I have known of him for several years, and this past summer I was privileged to spend three days in the clinic that bears his name. I was worried that I wouldn't be able to meet "Papa Ponseti" (as he was known to the small group of his patients who were old enough to call him anything), as I had heard that he was no longer working. He had sustained a hip fracture a few months earlier, and at age 95, it was reasonable to assume that he would be staying close to home.
My first morning there, after about a half-hour of seeing patients with one of his younger colleagues, I came out into the hall, and there he was, a commanding presence, despite his slight build and the bit of stoop brought on by his 95 years, and a recent hip fracture. He was still coming to the clinic every day, although he no longer was directly treating patients. He watched the younger doctors, making occasional comments. Mostly he focused on the patients. The toddlers gravitated to him, standing at his knee, and exchanging stories and observations. They had no trouble understanding his weak voice and heavy Spanish accent.
I had a couple of brief conversations with him, and had my picture taken with him. Then on the second day, he left me a note, asking me to come by his office after his siesta in the afternoon. I hovered near his office, checking frequently to see if the "do not disturb sign" was still there. As soon as it was gone, I knocked. I spent the next hour and 15 minutes listening to his stories and answering his questions about myself, about PNG and about my work here. He gave me a treasure of gifts; teaching materials, practice models, and an autographed copy of his book.
Our conversation touched only briefly on spiritual things. He had felt deeply betrayed when the Catholic Church supported Franco in the Spanish Revolution. He served as a surgeon in the Loyalist Army, eventually evacuating 40 wounded soldiers by mule over the Pyrenees to France, where he continued to work for a time. His path led to Mexico, where he served as a country doctor for 2 years before seeking orthopedic training at the University of Iowa, where he stayed on as a member of the teaching faculty.
Through most of Dr. Ponseti's life, the medical world believed that the only treatment for clubfoot (also known as congenital talipes equinovarus, or just "talipes") was surgery. Dr. P noticed that most patients who had surgery for this problem ended up with stiff, painful, poorly-functioning feet. Through careful study of the biomechanics of the foot, he came to realize that gentle manipulation could correct the problem in nearly 100% of cases. Patients treated this way usually have pain-free, functional feet for the rest of their lives.
In 1948, when he was 34 years old, Dr. Ponseti had the insight that led to the development of his method of treatment. In 1963, when he was 49 years old, he published the definitive paper on the non-surgical treatment of talipes. He retired in 1984 at the age of 70, with very few people recognizing the value of his work. Only the orthopedic surgeons at the University of Iowa, and the ones that they had trained used his method. In 1986 he came out of retirement to work part-time, mostly treating clubfoot.
Then in the early 1990s when he was about 80, two key events changed his life. First, two younger colleagues published a long-term follow-up study of his patients, documenting conclusively the superiority of his method over surgery. Second, the internet happened, and parents seeking alternatives to surgery for their children started learning about The Ponseti Method, and started flocking to Iowa city, where their babies were lovingly and gently treated by this genius. Soon doctors started flocking after them to learn the method. Dr. P's younger colleagues have traveled the world, teaching it to thousands of doctors in dozens of countries.
From about 1994 until he sustained his hip fracture in January of 2009, Dr. Ponseti worked 3 mornings per week, treating children from all over the world in the clinic that is now called "The Ponseti Clubfood Clinic". He treated more patients in most weeks than he had treated per year early in his career.
My interest in the Ponseti Method grew out of necessity, seeing patients here in PNG who had talipes. I learned from books, and from the internet. A couple of years ago I contacted Dr. P by email to ask a couple of questions. I received a very quick and helpful response. Later he invited me to come to Iowa City, and spend time with him in the clinic. After his hip fracture, his work load was assumed by Dr. Jose Morcuende (also a Spaniard, incidentally), who graciously extended the same invitation to me.
I know that the details of Dr. Ponseti's life might not be interesting to everyone, but I just wanted to tell my friends about this great man who has had a great impact on my life and work. He epitomizes many of my cherished values; overcoming adversity, serving others. And, the fact that he did his greatest work in the last 10 years of his long life is a great encouragement to me.
The first picture is a stock photo from the University of Iowa obtained from the web, but it shows Dr. P very much as he was when I visited with him in his office, right down to the book case behind him, and the skeletal model in his hand.
The second is of me with Dr. P and Dr. Morcuende.
The third is one that I took of Dr. P and a little girl that he had treated some years earlier who was in for a recheck.
Do you remember Baby Priscilla? No? Well, that's because I only thought I wrote a blog post about her. Now that I look back, I don't see it. I intended to. I often have a story or two in reserve for that day that I find myself blogless.
