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The dazzling advances in medicine made possible in recent decades by modern technology have tended in some circles to obscure the basic unspectacular role of clinical experience.
Harvey Cushing, MD, said that the operating room was his laboratory, and so must it be for every surgeon. But he would have welcomed today's yardsticks of human biology, and a nice balance must be kept between physical-chemical expertise on the one hand and accumulated clinical acumen on the other. The spectrum of surgical problems is broad. Some can be solved only in the laboratory, others primarily by decisions based on previous direct experience.
It is, for example, hard to see what a knowledge of electron microscopy or collagen chemistry could contribute to the ingenious and successful treatment of two shattered elbows described by Young elsewhere in this issue. Only intimate and extensive operating room experience with acute musculoskeletal trauma made it possible.
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