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Orthopaedic Medicine

 (Whenever you desire, the  Photo Album links are available. You will need to scroll the approximately 15 photos to find the relevant one.)

If the substance of Orthopaedic Medicine is essential for effective care, then why is that fact not already generally known? And most importantly, integrated?

The question is reasonable, logical and asked many times, its essence confluent with my professional lifetime. From its sometimes turbulence, herein is my authoratative response best supplemented by Release From Pain. If you came here before reading at least the sampler of Release From Pain, then perhaps you should, especially Chapter Two to better understand the extent of my commitment that drives my need to express this. 'The more the white light, the heavier the darkness that seeks to extinguish it.' In this world, it seems a constant. What follows is a succinct and candid journal determined to preserve the true record. Hopefully, some will learn important lessons, and medicine will be better for it.

Above all, I wish to impart this: Anyone who enlists in a great task to necessarily change an order of things assumes commensurate, special responsibility for his behavior - and must struggle, if necessary, against the base motivations that crave to extract personal gain. So long as the energy of an organization flows out, to fulfill its worthy goal, that organization remains unadulterated. When the energy is reversed, drawn in, literally to suck - so that the organization is regarded as a personal adornment, a source for sense of power, and self aggrandizement, -then that organization has lost its vitality and its purpose.

~

When the specialties began, disciplines such as Internal Medicine and General Surgery, Neurology and Neurosurgery, developed conjointly with a healthy tension providing balance between their non-surgical and surgical perspectives. That didn't happen with Orthopedic Surgery. From the first, long, long ago, no specializing group competed with the dominant natural predisposition of orthopedic surgeons. With few exceptions, from the beginning, the surgical attitude dominated them, and the penalties of the skew were severe because roughly 80% of orthopedics is non-surgical yet it found no base in traditional medicine. Instead of performing a ‘systems review' to remedy the ovbvious flaw, medicine reacted to the schisms of osteopathy and chiropractic with reflexive antagonism and thus fed what became the Pain Pandemic. Physical Medicine & Rehabilitation, incidentally, is a very, very late comer. The issue is discussed fully in Release From Pain.

Finally, the only means to fill the vast void in traditionalism was through the forming of a new organization. The first eventually failed. Then another began. I was committed to both of them - the first as one of the founders, and as founder of the second, so I am intimately familiar with this history and its effect on the work to resolve what I have termed the Fundamental Flaw.

This history is important because it relates how personal failures of people can impair a needed movement for decades. In it is the visceral answer to the question that was initially asked. If you need the answer, it will not be found in abstract events but in the motivations and actions of people who were involved.

The first, organization,  The North American Academy of Manipulative Medicine (eventually Manual Medicine) had its organizational meeting at 11:00 P.M. on a winter night at the Waldorf Astoria, in New York, in 1966. Photo Album As I relate in Release From Pain, my commitment began in 1961 and through my ongoing relationship with John Mennell, I was invited to become one of the founding members. The stimulus for that meeting had come from a few of them having met with the Europeans at another meeting some months earlier.

There were less than ten of us, Americans and Canadians, all M.D.s. One of them, not in the photo, made a remark that never left my memory. With a small smile of self satisfaction, he stated that from now on we would be the medical authorities concerning manipulation, despite that only a few in that room had more than some basic skills. I sensed a blackness enter the room We were only in our infancy. Yet that spirit of deriving importance (power) from NAAMM was there at its inception, and it would grow and near the end stagnate everything it touched. From the beginning, there was adamancy that no osteopath, certainly no chiropractor, could join. From the perspective of 1966, the chiropractic decision was understandable, but refusal to osteopaths was another sign of the failure of perspective of some of the members, and everyone wanted to be congenial. Also, in 1966, Physical Therapy wasn't in the manipulative picture. That didn't happen till, at least, the seventies. Regardless, each year only further illuminated the original mind set.  From what was eventually perpetrated, the organization could not survive. The membership voted with their feet, and  NAAMM died in less than 20 years. None of us, of course, knew that in the beginning.

Good relationships developed, and Janet Travell and I were close for a time. Center in the photo. Photo Album  (You may wish to peruse the Photo Album and become familiar with it.)

Ken Boake and Charles Godrey, both Canadians, were always gentle stabilizers. Photo Album

I was the first treasurer, editor of the Newsletter from the beginning, and soon secretary for several years. I was gifted with incredible energy, something I denied for years until it became unavoidably obvious to me. For me, my work was an act of love. Mennell credited my efforts the reason for NAAMM's survival during its first critical years. The membership was growing, and, in 1969, I was elected to move through the chairs to assume the Presidency at the October 1972 meeting. One, at least, on the Board was not happy with that. They wanted me doing the work - so long as they could bask. And then I was "only" a GP.

