Recording - 10-03-2024 09:31:14

00:03 Hello, this is Mark Swiontkowski from the University of Minnesota, and I am honored to be speaking to my predecessor as chair of the department of orthopedic surgery, Doctor Roby Thompson, who I can't remember the years in which he was chair, but Doctor Thompson is a native of Virginia and a graduate of VMI and did his residency in orthopedics at Columbia Presbyterian, I believe. And what I'm interested in speaking with Doctor Thompson about is, first of all, a little bit maybe about how he got into orthopedic surgery, but then what was the pathway that brought him to Minnesota? So, Roby, let's just have you talk about the pathway into medicine, maybe starting with your experience at VMI and why you went into medicine and didn't stick with the military.

01:08 Well, that's pretty easy at VMI. When I went to school there in 1951, when I entered there, you had a limited choice of what your educational options were. And I chose a biology major because it had the most diverse coursework of any of the other majors. And so I ended up graduating from VMI after four years with a bachelor of arts in biology. And during that time, which that was a pre medden course, I ended up deciding to go on into medicine and applied to med school and was accepted that time. Med school was pretty easy to get into. When I went for my one and only interview, I interviewed the dean of the medical school, a guy named Doctor Thomas Hunter. He was the admissions committee. And I can remember vividly today walking into his office, and he had my file on his desk, and he looked up at me and he said, he said, you're a good looking young man. He said, I think you'll do fine in med school. We'll give you a spot. And that was my interview to get into med school. So I entered med school with in a class of 72 or something like that. And.

02:45 I'm sorry, which medical school?

02:46 University of Virginia.

02:48 Right. Okay.

02:49 And graduated in four years with probably 70 of the 72 graduated. And during that time frame, I became interested in primarily in surgery. And the chief of surgery was a very distinguished cardiac surgeon who trained at Johns Hopkins. And he was my advisor. And he told me, he said, you know, I think you can go for an internship wherever you want to go. And my first choice was the Peter Brigham hospital in Boston. And I went there for an interview. They had about 200 applicants for internship, and they had six slots.

03:45 Wow.

03:46 And we all sat in a big auditorium and they gave us a written exam at 08:00 in the morning and divided us up into groups, and we had interviews through the morning, came back at noon into the auditorium, and the proctor came in and he said, the following, are excused and read the names off. And people got up and walked out of the auditorium. That was it. And they did that again at 03:00 in the afternoon. It was down to twelve of us. It's 03:00 in the afternoon. And then we, the twelve of us that were left, interviewed the six department chairman at the Brigham, and I was invited to stay with the chief of urology at his home. He was a University of Virginia graduate and he knew I was from Virginia, so they arranged for me to stay at his home. He came up to my bedroom up on the third floor that night. He said, roby, he said, you had a really good interview today and you have great record, and if you want to come here, you've got a job. So I went home convinced that I was going to Boston for my internship, until I opened my match envelope two months later and found out I was going to Columbia Presbyterian Medical center, which I really had not paid much attention to. So I ended up going to New York and had a class of twelve surgical interns. There were twelve surgical interns and twelve medical interns. And that was one of the more exciting and challenging years of my life, being a surgical intern at Columbia Presbyterian. I had a group of very talented people with me. Of our twelve interns, ten of those became surgical department chairs.

05:58 Wow.

05:58 In one place or another, all the way from Hopkins to Stanford, and all of them very talented people. And then during that time frame, I became exposed to orthopedics, which I really had almost no exposure to as a medical student. And they had a terrific fracture service at Presbyterian hospital. It was run by a guy named Harrison McLaughlin, who published a book about in the late 1950s called Trauma. And it was a bible for everyone in my age group that was interested in fracture work. And that's what that exposure attracted me to, orthopedics. And so then I applied for orthopedic residency and had to go in the army and left and came back two years later.

07:01 Where were you stationed in the army?

