ASSH International Travelling Fellow 2019: Did My Pulse Beat?

Yes, it did with huge enthusiasm, enthrall, and contentment, which was not merely due to the confirmation letter, but something beyond these emotions. The large majority of surgeons, if not all, want to experience being an American Society for Surgery of the Hand (ASSH) international travelling fellow. My pulse did throb a bit more for this reason alone.

The Indian Society for Surgery of the Hand’s (ISSH) history will bear testimony to the fact that sending a fellow to the US for this purpose would lead generations to come to firmly believe that such training endeavors and productive sharing of knowledge in the field of hand and microsurgery between two powerful nations is an extremely useful exercise.

Every fellow would be assigned to travel in his or her preferred groups to various hospitals pre- and postannual ASSH meetings. I chose group eight with eagerness. Dr Francisco Mercier (Portugal) and I were supposed to travel along together with this group. I was a tad worried when my US VISA process became time consuming and approval could not be positively predicted. However, by virtue of the efforts of many well-wishers, I finally managed to sail through the tough times by obtaining the US VISA in a timely manner and eventually landed at the John F Kennedy Airport, with my heart beat matching the speed at which the aircraft took off.

This rapid pulse made me realize the enormity of the task at hand.

The first stop was Charlotte (North Carolina). Dr Glen Gaston met me few seconds short of 6 am at my hotel and we drove to the Ortho Carolina Hospital. The dictionary defines “courteous” as polite, respectful, well-mannered, chivalrous, genial, well-spoken, and decent; I could sense all of these qualities in Dr Glen Gaston. “Hand surgery and its Indian contribution” was to be the integral part of my 10-minute talk that day before we moved onto the operating room. What I learned out there, the technique of flexor carpi ulnaris motor branch transfer to triceps branch, in addition to the radial nerve palsy tendon transfer, will be etched in my mind for time immemorial. Deeply engaging and memorable moments emerged through the course of our time with him at the office of the Ortho Carolina Hospital. Steroid injections, Xiaflex and knock, knock!! kept buzzing in my ears and thoughts. What was possibly more fascinating was our trip to Hendriks Motorsports (HMS). Thanks to Glen for his efforts in aiding our entry into the HMS center and experiencing their fabulous workshop, car-making process, and pit training; also, his impressive Hendriks car and guitar museum were sights to behold. Rock and roll followed a sumptuous food party at Dr. Gaston’s residence in the evening.

The next stop was Massachusetts General Hospital (MGH), Boston. Tall and tender-hearted Dr. Chaitanya S Mudgal braved Boston’s heavy rains to welcome us at the hotel. This also proved to be a joyous encounter. The following day we met Dr Neal Chan at the Yawkey building, who accompanied us to the operating room 66. The building had innumerable operating rooms in the same building, making it one of the largest centers in the US. Distal radius fracture fixation with Miami hand plate and instrumentation and the technical tips were particularly high in utility; anticlaw surgery was advantageous too, as there was significant mutual learning involved.

The next day Dr. Chaitanya Mudgal went along with us to the Waltham building operating room. The proximal phalanx fracture fixation of the thumb was quite complex in nature; however, his immense knowledge and teaching skills helped us fall in line. His prowess has the effect of shaping the character, caliber, and future of fellows. I consider him to be the one of the best teachers in recent times. Dr. Lee’s art of wrist arthroscopy was awe inspiring as well.

Then, we went to Las Vegas for the ASSH Annual meeting 2019. I presented “role of 3D power high frequency doppler study in postoperative scaphoid nonunion” during the fellows’ meet and greet. It was unique in many ways: Meeting up with the vice president ASSH, council and educational committee members of ASSH, and sharing knowledge between various travelling fellows over the course of a satisfying meal. The technical issues were organized in a systematic fashion at the ASSH annual meeting, driving edification propulsions like instruction course lectures, hands-on cadaver workshops, solution providers programs, advances and best practices, pre- and postcourse didactic lectures, residents’ and fellows’ conferences, clinical consultation corners, surgical suites, hand-to-hand workshops, industry forum sessions, opening ceremony, presidential lectures, international guest lectures, symposia, clinical par sessions, e-posters, interactive case reviews, recreational Handapalooza meets, and local club meets, thereby making it the benchmark for any hand conference.

Las Vegas looks the way you'd imagine heaven must look at night. A little bit of this town goes a long way. Vegas is the answer no matter what the question. Las Vegas is a 24-hour city. It never stops.

My next stop was at Ohio, Columbus. Dr. Sonu Jain, Dr. Awan, Dr. Amy, and Dr. Kanu Goyal welcomed us at The Ohio State University Wexner Medical Centre. The city had many small towns, growing suburbs, and affordable destinations. It was a great experience with these hand surgeons both at their offices and operating rooms. My presentation about “Hand and Reconstructive microsurgery and its Indian perspectives” was well-received during the hand conference along with the other interactive case discussions.

My final destination was the Mayo Clinic, Rochester, MN. Steve L Moran, who was the chair of the International Traveling Fellows Committee, received us. This was not only a dream but also a cherished aspiration and that made me very awake and focused here. This dream became a reality, as I got to present “Things which really worked with me-The nerve” in front of the stalwarts and doyens of hand surgery: Allen Bishop, Peter Amadio, Steve Moran, Alex Shin, Marco Rizzo, Sanj Kakkar, Rhee, David, and other hand fellows.

“Learning is not attained by choice; it must be sought for with ardor and attended to with diligence.” Thank you all is the least I can say to you all who have made this learning happen.

The historic relationship forged between India and the US, from as early as the times of President Lincoln and Mahatma Gandhi, who shared the same ideals and values of inherited tradition, strengthened during the course of the ASSH travelling fellowship. Needless to say, this marks the history and chemistry between our two nations.

Mahatma Gandhi’s words of confidence for the young minds rings true, “find purpose; the means will follow.”[1] Gandhiji’s positivity foresight and humanness have impacted me like countless others around the world. This travelling fellowship has definitely instilled within me the values of forward planning, prudent care and precision along with the surgical skills and technical nuances, which are indispensable components of the sphere of hand surgery.

I believe that trust begets trust. For the great man had said, be the change that you wish to see in the world. I am certain that there will be a change for the better in me and in the field of hand and microsurgery. The academic and surgical technique dimensions of one’s thinking cannot be comprehended unless one is prepared to accept that different parts of the world and different treatment modalities, and their logical aspects of practice, are deeply enmeshed in the very fabric of innovations and advancements in the field of hand and microsurgery.

“The ASSH legacy shall remain alive among the annals of man.”

Finally, I conclude this letter with the question “did my pulse beat?–Yes, it did and still does with sweet memories.

Publication History

Article published online:
08 April 2020

• References

• 1 Quotefancy. Available at: https://quotefancy.com/quote/856082/Mahatma-Gandhi-Find-purpose-The-means-will-follow. Accessed December 24, 2019