Several in the NAAMM leadership had nurtured a close and relationship with Dr. Robert Maigne and his French colleagues . He had invited me to come to Paris and study during a 45 day period early in 1972 during the same time that I had subsequently been invited to enter the Physical Medicine & Rehabilitation (PM&R) residency at the University of Southern California under Dr. Betty Austin, who I knew from other circumstances. By then, I had been in general practice for 12 years. She resolved the time conflict by allowing me to go as part of my residency, “So you can teach us what you learned when you get back.”

I had heard of Dr. James Cyriax but never met him. I stopped in London for a few days, spent time with him and learned that a few weeks hence he would be conducting his annual week-long seminar for physicians who would come from around the world, a time that would fortuitously coincide with Maigne's program recessing for a national holiday. But seminar had been filled two years in advance, and his secretary told me my attending would be impossible. I didn't have to test her adamancy. Within a day, there was a single cancellation.

Among Cyriax's attendees, presumably all physicians, a number of physical therapists who “sneaked” in. Two of them, Dick Erhard and Sandy Burkhart, told me that Freddy Kaltenborn would be conducting a course in joint mobilization in London, Ontario, Canada that would convene three days before my time with Maigne would end. Photo Album

I didn't know Freddy, but it sounded important. I told Robert. I didn't then fully understand his obvious disapproval, but, in the end, in 45 days, I was able to train with the French, the British and the Scandinavians.

When I returned to the States, my first afternoon was in Ortho Rheumatology clinic. The orthopedic surgeon wanted to do a hemiacromiotomy on a 20 year old girl. There was no precedent or research for such a procedure. A year of physical therapy hadn't relieved her pain or improved her shoulder motion after she had incurred catastrophic shoulder destruction from late juvenile rheumatoid arthritis. (Her story is in Release From Pain.) Just three days of therapy using techniques Freddy had taught relieved much of her pain and provided her with 60 degrees more functional motion.

I told the NAAMM Board that for six years I had edited the Newsletter and that this trip had been such an extraordinary experience that I desired to write a full Newsletter dedicated to it. They readily agreed with the admonition that it be clear that all opinions I expressed were mine alone. The result was Goodley's Travels – A Voyage Among the Giants . Goodley's Travels Writing it was one of those epiphany events when it seemed that it wrote itself. I did it in one sitting, changed a few lines, and there it was.  What I hopefully anticipated happened. It drew congratulatory letters from all over, from as far as Finland and New Zealand, but what I obviously didn't anticipate was that for the same reasons it infuriated members of the Board, and others.



The Board met clandestinely. Though I was then the 1st Vice President, I wasn't informed. I coincidentally flew to Miami for the annual meeting in the company of the President, Carrie Chapman. Photo Album I was obviously excited, she morose, and I didn't want to take the hint.

At the hotel, Dr. John Bourdillon Photo Album shamefacedly invited me to the bar for a drink where he apologized for replacing me as incoming president. The ensuing Board meeting was vicious. Janet Travell accused me of unethical conduct for having published the list of physical therapists who had studied with Kaltenborn. Later, she was one of the speakers. Carrie quietly informed her when her time was up. Travell scornfully hovered close over her until Carrie cringed into her seat pale and shaking. Travell then continued through the next speaker's time. I left the meeting and NAAMM.

Eight years later, I received an invitation to attend its annual meeting. My hurt still within me, I construed it as an apology of sorts and responded with my dues. The meeting was at a small seaside resort, again in Florida. Maybe there were 30 attendees. NAAMM had been largely static throughout that time. Ken Boake had been president years before, and again. He asked me if I wanted to move through the chairs again, and I took it as another organizational apology. The president was a young woman, a GP from Michigan. She announced a short time later that regrettably I couldn't be elected to any office “however much they desired” because I wasn't yet a member. I told her my membership card was in my wallet. She had been lied to. She resigned from the organization a short time later.

I returned to the next meeting, in San Antonio. The President was another Canadian, a new face to me. He invited me to his room for a drink before the business meeting and remarked that my enthusiasm was incredible. But, Paul, he said, “You have to remember the derivation of the word – enthus – the god within. “gods get crucified, Paul.” And they did.