07:03 I was stationed in Nuremberg, Germany. I had my first job there was commanding officer of the third Armored medical company, which was, I didn't see any patients except when I worked in the hospital, the station hospital, on emergency call at night. But I had a challenging experience running a military company in 120 bed field hospital for a year, and finally got transferred to the hospital where I could work as a physician. And there I was exposed to orthopedics again. And I worked with a young man who had just finished his training in orthopedics, where he trained with an icon of the time called Ernst Dana, who was known for his work in fractures and closed treatment of fractures at that time, and applied for orthopedic residency and got into the residency at the New York orthopedic hospital. And I had to go back for another year of general surgery, and then after that went straight into orthopedics for a three year residency. But I ended up having to stay for four years because the Vietnam War broke out and the chief resident got drafted. And my boss was doctor Frank Stenchfield, called me in the office and said, I want you to be the chief resident because we got to have somebody run this show. And the chief resident had just been drafted. So I ended up staying an extra year as the chief resident, which was a fantastic experience because we had probably twelve full time attending surgeons on the staff at Presbyterian at that time. And I ran the surgery schedule for everybody every day, which meant I could operate with anybody I wanted to and scrub on whatever cases I wanted to. And I spent a lot of time working with some of the icons of orthopedics at the time, Charlie Neera, Harrison McLaughlin, and Frank Stinchfield people like that. I scrubbed with them whenever I could and learned a lot of unique technology and as well as approach to patient care. And then I began looking for jobs around the country in orthopedics.

10:09 So you had decided you were an academic already?

10:16 Yeah, I think so. I really, I was exposed to, one of the people at Columbia that had a big influence on me was a guy named Andy Bassett, C Andrew L. Bassett. Andy was not a practicing orthopedist, although he was a very good surgeon, but he ran a full time research lab. And we had research lab. We had research lectures once a week by somebody in the department or in the school. And that appealed to me to being exposed to the, looking for the answers to what created the disease processes or the lack of healing in a fracture or whatever it was that we were dealing with. So I decided then to spend another year in the lab and go in the lab to learn some lab techniques before I went off to practice. So that was an important experience for me, that exposure to doctor Bassett.

11:33 So the first job, how did you pick that?

11:38 Well, it's interesting, going back to my childhood. One of the people that was active in academic orthopaedic at that time was a guy named Bill Hillman, who ran the orthopaedic program at Vanderbilt University. And Bill had grown up in a little town called Emory, Virginia, which is 6 miles from my hometown. And he came to New York as a visiting professor, and I met him there, and he kept in touch with me all the way through my residency and tried to recruit me to come to Vanderbilt. And I was about ready to move to Nashville when he told me. He said, you know, they just appointed a new chief at the University of Virginia. You might be interested in looking at that job as well. So I did and ended up going there to work with Warren Stamp, who was the new professor and chair of the department. And I had six plus years on the faculty at the University of Virginia, where I had a terrific experience in general orthopedics. And it was the emergence of joint replacement. I had the. That time you had to have a license to use bone cement, and that was the only way you could put in a joint was that was going to last Washington using polymethyl methacrylate. And I had the only license to use methacrylate in the state of Virginia for four years. So all the joints in Virginia were done by me for the first four years of that experience. So I accumulated some surgical experience and published some early work on joint replacements and began to be recruited for jobs as department head. At that time, I was still in my late thirties, and I looked at several jobs. And one of the junior residents in the program at New York was that I admired a lot was David Bradford, and he had moved to Minnesota and submitted my name as a candidate for the department head at Minnesota. Richard Varko, who was a very famous cardiac surgeon at that time, was chair of the search committee. And he called me and said he wanted us, me to come look. And so I did. And I was impressed with what the University of Minnesota offered in the way of opportunity, surgically and educationally. And that's how I ended up in Minneapolis.

14:44 Yeah, it was obviously a very front page headline cardiac surgery place at the time with so many innovations there. And was Wangenstein the person in charge of surgery then?

