Recording - 10-24-2024 11:14:44

00:02 This is Mark Swiontkowski coming from the 40th anniversary meeting of the orthopedic Trauma association in Montreal. And it's my honor and pleasure to be interviewing Tracy Watson from St. Louis, who has been around this organization for a long time. I think from the outset, pretty much. And as a past president of the organization. And what was the first meeting you went to? Can you.

00:29 The first meeting I went to was actually Toronto meeting, which.

00:38 95.

00:39 No, actually, I'm sorry, Seattle, 1991. Okay. All right. And you were actually the first time I presented.

00:49 Yeah.

00:49 You were the moderator of my session. I have to tell you, I never have forgotten it, because it was a, it was on a Saturday, and it was in the days when there was large discussion, there was small papers, small number of papers with a lot of discussion. There was mics everywhere. And it was the first time there was ever any papers on Ilzarov stuff. And you were the moderator. And I remember it like it was yesterday. I had a series of bone transport to ankle fusions for, for bad infected ankles or bad peel ons, what have you. Jim Gullet and John Herzenberg presented a small series of non union treatments. And then there was Doctor Paley, who.

01:33 Presented a lot of things and went over time, maybe.

01:38 Yes, yes. And I remember it because I had presented our complications and the issues that we had, and it didn't all go well. And Jim Goulet did the same thing. And then Doctor Paley didn't. He just had problems and obstacles, not.

01:54 Complications that annoyed him.

01:58 And to your credit, he went, and I anticipate, because Jim Goulet leans over and he goes, hang on tight, it's going to get really rough in about a few minutes. And he didn't disappoint, because you go, interesting. How come Doctor Watson and Doctor Goulet have complications and yet you don't? And so, and then the questions from the audience, Joe Schoster got up and said it was a tool of the devil. We just got beat to a pulp. But it was a great experience. I mean, I learned a lot. Like, gotta defend yourself as long as you can, and you get good data.

02:28 Then you're okay and present it on.

02:31 I remember like it was yesterday. Yeah, that's my first introduction to the OTA. It was a great meeting, though.

02:38 I think we all lament the days when we had a smaller groups and more in depth discussion.

02:43 Discussions were great.

02:44 Yeah, we've really lost that.

02:47 And then. Well, and it's just the way it is. There's fewer papers and minimal discussion. Yeah, I was at the sessions this morning, and there was. Most of the papers are presented by med students, which is fine.

02:59 Yeah.

03:00 And they ask questions, and they kind of look around back in the room, gets up, goes, well, I'm the primary author.

03:06 Yeah.

03:06 I mean, I understand. I understand to get more people involved, but it's different. I don't know if it's any better. It's just different.

03:12 It is different. Yeah. So, obviously, you had a lot of roles in the organization and must have done them well because you ended up being president in the organization. So what were the jobs you had that led up to that?

03:26 Sure. I was on the program committee, did my turn on the program committee, and then at the time, this would have been the late nineties, the number of fellow applicants were dropping off like this. You know, it was not a career choice, and the OTA really was trying to figure out how to maybe stem the tide or at least keep the profession alive. And so I was put on the fellowship and career choice committee, and that was a real challenge, actually. I enjoyed it because we set up these programs. Wherever we had residents, we'd have a resident. I give a big talk on the joys of being an orthopedic traumatologist at the same time. And you were heavily involved in this. The OTA was working to have basic tenants of what a trauma service should have. Hospital services, trauma, everything that people take for granted now didn't exist. So trying to talk people into becoming a traumatologist when it was still kind of the battle days of one guy and no Orlando, it was a challenge. But as everyone kind of coordinated their efforts, you did a lot, along with Roy Sanders, to get the, you know, what an orthopedic trauma service should have in terms of hospital, and became kind of disseminated. And I was working pretty hard to organize fellows because at one point, there was only six qualified applicants. I think it was 1999 and, of course, harborview and Tampa, and I. And shock trauma snatched them right up. It was total disorganization. And so trying to get everybody involved in a match was my task, and I did, but it was like gnashing of teeth and Roy Sanders and Chipper out. Everyone yelling at me, just hated my being for trying to change the mentality of how we go about a match. And we did it not overnight. We did it in slow baby steps. And now I think it's a very well oiled machine, but it didn't always used to be that way. And so that was the first test. Well, the second task I had, and then I was on the, I think, the fund development committee, and then once, somehow I get nominated for the presidency, which was awesome. It was one of the better experiences of my life because it was totally out of my comfort range.

05:47 You're not a meeting guy?

05:49 Not a meeting guy. No, not at all. At the same time, CMS had come to the OTA and said, you know, there's an on call crisis, not only in orthopedics, but everywhere else. And at the same time, the academy had come to us and said, we need a standard of professionalism for call.

06:07 Yeah.

06:08 So we all came up with one, and we presented it to the academy, and they go, nah, nah. It says that you have to take call. You do?

06:18 Yeah.

06:18 Okay. You do. So they didn't accept it. So we went back and we revised it, and all it said was, you don't necessarily have to take call, but if that's your group's responsibility, you have to have a transfer agreement. You have to have, you know, there's a way that you can be responsible. You don't have to necessarily take call, but let's not just have the patient show up and nobody takes care of it. You got to have a plan for your group, for your privileges, et cetera, et cetera. And that's all we said. The call thing nationwide got so bad that CMS had called the on call crisis, and they brought leaders from. It was really interesting. It was in Chicago, huge conference table. There was every society known to us, medicine there. And I was the OTA representative, along with Mike Bosse and Jeff Anglin, and the academy. They went in alphabetical order, the academy, and I forget who it was, but there was three folks from the academy, and this is in front of CMS and Medicare, Medicaid. The federal government's there. And they said, we're going to go around the room and just see what the problems are. And they went in alphabetical order, and the academy was first. And I don't remember who it was, but they said, well, you know, our organization is, you know, so many thousand orthopedic surgeons, we do a good job. But I have to say, young call crisis is because those guys say, we have to take call. And I can tell you that's just not the case. And they basically, in front of everyone, they called us out. It was a race. Our own academy called us out. So it was our fault. And it was a race to get. Who could get to the microphone first, me, Mike Bosse, or Jeff Anglen Mike Bosse learns about what I do.

