John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

New year offers a time for reflection

As I recounted my blessings during this past holiday season, I acknowledged the gift of some great mentors, all who showed me the way to practice effective and ethical orthopedic surgery. The “godfather” of my formation – a mentor to my mentors, Ray A. Moyer, MD, and Joseph S. Torg, MD, was John W. Lachman, MD.

Dr. Lachman, affectionately called “Latch” by his contemporaries, was the former chair of the Department of Orthopedics at Temple University Hospital. He was uniquely gifted both in intellect and surgical skill. However, what distinguished Latch from others was his absolute and unwavering commitment to integrity, humility, service and education. He simply dedicated his life to two causes: his God and orthopedics. Although Dr. Lachman left this earth more than 6 years ago, his impeccable principles and devotion have inspired countless orthopedic surgeons.

Lessons learned

Of the many lessons I learned from Dr. Lachman, I will share just a few, in hopes of enriching your life.

Never let patients dictate care  – Dr. Lachman never wavered in his decisions on patient care. He always insisted on what he considered was best for the patient. There was no equivocation in the office. Patients never swayed him into operating sooner or prescribing superfluous narcotics. For Latch, “what was right was right.”

Above all, humility  – When Dr. Torg published The Lachman Test and named perhaps the singularly most quoted knee examination in orthopedics after his mentor, Dr. Lachman was infuriated. He shunned the limelight and all the fanfare of fame. He brought awareness to ACL laxity to his pupils merely as a means of enhancing patient care. There simply was no egoic mind needed to have one’s name in print or quoted often. For Latch, it was all about education.

Personal responsibility – Dr. Lachman was relentless in reminding his residents to be accountable for their actions. Latch considered many complications to be the result of poor judgment, oversight or sloppiness – not merely an “occurrence.” For example, if a hip compression screw lost purchase, and if the resident would comment that “the screw cut out,” a sharp reproof from Dr. Lachman would follow along the lines of, “Now doctor, repeat after me. I inserted the screw incorrectly, which caused it to cut out.”

Keep it simple  –  Dr. Lachman’s residents became conservative by nature in time. They observed that Dr. Lachman eschewed “aggressive” approaches to problems and that the kinder, gentler approach to the orthopedic issue usually worked well. Latch was a master at closed reduction of fractures and would only perform joint arthroplasty if numerous injections did not bring relief. Both he and his patients agreed that surgery was always the last resort.

Meticulous care  – Dr. Lachman was a master surgeon and did not tolerate mediocre performance. His pupils all strove for excellence and the surgical outcomes were superlative. Aftercare was dedicated to details. Traction was implemented meticulously and bedsores or heel ulcers were not an option. All care was cloaked with humanism and compassion.

Knowledge, skill and ethics

Truly Dr. Lachman was beloved by his patients. The world may never see another Dr. Lachman. His influence on the knowledge, skill and ethics of his pupils echoes endlessly.

I have been indelibly impressed by this master surgeon and saint. Latch, you were one of a kind. I am so grateful for the honor to be called one your pupils.