John Mennell and I had met again after the '72 meeting when I was at Stanford University participating in a regional physical therapy meeting with Freddy Kaltenborn and Goeffrey Maitland, from Australia. When I kept my distance, Mennel's eyes went wet. He told me he knew that he had betrayed me and promised he would never do it again. I believed it and gave him a hug. Now, we were in San Antonio. NAAMM had become captive to personalities who insisted it reflect any light on them and remain comfortable to their size. In the end, the results were vastly consequential. These were doctors who were self-driven to act despicably. A few of them eventually became prominent in their fields, and I hope they learned from their behavior. I know one of them did.

As an incidental, the business meeting was scheduled before I would present my paper (on thermography). As we had our drink together, the president ( "enthus")arranged with me how he would give me time to discuss the issues that concerned me. But after the slate of proposed officers was announced and he called for comments, as I began to stand, a large, dead-eyed woman who never once had ever said a word to me but who, in previous instances, had looked at me from a distance with smoldering hostility, shot up from her seat directly in front of him, rapid fired a move that nominations and discussion be closed, which was instantly followed by a second to the motion, instantly followed by the president's slamming of his gavel. Then, someone else questioned if I was even a member and should be at the business meeting, at all. The President Elect was suddenly screaming hysterically, repeatedly, "He can't be a member, he can't be!" 
The secretary,  Stephen Levin,  then harshly announced that the point was moot because I hadn't paid my dues. I assured him I had. I wrote out another check and put it on his desk with the suggestion that he credit it while he rereexamined his records. It wasn't there for more than a few seconds before he swiped it viciously with his hand, shouting as it floated to the floor, “I haven't got time!” I looked at him and then out to what had become a mute audience of about a hundred attendees. But they had witnessed. I paused as I passed Mennell. He wouldn't look at me.

As I walked out, I was approached by one of the members, a tall, thin individual with whom I was casually acquainted, who, once, at another meeting had looked down at me unsmiling and asked if I knew what my reputation was on “the circuit?' I had silently shrugged to which he responded almost angrily, “G-d help you if you have to follow him on the program.” The twist of it was so astonishing I never forgot it. Somehow, to be regarded as such an effective speaker should be a compliment. But now, a few years later, in San Antonio, he was looking at me half embarrassed, half ashamed. “Come back the next year. Nobody will be able to stop you.” Nobody wants to be seen as a coward. I had responded stiffly, “What makes you think that I would ever want to associate with people who do things like that?” He dropped his head and walked away. As the door opened to the tiny elevator, Travell was inside. She turned ashen and tried to disappear into the corner as I entered. After that, I never saw her again .

I presented my paper that afternoon. I gave a teaching they'd never forget and received a standing ovation for it. Some of the perpetrators were there, keeping on the sides of the room back against the walls, sullen, sallow, wet faced, complexions a tinge of green. As I looked at them, I thought what I've thought on a few other occasions: “Thank G-d, I'll never know what it is to feel like that.”

Outside on the veranda, removing my slides from the carousel and thrusting them haphazardly into the plastic sheet holder, one of the members, who had been at the Florida meeting nine years before, came to me plaintively. I immediately remembered how he had come to my breakfast table the day after I'd been brutalized there. He had laughingly told me that I was an “SD, but then every organization needs one.” I'd asked him what an SD was. He continued laughing as he replied, “shit disturber.” From the expression on my face, he knew to leave. Now, he was looking at me with helpless frustration. He apologized for his remark almost a decade earlier excusing that he had just joined and didn't understand. He couldn't comprehend the absolutely random disorder with which I was reinserting the slides. All I could utter was a near furious, “I'm angry.” He walked away. He resigned from NAAMM soon after - and it kept on happening. The membership that had sat numb had been disgusted with what they had had to witness. Within five years, somewhere near its 20 th , when it should have been safe and maybe influential, NAAMM was dead.

NAAMM lost its mission because of people who lusted for the appearance of power. As I left the hotel, I said quietly that it was time for a new organization

I had flown to San Antonio in my plane and landed in Phoenix to pick up Kent Pomeroy. We had met at other meetings. He was in my specialty and also involved with Prolotherapy. He seemed trustworthy.

I didn't want to return to the airport and fly out immediately. I needed to get the heat out. We walked and bought souvenir swords from an Indian shop. I told him I was starting another organization if he wanted in. In front of my plane we drew the swords and crossed them as someone took a picture. We talked as I flew, and he played with some words on his notepad. As the sun set on the vast Texas flatness, he looked up and said, The American Association of Orthopaedic Medicine. I nodded. All the AAOM Newsletters I wrote are in the Archives here, and there are many other documents available.

