The Upper Hand: Chuck & Chris Talk Hand Surgery

Giving A Fantastic Presentation

September 19, 2021 Chuck and Chris Season 2 Episode 35
The Upper Hand: Chuck & Chris Talk Hand Surgery
Giving A Fantastic Presentation
Show Notes Transcript

Episode 35, Season 2: Chuck and Chris discuss two HBR articles on presentations.  While these reflect on non medical lectures/ presentations, there are many valuable lessons to consider for those in the medical world.  Chris and I considered these lessons in preparation for the upcoming ASSH and ASHT meetings.

HBR articles
"What it takes to give a great presentation", Carmine Gallo 2020
"How to Give a Killer Presentation," by Chris Anderson 2013

We plan a newsletter launch soon.  Subscribe here:  https://wustl.us6.list-manage.com/subscribe?u=c6fe13919f69cbe248767c4e8&id=10e0c1dd85 

Survey Link:
Help Chuck and Chris understand better what you like and what we can improve.  And be entered for drawing to win a mug!  https://bit.ly/349aUvz

As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
theupperhandpodcast.wustl.edu.  And thanks to Eric Zhu, aspiring physician and podcast intern.

Charles Goldfarb:

Welcome to the upper hand, where Chuck and Chris talk hand surgery.

Chris Dy:

We are two hand surgeons at Washington University in St. Louis here to talk about all aspects of hand surgery from technical to personal.

Charles Goldfarb:

Thank you for subscribing wherever you get your podcasts.

Chris Dy:

And be sure to leave a review that helps us get the word out.

Charles Goldfarb:

Oh, hey, Chris.

Chris Dy:

Hey Chuck, how are you?

Charles Goldfarb:

I'm fantastic. How are you?

Chris Dy:

I am well, it's a it's a nice Sunday here in St. Louis. You know, have had a nice full day so far. Had a little washed out in the morning with our fantastic fellow Elizabeth Wall, who, oddly enough, she did mention how you mentioned your fellow by name. And I have not yet mentioned my fellow by name, probably rotating, so. Elspeth got a shout out last time Harrison has gotten a shout out before and of course, last but not least Dr. Elizabeth Wall. Welcome to our fellowship.

Charles Goldfarb:

Well done. Yeah, podcast jealousy. Who knew who knew there was such a thing?

Chris Dy:

Oh, but it's good. It's a good day in the house. I've got this wonderful pork shoulder roasting in the oven. I'm very excited to bite into that later. And it's kind of how I build my Sundays now is around food. So

Charles Goldfarb:

That is one thing I will never, that'll never come out of my mouth. I've got a wonderful, wonderful pork shoulder roasting in the oven.

Chris Dy:

Well, you were kind enough to come by the house yesterday. So you know, you saw our kitchen and everything. And you did mention that you are always pushing for, you know, a bigger range.

Charles Goldfarb:

It's funny because Chris now lives within walking distance. To me, it's not the shortest walks. But it's also not the longest, I don't know how much maybe half mile or something. And so Talia and I walked over and my wife was completely completely humiliated by me. Once again, I had a bunch of stuff added bring over to Chris and a housewarming gift. And so I had a backpack and all this stuff. And I was carrying this plant. It was she wanted to get off the main roads as quickly as possible. But we were we love your new home. Congratulations. And then you're gonna have many happy years in it.

Chris Dy:

Thank you. I'm currently sitting in the basement in the gym, because it is the closest to the internet router. So I am doing my absolute best to improve the quality on my end.

Charles Goldfarb:

It is working. So two things about the about generally about the pod. The first is and you you throw this out there on Twitter, we haven't we have some new swag out there.

Chris Dy:

Yes, absolutely. You mentioned it at the end of last week's episode. But for those of you that are wondering what the swag is, it's essentially some croakies that you could use for your loupes or your glasses or sunglasses to hang them around your neck. And I remember always trying to find the right pair of croakies for for my loupes. When I was starting out and I finally switched them. I did my first case today with the new upper hand croakies. And if you catch me at the ASSH meeting in San Francisco, or at the ASHT meeting here in St. Louis, I will have a bunch of them in my bag and I am looking forward to giving them away.

Charles Goldfarb:

I love it Chris is gonna be like the most popular person at the meetings, handing out swag cuz there's nothing much swag to be gotten anymore at these meetings.

