council award
We recently spoke to Dr. Bhandari about his life and work.
Where did you grow up? My parents moved to Hamilton from India in 1969 when I was nine months old. In India, Mum was a teacher and Dad was a textile engineer, but of course they weren’ t able to do those jobs in Canada, so they took whatever jobs they could to support their family. Mum and Dad worked very hard, and I never felt anything but their desire to support me wholeheartedly in making a life in Canada.
What influenced your decision to choose orthopedics? During an elective block in my first year of medical school, one of my teachers was Dr. Robin Richards, an orthopedic surgeon at St. Michael’ s Hospital. One day I was observing Dr. Richards doing fracture surgery. I was the only medical student in the room and it was quite intimidating being surrounded by senior residents and fellows. All of a sudden, Dr. Richards said,“ Mohit, where’ s Mohit? I’ d like him to come and take out this screw.” Next thing I knew I was removing a surgical pin. Now, for Dr. Richards, it was probably nothing, but to me it meant the world – so much so that I went home and made a commitment to pursue orthopedics. I wanted to be just like him.
What led you to a focus on research over surgery? During my orthopedic residency in the early 90s, people started to talk about a new concept called‘ evidence-based medicine’. I was intrigued and decided to complete the new Masters of Design, Measurement and Evaluation at McMaster University. It was there that I met Professor Gordon Guyatt who transformed my vision of what an academic researcher could be and, from that point on, I was hooked. Research for me was a bit of a self-fulfilling prophesy – the more I learned, the more I learned what I didn’ t know and the more I wanted to search for answers. And those answers can mean that instead of helping one patient at a time, you can be helping hundreds at a time, even though your personal impact on them is not direct.
What does‘ evidence-based’ medicine mean to you? In the past, surgeons worked hard, developed their skills and then could rightly see themselves as“ experts”. But in the last few decades, our profession has come to recognize that what really separates a“ great” surgeon from a“ good” surgeon or the“ exceptional” from the“ great,” is not skill alone, but good decisionmaking. And in order to make good decisions, doctors need the best evidence to better guide them.
Why is it important for orthopedic surgeons to know when their fracture patients are victims of intimate partner violence? Isn’ t it more important for emergency department physicians to identify? The fact is, the majority of domestic assault victims don’ t disclose the true cause of their injuries to ER physicians; and they usually only see that physician once. But in the course of repairing fractures, an orthopedic surgeon builds a relationship with the patient over a longer period of time, making them perfectly placed to help. Our research showed that one in ten women attending fracture clinics had a history of abuse and by the time the fracture has occurred they are dealing with serious, escalating violence.
You are leading a number of research trials in underdeveloped nations regarding road traffic accidents. Tell us about this. Broadly speaking, the majority of trauma cases occur in developing countries. In contrast, most of the gains made in orthopedic research have little impact in those countries because the research recommends treatments and utilizes resources not readily available in poorer countries. By lending a local focus to research, surgeons can more easily find ways to help patients by taking into account the available local resources.
What keeps you grounded and moving forward? Nothing has been gifted to me. I’ ve had to work hard and I’ ve had to fail a lot. I think I’ ve learned so much because I failed so much, and those failures continually push me forward. I also try to never lose sight of my parents’ good example. They worked hard to create a good life in Canada for me and my sister. I think that much of what I do is my way of honouring their sacrifices and giving back to the country that welcomed us. MD
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Dialogue Issue 4, 2016