When I had returned from Florida to my residency after the 1972 NAAMM meeting, Betty Austin was no longer Chief. She had retired suddenly and been replaced by Rene Cailliet. I had had the chutzpa to go to Dean Franz Bauer to tell him that, of the candidates being considered for the position, the residents preferred Cailliet. I had known him, I thought, for about ten years. Highly popular, excellent speaker, seemingly always with a smile, apparently universally adored. I had been long impressed and convinced that he was one of the shining lights of PM&R. He was appointed. And what began as cognitive dissonance, belief in what is in total conflict with reality, became the pain filled experience of his real dimension.

In the clinic, I might have been working up a difficult case when Calliet would half enter the cubicle, shoot off such a rapid series of yes/no questions to the patient who would soon shrink back confused and intimidated, to which he responded to with a declaration of diagnosis accompanied by a rapid affirmative shaking of his head as he suddenly disappeared behind the curtain. He didn't examine. He was repeatedly wrong. Always superficial. Then, with one fateful malpresentation before the most important meeting of each medical school week, Medical Grand Rounds, in which everyone important to USC attends, which, this particular week, Dr. Charles Bethune, Chief of Medicine, had given Cailliet the opportunity to gain respect for himself and our department so we might be granted some beds, which the department had never had, he outrageously destroyed everything within the first half minute. It was a stupefying, shameful blunder of sheer ignorance. The residency didn't survive. I was there. Cailliet knew me for who I am: dedicated, honest, open and enthusiastic having nothing to hide. For that, he would become my lifetime hateful, jealous, nemesis. And he had power.

I was distraught when I had returned from the NAAM meeting. I told him it hadn't been a good. He blushed and said he knew. He was seated at his desk looking up at me. He blushed more and asked, “Do you know what you are?” I shrugged. He purpled. “You're a maverick!” I'd paused and then quietly asked, “What's wrong with being a maverick?” He looked back at me in startled near panic as he wide-eyed rasped, “Nothing! Nothing!” A few months later, in collusion with NAAMM, he fired me from the residency and tried thereafter to assure that I would never enter the specialty, and after that never get onto a hospital staff. The USC Residency was closed soon after. The last resident told me years later that he was told when he entered the department, that he could do much as he liked, but he must never mention the name, “Paul Goodley.” The rest is another story, but more than any other lesson I learned was the need to attempt to see beyond appearances – that it is so difficult to judge the real contents of anyone except by fire, and sometimes, by then, it's too late. But I tried.

I told Pomeroy that the secretary of an organization, particularly a new one, could, in many ways, be the most important, the most potent - and the most destructive officer. I reminded him of the mission - how important Orthopaedic Medicine is. I asked him if I could trust him. I will never forget his expression that I decided in his favor. He had looked down, not into my eyes, and slightly nodded. It wouldn't be long before I would taste the total incompatibility of our natures. He had said nothing. I realized what I had seen. I also needed dedicated people, and he had shown me that he certainly could be dedicated. And I didn't have much maneuvering room in my life. For a long time before, and thereafter, I was involved in near overwhelming challenges that, however, I never allowed to interfere with this mission. Unambiguously, I am a visionary, and, truly, I would have given my life for it to succeed, a quality that both attracts and threatens as the jealousies it can arouse when the expenditure of such immense energy succeeds. Such accomplishments can drive associates who also should have expended themselves in some degree, but didn't, to near insane actions to try to steal any or all undeserved credit.

And so I directed my energies into AAOM. Much of what transpired is in the Newsletters, especially “Our Crisis Of Rededication Shall We Begin Again?” my last, in 1986. AAOM ‘86

I immediately invited osteopaths to join, something NAAMM would never allow. There was a group of them involved in the Prolotherapy Association which was under the guardianship of an older doctor, Gus Hemwall, who had given unswerving loyalty to Pomeroy despite whatever he did. Jim Carlson was well known among them, friendly, an excellent clinician and a good teacher. In deference to osteopathy, I invited him to be the founding Vice President. I spoke to him in a similar manner to my discussion with Pomeroy and on many occasions thereafter that I expected work from him consistent with the commitment he had accepted. My Presidency would be for two years, and I needed him prepared.

The remainder of the Board was composed of both M.D.'s and D.O.'s. Among all of them, the one who always appeared the most steady and studious to me was Harold Walmer, an osteopath and Carlson's friend. As described in Release From Pain, my friendly association with osteopathy goes back decades.

Dr. Arielle Bar Sela was a joy but with us for only for a short, inexplicable time. Arielle, may he still be well and prospering, is a force of a man. I don't know why, but he had an aversion to osteopaths, and I told him that if he was on the Board he would have to contain himself until we could hopefully work out his problem. He had agreed.