Chris Dy:

There's I'm just gonna start throwing it from the podium. It's gonna be awesome. But speaking of the ASSH meeting, I just had a very brief text conversation with our sometime guests, longtime listener and of course, friend, Sam Moghtaderi over in Washington, DC. And he told me that he listened to the episode and he is on the fence now about coming to the meeting in person. He still obviously has to, you know, make some logistical arrangements. And yeah, for a lot of us the COVID concerns linger. But he's now thinking about it based on the stellar job that that Amy and John did last week of telling us how great the meeting is going to be.

Charles Goldfarb:

Hey, if one person who wasn't going to be there comes that I will consider that podcast a success.

Chris Dy:

And one more thing he did mentioned before the episode even ended, he ordered a Maui Jim sunglass case to put his two five loupes in based on some sage wisdom that he received.

Charles Goldfarb:

That is awesome. The other thing we're working on the podcast is maybe a little premature, but hey, it's coming. Chris and I have gotten questions about some type of more, I guess, more formal or more structured communication. So we're thinking about an email newsletter, which would be infrequent maybe once a month, we're going to try it with just important information whether it would be Chris and I's favorite journal articles, what's happening in the world of hand surgery. Opinion opinions for sure because we're full of them. But we if you look at the if you look in the show notes for episodes going forward, there'll be a link to sign up for the newsletter or if you Just want to reach out to us on any of our platforms and share your email address, we will include you. And we'd love to have you join us.

Chris Dy:

And this note handpodcast@gmail.com. We would love to hear from you get on the list and then also send in questions. Remember, Chuck will literally answer anything that you asked him on on air. And I will surprise him with it because I checked the email address more than he does.

Charles Goldfarb:

Yeah, way more than I do. That is true. I have a case. Can I share a case?

Chris Dy:

Sure.

Charles Goldfarb:

All right, this is one, you know, I have this, I have this thing where I really try to be good about taking pictures. And when I don't do it, and it was something that should have been photographed. It literally kills me It drives me crazy after separate the whole case and for several days later. But we had a super interesting case that I did with Dr. Elspeth Hill, the and fellow and it was a gunshot wound. They were the entry was near the pisiform. And the exit was dorsally through the thumb metacarpal. And it was pretty impressive. In the exit wound was large The metacarpal was destroyed, the trapezium was injured and the exam preoperatively was not very helpful. And so we'd like to to proceed to the operating room to do an acute carpal tunnel release because of the concerns of numbness into explore both the distal ulnar tunnel and the median nerve. So we get to the or we open things up and the ulnar artery was clotted, but there was good blood flow to the finger. So we weren't overly concerned by that the ulnar nerve was intact. And the median nerve was 90%. Lacerated is the wrong word, but 90% not in continuity. And then we dealt with a metacarpal. My question to you Dr. Dy as a nerve expert is what do you do now we have a patient who is a victim of violence. who, you know, I don't I don't like to make assumptions about who will or who will not come back to the office. But I'm not sure if this person could be counted on for long term follow up. What do you do in the OR that day before I tell you what we did?

Chris Dy:

So you said the ulnar nerve is structurally intact you don't know about a concussive type injury. As we've mentioned, on the prior episode, you know, the different kinds of injuries you can have to a nerve. So I would not do anything else for the ulnar nerve other than a comprehensive release of the distal ulnar tunnel, the hypothenar fascia for zone two, it's interesting what you could do for the median nerve at that level. So I'm assuming your 90% transection of the nerve is at the level of the carpal tunnel?

Charles Goldfarb:

It is in the middle of the carpal tunnel, and there is no evidence visually, both by loop and microscope of a visual zone of injury on either side of the discontinuity.

Chris Dy:

And you're there within 24, 48, 72 hours of the injury?

Charles Goldfarb:

For sure, probably 18 hours of the injury, you know, the next morning, we got time and took them the OR.

