The next session is going to be a little bit unique, but one that I'm really looking forward to. We're going to invite a couple of our prominent foot and ankle members to, in a sense, be honored over the next hour or so. The symposium is entitled Speaking from Experience, and Dr. Charlie Saltzman will be monitoring this special symposium. This is really, hopefully, a wonderful experience for everyone. I have the opportunity to think about two great people and what they've done for us and our patients and spend some time exploring how they think about patients. I'm going to ask Bruce St. Georgian to introduce Ted Hansen from Seattle. A lot of you guys know about him. Then we'll have Lushon introduce Don Baxter from Houston, Texas. Before you get 95 years combined experience to review your cases, because I know that when Ted Hansen retired, which he's done four times now that I know of, he retired on the day that was the 50th anniversary of his first day as an intern at Harborview. He had a complete cycle there and talked to Dr. Baxter. He told me he's been through 45 years of orthopedic meetings. So you've got 95 years with just two people there. Ted Hansen's got a lot of nicknames, including Ted. Sigvard is his actual name, but a lot of people, particularly East Coast Andy accolades, call him the white man, which is not a reference to his heritage, but a reference to the fact that Andy's children identified the senior mentor of the fellowship as a guy with a lot of white hair. So it's nothing politically incorrect. Trying to learn about Ted Hansen is not hard. If you Google search Sigvard T. Hansen, Jr., you'll come up with 14,000 hits in a little under a tenth of a second. That doesn't show the essence of the man, but actually there was this really, really great article in the Seattle Times Pacific Northwest magazine about six years ago called The Audacious Doc, where a writer called Carol Ostrom really, I think, did a fantastic job of capturing Dr. Hansen's essence. So who is he? He was raised with two younger siblings on a 300-acre farm in Spokane Valley. His parents were educators, coaches. He started fixing tractors when he was 10, according to his father, and he had some pretty simple rules in life. Self-reliance, analyze a problem, keep your eye on the goal, and make things work. And I can't tell you how many times in the last 31 years I've heard, just fix it, solve the problem, which was the opposite of his view of administration, by the way. So he started at Whitman College in 1953 in mechanical engineering. He was a fraternity president at Whitman. He was a football captain at Whitman. Whitman is one of those elite liberal arts colleges that sit in the middle of nowhere. This one's in Hayfields, and the average entering SATs and ACT scores are comparable to any elite university in the U.S., and the faculty-to-student ratio is about 1 to 10, or some magnificent number. So every professor knows every student. You come out of there with easy access to getting letters of reference and a really expanded view of the world. He switched out of mechanical engineering after taking a theoretical mathematics course. According to this quote, he couldn't see it, so he couldn't fix it. But comparative anatomy was real, something he could get his hands on. Went to UW Medical School in 57 to 61, and for all the Hanson Fellows out there, this is not make-believe. Dr. Hanson did an NIH research fellowship in the summers of 57 and 58. So he actually doesn't disdain research quite as much as he says he does. He went into the Navy as a general medical officer for 3 years. He was posted in Hawaii. How can you beat that? And he often recognizes those years in Hawaii as very formative as a general physician. He did his orthopedic residency in 65 to 69, and then a pediatric fellowship in Sheffield where he determined his interest in the foot. But look at these numbers. So he was resident from 65 to 69, but he was an instructor in the UW School of Medicine from 1968 to 61. So he got appointed to the faculty before he finished his residency. He was an assistant professor briefly for 3 years, then an associate for 3 years, then he was a professor, then he was a department chair. So all that was in the first 15 years of his training as a physician. The list of awards, I would have to take more than my 5 minutes to allot them, but he's had several distinguished alumni awards, lifetime achievement awards, the AO Innovation Prize, and the Mission and Caring Award from Harborview. The Mission and Caring Award isn't given to people for being famous or getting grants. It's for taking care of people. And Harborview is a county hospital where equally likely someone's going to come in the door and get shot off the private plane or they were found down drunk in Pioneer Square. And one thing I learned very early on with Dr. Hansen was he treated everyone equally. It didn't matter if they were found down in Pioneer Square. He would talk to the janitors the same way he talked to everybody else, and that's what that award was for. When he became full professor in 1977, these were the papers on his CV. Treatment of chronic osteomyelitis with closed suction irrigation. This was 20 years before the VAC. Closed intramedullary anemia femur. This changed the course of orthopedics. And the interesting thing