Monday: “I shall study prehistoric life.”
Tuesday: “My future is in creating permanent fixtures from animal skin.”
Dr. Bernard Bach, The Claude N. Lambert, M.D., Helen S. Thomson Endowed Chair of Orthopaedics and Head of the Sports Medicine Division at Rush University Medical Center, had the mind of a scientist and the curiosity of an adventurer from an early age.
As a young boy I could be found wandering the woods around suburban Detroit, catching turtles, digging up cow skeletons, collecting bones and studying pond water under a microscope. My fascination with nature and science was unlimited. One day I would declare I was bound for paleontology…the next day my mind was set on taxidermy.
-Dr. Bach
Rather than scolding their son for coming home with bones and pond water, Dr. Bach’s parents encouraged this curiosity in all four of their children. Dr. Bach: “My dad was the first person in my family to attend college; my mom obtained a masters in education. They exposed us to many different activities and ideas so that we could make solid, but exciting, plans for our future.”
Dr. Bach’s experience with illness in the family also set the stage for his career choice. “My maternal grandmother had diabetes and went blind when I was quite young, so I was there to witness all of the difficulties involved in her new life. In college my mother contracted breast cancer, something that furthered my interest in medicine.”
When not selling Amway or serving as class president, Bernard Bach was calling the shots on the field. Or he was being profiled as a scholar athlete by the local media. “I had the pleasure of being captain of all the sports teams in my high school and was actually recruited by Division 1 schools for baseball and football. In 1970, at the beginning of my senior year, I injured my knee and was cared for by a wonderful orthopedic surgeon by the name of Tom Peterson. I was impressed with his charisma and interest in my well being, things which only solidified my interest in medicine. He soon loaned me a book on the sports medicine treatment of injured athletes which I used to write a paper on knee ligament injuries for biology class. During this time I was profiled in the Detroit News. During the interview I let my intentions be known, namely, that I would become an orthopedic surgeon who specialized in knee problems.”
Although knee injuries slowed him down on the field, his academic career raced on. Entering Harvard College in 1967, Bernard Bach continued his study of biology and furthered his passion for sports medicine. “In my junior year I injured my other knee, a condition that was managed by the Harvard team surgeon, Thomas B. Quigley. ‘Quigs’ and I became close, and he sponsored my senior year thesis on Achilles tendon ruptures. Years later, upon retirement, he donated his entire library to me.”
Bernard Bach continued his top-flight education by enrolling at the University of Cincinnati College of Medicine in 1979. “UC offered a superior education with outstanding faculty. One of those was Dr. Frank Noyes, who was recently admitted to the American Orthopaedic Society for Sports Medicine Hall of Fame (AOSSM). My summer research on knee ligament injuries was conducted under his tutelage. During my senior year I committed to orthopedics and did a rotation at the Brigham and Women’s Hospital in Boston and an orthopedic rotation in San Francisco. Part of my time in Boston was spent on a one month rotation with Dr. Art Boland, the Harvard team doctor, and a man who I would come to call my ‘orthopedic father.’ Dr. Boland was one of those people that after meeting for 10 minutes you felt like he had known you your entire life; he definitely did not take the medical school class on arrogance despite becoming President and a member of the AOSSM Hall of Fame.”
Bernard Bach was impressed with Harvard and Harvard was impressed with Bernard Bach. “The Harvard orthopedic residency was overall a great training experience but, our residency training in sports medicine wasn’t very strong because it was the early days of the field and our Chairman didn’t acknowledge it as an orthopedic subspecialty. Fellowship training in sports medicine would be different, however, as I was invited by Dr. Russell Warren of the Hospital for Special Surgery (HSS) to consider their program.
What would follow would end up being one of the best years of Dr. Bach’s life. “Kismet was at work. Entering the HSS Sports Medicine Fellowship under the direction of Dr. Warren was a perfect life decision that just blew me away. Russ and I wrote papers together, and he helped rekindle an academic flame for me. He was a tremendous role model who examined things in a critical fashion, was a fountain of research ideas, and a ‘Teddy Roosevelt/ let’s charge up the hill’ type of leader.”
