The rise of academic orthopaedic surgery during the past 44 years

In accepting this invitation to write a prefatory chapter as a mini professional autobiography, it has become all too obvious that this has touched a few nerve endings that had healed many years ago. Contemplating personal experiences, thoughts, and philosophies and then writing them should have a purpose. During these past 44 years, I have had the good fortune to share in the breaking away of orthopaedics as a clinical practice, into an academic and scientific subject. Such a radical and difficult birth has been in the presence of many able and good fellow travellers and perhaps, therefore, may serve as a guide for the future by those who care to follow. The mixture of clinical practice with caring for people, teaching, and research has to be bound securely together by academic professors. This has presented the greatest challenge to me and certainly the greatest difficulty, because we have all faced criticism, not always constructive, from these three separate cultures. Even so, our responsibility has been to integrate science and medicine sensibly. Richards described universities as being places of high technology and remoteness from reality. In my experience having spent most of my professional life in British and American universities, the reality has always been too near and real.