about this last paper on the spine was his co-author was a guy named T.K. Taylor, who I've heard variously was a mentor, attending, and tormentor during his residency, and whom Dr. Hansen tormented in return, as I recall. His intolerance for bureaucracy is legendary. In 1989, when invited to apply for a dean position at the School of Medicine, he wrote a short letter to the committee saying, I consider my 5 years as chairman a prelude to hell, and I can only imagine that being dean would be like actually being there. He has some other famous quotes. Screws are like rental cars. They're overpriced, underpowered, and the person driving doesn't know where he's going. And regarding diabetic feet, if you can spell the patient before you can see him, you've probably lost the game. So who is Ted Hansen? Someone who doesn't like bureaucracy, someone who prefers doing things to writing peer-reviewed literature, someone who believes that the OR is the best laboratory, and someone with a perceived irrational exuberance for surgical intervention, which I'll mention in a minute. His trainees over the years have noted his golden hands and amazing 3D skills. Bob Winquist, a famous traumatologist in town, was quoted as saying, his jig is his brain. He famously does not use any guides when he makes his cuts. His skills just end up in the right place. When he asked Dr. Hansen how he learned all that stuff, he said he wasn't doing anything that was in the books, and I asked him early on, where do you get your information? He said, I don't ask anybody east of 9th Avenue. So you all know that you're on 7th Avenue, and two blocks up from here is 9th Avenue where Harborview lives, and so east of 9th Avenue is basically the entire United States. So he played a key role in intramedullary nailing in the U.S. Community docs were invited to bring their patients with femoral fractures to the UWMC for treatment while Dr. Hansen was still a resident. And Dr. Smith, who was the attending running that operation, left for private practice, and Dr. Hansen took over as the champion for that group. Patients were initially treated in femoral pelvic traction for one to three weeks, and Dr. T.K. Smith, who I mentioned earlier as his tormentor and mentor, sorry, Dr. Smith was the attending doing the nailing, and he was known as Captain Crunch because the C-arm imagery wasn't great, and sometimes you hit the nail a little bit too hard and it would end up at the tibia instead of the femur. And Dr. Taylor, who was the attending at Harborview, said he'd rather crawl over broken glass than have his femur fracture treated with an intramedullary nail. And he was frequently trying to put some barriers in front of Dr. Hansen's care as a resident that broke down over time. Curiously, from the departmental history, there was a 17-year-old patient who had a head injury, was comatose, but had a femur fracture and was flailing about in the bed. Dr. Hansen wanted to fix it. Dr. Taylor was resisting, and he finally gave in and said, fine, you can fix it, just don't tell me about it. So anesthesia and neurosurgery agreed, only because they didn't think the patient was going to survive. They nailed the femur, and then two days later the patient woke up, and the family thought the nail fixed everything. So Dr. Clausen, when he came to the initiation of the Sigmar T. Hansen Institute, said this to the group assembled there, although Dr. Hansen spent more time on probation than any other resident in the program's history, his skills earned him an instructor position even before he graduated. So he was constantly pushing the envelope, even as a resident, to the point where the chairman recognized his skill but said, put him on probation, he's not listening to his attendings. And then a year later, he put him on the faculty while he was still a resident. So he's surrounded by a whole bunch of important people, starting with Dahla, that is probably in the room here somewhere, Janet Grant, his long-term assistant, and all the fellows who have come through over the years that become part of the Sigmar T. Hansen, and not to mention Dr. Bernerske and myself, who are in our 32nd and 31st year of fellowship, and Dr. Bernerske, a well-known guy, and Andy Sands and Betsy, who have become adopted family for the Hansens. And briefly, this wall is how you train orthopedic fellows. They come to your house on the weekend and they help shore up your garden with big rocks, and they come down into your wine cellar and carry big rocks out there to put in this wall, and they build muscles and then they get to drink some of the best wine in Washington. This is Dr. Hansen when he was a young guy, and here he is, I can't really make it out, so here is Dr. Hansen looking every bit the football coach, not the orthopedic surgeon from his time as residency, standing right next to the chairman who put him on probation. So he doubts a lot, and he goes by instinct. He's got friends from all around the world supporting him, fellows over the years who've become loyal advocates, and I'm happy to introduce the famous Sigmar T. Hansen. Don't believe what the big guys tell you is what he tells everyone. Don't believe what the big guys tell you is what he tells everyone. Thank you.

symposium

Speaking from Experience

Ted Hansen

Don Baxter

foot and ankle members