the deep cavity. The heavy alloy, odd-shaped implant seemingly seats itself
into the crater, like a spaceship pod docking into a spaceport, with no less
science fiction conviction.
I secure the custom-milled implant to the scapula with multiple screws,
whose trajectory and length I determined weeks ago. What was previously
impossible now seems mundane. Carefully drilling through the metal
implant and blindly drilling into the compromised bone, I already know
the length of the screws. One by one, the screws are exactly the same
length that was predicted weeks ago when I was a cyber-surgeon. After
implanting all the screws, Stanley now hosts an implant that was planned
in Montreal, expertly milled by a team of skilled technicians in Indiana,
overnighted to my partner company representative Jodi, who ferried it to
me today. Engineering, commerce, bioresearch, computer imaging,
satellite and fiber optic communication, advanced manufacturing, airline
shipping, cooperative sales engagement, skillful surgery, and exceptional
anesthesia, nursing, and tech support have all fused together to care for
this man with a terrible problem that today seems like not that big of a
deal. Dr. Neer would be astonished, and duly proud.
Charlie Neer’s practice was similar to that of all orthopedic surgeons in
the 1950s, when very few specialized in a particular joint. There were
almost no specialty orthopedic clinics anywhere in the world, with the
exception of hand surgery practices in San Francisco, New York, Chicago,
and New York, under the guidance of the fathers of hand surgery, Sterling
Bunnell and William Littler, among others. Dr. Neer continued to be a
fracture doctor, even publishing a knee trauma paper in 1971, more than
twenty years after finishing his residency. But as the pace of medical
discovery quickened, surgeons like Charlie Neer trained their sights on
particular joints. Just like the emergence of orthopedics as a specialty
(separate from general surgery), the specialty domains of orthopedics were
conceived by fanatics who were more narrowly obsessed.
War has always been a dastardly effective originator of advances in
technology, transportation, communication, design, and medicine. With
the advances in metallurgy and antibiotics during the 1940s, the
orthopedic specialty was poised to launch into its most important era, but
the treatment of arthritis had received little direct benefit. Charlie Neer