Making expert sense of the facts at hand

It was a stupid little accident on a Saturday afternoon. I fell over on a bike traveling about two miles an hour. But I landed oddly on my shoulder and knew something wasn’t right. My wife drove me to the ER and the verdict was a broken humerus. I was given a sling for my arm, pain meds, and instructions to see my primary care doc on Monday. On Monday, my regular doctor thought there might be more going on based on his reading of the X-ray and sent me off to an orthopedic surgeon. After more X-rays and an MRI the diagnosis grew more ominous. What I actually had was a “comminuted fracture of the right proximal humerus.” What I had done was to crack the top of my humerus like an egg. After several hours of surgery I ended up with multiple screws and a steel plate putting everything back where it belonged. A year’s worth of physical therapy got me back to about 90% of normal.

One of the things that struck me during this process was the interplay between information and expertise. Pain and the inability to move my arm more than a few inches told me pretty clearly that something was wrong. The initial X-ray provided a bit more information but the expertise in the ER was only enough to pass me along to the next experts. More imaging technology combined with more specialized expertise brought me into the operating room. Even then, I had to authorize several options before my orthopedic surgeon could start the surgery. He wouldn’t know until he opened me up whether he could repair the shoulder or would need to replace it. I was lucky, he was good, and a repair was sufficient.

Facts don’t speak for themselves. There’s always a storyteller picking, choosing, and interpreting the facts. Technology can often reveal new details and new facts. But they all depend on a storyteller to make sense of the facts at hand. And sometimes, the right expert has to go and observe directly.

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