Dr. Kenneth DeHaven

He hasn’t done a history and physical on Big Ben, but he would if asked. The distinguished Dr. Kenneth DeHaven, a pioneer in the field of arthroscopy, is also trained in the mysteries of clocks and runs his own repair business. More on that later.

Born in small town Ohio, Dr. DeHaven, now part time at the University of Rochester Medical Center, grew up during the Great Depression. “My mom taught English and my dad taught math and physics and was the principal of the local high school. The school closed and we had to move in order for my parents to find new work. Each of the three kids had to do their part as well, with the family mantra being that you absolutely must work hard. When I was nine we lost my older brother to leukemia. That tragedy left a strong imprint on our lives.”

With compassion as his compass, Ken DeHaven found his way to medicine.

In part because of my brother’s illness I decided to become a doctor early in my life—while in junior high school. The driving force was that I would be in a position to help people.

Although he attended Dartmouth, Ken DeHaven still needed a dictionary to look up a certain term. “I played football, basketball and ran track in high school…I also played football throughout college. I knew no matter what else happened that I was good at sports. I had academic problems initially because I had to take courses that I was not prepared for. When my advisor said I had to take calculus, I replied, ‘Is that math?’”

His new sport? “Catch up.” Dr. DeHaven: “I was unsure about being admitted to medical school and decided that plan B was to give the NFL a try, and to hope eventually go to medical school. I plowed through courses off season and got up to speed. Dartmouth Medical School was a two-year program and when it ended I headed to Northwestern in Chicago.”

Then he pulled out a broad brush. “I felt that surgeons were jerks, and thus steered myself in other directions. The only exposure I had to orthopedics was a brief elective rotation in my fourth year (and among my fellow rugby players who were headed for orthopedics). I left medical school considering either internal medicine or pediatrics.”

Finding mentors who were comfortable in the scrum—of rugby and orthopedics—would begin to shift Dr. DeHaven’s thinking. “I started an internship at Cleveland Clinic in 1965 and met Dr. John Bergfeld, also a rugby player. Another rugby fan was an orthopedic attending, Dr. McCollister Evarts. ‘Mac’ was a critical influence, and I started rethinking my direction after attending the anatomy classes he taught. Also important was Dr. Rupert Turnbull, a colorectal surgeon who was astoundingly talented. Puzzled that I had selected medicine, he said, ‘You have an aptitude for surgery that I only see once every 10 years.’ The result? Cleveland Clinic added me to the first year surgery resident group for the next year.”

“Then came a two-year stint in the Navy. I went to sea and served as the only doctor on a ship of 1, 000. Much of the year was spent in dry dock, but we had to maintain on board sick bay because sailors were working on the ship.”

Following this Dr. DeHaven got a taste of battlefield orthopedics. “I went to Camp Pendleton (during Vietnam) for a year of orthopedic work. That was an intense experience that cemented my desire to pursue orthopedics. When I returned to Cleveland Clinic as an orthopedic resident my compass was set. Shortly thereafter I became aware of the field of sports medicine, and was thrilled to see I could possibly combine my two loves, sports and orthopedics. I graduated in 1972.”

A big leader in small incisions would then change everything. “I headed to Toronto to pursue something that had peaked my interest—arthroscopy. There I saw that the esteemed Dr. Robert Jackson was having success, and was doing two or three minor things that we in Cleveland were not doing with arthroscopy. It was still tough, however. Dr. Jackson would move his head and try not to move his hand while I looked through the scope. And there were times when we couldn’t see anything.”

Standing astride sports medicine and arthroscopy, Dr. DeHaven wanted to have both feet firmly planted. “Along with Dr. Jackson, I was one of the first people to be engaged in both fields from the beginning. Part of my training was three months in Atlanta in 1970 with Dr. Fred Allman, the first orthopedist to dedicate his entire practice to sports medicine. By developing credentials in both fields I was able to show the established surgeons in sports medicine how much it could help them to use this new thing…the arthroscope.”

A self described “young pup” just out of residency, Dr. DeHaven had some nerve.

I told the senior surgeons that when they opened up the knee and didn’t find what they expected, that they had the experience to get the right answer on the spot. I said, ‘The arthroscope gives me the same opportunity to be correct about diagnoses even though I don’t have all of your experience.’ It was not an easy sell with the older surgeons.