Chris Dy:

So, I think old school, you close and you call So I'm going to flip it around. Now that I've exposed myself and it a day and you have them come back to the office, you know two weeks later and plan for going to the OR after the zone of injury on the nerve has theoretically declared itself within probably three or four weeks and then you proceed with nerve grafting. I think that it would be acceptable to me if you had consented the patient for an autograft which you may or may not have to proceed with an autograft. And what I would probably do is try to isolate if I could, where the recurrent motor branch had come off of the median nerve. Now it sounds lik that'd be really hard jus because of the location in whic your transection is it' probably right where you know most recurrent motor branche are coming off. But you coul tease apart the recurrent moto branch if you can still see i going to the thenars and th n graft preferentially into th t really funnel things into th re. After going back being a li tle more aggressive on your zo e of injury, or you know, yo r resection proximally I don t know if that all makes sen e. And then after that, I mea, I think that you could if you visually saw an area of tra sition resect back a little mor and go for the go for the com lete grafting at time zero. Now hat's wading into contr versy. And I think there are a lot of people who would say N way, why would you do that? say, Well, why so we did not have consent for an autograft? We talked about allograft but decided that an allograft was not appropriate in this situation. And so why would you not what do you have to lose? What does the patient have to lose by a resection of a presumed zone of injury and repair if it's able to be primarily repaired? No, I like it. I guess I hadn't mentioned that or thought about that, because I had assumed that the zone of injury was relatively wide. And you wouldn't be able to get it together primarily without tension. But I've actually done that with all nerves at the same level. And there's you know, there's some case series out there about ulnar nerve injuries from distal both bone forearm fractures with the ulnar nerve being injured in the distal forearm kind of just proximal to the wrist crease. And I have primarily repaired those because of that very reliable topographical relationship of the motor and sensory components. I've repaired them primarily. And I will admit, I have flexed the wrist in order to get that to you know it to come together. But then I will check it with the wrist of neutral to make sure it's not gapping. And I'm comfortable with it, it's a very fine line. And I think you'll find many old school surgeons who would shake their heads at that. But then that the key there is in making sure that you keep the wrist flexed, and the dorsal blocking splint of sorts, and then gradually, progressively bring the wrist out into a more neutral and then eventually slightly extended posture. And the way I've done that in the past is to monitor it with ultrasound. So obviously it takes the right patient because the ability to come in for those kinds of serial monitoring exams can be a little challenging.

Charles Goldfarb:

I love everything you said. I have a comment and a question. My comment is, it's nice. Well, let me just back up for historical reasons. You know, it used to be that in orthopedics, we would treat patients with a wrist flexed posture for certain fractures, that I think is the so called cotton loader position distal radius fractures, which is a really effective technique to obtain a distal radius reduction. But it doesn't work out well in the end, because of the increased pressures inside the carpal tunnel with extreme wrist flexion or extension. So we don't do that anymore. But in this case, we've released the carpal tunnel. So we're not so worried about the pressures. And so we were quite comfortable with flexing the wrist to minimize the tension. My question is, is there any role for a slightly larger suture to detention, the repair of 5-0, or something like that epineurial stitch crossing over to de-tension a bit on the repair site? Is that something you'd have done or advocate for or against?

Chris Dy:

I haven't done I wouldn't advocate for it. I know that there have been some groups that have tried to study it, including our own Dr. David Brogan, using not that exact technique, but looking at ways to splinter repair, and the experiments never quite got off the ground. You know, at the end of the day, if you don't have tension on your repair, then you should be in good shape if it kind of depends on the caliber of suture that you were to use. So an 8-0 nylon suture, which you know, classically in the literature, we talk about the 8-0, nylon test? There's a really nice paper, I think it was from Jeff Greenberg's group that looked at the characteristics of 8-0, nylon versus 9-0, nylon versus the relative normal strain and a nerve. 8-0, nylon, you can get away with having a little more attention than the native tension in a nerve occasionally, whereas a 9-0, nylon will not let you do that. So for me, if it comes together with a 9-0, nylon, I feel comfortable knowing that it's not going to be under excessive tension provided that the wrist doesn't get fully extended violently. 8-0 nylon is still kind of wonder. So I guess the question about you know, whether what caliber suture to use for your cooptation is probably different than what you're describing about using a de-tensioning stitch. I haven't don't have any experience with that. And actually, Elspeth I think has asked me about that before when we were having one of our sessions and I told her, I was not an advocate for it.

Charles Goldfarb:

Yeah, she may try to bend your ear a little bit on that technique. So bottom line is relatively small caliber bullet, relatively narrow area of discontinuity with visual injury, not that huge. So we excise the what we consider the injured segment, and then a little bit more. And we were able to primarily we approximate without a de-tensioning suture, but we added a detension suture and we flexed the wrist. And you know, my opinion here is we didn't lose anything. If he does not get recovery, we can come back and graft, if he gets recovery. We're all going to be happy. We approached it this way.