Our organizational meeting was in Dallas, Texas on October 17, 1982. We sat down to a tentative silence around an ornate conference table, and it was Arielle who spoke. “I move that we form an organization called The American Association of Orthopaedic Medicine. All in favor say, Aye. I move that the founding President is Paul Goodley. All in favor say Aye.” He then said that we had an organization and a President and let's get started. Just like that, and we did, but it immediately wasn't that easy. In short order, Arielle exploded against osteopaths. I took him aside and tried to reason with him in earshot of Carlson and Walmer. At least, I thought I had further earned their respect and trust. Perhaps I did, but as time went on it made no difference. I drove Arielle to the airport. We said an affectionate goodbye. He got into his Mooney and flew off. I never saw him again. The time was soon coming when I would sorely need a few with his fundamental strength of character.

Dr. Max Negri, an orthopedic surgeon, and I had trained together when I was an intern and he a resident. He came from my “neck of the woods” and in our casual conversations he had repeatedly expressed admiration for what I was involved in. He was a member of the American Academy of Orthopaedic Surgeons, and he knew that his Board appointment had the specific purpose of his becoming our liaison with his specialty. He accepted. Despite all my efforts, he never wrote a single letter or made a single phone call.

AAOM immediately attracted members. It was extraordinary, about 400 physicians in only two years. Everyone on the Board had, of course, immediately accepted responsibilities, but they were rarely done, and, I eventually concluded that, realized or not, they couldn't long tolerate their accumulating guilt that only compounded by my doing the work and succeeding. Something eventually had to give, and they became increasingly bonded by their failures.

Pomeroy was productive - but on his own counter productive course. He wanted to design the brochure for the first meeting. I agreed but with the condition that nothing would be finalized until the Board had reviewed it and made its recommendations - as I had submitted my design of the logo and the letterhead. Pomeroy precipitously printed them regardless. Thousands that, to me, resembled the outside of a Cracker Jack box - for the inaugural meeting of an organization that allegedly aspired to be a major medical influence - February 15-19, 1984, in Scottsdale, Arizona. AAOMBROCHURE 1st MEETING 1,2,3,4 . He unilaterally appointed his office secretary as his “Executive Secretary,” and, of course, she had to have her own Newsletter and total independence.

The Prolotherapy Association disbanded and became part of AAOM. The written directive was that its funds were to be melded with AAOM's. Pomeroy never revealed the directive or relinquished the funds. The discovery occurred very late in the scheme of things, but by then the Board would have covered each other for virtually anything. The eventual correspondence that ensued as I tried to communicate rationally to them would make an excellent study in psychopathology. Still, AAOM grew. 

Finally, at a Board meeting in Kansas City, I related the difficulties I was having with Pomeroy. I was stunned when Negri indignantly responded that every member of the Board had the right to do whatever he wanted without reporting to anyone.

The time approaching the 1985 meeting was a special trial. Pomeroy's rebellion persisted. Once, in a moment of candor he confessed to me that whenever we were together he felt like a “little boy.” Maybe that explained some things. Again he wanted to do the meeting brochure. I was worried. The Board agreed “so long as he accepted the supervision that I, this time, demanded.” It made no difference. He again precipitously printed up thousands, black print on plain dark grey paper, all fonts and sizes exactly the same, the salad selections getting as much emphasis as the names of the guest speakers. Not one design or illustration. Over 10,000 had been sent out. I was in Kafka land and heartbroken.

I had been invited to teach in New Zealand and had only a week to design an entirely new brochure. Every night I arrived home late from my Institute, worked till about 0300, got a few hours sleep and finished it barely in time to leave it at the printers on the way to the airport with everything arranged for mailing. AAOM Annual Meeting 1985 The Board, by then, in full rebellion and agonizing “consultation” begrudgingly “allowed it” so long as etc., etc., etc.

A few weeks before the meeting, Negri baldly declared the issue, “ What you have accomplished in the first year of your Presidency is amazing. If we allow you to finish your term, we will never be able to match you. We're taking over now.” I had to respect him for that. All the underhanded ambiguities were almost over. It was an honest statement regardless that it been made by jackals.

Approximately $25,000 was left in the treasury after what Pomeroy had squandered. They transferred it to another account. I was without funds. They told me that if I tried to go to the membership they would prevent me. They tried. Of all of them, Walmer had led a group down to the parking garage and attempted to serve me with papers allegedly removing me from office. Then they surrounded me in the doorway to the meeting room before it began and tried to rip off my President's badge - like little kids trying to pull off someone's Levis tag - and prevent me from entering. In a meeting of physicians. The members who happened to be close by suddenly  “disappeared” into fixed interest in the overhead architecture. I couldn't fault them. What was happening was impossible.