Recruited to Rush University Medical Center in 1986 as Director of Sports Medicine, Dr. Bach went on to develop a nationally recognized sports medicine program, as well as the Rush Orthopaedic Sports Medicine fellowship. “When I went to Rush there were no sports medicine faculty. One of our residents, Dr. Charles Bush-Joseph, had done a fellowship with Dr. Noyes, so in 1989 I brought him back to Rush. Dr. Tony Romeo, a shoulder and upper extremity specialist, was our third hire (1993). In 1997 Dr. Brian Cole, who had trained at HSS, came on board to develop our articular cartilage restoration program. Dr. Greg Nicholson, formerly of OrthoIndy, joined our team in 2001; Dr. Nikhil Verma, who trained at HSS, rounded out our group in 2004 on the knee, elbow, and shoulder fronts.”
In hiring these rising stars, Dr. Bach followed the leadership maxims, “Recruit individuals who will be as good, if not better, than yourself, ” and, “It is easier to lead leaders than followers.” Of his leadership approach and philosophy, Dr. Bach says, “You must put your ego aside and take pride in the successes of your associates. Forget about being ‘top dog.’”
“One of the things that we have focused on is developing particular expertise in certain areas. For example, after Dr. Romeo joined our group, I stopped performing total shoulder arthroplasties and directed them all to him. If patients have rotator cuff deficiency and arthritis and are candidates for reverse bone-socket arthroplasties, a very complex surgical procedure, I direct them to Dr. Nicholson. When Dr. Cole joined our group in 1997, both Dr. Bush-Joseph and I made a decision not to ‘compete’ by performing meniscal transplants. Instead, we decided to direct all of the complex articular cartilage resurfacing of the knee, as well as meniscal transplants, to Dr. Cole. This type of teamwork is very beneficial as it optimizes patient care, and, for the surgeon, it quickly develops significant expertise.”
To those young surgeons whose reverie centers around the sports spotlight, Dr. Bach advises, “Although many young attendings have aspirations to be pro team physicians or Division 1 team physicians, there is a significant responsibility and time commitment that is required of these positions. I spent many weekends covering sports events on Fridays, Saturday afternoons and Saturday evenings. If I had been a Division 1 team physician or professional team physician in the first few years in practice, it would have negatively impacted my research endeavors, the development of my clinical practice and potentially the direction of our sports medicine program. The research and publications that come out of our efforts touch many people’s lives—not only other residents and sports medicine fellows, but other orthopedic surgeons and the patients they care for. As such, our ‘sphere of influence’ is greatly expanded by education and research.”
Regarding his sports medicine fellowship, Dr. Bach notes, “We are now at the point of having five residents and four sports medicine fellows annually and have trained a total of 52 fellows since the program began. In establishing the fellowship, I studied some of the premier sports medicine programs in the U.S. and chose the ideal components. It was particularly important that we have a fellowship where trainees could not only be exposed to a high volume of surgical problems, but where they would learn the ins and outs of pre and postoperative care.”
A knee aficionado, Dr. Bach revels in the questions surrounding torsion and hyperextension. “My research, primarily clinical in nature, has largely been focused on the anterior cruciate ligament and knee ligament conditions. The most significant contribution that my team and I have made has been in the follow up of ACL surgical techniques, with most of our papers being ‘how to’ documents on surgical techniques, basic science studies on gait analysis of those with ACL injuries, and postoperative ACL follow up studies of several different patient study groups. This work required that we travel to 10 states to see these patients, most of whom are young and mobile. In our most recent study we demonstrated that a single incision or two incision technique using a patellar tendon graft, with either autograft or allograft, was a predictably successful operative procedure.”
