What does your work involve?
I’m a consultant orthopaedic surgeon. I perform all forms of knee surgery, from keyhole surgery through to joint replacement, and I also do trauma surgery – all forms of surgery needed with broken bones or joints after accidents.
I do lists of surgery, and clinics, and I also spend time training and assessing junior surgeons, and teaching medical students.
The administration of the clinics and lists also takes up a lot of time – I have to read and write a lot of letters.
What do you do in a typical day?
On most days we’ll meet for an x-ray meeting, or discussion of cases at around 7.30 am, and then go on either to a clinic or an operating list. My list days go on all day, twice a week, and just half a day once a week.
On other days I’ll go to clinic where I and my team see patients referred in by their GPs or physiotherapists. One of these clinics is devoted to patients who’ve come through the accident department with knee injuries.
Two or three times a week I and the team of trainee doctors who work with me will go round the wards (I work in two hospitals) to see all the patients recovering after surgery. The days typically finish at about 6 pm unless I’m on call when the evening and overnight duties vary according to how many emergencies are coming in.
Why did you choose to do this work?
The work chose me! I went into medicine from school because of a lack of other ideas, and when I qualified I found that I enjoyed surgical duties more than others.
I got a few lucky breaks and ended up in good busy general surgery jobs, and then I looked at specialties with good variety and a high patient satisfaction rate. Orthopaedics and trauma fitted the bill!
What’s the best thing about this job?
Most of the operations work well in relief of suffering and disability. The patients are all ages, shapes and sizes, and the operations go from routine keyhole surgery right through to more risky long, challenging cases.
I like to train other surgeons and also to go away to meetings and other centres to be trained in new and better techniques by my colleagues around the country.
What’s the worst thing?
The NHS is a huge organisation and getting things done the way you’d like them done can be difficult and tedious. Standards can be inconsistent, and it’s important to make yourself and those around you perform to the best of their abilities, and not be complacent.
Operations can and do go wrong, and patients can be left unhappy and frustrated. This is always difficult, and I still lose sleep and worry over things that haven’t gone according to plan, because that means that someone remains disabled or in pain.
How has research informed the work you do?
Improvements in joint replacement, including the newer approaches to partial joint replacement, have arisen due to painstaking assessment in hundreds of centres, incremental changes in design and technique over the last 20 years, and by these centres reporting their experience and impressions.
The same process applied to the huge progression in techniques for ligament reconstruction and stabilisation of unstable joints (and not just the knee). It’s only now that we are looking seriously at the role of this type of surgery in preventing joint degeneration, and liaising with our scientist colleagues in investigating the effectiveness of these interventions by looking at the actual changes in the biochemistry of these vulnerable joints.
Chris Wilson is an orthopaedic surgeon at University Hospital Cardiff and Llandough Hospital in Cardiff.