In a Surgeon’s Hands

March 27, 2012

Every year, Dr. Joseph Sheppard, University of Arizona professor of orthopaedic surgery with expertise in the hand and upper extremity, travels abroad to perform much-needed surgeries. He went to Haiti to help shortly after the 2010 earthquake, and he has made multiple trips to Honduras. In each location, he not only offers the service of his hands as a surgeon to help the local people, but he also strives to involve the residents in the work to deepen their training.

All told, Sheppard is a man who pushes limits – in himself as well as in his students – to achieve the greatest results possible.

“The first year I I went to Honduras in 2005,” he remembers, “I had the opportunity to work with a first year Honduran plastic surgery resident at the Hospital Escuela in Tegucigalpa, the main teaching hospital.”

Dr. Claudia Coello was in her very first year of plastic surgery training at the time. Sheppard went on to work with her for three consecutive years.  She then came to Tucson for a series of one-month stints as a resident. While here, she honed her skills in microsurgery in the Department of Orthopaedic Surgery before returning to Honduras to practice in the capital city of Tegucigalpa.

In January 2012, during Sheppard’s annual trip to Honduras, he and Dr. Coello had been operating and seeing patients in a small community hospital 6 hours from Tegucicalpa.  On their last night there, Dr. Coello received a call that an 18-month old girl had suffered a machete injury, almost completely severing half of her left hand and four fingers.

“She (Coello) came to me and asked, ‘What should I do?’” Sheppard recalls. He didn’t hesitate: “I said to tell them that the best hand surgeons in Honduras are right here.”

At 6 am the next morning, there was a knock at his dorm room door and someone said, “Dr. Sheppard, the child is here. It’s time.”

The surgery took five hours, during which Sheppard and Coello repaired all the bones, all the tendons and all the nerves, as well as several blood vessels in the little girl’s hand. While she will most likely require more surgeries in the future, today, she is recovering well.

And the satisfaction Sheppard feels about the operation, as well as seeing the success of his student, is indescribable. Knowing that Dr. Coello will continue to be there helping patients for years to come makes it all worthwhile.

“That’s why it matters to me. Going down to Honduras for a week is one thing,” he says, “but teaching someone like Dr. Coello multiplies it and really makes a difference.”

Pushing Residents, Pushing Limits

Sheppard thinks of his practice in relatively simple terms: his job is to remove pain. But beneath that simple mission lie countless layers of complexity. Unlike orthopaedists who primarily focus on joints, as a hand surgeon, he deals with skin, nerves, tendons, blood vessels and bone.

“Patients don’t come in with a diagnosis or surgical procedure,” he says. “When you think about it, when you take a knife to someone’s pain, it requires the skill and insight to know where that pain is originating from.”

Sheppard considers it his responsibility to diagnose the problem, recommend the procedure, perform that procedure correctly, and ultimately manage post operative care for a successful outcome.

“That’s where residents derive the most benefit from their experience with me. It’s start-to-finish,” he says.

It’s that same drive to understand problems that have driven Sheppard to collaborate withDr. Mihra Taljanovic, professor of radiology and orthopaedic surgery and head of musculoskeletal imaging at the University of Arizona. Together, Sheppard and Taljanovic have collaborated to evolve the understanding of the anatomy of the wrist, augmenting the current understanding with their interpretation of the joint’s collateral ligaments. Through doing studies comparing anatomic dissection, MRI and ultrasound images, they are teaming up to breathe new life into the use of ultrasound as an inexpensive and accurate option for imaging the wrist.

From the Resident’s Perspective

“In all honesty, it’s a little bit intense, because he knows so much,” says fourth year resident Dr. Annie Francois. Like all of his fifteen residents, Francois feels the pressure of working with someone like Sheppard. “We quake in our shoes when we know he’s going to be at a presentation we’re giving or that he’s going to ask questions.”

But she also appreciates the huge opportunity she is benefitting from in being part of Sheppard’s practice.

“It’s been good working with him,” she says. “You learn a lot, one, because he teaches, and two, because you have to keep up.”

All told, Sheppard’s commitment to sculpting the world to be a better place shows through in everything he does, from innovating in his field, to shaping the professionals of tomorrow, to fashioning solutions to patient problems, to creating simple things of beauty.