Chris Dy:

So you removed the 10% that was intact, right? Structurally intact.

Charles Goldfarb:

We did and it was a it was a very posterior and ulnar 10% which didn't worry me much.

Chris Dy:

Now, how do you know. How do you judge taking a little bit more than the visually injured zone segment? Like what's the what's the.

Charles Goldfarb:

Yeah, well, this is a classic paper that's not been written yet Dr. Dy. We use two millimeters more than the injured visibles segment on each side.

Chris Dy:

That said with such confidence, you know wonderful I can't wait to read that paper when it's finally written. And then we'll call it then we'll call it a classic there's there's Chuck Goldfarb again a workman just hammering nails.

Charles Goldfarb:

That's right in my in my chosen field of nerve repair.

Chris Dy:

Did you voluntarily present a nerve case? That's amazing.

Charles Goldfarb:

I knew you'd be excited about it. That's another reason I was frustrated. I didn't have a picture.

Chris Dy:

I love it. I love it. Well, why don't we jump into this week's topic, apropos to our theme last week of the ASSH annual meeting, I actually got a couple of emails from the HBR, the Harvard Business Review listserv that talked about how to give a great presentation. And there were two, I think, really good articles in that set. One was from January 6 2020, by Carmine Gallo called what it takes to give a great presentation. And the other one is actually a little bit older. It's from how to give a killer presentation by Chris Anderson, which is June 2013. And I like the the Gallo went a little bit more just because it gives you breaks down very easily, but how to give a great talk. And it was top of the mind for me, because I feel like we're getting closer to normal. Although we're also really hesitant about Delta, I've, I'm going to be giving a couple of talks at the ORS, ORIF clinician scientist development program this week, then I've got the hand society a couple weeks later, as do you with some presentations. And we have the ASHT meeting the week after that. So I'm in talk mode. And then I also just get grand rounds for our department a few weeks back. So all this has been top of the mind for me in terms of thinking about how to sharpen my presentation skills.

Charles Goldfarb:

You know, it's something that I always am interested in reading about. One of the things I struggle with are these type of discussions are tough, because it's really, they're really not discussions about medical presentations. And so there's there's certainly takeaway messages that are important. But it's not as if you can give a talk like they described or perhaps like Steve Jobs used to give, because we have, we have to do things somewhat differently. But we absolutely can learn from these type of discussions. And I will say that Chris Anderson, I think is one of my favorite thinkers. You know, he Chris was the I'm on a first name basis with him, apparently, was the prior editor of Wired Magazine, which I know, you know, is one of my favorites. And he wrote the concept of the long tail, which I think we've talked about in this forum. If we haven't, we will one day. And I think he really, really, really did a great job in this article as well.

Chris Dy:

But let's jump into one of the articles. And they The first tip that they give is great presenters use fewer slides and fewer words. Now we'll talk about this a little bit when we gave, we had a podcast episode about virtual talks. But it's a your your just talks in general. I mean, how do you construct your slides, because I remember towards the end of his teaching career, Dr. Gelberman, giving talks and just being mesmerized by the quality of the pictures he would have in his talks. Now granted, the department had a photographer at that point, which enabled it. But I thought those were incredibly powerful slides.

Charles Goldfarb:

Yeah, I think we should be clear, you know, if you are giving a scientific presentation, a five minute podium, talk about your research, that's different. If you're giving a bigger picture discussion on nerves, or congenital or sports or whatever, I think you can do a little more, you can work with these techniques a little more, and there is no doubt that Dr. Gelberman as his career advanced, use fewer words, fewer bullet points, nice visuals, and more talking. But let's be honest, that requires a lot more preparation, you know, none of us, I would hope would go up there read the bullet points, because we know that's just just not that helpful, but sometimes require bullet points. And I just recorded a presentation for the hand society. And I didn't want to use bullet points. But I found that it was just it doesn't convey the message when you're kind of working through research without them. And so I love this concept. fewer words, more pictures, more verbal, I guess depth to each slide.

