At sixteen, flat on his back in traction with a broken neck, Christian Gerber started collecting quotations. One was Einstein: try not to become a man of success. Try to become a man of value.

Fifty-eight years later he says that line still governs how he works, that finding out something does not work is not a success, but it is value.

Professor Christian Gerber is the most decorated shoulder surgeon alive: four Neer Awards, the Kappa Delta Award, twenty-two years as chairman of Balgrist in Zurich. Asked what drives him, his answer is flat. No particular talent. Just curiosity.

He was going to be a professional footballer, and captained Switzerland's national youth side. Then at sixteen he dove into shallow water and dislocated his cervical spine. Doctor after doctor said the same thing: do not touch it, he could end up tetraplegic. Twenty weeks passed in traction.

Then the family were told to see Professor Maurice Müller, because he was a magician. This was 1968. When Gerber's father raised the warnings, Müller looked the sixteen-year-old in the eye and said that if it were going to happen it would have happened in the accident, not in surgery. "You are not planned to become tetraplegic." The fear left him instantly. The first time he understood the power a physician holds. Müller charged a thousand Swiss francs and made a deal instead: the boy would give back to orthopaedics what orthopaedics had given him.

One question shows how differently he thinks. Roger Federer served a thousand times a day for two decades and never had shoulder pain. We say 40% of rotator cuffs are torn by 60, nobody asks why the other 60% are not.

In 1991 he described the subscapularis tear. The first sixteen cases were so strange he photographed every one. The American journal wrote back saying it was probably a Swiss disease and did not occur in the United States. The British journal published it. The lift-off test is now done in every shoulder clinic in the world and he hates that it carries his name.

And a line that sounds like arrogance until you hear the reasoning: he has never had a bad result in his life, and never a good one. His patients have.

Chapters

  • 00:00 Why doesn't Roger Federer have shoulder pain?
  • 00:28 We ask why 40% tear. Nobody asks why 60% don't.
  • 03:04 Welcome, the most decorated shoulder surgeon alive
  • 04:33 What drives him: curiosity, not talent
  • 04:51 Starting his orthopaedic career as an orthopaedic patient
  • 05:40 Realising much of what we "know" isn't true
  • 07:13 His research algorithm, step by step
  • 08:16 Why he never falls in love with a project
  • 08:39 "I have never had a bad result. My patients have."
  • 09:26 Collecting quotations from a hospital bed
  • 10:00 Einstein: be a man of value, not a man of success
  • 11:44 "Faith is a culture of belief. Science is a culture of doubt."
  • 12:54 If half of medical knowledge is wrong, what should we teach?
  • 16:22 Look for understanding, not knowledge
  • 16:46 Why he thinks critical bone loss is irrational
  • 18:45 "At 74 it's easier to be thought crazy than at 55"
  • 18:59 A Swiss village, a builder father, a football career
  • 19:20 Diving into shallow water
  • 20:48 Meeting Maurice Müller
  • 23:15 "You are not planned to become tetraplegic"
  • 25:29 The reason he ended up in orthopaedics at all
  • 28:55 Müller, Ganz and Rockwood
  • 29:24 What Müller taught him about planning
  • 31:11 Why Ganz was a genius
  • 33:14 What Rockwood taught him about patients
  • 34:04 Criticising Rockwood's implant, then meeting him in the lift
  • 35:21 Surrounding yourself with people better than you
  • 37:39 Rockwood's optimism, and the stiff shoulder
  • 39:39 1991: describing the subscapularis tear
  • 40:57 The patient who knew something was wrong
  • 43:09 Photographing all sixteen cases
  • 43:40 "Probably a Swiss disease"
  • 44:23 Why he dislikes the test carrying his name
  • 46:38 Four Neer Awards, and which mattered
  • 50:04 "Rotator cuff: from bedside to bench and back"
  • 51:07 Twenty-two years running Balgrist
  • 52:02 What it cost his family
  • 53:48 Dominic Meyer
  • 55:15 Motor neurone disease, and losing him at fifty
  • 56:02 Creating the Meyer Award
  • 59:28 The ResOrtho foundation
  • 61:33 Why research is what differentiates a hospital
  • 63:35 The posterior instability procedure he is teaching in Brisbane
  • 64:56 Why orthopaedic thinking starts too late
  • 68:14 Why a Bankart repair is intellectually strange
  • 71:00 Advice for a young doctor who wants to make progress
  • 73:46 Doing your best with the information you have
  • 74:54 Why the failures are the interesting ones
  • 77:49 What he'll do before he scrubs in tomorrow