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Faculty Five with David Gibson, MD

March 29, 2021
by Matt O'Rourke

What is your Orthopaedic subspecialty, and why did you choose that subspecialty?

I'm a hip and knee arthroplasty surgeon. I spent time with Kris Keggi who is a great mentor and a real character. The size of his personality and his approach to surgery was something I wanted to emulate. He made all of orthopaedics seem fun. The clinic was fun. The surgeries were fun, and also, the results were always very dramatic. Mrs. Jones comes in, and she can't walk. When Mrs. Jones leaves, she can walk again. It becomes this great transformation for the patient as well.

Kris was this great role model and showed me how to take this simple problem and transform it. When I was in training, we worked with technology that wasn't the most current, so we had to learn to be creative. It was a challenge and something I really appreciated.

What is the best part of your clinical practice?

It's all about the patients. Living in New Haven, you have this cross-section of Yale professors and regular folks. The best part of my practice is that when you take a look in the waiting room, you can't tell who's who. They're all here together, talking together, getting to know each other. It's this great mélange of individuals in that respect. I enjoy each one: I enjoy interacting with them, getting to know them, and solving their problems.

You get something back from everyone with these interactions. I am fortunate that I get to follow my patients longitudinally. You become good friends with some of them. You know them, their kids, their grandkids, and their stories, that sort of thing. It's almost what would be considered that old-timey doctoring.

The interaction goes on beyond the clinic too. I've been walking down an aisle in Stop & Shop, and suddenly, I'll either notice their familiar face or they'll see mine. You have this moment to yourself where you say, "I know that guy. He's got two hips of mine and one knee of mine,” or something like that. And you can watch them walk, and you can see how they're doing. And really, there's a lot you can tell with the experience of just watching somebody walk when they don't think they're being observed, or watching people walk in their everyday lives. It's really nice to see your work in action that way and how people can function again in a way they hadn't before.

What do you think makes Yale a unique place for patients to come to get treatment?

My personal story is that I'm a New Yorker. I thought I'd be a New Yorker forever, but then I came up to New Haven and saw the quality of medicine we're doing and the types of world-class thinkers we have here. I had this moment where I said to myself, "I've got to stay," because this is an incredible place to learn. This ties into the question you’re asking too.

Yale has a lot of innovators and risk-takers, and you become a part of this community. It's a congenial environment, and you don't want to leave that. I think that spirit of collaboration translates into excellent patient care. I was in with a patient in my clinic the other day, and she was suffering from a complex problem. I could just pick up my phone, shoot two other experts a text, and find out where we were in her treatment. It seems simple, but you build this great cross-collaborative process where everyone is working toward the same goal.

What’s advice you give to medical students interested in orthopaedics, and what do you tell residents?

The typical conversation I have with medical students is, "What do you want to do? What do you want to be when you grow up?" They reach a point where they have to decide their career path, and I always tell them my personal journey. It was one that, when I walked by the orthopedic room, it just looked like fun. You have to understand who you are, understand your needs, what your goals are, and figure out what is fun. You may want to be the most prestigious cardiac surgeon in the world, but if that's not fun to you, you're going to be miserable for 30 years. It’s worth taking that time to figure out where you think your best place will be.

For residents, they’re in a different setting. Approaching a career path is one thing, but approaching a problem is entirely different. Problems can be a simple thing: what is the problem, how are you going to approach it, what are the treatments? What is inside the box in terms of being literature-based, and what is outside the box in terms of how you apply that technology to a given individual? And that part is essential for residents to learn. It's vital for how you think about a patient and a problem. The mechanical part of surgery is to learn to feel, what the surgical procedure is designed to do, and what mechanically you're going to achieve with that feel.

When I think about teaching residents, I think about how to dissect through different planes. For example, I was making soup the other day, and I had a series of tomatoes. Some were riper than others. To successfully slice the tomato, you had to get the feel of the knife against the tissue, against the fruit, and how much pressure you had to put. If you put too much pressure on the overripe tomato, it would blow up. If you put too little pressure on the unripe tomato, you never get through. So you have to learn feel. Surgically-speaking, the challenges that I see, particularly with resident education in the earlier stages, is teaching that feel. That’s a mechanical part of surgery.

Part of it is like building something. You don't start building a building in architecture by putting together all these 2x4 boards at odd angles. So how do you do that? Some of it is intuitive. It's about finding a construction that makes sense. You might do 10 hip reconstructions, but everyone is slightly anatomically different. Residency is about finding that approach and feel to have an appreciation of what makes it all happen.

What do you enjoy doing when you’re not in the operating room or clinic?

Oh, I love music. I’m a huge music hound: I love to sing, play music, and go to live concerts. I loved singing so much that I took a cabaret class at the Yale School of Music. It was wonderful. I also love fishing and doing all those types of fun side hobbies, but I don’t have nearly enough time to do it. That’s what I’m looking forward to in retirement.

Submitted by Matt O'Rourke on March 29, 2021