Chris Dy:

You know, I think that your point is is right on about you know, two to five minutes scientific paper presentation has to be very tightly scripted. Not that you're reading off of off of the slides. But it has to be tied to scripts. It has to be formatted in a certain way. It can't be the beautiful. Here's a picture of a nerve kind of talk. I actually just met with one of our one of our former students that I've been working with who is now a resident at SLU Alexa Powers and she's giving a talk at the resident fellows meeting in a couple of weeks right before the hands society. They've got two minutes. So I told her I was like look like you've got to be tightly scripted. Got to practice it a bunch so it doesn't sound like you're reading. But there's really no room for error because you don't want to be that that runs over and throws off the whole program. I noticed that the talks that I gave every year in terms of the you know, Introduction or overview of Plexus or nerve or nerve studies, as I've go back every year, I take more words out. And that's also me becoming more comfortable with my ability to remember the things to hit on the slides. Now, I'll admit, in kind of the speaker notes section, I will just remove the text that was on the slide and drop it in there. So I remember if I have presenter mode available, what points to hit. But I think that the point in this, you know, that they make in here is that, you know, people remember pictures more, you know, they remember, they remember, they remember less about the words that you're that you're saying and more about stories that you're telling and the points that you make when a picture is on the screen. And I you know, the second point is, you know, great presenters don't use bullet points, I agree with you, I think that in our field in our world, unless you have a picture on the screen, you have to use, you have to use some bullet points, some kind of texts.

Charles Goldfarb:

Yep, exactly. But I should look, I would never consider myself a great orator. Hopefully I get my message across, it's something I think I've gotten better at and hopefully will continue to get better at, I hope content really matters to the audience. But you know, you want to make it easy on the eyes and easy on the ears. And just it's a it's a it's really an acquired skill, which gets to the third point of this Gallo article, which is the great presenters enhance their vocal delivery. And so you know, regardless of the political spectrum, I think most would agree that Obama was a great is a great orator. And I'm never going to present like he presents. But it practice helps. Having a even a non medically involved person listening to your talks helps. It is a skill set, though.

Chris Dy:

And this kind of gets into the stuff that's in the Chris Anderson article. But I mean, it's connecting, and so your, your intonations, and the way that you talk, are gonna vary if you can connect with people in the audience. So so one of the suggestions that his his article was to find five or six people in the audience and constantly make eye contact so that, you know, you can connect with somebody and see that they're following along and helps you understand when people are engaged and not engaged.

Charles Goldfarb:

Absolutely, absolutely. Well said. Do you consciously think about how you the tone of your voice, the cadence of your delivery, the volume of delivery? I mean, clearly, for some people, that just comes naturally, if it doesn't, do you think about those things?

Chris Dy:

I, I don't know. If it came naturally to me, I think I worry less about it, I became more comfortable speaking in public, for whatever reason, I think there were things that I did growing up in terms of activities that helped. I wasn't like a debate or anything like that. But I did do a lot of like Performing Arts, which I think helped my ability to feel comfortable speaking in public, by no means am I an expert, and I'm not the orator of the year. But I do feel comfortable with that. And I'll be honest with you, the podcast has helped a lot in terms of just being able to think on the fly and to talk and, and to work through things and to remain confident and conversational about things. So we were talking before about benefits of the podcast, that's probably one that had thought about a lot before. But I do feel more comfortable in a lot of venues because of just the you know, we put ourselves out there every week.

Charles Goldfarb:

It is it is really true. That I think my next live symposium where there's multiple different people giving their opinions, I will be so much more comfortable than I would have been pre podcast. So what Chris and I are saying is we hope some of you out there, start your own podcast and jump into the game we were not afraid of competition. The more the merrier. We're kind of like Elon Musk, you know, if you want to build a electric car go right ahead. But I don't know if you're gonna overtake the Tesla here.

Chris Dy:

Are you bragging right now Chuck?

Charles Goldfarb:

Definitely not. We want you out there. We want more people in this space.

Chris Dy:

So they it one of the last points in the Gallo article is about rehearsing. And I admit I do not rehearse as much as I should. But I you know, for example, the Grand Rounds I was asked to give for our department I practiced that one. Because that talk meant a lot more to me than many other of the presentations that you know, I've given recently. So I do think that rehearsing helps. We don't always put in the time I tend to kind of take my rehearsing time and really just refine my slides and think to myself what I'm going to say, but sometimes it is super important to time yourself and just to get the words out to know the right things to say at the right moments.

