For this episode, Gloryren especially invites the internationally renowned master and pioneer in Germany in Foot and Ankle Surgery, Dr. Olms, for a special interview.
Dr. Olms is currently the Senior Consultant of the Department for Orthopedic-, Trauma-, Hand- and Plastic Surgery at Diako Krankenhaus Flensburg. He founded the Foot Surgery Foundation in Germany in 1996, with only 5 members back then now developing into 2,000. He founded the training system for Foot and Ankle Surgery and has been carrying courses around the world. For the past three decades, he traveled around the world performing surgeries and giving lectures. He is keen on charity and has taken self-funded flights to developing regions to operate free surgeries for those in need. He has always been fond of taking a long way to meet interesting people in the world.
1. When did you first know you wanted to go into medicine? Why did you decide to pursue a career in medicine finally and why, in particular, did you decide to specialize in foot and ankle surgery?
Re: Well, um, it took me a while, as usual, to find my career path after I left school. I started my education at the University of Göttingen in the field of forestry at that time. As I had to earn some extra money for my life as a student, I worked at the ICU department of the Göttingen University Hospital. And well, of course, during the night shifts, you have some time to talk to the colleagues on duty. And they kind of created my interest in studying medicine. This was one point. The other point was that when we checked for job opportunities in forestry, we found out that these jobs are very limited. So there were only forty jobs per year in Germany in the field of forestry. But there were 400 students finishing every year. So I said this is not a good way to continue. So I finally stopped studying forestry and started medicine at the University of Göttingen. Well, in essence, I mean, this is kind of fun, is that I just changed using the saw from cutting trees to cutting bones. So it's more or less I stuck to the saw. But from the beginning, I knew that my future career had to include surgery. I was still working at the ICU at the University of Göttingen and I worked as an assistant in surgery and the Pathology Department. So this kind of made my way to surgery. And the specific move to foot and ankle surgery, I think we can cover that in the questions later on because I was just lucky to be at the right place at the right time.
2. Who have been your greatest influences? What have they taught you and how have they inspired you?
Re: Well, my greatest influences in the field of surgery were, of course, my teachers. And I had very different teachers. One of my teachers, my first teacher in trauma surgery, he told me that once you have blood on your fingers you have to leave the OR. Just use the instruments in a very delicate way. And he showed me how to reduce the fractures without sticking your hands and fingers, always in the surgical field. And I learned how to behave in the OR. When I saw some surgeons throwing instruments during the case, I learned that this was not the way to speed up the case and increase the attention of the scrub nurse. You have to behave in the OR and because you are a team member. And most important was my training in hand surgery. I learned to handle soft tissue very gently and experienced my knowledge in anatomy which is as important in hand surgery as in foot surgery. Furthermore, and even more influential were the outpatient clinics. Finalizing the indication for the surgery was something that was really important. And I have to make sure that I'm not following my personal desire to do surgery in every case. I had to consider the personality and other life circumstances of my patients. And I learned to send away patients. My feeling was that the chemistry between me and the patient wasn't ideal. Sometimes I knew in advance that the outcome of surgery would not be optimal so I sent the patient away. And we have to keep in mind that this is something that is very important for me, that we are not treating a disease or a pathology, but we are treating a patient. And that really influenced my surgical life quite a bit.
3. You founded the foundation of Foot Surgery with five members only, but now it has grown to one of the largest in Europe - the German Foot and Ankle Surgery Association with more than 2000 members nowadays, what is your motivation to found it? What's the biggest challenge to manage such an association?
Re: Yeah, this is a very interesting question because it really covers my whole surgical career. I have to start with a little hospital in my hometown in Bad Schwartau, which is close to the city of Lübeck. This hospital has 75 beds, so it's just one ward in a Chinese hospital. It's very, very small. This hospital was bought by a group of investors. They owned a hospital in Atlanta, Georgia in America. They asked me if I would like to do foot surgery. (At that time, foot surgery was almost, I wouldn't say unknown, but was very unpopular and underdeveloped in Germany.) So I said, of course, I like the challenge, let's go to the U.S. and learn about foot and ankle surgery. This is what I did in 1990.
So, I got my first exposure in foot and ankle surgery. After I returned home. I started my first case immediately. In the first year, I had 65 foot and ankle cases. Very few years later, I already had 300 foot and ankle cases. It was an extreme, rapid gaining of experience. And I invited American surgeons to visit me so I could participate in their experience and lower my learning curve. In 1994, I decided to offer the first practical course in foot and ankle surgery in Lübeck, which is about thirty minutes away from Bad Schwartau. At that time, we used saw bones. The courses were very successful, so I started organizing more courses. In 1996, I was more or less pushed to found the association of foot and ankle surgery by other colleagues, and we needed five people to sign the foundation paper.