15:04 He was still here. And his son, who was a good friend of mine, he and I were residents together in New York, and then he was at Virginia with me, where he was on the faculty in general surgery. Son was named Steve Wangenstein, went on to become chief of surgery at the University of Arizona. But I lost my train of thought there.

15:31 Well, I was just wondering about the challenges when you had a surgery department that was so famous in one particular area, and you'd taken on the responsibility of another area of surgery that maybe didn't have the attention that the others had. And did that create any difficulties for you trying to build a department?

15:53 It really was more of an opportunity than difficulties, because the orthopaedic department at the University of Minnesota at the time I came, was world renowned as a department of initiatives in spine surgery. My predecessor, John Moe, was a very, very well known spine surgery surgeon, particularly in scoliosis, and that's what it was known for in the orthopedics. But in fact, the orthopedic community in the Twin Cities was very well developed, and they had some of the best trauma programs anywhere. We had two big trauma hospitals at Hennepin county and at St. Paul Ramsey, both of which were run by extremely talented people. People. And provided very unique educational experiences for resident training, plus children's orthopedics, with separate children's hospitals, both at the shrine and at Gillette Children's. It was a comprehensive opportunity to bring things together in a way that I thought could make a unique contribution in orthopedics. And it wasn't as easy as I thought it was going to be, but it was an opportunity that eventually turned out to be pretty well.

17:30 Well, it sure did. And you built up a wonderful department and a big basic science research program with Ted Ogama and a lot of work on injury to cartilage, other things. What would you say is the thing that you're most proud of in your time as chair? Was it eight? How many years was it, Roby, you were chair of the department? I'm asking you to do higher level math here.

18:10 Probably close to 25 years.

18:14 Okay.

18:15 74 to 90, maybe 96. 95.

18:20 96, yeah, right. Yeah, I came in 97. And Jim Ogilvy, who you recruited, a wonderful collaborator, previously private practice spine surgeon, great leader, wonderful surgeon, and great role model. But what would you say of all the things that you started the tumor service, which you built up, recruiting Dennis Clohisy and Ed Chang, and the multidisciplinary tumor service, and then the basic science work that you did and bringing in shoulder surgeons and Ed Craig, who on his own, became quite a famous shoulder surgeon, and the merger of the VA residency, which was separate from the university. I could go on, but I've asked you a very difficult question, and we'll end with that.

19:26 Well, I never really thought that the VA residency program was a separate program, even though it was titularly a separate program with Bud Premier as the department head at the VA. But he had. He was a very bright Man And he realized that the same reason that he was there was the reason I came was that the breadth of orthopedic exposure in the Twin cities to be brought together in a residency training program was unique. And to have the right people training in every hospital that we were associated with was a real opportunity that we need to take advantage of. And to compete for residency positions with two separate programs in the same small community didn't make much sense. So I think it was probably three years or so into my job as head of orthopedics at the university that Bud premier and I had a good working relationship, and I proposed to him. I said, Bud, I think we should merge our two programs and have one program, and you can, will continue to be chief of orthopedics at the VA, and you can have veto rights over anybody that you want to bring into the program, as you have had all wrong. But I think about one program and coordinate the two residency programs into one better program. And Bud agreed with me on that, and so we did that. And that was, I think, a good move for everyone. Both the students and the faculty couldn't agree more.

21:44 And it has built a program that we're all very, very proud of for the reasons you outline and, of course, so many other things you did to develop this department, creating sports medicine as a specialty and recruiting Liza Arendt etcetera, etcetera. And then, of course, after you left the chair, you went on to really establish the University of Minnesota physicians, which was a challenge in and of itself with 18 separate practice plans that you were able to merge into one and have been a great servant to the university and the medical school as well. So, Robie, thank you for letting me get this down for people that have never had the privilege of meeting you, and I appreciate your time and everything you've done for this department and for me personally.

22:33 So my pleasure, Mark, my pleasure.