05/09/07-06/09/07

Boston

Arrived in Boston after a slight delay for fog in Detroit. Taxi driver refused to accept that the Hotel we were going to was actually open but after some encouragement, took us anyway. Turns out the Liberty Hotel (formerly Suffolk County Jail) had only opened that day. Fantastic galleried entrance hall, barred windows Alibi Bar & restaurant called “Clink” but most importantly less than 20 yards from Massachussets General Hospital where we met Henrik Malchau & had a tour of the Harris Biomechanical Lab.

This is the lab where highly cross-linked poly was developed & they are currently working on impregnation with Vit E to scavange free radicals & prevent ongoing oxidation & deterioration of mechanical properties. Also they are working on hyrogels (PVA) as potential a biomaterial for cartilage replacement, amongst other applications.

Visited the “Ether Dome” where Morton, a Boston dentist, gave the first general anaesthetic for removal of a neck lump by a Dr Warren in 1846. The amphitheatre-like building is still decorated & set out as in the C19th.

Next to theatre with Dr Andy Freiberg to see a mini modified lateral approach for a cementless THR (metal on x-linked poly of course) in a man of 6’8” weighing 260 pounds.

The following day was spent with Dr Joe McCarthy at Newton–Wellesley Hospital watching hip arthroscopy, a day that would have been good enough even without the fact that they were having a “clam bake” which turned out to mean that all hospital staff were given a traditional New England (free) lunch of clam chowder & lobster. Didn’t seem to notice two Limeys slipping into the queue (sorry, line). Certainly a distinct improvement on UK hospital canteen fare. Perhaps we could do the same with Cromer crab?

03/09/07-04/09/07

LondonOntario

Arrived London on the afternoon of 3^rd September after a connection in New York.

It’s Labor Day in the USA & Canada, a Bank Holiday to honour the workforce, celebrated by no-one doing any work. Wonder if we could transfer a similar concept to the UK & have a “Trauma Day” Bank Holiday where no-one hurts themselves & the Trauma Theatre has a day off?

London is about a 35minute flight from Toronto, a University Campus (University of Western Ontario) & we have arrived at the beginning of “Frosh” (Freshers’ week), so the bars are all heaving. Dinner at the wonderfully-ambigously named “Blue Ginger”. Fortunately Canadians are blissfully unaware of Cockney rhyming slang.

The unit at University Hospital was made famous by Cecil Rorabek & Bob Bourne. We are being hosted by Steve MacDonald & spend the 4^th in theatre with Steve, Doug Naudie (Ganz-style open debridement & MoM THR with Summit stem & Pinnacle cup via Hardinge approach) & Jim McCauley (Summit & Pinnacle THR with ceramic on x-linked poly bearing via Hardinge approach).

We were shown their very impressive research facility with wear-stimulators & RSA lab plus introduced to their IT guy who has developed a software program (ORTECH) for saving data in an orthopaedic surgeon-friendly manner. Fantastic tool for recalling data & setting up studies, eg, you can pull out all male patients with a BMI of 36 who had a cemented stem in their left hip etc, etc & see their Womac, Harris score etc in excel or graphic form. Makes preparing presentations & papers very easy. 2 full-time joint replacements nurses collect the data, entered by a full-time clerk.

Dinner at The London Club, an MCC style gentlemens’ club (which now does allow ladies, not that there were any seen) before an early night prior to a 5am rise for the trip to Boston via Detroit. Breakfast at the ubiquitous Tim Hortons (Ontario coffee shops founded by an Ice Hockey player who was afraid of flying, but died when he fell asleep at the wheel driving to a game in the US). Usual, “oh yeah, two British Doctors, empty your bags” at customs whilst the hoodies, multiply-pierced & tattooed waltz through. Fortunately no pointed  pulling on of latex gloves..yet.