Charles Goldfarb:

Well, I think is a really The important point and Gallo cites Martin Luther King Jr., who comes across as one of those spontaneous speakers that could say anything and make it sound beautiful. But there was much practice that was behind that I Have a Dream speech, etc. I'll tell you my personal story of when I learned to practice to focus my delivery. And if there's any of our current residents listening, hopefully, a touch of this will resonate. But when I was so when I was a fourth year and a fifth year resident, I was fortunate enough to do the hand rotation, by a fluke of need in the in the department, I volunteered to do it twice. And that was back in the day, there was a little more heat and a little more expectation for our anatomy sessions. And it was a 100% from memory, and had better be Word Perfect. And I spent hours preparing each of those. And they were, every week, we had an we had an anatomy session. And I practiced and practice in the shower in front of my wife, I mean, not in a shower and in front of my wife, but in the shower, or my wife. I was constantly practicing, it was something and I got better.

Chris Dy:

Well, I mean, I think that, you know, when, when the stakes are high, you know, I've we've talked a little bit about my feelings about the fellowship, and I got the much softer end of things. And when, when you're in training, the stakes, right, the expectations are high. And you don't want to you don't want to get it wrong. And I remember even as a fellow here watching the residents give what I call it that point their recital, you could tell the ones that had put in the time, and honestly, at the end of the day, I'm sure that they learn the material quite well. The next step is then learning why it's important to memorize those things and recite them in a certain way. I should say that along the way, in my residency training, one of the expectations was to give a lot of presentations, whether that was something as routine as indications conference, but also giving indications without also giving say like a 15 minute talk on a random topic. And it was usually the paid service that was the most notorious for making you give a talk and it was painful at the time. But it was super, super helpful because you learn how to synthesize information, you learn how to make slides. And oftentimes, like for example, on on our trauma service, you would have to do kind of the the cases, you know, the pre op post Ops, but then there was also like a 45 minute lecture that you had to give every month in which you truly learned a topic, well figured out how you operate as a as a speaker, which I think you know, was probably not the intention of the rotation. But it was a certainly a nice benefit.

Charles Goldfarb:

I think what you said is very true. And I think that is really an important lesson for all the trainees that, yes, these are asks in a training program or in a fellowship program. But you will get benefit from each of these efforts in knowledge, in skills. And we had to give in my fellowship, we had to give a presentation every week. And so we put together a PowerPoint for a presentation every week. And yes, it was torture, but it is much better. PowerPoint presentation builder, much faster, much more efficient, and can really put things together quickly, which has served me well for many years. And so there's a lot of good to come out of it. You want to switch over to the Anderson article.

Chris Dy:

Sure, yeah, I think we've kind of been sprinkling in some of the Anderson stuff along the way. I mean, I think the biggest thing I took away from the Anderson article is something that I've learned along the way, in my short career is to tell a story. You know, and it's it's, you know, good talk will make people think, and you don't necessarily need to have them come to the conclusions and that you have intended. But telling a story will will will allow you to take them on the journey. You know, if you do it right, it can show them kind of why you are for example, like I gave the talk on brachial plexus and the work that we've done. And the first portion of that talk was mainly about kind of showing a case, showing something that I thought was an amazing technical outcome, and then showing how the patient really didn't like it, and then launching that using that as a segue into kind of why we're studying what we're studying in our you know, brachial plexus clinical research lab. And I think that, you know, people were able to follow along with that I got a couple of notes from a lot of people that I respect, kind of saying how that story worked out really well. And I had not really used the story a whole lot in many presentations. So I don't know how often you know, you have the opportunity to do that with a longer kind of talk but it certainly captures people's attention and engages them a lot more.

Charles Goldfarb:

Yeah, all well. First of all, I don't know if I said to you directly, but your talk was spectacular. And you really achieved your goal of telling a story about your research while imparting really important lessons and so it was really really well done. I don't know if we I don't know if that's on YouTube, but we you would. People would love that and then certainly there's different venues That's another story. I think it's harder to do over zoom. It's harder to connect with your audience. But really with it again, not a scientific presentation, not even some of this symposium type presentations, different kinds of presentation, to tell, tell a story, tell your story. It's just an opportunity. I love what Anderson said about nerves, no matter how good you are at this tokay to have nerves, because in some ways, it does help you is one example of something that helps connect you to your audience.

Chris Dy:

We talked a little bit about the Amy Cuddy in the episode about the ASHT, upcoming meeting and the power posing. You know, I think whatever it takes for you to feel confident, and to manage your own nerves, you got to do it. And that's different for everybody. But I think part of it is acknowledging the fact that you're going to be nervous and channel that energy into something that'll be productive. And unfortunately, it tends to be a bit of a trial and error, kind of situation.