In 1975 he took his boldness and talents to Rochester. “Several of us, including Mac Evarts, left for the University of Rochester. Dr. Evarts, the new Chair, laid the groundwork for me to become the doctor for school’s athletic teams…I would be a one-man band for the next 15 years.”

Lonely no more, in the late 1980s the new chair asked Dr. DeHaven to draft a proposal for growing the sports medicine program. “In 1989 we hired a second faculty member and continued to work closely with residents. Since 1989 things have changed dramatically and we now have six fellowship trained orthopedists, and four non-operative sports medicine specialists, including me.”

Meaning that Dr. DeHaven can be more selective about how he spends his time. “From 2004 to 2008 I was the Senior Associate Dean for Clinical Affairs and Director of the faculty practice group. I stopped operating in 2005. I was surprised to find that a major source of chronic stress was gone. I always felt that the OR days were less stressful than non-OR days, but there was dramatically less stress immediately—stopping surgery was the only thing that had changed. The stress was so suppressed that it ‘never saw the light of day.’”

Reflecting on a significant part of his life’s work, Dr. DeHaven says, “I have dedicated much of my time to learning how to repair menisci, as opposed to removing them. The old thinking was that even if you couldn’t find anything wrong, just remove the meniscus because there was probably a tear in the back that you couldn’t see. The red flag was that many people got arthritis after the removal.”

“In 1976 I had a case involving the best heavyweight in the Olympic wrestling trials. His lateral meniscus was torn into two separate pieces. The medial meniscus had a peripheral tear, but the medial ligament complex was normal. I could always remove the meniscus but this was my only chance to save it, so I sutured it back to the capsule. It worked so well that I began doing the procedure somewhat regularly. As I traveled around the world the next few years I never found anyone else doing it. While it is now an established treatment, it remains a hard sell, and I am disappointed that repairable menisci are still being removed. I think people are afraid of failure; they also know that they can’t do repairs as quickly as removals.”

Moving forward, says Dr. DeHaven, we will see more of a temporary structure that is used in permanent soft tissue healing…the scaffold. “The future is in tissue engineering. Permanent synthetic materials don’t last in the joints as menisci or ligaments, so what seems best is to put an absorbable scaffold into the defect of the natural tissue, or even to replace a missing ligament. This attracts cells that once in the scaffold, generate tissue that is similar to the original. After six months to a year, the scaffold is gone and you are left with the patient’s new tissue. We are on the first generation scaffolds…they are only bound to improve.”

Dr. DeHaven has a history of being a leader in both thought and action. Elected captain of every athletic team on which he ever played, he later was elected president of every society he joined. “I have had the pleasure and honor of guiding the activities of the Herodicus Society, the Arthroscopy Association of North America, the American Orthopedic Society for Sports Medicine, the International Society of the Knee (a parent of ISAKOS), and the American Academy of Orthopaedic Surgeons. These experiences have brought hours of learning and lifelong friendship.”

But his best friend is his wife of 41 years. “Jean is an artist, skilled in portraiture and figurative oil paintings. Our daughter Kathleen lives in Colorado, and has just stepped down from being a clinical trials administrator for a pharmaceutical firm. Golf, skiing, and travel are some of my hobbies, along with snowshoeing and ‘non-professional’ reading.”

Or, perhaps, clock manuals. “We had five old pendulum clocks in the family. When they stopped working we found a man who quickly got the clocks running. I peppered him with questions, and ended up spending a lot of time at his shop watching him take clocks apart (a four-year, part time apprenticeship). Then, after nine months of clock school, in June 2009 I launched ‘Ken’s Clocks’, a mechanical clock repair service.”

“Like patients, no two clocks are exactly alike. Also, there are similarities to orthopedics: you must take a history of the problem, followed by a diagnosis, cleaning, fixing the problem, and putting the clock back together. (A surgeon’s manual dexterity also comes in handy.) It is amazing that these clocks, some of which are over 200 years old, can run again and keep good time. I love the history involved, and enjoy seeing how much pleasure the owners derive from learning the background of their clocks.”

Dr. Ken DeHaven…still ticking.