At first, I didn't want to do that because I knew the responsibilities of a founding president. But fortunately, the courses and the annual meetings were supported financially by an American company. The company was called DARCO who manufactured the first shoes in China. So that was already the connection to China. And everything else had to be achieved by personal effort without making any money-I had to pay a lot of money out of my own pocket for travels and different meetings. When we had meetings in Lübeck, we had the final meeting of the group and of the faculty in our private home, just to lower the costs for the group. And I was actually driven by the fact that I wanted to really give the best way of training to other surgeons, to give patients the best treatment of their foot problems.
The biggest challenge to organize such a big group (and I had a lot of helping hands) was that we had another foot and ankle association in Germany, which was founded under the orthopaedic umbrella at the same time. My goal was to bring them together. because these two groups had the same goal, so why should we not have the same umbrella, the same organization, the same annual meetings? But there were a lot of political issues between the two groups, and when it comes to politics, everything becomes difficult. Until now, I did not manage to form one association in Germany. However, both groups are now under the umbrella of the EFAS, the European Foot and Ankle Association since 2022.
4. You are called "Mann der ersten Stunde"- the man of the first hour in foot surgery, what is your thought on this and how this title affects your whole career?
Re: Well, actually, when it comes to discussing this point, I must say I was just lucky to be at the right place at the right time. You know things that happened. The group that bought our hospital, they had this strong foot and ankle affiliation in the U.S. They opened the door for me. But on the other hand, there must be somebody who steps in. I was young, I was active, I love to see new challenges. And I said, okay, let's go on. If there's a new project, a new field of surgery, for me, I will just step in and start doing my work. To me, it was almost very important to serve the goal of establishing modern foot and ankle surgery in Germany. I knew from very traditional procedures in the hallux valgus surgery, which destroy the joint more or less. And now from the U.S. experience I learned that this is only necessary in very rare cases. There are many other techniques through which we can preserve the joint and give the patients a better life. My colleague in my hospital, the elder colleague, he did the hallux valgus surgery in this traditional method, and the patient had to stay in bed for three weeks until they could go out of the bed. Now, with the new procedures, they can leave the hospital the same day, which was an extraordinary and good development for the patient.
And you asked me about the title, how does it influence my career. The title is just a formalism for me. It never influenced my career. I lived with what I love to do and I actually didn't care about my title, because I never worked in a university hospital. I worked in a teaching hospital, but never in the university where the titles may be more important. However, our small community hospital with 75 beds served as a global teaching center for foot and ankle surgery. I had many many people from all over the world, actually from all over the world I must say, that wanted to visit me and participate in the development of modern foot and ankle surgery. It was far more than just foot and ankle surgery, it was an exchange of cultures, it was an exchange of views to life. The foot was for me, in the nucleus, or an extraordinary development of my life and my surgical career.
5. What is your proudest career achievement to date and why?
Re: Well, actually everything comes back to foot and ankle. I think the proudest achievement I had was this foundation of the foot and ankle association. Especially because we were creating a format for the education of young surgeons, and this format still exists. It was unique at the beginning, and education is one of the fields where I really want to focus my energy. I want to educate the rising stars. I want to educate the young surgeons and kind of transfer my enthusiasm14:00 to the young surgeons, so they can pick up and follow the path that I may be open for them as well. So, I think creating the education format and teaching the young surgeons successfully were probably the things I most proud of.
6. After you retired, you have been paying high attention to charity work. We also learn that you fly to many less developed countries and regions performing surgeries for the poor without honorarium, what contributes your passion of it?
Re: I started my contribution to charity work during my active work time, not only after my retirement. I had to do all this in my vacation. So, it was my vacation that I took to go to charity work, to go to different underdeveloped countries. Again, this has to be supported by your family. I mean, if you spend your family with your work, it's sometimes not the best idea. But due to my exposure to the U.S. colleagues, both orthopedic and podiatric. I heard about the group from Seattle called Healing the Children. The deal for the participation in that group was that every team member had to pay everything out of his own pocket, which means travel, accommodation, food, transportation, everything. The organization only sponsored one dinner with the hospital staff and our group. Our group usually consists of surgeons, anesthesiologists, scrub nurses, interpreters, photographers. It was quite a big group about fifteen to twenty people. During that time, I just met wonderful teachers who were experts in the treatment of club foot deformities in children, really tremendous teachers and wonderful persons. I went with this group to different countries in southeast Asia. On one of these trips, I took my son with me. Because I thought it was very important to expose your own kids to underdeveloped countries, to really appreciate what they have at home. This was something that I was able to show him, my son, that even very poor people can be content and happy. And what I learned is that they are extremely grateful. During these trips, again, we always had students or young surgeons with us to expose them to surgical procedures without these luxurious technical support that we have in the western world.
7. Do you have suggestions (to the directors in China) on how to train the young generation? What advice would you give to the youn