Charles Goldfarb:

Yeah, absolutely. Right. I think one of the, you know, this is a little cliche, and maybe a little, not in our field, but I love the quote, which reads, a successful talk is a little miracle people see the world differently afterward, which is really powerful. And again, he was you had many goals in the talk that you gave to our department. And but part of it certainly was telling your story. But part of it, I hope, and assume was to potentially inspire our trainee to see a problem, and how to tackle it from different angles. And so that has just great potential to make medicine better, and give the residents a little something. And so while it's a little cliche for our world, it can absolutely be true.

Chris Dy:

I'm working on getting that talk up to YouTube, I have to find a way to blur out the patient face that's on there, who, you know, he gave us permission to use it locally. But before it goes out there, I want to make sure that we're on the up and up with that. But yeah, that's you know, I remember seeing presentations from visiting professors before who I got inspired by and you know, I listen to a lot of, there are a lot of a lot of areas in our field in orthopedics, plastic surgery, hand surgery, neurosurgery, nerve surgery, where there are a lot of questions that can be answered. And all it takes is an interesting question. And I learned a lot from one of my mentors at HSS, Scott Wolfe, who was trying to scratch the surface on this question about how to improve outcomes for brachial plexus injury patients. And he was kind enough to let me run with it. You know, and I think some of it is just kind of letting the idea grow into being your own, you know, seeing it as an issue. And I think that if there was a trainee that was able to pick up on that, and think of, you know, well, why don't I approach it this way, maybe that was, you know, a good thing for them. And hopefully, it resonated so.

Charles Goldfarb:

Yeah, and let's be clear, we recognize that many in the audience are not going to give big, powerful career presentations or anything like that. But I would argue strongly that if you are presenting to the local therapy group, or you're presenting to high school students, which are like, ah, whatever, I'll throw a talk together for some high school students. But you know, what, you may change someone's life. And that sounds a little corny. But if you're talking about your high school students telling you about why you've chosen medicine or hand surgery, and what you've been able to accomplish, it really is a powerful opportunity. So I love both of these articles. And they were fun to read.

Chris Dy:

I mean, to bring it to a close. I mean, I think that, you know, when when we're giving presentations on a topic, for example, distal radius fractures, we all love cases, we love cases, more than just, you know, cases that will illustrate certain points about how to evaluate, you know, patients radiographs, how to think about treatment strategies, as opposed to just, you know, here is the literature. If you can find a way to tie cases, you know, together so that you you can string together the same points. That's a better talk to me. So for a lot of times, residents will be asked to give a talk on say, balloon a for set fractures or when to use a door sustaining plate, if you can find cases that are illustrative that is the orthopedic or medical version of a story.

Charles Goldfarb:

Yeah, that's right. And I'll tell you again, we should close but I'll tell you that when I was a resident, we transition from the concept of a resident or fellow presentation or quote unquote, Grand Rounds, which traditionally had been a bunch of slides which a bunch which with a bunch of words, it took years for Dr. Gelberman to imprint his preference on us. That would be case based, and have four or five cases on the volar lunate facet or some type of specialized distal radius fracture, it is so much more impactful and Gosh, it's true. And I like how, what you said that that is our surgical world, our medical world of the powerful presentation.

Chris Dy:

Alright, so now everybody's ready to go give a talk or presentation or a case series and hope We'll see. You guys can share your pointers with us and let us know what works for you.

Charles Goldfarb:

Please do. Alright Chris, this was fun.

Chris Dy:

See you next week.

Charles Goldfarb:

All right. Hey, Chris. That was fun. Let's do it again real soon.

Chris Dy:

Sounds good. Well, be sure to check us out on Twitter@Handpodcast. Hey, Chuck, what's your Twitter handle?

Charles Goldfarb:

Mine is@congenitalhand. What about you?

Chris Dy:

Mine is @ChrisDyMD spelled d y. And if you'd like to email us, you can reach us at hand podcast@gmail.com.

Charles Goldfarb:

And remember, please subscribe wherever you get your podcast

Chris Dy:

and be sure to leave a review that helps us get the word out.

Charles Goldfarb:

Special thanks to Peter Martin for the amazing music. And remember, keep the upper hand. Come back next time.