Professional Profile: Mary Williams Clark, MD

Sandra Smith and Janet Marshall

What inspired you to become a pediatric orthopaedist?

I became a pediatric orthopaedist in 1977, 5 years. after the end of my residency. Before that I was a 'general' or-thopod, which most of us were then-there were only a few fellowships in any sub-specialties.

What do you like best about being a pediatric orthopaedist?

The best thing about being a pediatric orthopaedist is the kids! They are open, curious and almost always cooperative. Especially if you have a retractable tape measure in your pocket and show them how to use it (make sure they don't pull it out too far). While they play with it, you have 5 or 10 minutes to do an exam. (Don't forget to ask them to 'put the tape back in my pocket' before they go-works better that way than asking them to give it to you:).) Also, most children need to be followed for some time, and in this part of the business you get to watch them until they're grown.

Can you identify a mentor that influenced your career path?

I've had lots of mentors: first was Dr. Wayne Southwick at Yale (medical school); he encouraged my interest in orthopaedics. Then Dr. A.B. Ferguson at University of Pittsburgh, who accepted me first as a resident (the first woman in his program), and then arranged 3 months for me at Rancho Los Amigos (Downey, California)-the first orthopedic "hub" of rehabilitation. This was at the end of my first orthopedic resident year.

At Rancho I began to learn about "rehab", and met Drs. Vert Mooney and Jacquelin Perry. Dr. Mooney, after my first presentation at rounds there, told me that I'd given a good summary of the patient's examination, but he still didn't know what the patient could or couldn't do. Dr. Perry gave awesome anatomy lessons that kept us awake even at 6:00 am; standing on bleachers around the dissection table helped. Just meeting the doctor who devised the halo apparatus was a thrill, and then she became an encouraging force in my life-and still is. About 1969, when I was still a resident & at my first Orthopaedic Academy meeting, she invited me to dinner with 6 or 7 other women orthopedic surgeons-almost all there were at that time. I need to acknowledge another mentor: Hugh Watts, (probably known to all of ACPOC); he's been a good friend since his first ACPOC meeting, and 'mentored' me into writing, "Who is Amelia?" with him. The book, published in 1998, was a "Primer" for residents and other doctors, about some of the situations in which young amputees appear, and what they (residents and other doctors) should know: what to say to parents (and doctors, nurses and others), how to examine the baby and some of the more common limb differences. Includes accidental amputations, and other none-congenital child amputations.

Where have you practiced?

After my residency, I stayed on at Pitt on the faculty, working both at Children's Hospital and 'Presby' (Presbyterian Hospital). I was the "Rehab" person for Children's, and expanded the PT department, and convinced them they also needed an OT. I started an amputee clinic there, which was continued for many years by Bill Green MD (also an ACPOC member), until his retirement. I also gave the orthopaedic lectures to the Pitt PT, OT, and Medical Records students-a whole semester of it! In 1976, I received two simultaneous grants to establish a Therapeutic Recreation program at the Children's Hospital; three years after the grants ran out, the program became part of the City of Pittsburgh's program for disabled activities. I was inspired by a paper by Ned (G.E.) Sharples at ACPOC (when it was still Amputee Clinic Chiefs meeting), about a camp for teen-age amputees, done by the Grand Rapids/Mary Free Bed clinic. In 1976, we got our Pittsburgh area amputee camp going, which lasted for more than 25 years.

My next job took me to New Orleans. Dr. Bob D'Am-brosia (also a mentor), one of my chief residents when I was at Pitt, suggested me for a position at the fledgling Children's Hospital. There I met Dr. John Roberts, another mentor, who ushered me into pediatric orthopaedics. There were two operating rooms and orthopedic residents from all three schools in New Orleans (LSU, Tulane, and Ochsner) "rounded on" and saw the "acute" patients, no matter who referred them. The state clinics were already established; Dr. Raoul Rodriguez (another ACPOC member), from Tulane, ran an excellent amputee clinic. I was on clinical faculty at LSU and Tulane, and taught PTs & OTs at LSU (but no longer a semesters' worth). I also did an adult amputee clinic at LSU, (where I was unable to change the (general) surgical team to using post-op casts, instead of little stockinette caps that slid off the end of the stumps.)

Moving from New Orleans to Charlottesville, VA, I took a position as Co-Director of the Children's Rehabilitation Center (CRC), now the Kluge CRC. I had the privilege of working with Dr. Mike Sussman and Dr. Dave Heilbronner there and with a terrific staff of therapists (PT, OT, Speech T, Nurse Practitioner, pediatric nurses) and (from the main hospital) orthotists and prosthetists-all very well trained and all inventive for challenging things.

(Also, during the 'Virginia Years' I had the spectacular opportunity to work with Project Hope, starting in my first 2 or 3 years there, going to Poland to evaluate progress on a Rehabilitation addition to the Children's Hospital in Kracow (4 visits over 5 or 6 years), and then helping the UVA Hospital and CRC arrange to host/ take care of 4 (of the 30-some) children who were 'airlifted' to the US by HOPE, after the Armenian earthquake (December 1988). Ialso went as the ped. Orthopod, with a multi-professional group which went to Armenia in April 1989, helping to install ongoing care for patients when they returned home.) (that could be another book...)

Enticed by two former Pittsburgh colleagues, my 'practice trail' led me to Hershey, PA. Hershey's the home of the Penn State University School of Medicine; I stayed there almost 9 years, beginning with most of my time at the Elizabethtown Children's Hospital/ Rehabilitation Center, 12 miles away, which eventually moved to the Hershey Medical Center. I inherited the amputee clinic, with 'in house' prosthetists and ortho-tists, which included an adult amputee population. The adults loved watching the kids in the waiting room. We also developed an amputee consultation team and a post-op protocol for all age amputees.