I had done everything I could to avoid the confrontation. I had met with members in California . The results were also bizarre. They had become a gang bent on revenging their egos against me. There was a stream of phone calls around the country, the writing of circumlocutory notes both threatening while disavowing. Finally, I began preparing copies of the incriminating documents to present to the membership at the meeting. Shortly before, I had consulted with the Parliamentarian of the Arizona State Senate and retained him to sit in. That is how bad it was.

At the hotel, the night before the meeting, I had accepted that they wanted to salvage things, and I ceased my document packaging. I tried to negotiate with them one more time. They sent a spy to my room. He sat there wide eyed, heard a few things and raced out the door before returning again. The second time around, I saw his passage and disinvited him.

Before I met with them, I sought some members who I thought had integrity, to let them know what was happening and to seek support. I asked Jean Pierre Oulette, from Canada , who was the member of the Canadian contingent, who had the integrity I needed. He hesitated. I should have asked him. He, in retrospect, reluctantly offered Robert Kidd. I invited him to my room. As I explained the situation, he sat back resembling a Currier and Ives caricature of a stern, cynical schoolmaster that had hung in my childhood home. His only words were an acid, “You have a knack for getting into trouble, don't you?” I asked him to leave. Essam Awad was a professor of PM&R at the University of Michigan . I explained the situation to him and asked for his help. He stood there for a moment, and then his only response was a continuous nudging of my shoulder with his elbow and a repeated silly smiled urging, “Aw, c'mon...” Years later, I saw him across a large room looking at me. He didn't look so good. It was another time I said, “Thank G-d I will never know what it is like to feel like that” (As I write this now, for the first time ever I examined the AAOM website. Kidd and Awad are listed as former presidents.)

The last private meeting with the Board took place in one of their hotel rooms. The light came from one low watt lamp in the corner. All of them but Carlson and Schacter were huddling together, sitting up squeezed tightly, leaning back against the bed board, all of them sullen and silent. Carlson sat in a chair in the far corner by the lamp. Schacter stared at me, his only inexplicable comment, "I heard the story about NAAMM...twice!" The only constant sound in the room was Carlson's repeatedly spitting tobacco juice every few seconds into a glass he held close in front of his mouth. All that came out of the meeting was an ultimatum: Stand up. Praise the Board and resign or we will…. (which they attempted).

The auditorium was packed at the business meeting. Behind me sat the Arizona Senate Parliamentarian. I had only maybe twenty of the evidence packs prepared each numbering about thirty pages. There would be no time to examine them. Months before, I had been counseled that in any dispute between a Board and President, the Board always wins. Regardless, I saw no other choice.

The Board was sitting together close to the front as I explained what had transpired. I told the membership that they had to know and had to decide. A presumed member who I did not recognize said that since I was part of the dispute, I should not conduct the meeting. Some requested members refused. Dr. Tom Dorman came to the platform, and I stepped back and soon down. He should have moderated between the Board and me. He didn't. I don't know why he did what he did. I never asked him. Whenever he saw me after, he paid me great deference, as he had when he visited me at my facility years before when he was just beginning to appreciate Orthopaedic Medicine.

As the debate began, he came back to me twice when I raised my hand to answer, and then he ignored me. He just kept pointing to Board members or the audience. There was no inquiry. No document based presentation of the issues. I walked up the aisle to leave. Negri had stood, half turned and pleaded that what the Board was doing was for the good of AAOM. How could anyone think otherwise? The others were mute.

Some time later, at another medical meeting, I was on a river tour boat and heard animated conversation and laughter below decks. It turned out to be from Negri and some others of the Board - a painful surprise, and I stayed on deck to minimize the bleeding. The boat tied up. I was standing close by where the crew would lay out the debarking plank on the Port side. The enclosed "ladder" (the vernacular for a stairway on a vessel) from the below decks compartment emerged about twenty feet in front of me opening Starboard (the right side - I'm a Coast Guard veteran). Suddenly, Negri had burst around the covering. His sideways glance instantly identified me, and he literally froze grotesquely on the spot, his left hand holding onto the stanchion, his left foot planted, his right leg fully parallel to the deck, his right arm openhandedly stretched forward by his propulsion, all caught in space, his glazed gaze somewhere down in front of me, his expression in the first stage of startled. The crew wasn't anywhere near the plank. Negri remained that way literally for minutes. It was remarkable, the price of such deceit incalculable. (I was told that he died of a massive coronary some time later.) When the crew eventually got around to clanking the plank onto the deck and shore and clamping it, his tragicomic attempted disappearance into limbo snapped, and he ran off the boat. And I whispered again, “Thank G-d….”