I went over the facts of the case again with her parents. We don't know what the exact cause of her heart failure is. We may be able to find out next May, when they will do screening for the Australian heart surgery team that come annually to PNG. The problem could be something that will become less significant as she grows, and she could end up being essentially a normal kid. Or it could turn out to be a life-altering, life-shortening serious problem. For now, as long as the meds are working, we'll stick with them. They promised to come back faithfully. I prescribed a month's supply of meds, and sent them on their way.
There are two kids on A-Ward (pediatrics, my current ward assignment, along with Dr. Becky Wallace) who have had me a bit worried.
Tom was originally admitted sometime before I got back from furlough. He obviously has had an infection of some kind in his brain. Whether this is caused by a virus, a bacteria, or even TB is something that we can't prove. Virus and TB are prime suspects. He's getting TB medicines. There is nothing except supportive care and time for the viral infections.
Last week he started bearing weight on his legs, and then taking a few hesitant steps, mostly holding on to the side of the bed or to someone's hand. In the last few days he has taken a few steps at a time unsupported.
Tom has tuberculosis in his central nervous system. At least we think he does--we have no way to prove or disprove it. He was admitted several weeks ago (before we got back from furlough), was treated with TB meds, and got a lot better. He was transferred to the TB.
As he has gotten to know me, he has gotten a lot more comfortable with me, and interacts a lot more. He smiles and seems happy to see me when I come on rounds in the morning (unlike many who cry, hide or ever scream when they see me coming).
When someone experiences a birthday on Kudjip Station they are subjected to various celebratory indignities. They are often made to wear the Dooley's birthday-cake hat. But they are always made to listen to a medley of 5 songs. I don't know how the medley started. Maybe someone knew a song that got added to the super-traditional one. Eventually others contributed their favorites, and they were all sung in sequence. The fourth one in the group comes from us; it's what we sang to our kids every birthday since they were small. The last one was written by some of the MKs here in the past. It always catches newcomers off guard, because it ends without resolving to the tonic chord.
Those of you who heard our main deputation presentation during our recent home assignment may remember the story of Mr. Kol, the attorney who had laryngeal cancer. For those of you who don't remember, volunteer ENT surgeon Dr. Tom Staton operated on him in 2000, an operation that saved his life. Mr. Kol became a Christian when he was in the hospital at that time.
I met a unique family this morning. The lady in the first photo is the mother of the lady in the second photo as well as the baby on her own lap. The lady in the second photo is holding her daughter, the granddaughter of the lady in the first photo, and niece of the baby in the first photo, who is younger than she is. Confused?
The little girl in the second photo has craniosynostosis, a premature fusion of the sutures in her skull, which doesn't allow proper growth of the brain. As a result she is mentally retarded, and developmentally delayed. She doesn't babble, make eye contact, sit up or crawl.
Young people need to have fun. It's an important part of their development and emotional well-being. Well, old people need to have fun for the same reasons, but this story is about young ones. Left to their own devices, they will have fun somehow. The students at our Nazarene College of Nursing have fun visiting with each other, playing sports, and .... Well, those are the only things I know about. Oh. Occasionally some of them will do something that gets them into some degree of trouble.
Mike and Diane Chapman have been concerned that there aren't opportunities for wholesome fun for the students, so they organized a movie night a few weeks ago, and then a game night this past Saturday. Diane organized the games, Mike was in charge of pop corn. They invited Judy and me to come and just be involved. Judy made a cake, not realizing how many students would come, and how far the cake would have to go. She ultimately cut it into pieces that were about bite-sized, so most of the students got a taste.
Each student made and decorated a name tag for him or her self. Games included Musical Chairs (depicted in the photo), Rhythm, and an old "mind-reading" parlor game that I don't know the name of. The students really got involved, and had fun. Which was, of course, the object. And the older people had some too, which was a bonus.
I don't think I've really explained about the Tausi family. When we were first in PNG, Sam became good friends with Stanley Tausi. Soon the boys were eating or staying over at each other's houses. Before long, Stanley's family decided that Sam needed a PNG family, and they "adopted" him. From that point on, they and their extended families have treated him as a member of the family. Stanley's dad Simon is from the Kobon tribe, in the Middle Ramu area, high up in the mountains north of here. His mom Esther is from the Kuma tribe, the one adjacent to the hospital. Needless to say, they were all sad when Sam left.
Since we've been on furlough and have spent time with Sam, they were all anxious to hear news about him, and to see pictures. So last evening, Simon, Esther and the kids (Stanley, Lilly, Natina, Ishigel and Aku), and Esther's mother, Abmi all came for supper. After supper, Simon's brother Michael and his wife Martha, and their boys Nason and Randy (a sort of name sake of mine), and several other people came. We borrowed a projector, and I made up a slide show of pictures from our furlough, emphasizing a large proportion of pictures of Sam. A good time was had by all.
