David Brogan, MD, MSc, hand and wrist surgeon

Transcript: 

I was a medical student here many years ago and enjoyed that time and was always impressed and fascinated by WashU and Barnes-Jewish Hospital. I think we're fortunate to be surrounded by you know thousands of colleagues who are many of them world famous and the best in the field and it's a both a humbling and really awesome thing to be on faculty with them. So as a medical student I have great fond memories and I went away and did my training elsewhere and had always kind of hoped in my heart that I'd be able to come back. So I had a started my faculty position that another institution and then had the opportunity to come back to WashU and really jumped at the chance and have not regretted it since at all.

I treat everything with regards to the upper extremity. So, everything from basically the elbow and mid-arm, all the way down to the hand. So some of the common things that I see are fractures; people fall and break their wrist or break their fingers or their forearm and we treat those both operatively and nonoperatively not all the time does everybody need a surgery just because they break a bone. So when it's appropriate we'll use cast or splints as indicated, but also surgical treatment of putting plates and screws to fix bones.

I also treat things that are common such as arthritis in the upper extremity and the to treat that again nonoperatively with injections and splints, but when disorders of tendons when they have tendonitis, that often responds to injections and occasionally need surgery, and then also things such as nerve irritation. So the most common one of those is carpal tunnel syndrome which is everybody's heard about but people come in with numbness and tingling in their hands and fingers and there are a variety of ways that we can address that to hopefully give people improvement of their quality of life and and also allow them to hopefully sleep better and have some pain relief as well.

I think that you have to look at the patient as a whole and I try in general to really use surgery as a last resort. I think that surgery is a big undertaking for anybody and certainly not without risk in any surgery, but try and look at ways that we can make people at least improve them and certainly regardless of what their x-ray says or what their MRI shows.

I think what I've learned the most is at the end of the day you have to listen to the person and treat what their concerns are. Even if the x-ray looks terrible or even if the x-ray look s great if the patient's condition and what they feel doesn't match up to that, treating the x-ray or the imaging doesn't really help them in the long run and that if you can tailor your response and your treatment to what it is that bothers the person, then ultimately they're going to be more satisfied and and that's going to be a more successful outcome. I think the the ability and the privilege to take care of people and and hopefully do so in a manner that really helps them is a driving force that is really the reason that we all come to work in the morning.

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