Back in the auditorium at the business meeting, there was by then near pandemonium as I approached the door. One of the members, bless her, who had been in AAOM from the beginning was shouting, “Dr. Goodley is the spirit of AAOM! This is terrible! Oh, G-d, we can't let this happen…!”  

I learned from others later on what had transpired. Much had been said praising me. The  demand had been made that if the vote was against me that I be given given the title, “Lifetime Founding President Emeritus.” It had passed unanimously. The Board won by a moderate majority. There had been no certification of membership. No elections were conducted for the new officers. The gang just stepped in. Perhaps strangely, I felt clean and at peace. I'd gone down with a sword in my hand.

That afternoon, I was walking from the reception after having made a brief appearance, as Carlson was approaching up the path to claim his reward. He was walking sort of a jig, and as he came close, crinkled his face and cooed, “I love you, Paul.” For two years, he hadn't done a thing. I was incredulous.

I was told the luncheon was subdued. No one spoke much except Schacter who had bounded from table to table shouting that they had brought me down. 

The over 400 members almost immediately plummeted to less than twenty. I was told that most of the Board never returned. How much their conduct in this influenced what happened to several of them, only G-d knows, but Harold Walmer died of pancreatic cancer within two years. I already wrote about Negri.  For a time in the 90's I had an office in Big Bear Lake , California . One of my patients had been referred to me by him. She told me how he had said “the most marvelous things” about me. She was startled by my expression at his name. When she repeated that he had said such beautiful things, and I responded that he should have, I left her befuddled. I had no desire to explain. The wound were bleeding again. Carlson had a stroke and had to retire, and Pomeroy developed constrictive pericarditis (the covering of the heart) and had to have a cardiac “circumcision.”

I attended the next meeting in 1986, in Portland , Oregon , and tried fruitlessly once more to save AAOM. I had printed my last Newsletter AAOM '86 #4 which candidly stated the case and mailed copies to the membership from my old list. Too few were there to counter the hostility from the jackals.

 The Board had never acknowledged to me the demands of the membership at the '85 meeting. The only letter they ever sent me was through an attorney, Thomas Lofy. AAOM Lofy letter . Until then, my rage had been contained to my dreams but not when I read it.

I didn't receive anything further from AAOM for about 14 years when I received a notice of its annual meeting, that year in Las Vegas. I received a call from Dr. Bjorn Eek, always a gentleman, a pure pursuer of good medicine. He was the program chairman that year, and I was being invited back as an “old timer.” He said that people wanted to meet me. The wound hadn't healed, and I wanted closure. I hoped (imagined) that there would be some rapprochement. All my expenses would be paid. I went. It was a large and very successful meeting. Bjorn had made it big budget, and he had done very well.

I didn't know the president, Michele Fecteau, an osteopath from Colorado who several times announced nervously that Dr. Goodley, the founder, was in the audience, but she never approached me, introduced me or invited me to the platform. The AAOM staff was very nervous any time I came near their booth. I still had a supply of my Newsletters. I had brought them and offered them. Some I put out at the entrance to the meeting room. Only a few were picked up. The staff took the others and put them under the counter.

I brought a copy of the Lofy letter. Jeff Patterson was a Family Practice Professor at the University of Wisconsin. We had met and become friendly years before when I was on a program there. Now he was AAOM secretary. I gave it to him and asked him to present it to the Board with the request to remove the stain. Later that day, he told me the Board would let it stand. If I wanted to be part of the organization, I could ask for an application. I didn't know how to interpret his expression.

There was a small luncheon that less than 50 members attended. Tom Dorman went to the podium and asked me to come forward. He gave me a piece of generic paper of welcome to the meeting. It didn't even have my name on it. All I could do was smile. Reluctantly, he said that he supposed I would like to say something.

As I related, until today, writing this, I had never examined the AAOM website. What is on the Google is exactly how that meeting program began. (text underline mine)

AAOM Home The American Association of Orthopaedic Medicine (AAOM) is a not-for-profit organization, which provides information and educational programs on the accurate ...

Their very first statement about an organization conceived to fundamentally change the face of medicine was that it was not-for-profit! It more than perturbed me, but all I said was that it was untrue.  I said emphatically that AAOM had been founded to profit the entire world. Any statement that might relate to taxation issues belonged in some obscure place, if any reference to it was made at all. Today, on its website, it's still all over the place.

