In 1981 a rotator cuff repair was regarded as an impossible operation. When David Sonnabend presented a case at the weekly meeting at Royal North Shore, senior colleagues told him not to bother. It never works. Give them some steroids and send them on their way.

His patient was a little Italian stonemason whose entire cuff had come away, subscapularis, supraspinatus and infraspinatus. Without a repair the man's trade was finished and his family was in trouble. Sonnabend and his first registrar, Des Bokor, read up a transacromial approach that had been described in England, reattached the cuff slowly, and the man went back to work. Every year for the next twenty years, until he died, a dozen bottles of red wine arrived.

Years earlier, a young consultant at a small district hospital had been handed the patient nobody else would touch. The Health Minister's mother, a shattered shoulder, an operation he had never seen performed. He read what literature there was, then picked up the phone and called New York. Charles Neer, the father of shoulder surgery, talked him through it down the line while Sonnabend sat in his lounge room with three textbooks and a notepad. The next day he walked into theatre with diagrams stuck to the wall, terrified he would drop the prosthesis on the floor. The patient did remarkably well.

He never did a fellowship. The year in Toronto fell through when the Canadian funding dried up, so he built his own education instead, inviting himself into American operating theatres a week or two at a time. He did one of the first reverse shoulder replacements in Australia without ever having seen one performed. The second patient, private secretary to the Governor of New South Wales, did particularly badly, and he came close to giving the operation away.

With Des Bokor he took the constitution of the Knee Society, wrote shoulder wherever it said knee, and founded the Shoulder and Elbow Society of Australia. The two of them co chaired the Seventh International Congress of Shoulder Surgery in Sydney in 1998, six weeks after the conference organiser walked out with 500 delegates already booked. Ninety Japanese surgeons nobody knew were coming turned up on the first morning and asked for a program.

He designed the retractor that carries his name, and an oval glenoid reamer that could inset a component into bone years before inset glenoids were a thing. They patented it, sold it to a major implant company, and watched them put it on a shelf. We thought we were going to be multimillionaires, he says. We were babes in the woods.

Ask him what mattered most across all of it and it is not the papers. It is the more than fifty surgeons he trained. I did not have a wife in orthopaedics, he says, but the younger guys became a family.

Chapters

  • 00:00 The Italian stonemason
  • 01:39 Introduction
  • 02:13 The phone call to Charles Neer
  • 04:50 Biochemistry, and the plan to be a physician
  • 05:52 Harry Tyer and the traction ward
  • 06:47 Indonesia and real pathology
  • 08:06 The Toronto fellowship that fell through
  • 10:49 Three months with Charles Neer
  • 11:43 Neer, Patton and the theatre that would not close
  • 13:00 One of the first rotator cuff repairs in Australia
  • 15:10 One of Australia's first reverse shoulder replacements
  • 16:28 The second patient
  • 18:17 Jim Ellis: if in doubt, don't
  • 20:42 Why training surgeons mattered most
  • 22:26 Jeff Hughes, and founding the societies
  • 24:38 The 1998 congress in Sydney
  • 25:56 Personal guarantees
  • 27:33 Bill Walsh, the metal backed glenoid and the oval reamer
  • 32:27 Advice to his younger self
  • 33:40 There's no condition that surgery can't make worse
  • 35:25 Closing