08:01 Yeah. Well, that's a really great story. So you're still coming?

08:07 Yeah, well, you know, I do it, you know, I'm still involved. I present symposiums, and I have a few papers with residents and so forth. So I'm very, I like, and I like it because I get to see you guys.

08:18 Yeah.

08:18 Yeah. That's why. I mean, quite honestly, I can read a journal. I can see a paper, but I like to revisit and, you know, we all kind of reminisce and talk about things. Like I said, it's a very close knit, even though it's large. Yeah, it's very close knit with common experience that's shared. And so I like to see those folks once a year. It's very, for me, it's very enjoyable.

08:40 Yeah, I agree completely. And so it's always fun to catch up with colleagues that you've known for 30, 40 years. It's all good.

08:48 And, you know, quite honestly, most, most of the folks that started when I started, and I. You were one of the giants, obviously, of orthopedic trauma are still involved. You know, they're still there. I saw Jim Kellam just a few minutes ago, and, you know, he was like a God. All you guys were, you know, and now when I'm reaching towards the end of my career, I can't believe it was a blink of the eye that I was able to be influenced by so many giants of orthopedic trauma. It's a very cool organization to get involved in.

09:20 You certainly have had major contributions, and that's all good. So what, you, you've had a few locations in your career.

09:29 Yes. So. Yes.

09:30 And a lot of people have kind of would always associate you with Roy.

09:37 Absolutely. Yeah. Well, Roy. Roy was obviously my, when I first came out, I was, you know, I knew nothing, just green as green could be. And he basically hired me. I don't know why, but he did. And the guy was very astute, awesome surgeon, very research oriented, but he really knew how to manage people. Above everything else, he had awesome people skills. He could be pretty gruff at times, but five minutes later, he'd forget what he said. He was always your best friend. And so he really kind of molded me and mentored me. I'm sure he got me on the program, program committee because he was the chair of it and somehow weaseled me on at some point in time. I know that's how it happened. And he basically stood up for the patient, and we had occasion both in two locations in Detroit where he thought we were being wronged, and we certainly were, but he had the wherewithal to kind of stand up to the administration, but he always had a plan B. And on two separate occasions, I went to him with these administrator meetings and we, and he walked out saying, okay, well, I'm out of here. And he looked at me and said, hey, are you coming or what? Two times. And I'm like, okay, yeah. So then I just realized I had just quit. I just resigned. And the first time it happened, as we're walking down the hallway, I'm like, I can't even speak. I'm aplectic.

11:01 What just happened?

11:02 He goes, don't worry, I got a plan B. I'm like, thank God, because I got bills to. And then, and then when it happened the second time again in Detroit, he had already taken the chair at St. Louis University and was kind of keeping it under his hat. And same thing, he gets up, walks out and goes, hey, are you coming or what? I'm like, okay, yeah, yeah, I'm with you all the way. And he goes, I got a plan. We're going to St. Louis. I'm like, well, I wasn't from Detroit. He was. And he was going to move. So I'm like, yeah, whatever. Yeah. So we went to Detroit. So we followed him. Followed him. You know, you lead, I'll follow. He was, and that was the definition of a great leader because he brought six people with him.

11:42 Yeah.

11:43 You know, which was quite an accomplishment because he was such a dynamic individual. So, yeah, I pretty much learned from him. And his only mantra was he had two of them. He was never, never talked to a middle Mandev management person. Always go to the top. Don't deal with anybody. Go right to the top because they're just, their job is to delay, to delay. So just go right to the top. Number two, don't send any emails in the heat of the moment. Yeah. Which is very important.

12:11 Yes.

12:12 Keeps you out of trouble. And number three is the golden rule. Mo. Its golden rule. He who has the gold makes the rules. Three things to live by. And I've tried to emulate that. But, yeah, Roy Watson was awesome. Big influence to me.

12:26 Yeah, we all miss him a lot. Back in the days when we had those small discussions, he was always in the heat of the discussion.

12:34 He was very, he would voice his opinion very strongly and always with a insane, cogent argument. He always knew the data, knew the literature, and it was tough to argue.

12:47 With the guy, clear thinker that always would address the potential confounder before he started collecting data.

12:58 Yes.

13:00 He was brilliant. We miss him a lot. He had a lot of influence.

13:08 He was very good at mentoring younger surgeons. And actually a lot of people from other programs, when they were looking to be a chair, he would, he would call them up. They would call him. He helped a lot of people who are now in positions of leadership. He was very good. Yeah. Which I think is another, probably another trait of most of the folks at the OTA. The members are always, I mean, there are some egos, but by and large, it's pretty ego eagle less. I won't say ego less, but there's no real competition to help somebody. I don't really sense that. I mean, there probably is like, there is everywhere, but much less than, let's say, a spine group, total joint or sports magic doctor. I think we all leave our egos at the door because at three in the morning, everyone's created ego, right? More or less. That's another attribute that I really like about the membership.

14:01 Well, that's great, Tracy. Thank you for taking the time. And I'm sure that people listening to this that have never gotten a chance to meet you will have a small sense of your contributions and your life as a trauma surgeon and have a great rest of the meeting.

14:18 Thanks a lot, Mark. It was a pleasure. It was really good.