Robert Kidd had not changed. I was in line for something, and he was saying something to me with his cynical expression intact, but I didn't hear him, or want to. I recognized only a few people there. Some wanted to know what had happened to me. I told them briefly and to read Newsletter #4. A few said they intended to do something. I had no expectations and drove back to California.

I performed a consultation here in Israel about six months ago. The man returned to New York and contacted me. When his doctor learned who he had seen, he had become excited and referred to my having founded the organization he was about to become the president of. He emailed me, referring casually to no one seeming to know why I was no longer in AAOM and that someone had said “because of some politics.” I wrote him back with a fuller explanation. He didn't respond.

The website had some other items (copied directly from the website).

Lifetime Achievement

The AAOM Lifetime Achievement Award recognizes the lifetime of work of an AAOM Member for their contribution to the AAOM and to Orthopaedic Medicine. Winners of the AAOM Lifetime Achievement Award

  • 2003 AAOM Lifetime Achievement Award Recipient - Kent Pomeroy, M.D.
  • 2002 AAOM Lifetime Achievement Award Recipient - James Carlson, D.O.

The following is their published list of past presidents. Dr. Zeiger was listed as the immediate past president so perhaps it was a clerical error to put him on top, I don't know. (At some time the error was corrected. I am leaving the list as I originally saw it.)

AAOM Past Presidents
David Zeiger, D.O.
Paul Goodley MD
Jim Carlson DO
Essam Awad MD
Kent Pomeroy MD
Robert Kidd MD,CM
William Loomis, DO
Thomas Ravin, MD
John Finkenstadt, MD
Michele Fecteau, DO
Ken Knott, MD
Lawrence Wang, M.D

So, why then is Orthopaedic Medicine not generally known and influential? Because of a lot of littleness? Yes, I think so. Because no reputable force entered into prolonged and honest debate with orthopedic surgery? Yes, I think so. Because of the paucity of a dedicated, reputable, consistent, persistent organizational voice? Yes, I think so.

I reflect that there is much to be said for having to sincerely study and swear allegiance to a credo as a preliminary to leadership. Such an anachronistic thought. Regardless, there is a spirit in endeavors whose highest goal must be to maintain the guiding principles that serve that endeavors' purpose. What happens to the spirit when its leadership is despoiled? What lingers? Is the fetish with “not-for-profit” unconscious and self-fulfilling? That wouldn't be too strange a story. It certainly immediately impresses the imagination. None of the administrations, some for obvious reasons, ever attempted to resolve the wrong that, in civilized terms, is monstrous.

When I first wrote this, there were some on the Board then who I have believed are honorable physicians. If I did not manifestly believe in this mission, and that there must be others who willingly will see this cause, then I would have to believe that medicine is incapable ot resolving the Fundamental Flaw. I refuse to believe that.

After having painfully written this history so the truth will be in record, possibly to be pondered and absorbed - and, in the end, only then having examined the AAOM website, I came to a conclusion.

The Lofy letter notwithstanding, the Board in 1987, nor at any other time, was never empowered to annul the explicit demand of the 1985 membership and to act against me as it did. The privilege the membership unanimously granted me became immutable, especially as denoted by the “Lifetime…” status of the title. Most proximal to the events, only the membership at the 1985 meeting understood the necessity and both implicitly and explicitly affirmed its unconditional insistence. It needs to be noted that on that day, everything was precipitous presentation to the members, absent of any possibility for timely investigation by them. Technically, as there were no elections that year but only an illegal assumption of offices, there was also no certification that those who voted were actually members of AAOM in good standing.

To the point, no Board can negate the membership's unanimous demand as the condition for its accepting the permanence of what transpired because of that Board's disgraceful malfeasance.

And so I assert the title that the membership permanently granted me in the same spirit with which they originally honored me.

In the same frame, I wonder if AAOM knows what the purpose of its conception is about. Is it still a (passing) of insular administrations, each with its small time in the sun? Or, is there any maturing towards fruition of the original concept, evolving from clan to instrument? Has there been the establishment of liaison, at least, ongoing communication with AAOS? Is there communal realization that we are now well into the time of "The Bone and Joint Decade, 2000 – 2010", for Prevention and Treatment of Musculoskeletal Disorders? Has there been intercourse? Association? Contribution?

What is AAOM in the process of becoming?

Paul H. Goodley, M.D.
Lifetime Founding President Emeritus
American Association Of Orthopaedic Medicine (AAOM)

December 2005 (edited December 2006)