select few other organizations that share that common denominator. But I think it's a unique way of bonding and a unique way to transfer information, because information and education, you know, you can learn as much facts and factoids as possible, but to be able to relate them to people, patients, students. We're all students, but, you know, even other colleagues is a skill that I think you can only learn in social situations, in person.

14:31 Social situations, not via zoom.

14:35 Correct. Yeah.

14:37 Well, thanks, Herb, for chatting with me about our dear departed friend and colleague, Neil Green, who thought so much of this organization and gave so much to it and led it for five years and really brought a lot of wonderful people into the organization. We miss him greatly and glad that Leslie's doing well and we'll continue to keep our eyes on her. So thanks very much. It's been a great pleasure.

15:04 Thank you, Mark and Goodwill for the memories of Neil and hope. They're a blessing for all of us.

15:11 Absolutely.