After a change of personnel I moved twice more-the 'next and last' one to Toledo's Medical College of Ohio, which included a newly established Mercy Children's Hospital, as part of St. Vincent's Hospital. Then I got a letter asking me to consider moving to Lansing, Michigan, as they had lost their only pediatric orthopaedist to an aneurysm, and hadn't been able to replace him. So, I made another move to a great environment, working for a hospital (not a university), with an established pediat-ric subspecialty group. Each of us had 'our own' nurse to work with us, along with a well-staffed pediatric rehabilitation section of therapists. In both Toledo and Lansing I had small but well-staffed quarterly amputation clinics, with a nurse, OT and PT, and three prosthe-tists from town. Instead of orthopedic residents, many of the pediatric residents rotated 3 or 4 weeks at a time with me-very enjoyable to teach them good Ortho/ Rehab exams!

Would you like to share any information about your family and other interests?

"My family" fits in here-I married toward the end of my residency (in 1971, to a former patient who was in traction with a broken leg when I met him ). In 1976 we had a daughter, born in New Orleans. My husband died there unexpectedly, and the next year I moved to Charlottesville, Virginia, to work at the Children's Rehabilitation Center. I had already met Beverly Gryth, the head of PT there, at ACPOC. I spent almost 9 wonderful years in Ch'ville, during which I met and married another wonderful man and acquired a stepdaughter. Our daughters are ~2 1/2 years apart, and we both have great extended families.

How long have you been a member of ACPOC?

Since before it became ACPOC! I went to 4 of the "Amputee Clinic Chiefs Meetings", beginning in April 1973. I was 9 months out of my residency. Dr. Andy Wissinger had an amputee clinic at a residential school 'for the handicapped'; he planned to 'give' it to me, so took me to the 1973 meeting. (The Clinic Chiefs Meetings were sponsored by the Committee on Prosthetics Research & Development, of the Division of Medical Sciences, of the National Research Council, of the National Academy of Sciences.)

What was your first impression of the organization?

My first impression of this group, in 1973, was 'where have you been?'-It was a place for me to learn to take care of children who needed care that I could learn about.

What Board / Office / Committees have you served on?

I've been on the publications committee ('86-'89), nominating committee ('87, '93-94), secretary ('88-'90), vice president ('89), president ('90-'92), and on the board 3 times (beginning in '79, '88, and '03).

Which position was the most satisfying or offered the best opportunity for you to make a difference?

Being president gave me the 'most satisfaction': I had excellent board members, and being able to choose the guest speakers was a wonderful 'present of an opportunity'. (In 1991 Dr. Robert Gillespie was the Presidential Speaker and Dr. Charles Epps Jr. was the Hector Kay Memorial Lecturer; in 1992 Dr. Michael Goldberg was the Presidential Speaker.)

Have you served as a host for any of the annual meetings?

Unfortunately I haven't ever been a host for an ACPOC meeting; wish I had.

What is your present role with ACPOC?

My present role is continuing my active membership (I've 'emeritused out' of almost all my other organizations), along with making comments/asking questions at meetings.

Do you have a favorite conference or conference memory?

It was an incredible honor to be Sheila Hubbard's Hector Kay Lecture speaker, in 1995, in Vancouver. I also remember at one of the dinners where we all danced over the tables, and the waiter comes to our table to ask me "what would you like to drink, Miss Ginger Rogers?"© And if I had an embarrassing moment I must have repressed it!

What are you passions, goals, or pet projects for the next 10 years?

Reading and re-reading things - notes from recent & even older meetings, and catching up with journals (about the 'ACPOC fields'). So much gets forgotten. And I'm also selectively reading the new journals, to try to understand the basics of what's being discovered/ created/etc. now. My "pet project" is the one I'm still working on, about adults who were born armless, or lost both arms (at a high level) as a child-most of ACPOC have heard one or more of my 'progress reports'. In the last 5 years I was so busy I had to put it on the shelf, but am working on it again now.

What other organizations do you belong to and how does ACPOC compare?

I belong to too many organizations to list, (well, not too many: AAOS, POSNA, Ruth Jackson Orthopaedic. Soc. & J. Robert Gladden Orthopaedic Soc. (both are 'diversity' groups), US-ISPO and ISPO, and AACPDM (re "C.P. & Developmental Medicine")). ACPOC is the most welcoming/friendly, most diverse, and most 'focused', with many key contributors to list. One of the benefits of an ACPOC membership is the interdisciplinary nature of ACPOC, and the exchange and discussions of many experienced people.

Please share any advice to the membership regarding the orthopedic care provided to children.

Please do all you can do to encourage young doctors (and therapists and orthotists and prosthetists and nurses and psychologists and researchers and...) to go into the pediatric fields! ! Pediatric Orthopaedic fellowships used to be filled every year, and there were ~ 70 of them; for the past several years we have had from 12 to 9 fellows finishing a year! There are still good mentors, and all of ACPOC knows how rewarding it is to take care of children (and even their families too-when they see that we care about their kids).

What is your present assessment of ACPOC and do you feel there are obstacles that may need to be addressed? What does the future hold for ACPOC?

My current assessment of ACPOC is that it's still got what it takes to make a great meeting-and the connections (newsletter, email list, website), but we may not be finding enough younger people who will be the 'standard bearers' for the future. The loss of young therapists and others who come to 'early' meetings (for them) but don't stay with 'us'/the organization is an obstacle. We need to engage them, get them connected in doing things with and for ACPOC, etc. I'm not any better at predicting the future than anyone else, but I think ACPOC has a strong organization and can stay strong by involving the members.