Having been on “the podium” many times, Dr. Bach was sufficiently experienced to get involved in planning programs. “In 1995 I was selected by the incoming American Orthopaedic Society for Sports Medicine (AOSSM) president to serve on the program committee, an experience that led to my becoming Chair. The process involves blindly reviewing abstracts submitted by the membership, grading them, and putting together a program. One year we had 240 abstracts and had to select 40 papers to comprise the scientific component of the meeting…this year we had 320 abstracts. The most important element in planning a program for any society is balance. For example, with AOSSM, we want a mix of topics, such as ACL, knee, shoulder, nonoperative techniques, spine, elbow, etc.”
A devotee of the AOSSM, Dr. Bach was tapped to lead a vital new undertaking. “In 1991, I was asked by Doctors Arthur Boland and Royer Collins to head up the fundraising efforts for the AOSSM’s research arm. We eventually identified a man who had a particular interest in sports medicine and who provided us with a matching gift challenge. Using this initiative, those individuals who donated to the Orthopaedic Research and Education Foundation could allocate, after their first $500 gift, the remaining monies to the AOSSM, a donation which was subsequently matched by Mr. Herklotz. That year this effort generated over $500, 000 for the ‘Herklotz Challenge.’ The interest that has arisen from the principle has been used to help support research endeavors within our society.”
Dr. Bach, who in 2007-08 served as President of the AOSSM, has also been President of The Quigley and Herodicus Societies. “The Quigley Society is named after Thomas B. Quigley, a general surgeon who endeared himself to many athletes who frequented the training room at Harvard. Because of his impact, many Harvard athletes, particularly football players, went into medicine…particularly orthopedic surgery. In 1988, a group of Harvard orthopedic surgeons, all former varsity letter winners, met and developed the Thomas B. Quigley Sports Medicine Society. We now have more than 40 active members.”
Dr. Bach continues, “The Herodicus Society, which started about 1975 as a small society of sports medicine specialists, is now comprised of approximately 90 individuals worldwide. The membership is comprised of Division 1 and pro team physicians and individuals who are in academic sports medicine practices (and in private practice). One of the wonderful aspects of this organization, as well as the Quigley Society, is its relatively small size, something that allows great camaraderie and interesting discussions. Of note is that over the last 20 years all but one individual who became president of the AOSSM has had a membership within the Herodicus Society.”
As the field of sports medicine continues to unfold, says Dr. Bach, it will increasingly address the needs of those at both ends of the age spectrum. “Sports medicine is growing leaps and bounds, with the AOSSM membership going from 1, 200 to 2, 600 members in the last decade. One of the organization’s areas of focus this next year is overuse injuries in the young, growing recreational athletes. It seems, unfortunately, that children and adolescents are being forced to ‘specialize’ in a sport prematurely and then are practicing their craft year-round. Kids no longer have an opportunity to cross train by playing, for example, basketball, football and baseball. On the other end of the spectrum, with an active, aging population, I think that sports medicine will increasingly treat those in their senior years. Additionally, biologic advances will likely impact the healing of tissues and result in improvements in things such as rotator cuff repairs.”
As for Dr. Bach’s future, it will hopefully be a continuation of his wonderful past and present. Dr. Bach: “My wife, Elizabeth, and I, along with our two children, David and Laura, always had terrific summer vacations. For five years when the kids were between 7 and 12 years of age, we attended a ‘dude ranch’ in Big Sky, Montana, where the kids learned to horseback ride, dad had an opportunity to fly fish quality blue ribbon trout streams, and my wife had the opportunity to relax, hike, and horseback ride. So often we gravitate back to these days when we sit and reminisce around the dinner table.”
Dr. Bach, who strives for a well-balanced life (and avoids golfing), adds, “I think if one is happy on the home front and has diverse interests, that it has an important spin-off in happiness in the workplace. My numerous interests are part of this balance, including my lifelong hobby of collecting antique glass, including patent medicine and bitters bottles. I also find woodworking to be relaxing (note the obvious connection to my role in the operating room). In my retirement years I hope to transition to wildlife bronze sculpting, painting, and glassblowing.”
