Botox and Burpees
Botox and Burpees
S04E88 The Humble Origins of a Superstar Orthopaedic Sports Surgeon: Dr. Ned Amendola, Chief of Duke Sports Medicine
Discover the journey of Dr. Annunziato "Ned" Amendola, leading figure in orthopedic surgery and sports medicine, as he shares his experiences and insights with host Sam Rhee @bergencosmetic on the Botox and Burpees podcast @botoxandburpeespodcast.
From his vital roles at Duke University to his upcoming presidency at the American Association of Orthopedic Surgery @aaos_1, Dr. Ned Amendola offers a unique and insightful perspective on the balance of high-pressure responsibilities with a relaxed approach. Learn from his philosophy of teamwork and communication, which has been key in delivering exemplary patient care, especially for elite athletes and special patients such as former Duke Men's Basketball Coach K.
Dr. Amendola also opens up about his personal journey of immigrating from a small village in southern Italy to Canada and the impact it had on his values and professional life. The challenges of adapting to a new culture taught him invaluable life skills that shaped his approach to family and career.
Listen as he shares heartfelt stories of mentorship, pivotal career moments, and the legacy of his mentors that inspired his transition from engineering to orthopedic surgery. Family traditions and the influence of these experiences enrich his narrative, creating a tapestry of professional growth and personal fulfillment.
Join us as we navigate the evolving landscape of orthopaedic surgery with Dr. Amendola, exploring the integration of traditional techniques and modern advancements such as computer-assisted technology.
His anecdotes about high-stakes surgeries on prominent athletes provide a window into the pressures and rewards of sports medicine. As a leader in his field, Dr. Amendola reflects on his heritage and future challenges, offering a compelling vision for the next generation of surgeons.
This episode is a must-listen for anyone interested in the intersection of medicine, mentorship, and personal growth.
#PlasticSurgery #MedicalPodcast #SurgicalLife #SurgeonSpotlight #HandSurgery #DoctorInterview #HealthcareHeroes #InspiringSurgeons #MedicalJourney #PodcastLife #SurgeryEducation #FutureSurgeons #BotoxAndBurpees #BotoxandBurpeesPodcast #LifeInMedicine @dukeathleticmed @dukeortho @dukeorthfootankle @dukeorthosmfellowship @aossm1972 @dukembb
All right, welcome to another episode of Botox and Burpees. I have with me a most special guest. This is Dr Annunziato Amendola, if you're in Italy, or Dr Ned Amendola, if you're in the United States. Dr Amendola is the head team physician and chief medical officer for Duke Athletics. He is the director of sports medicine at Duke University, professor of orthopedic surgery and this is true one of the top 20 power players in orthopedic surgery in the United States.
Sam Rhee:And this is from Becker Spine. And, just so that he was recently appointed the first vice president of AAOS, which is the American Association of Orthopedic Surgery, next in line to be President of the organization in 2025, and the past President of the American Orthopedic Society for Sports Medicine. Now, just so that the context in which these power players are, one of them is Brian Kelly serves as the President and CEO of HSS here in New York Hospital for Special Surgery. Gary Mitchelson, who is net worth $1.8 billion and is included in the Forbes annual richest people in the world. And Dr Neil Elitrash, who just recently did Shohei Itani's elbow surgery, as well as our New York Jets Achilles tendon repair for.
Sam Rhee:Aaron Rodgers. You are in esteemed high company here, dr Amendola, I would have been a little nicer to you. See, played against each other and I have to say the first thing I remember about you, dr Amendola, is that you were so apologetic. You had to play the front tees and they made you play the front tees because you had hit a certain age, which obviously you don't look like you did, and you beat my ass. But the way you beat my ass was like none of listen. Most of the golfers are not like Tiger Woods or anything. The back nine. Every time there was a money shot, a shot that had to be made, where I was hoping maybe Dr Amendola might not get this one, yeah, you hit it. You hit the putts, you hit the short game, you hit your. Your driver was like there's no way I can catch up with this guy.
Sam Rhee:So, welcome, Dr Amendola. It's a pleasure to have you on the podcast.
Dr. Ned Amendola:Thanks, Sam, for the introduction. That was very nice and I appreciate it. It was really fun playing golf. I don't play golf because I'm a competitive golfer, but I like to play golf because it is relaxing and it's a difficult thing to master golf. So we're talking about surgery. When I see patients in the morning for surgery, sometimes patients say, well, Dr Amendola, are you ready for this surgery? I said, yeah, surgery is something I can do. It's not like golf, that's very unpredictable it's. It is a nice time relaxing and get to meet people like you. Sam, Thanks for putting up with me on the golf course.
Sam Rhee:I will say, for someone who is as big a name as you are and actually there were a couple of guys like that who we played with you have one of the more laid back personalities. I never would have guessed that you lead such a big team at Duke in terms of heading up sports medicine their team athletics.
Sam Rhee:You got some major league responsibilities there and yet you are one of the more low-key people that I've met in terms of your personality. How do you mesh that low-key person really just congenial low-key guy personality with all of these big responsibilities, management, people management that you have to do on a daily basis?
Dr. Ned Amendola:I think we're all the same. I think we have to learn how to manage our environment and, personally, I think the best way to manage everything around you if you're a surgeon, or if you're a teacher, or if you're a professor or whatever you are I think you have to recognize the environment around you and really listen to people and listen to your collaborators, your team. We're a team of teams and you're never really on your own. So, for example, if you're seeing a high level athlete who's going to be the number one pick in the NBA draft, there's a lot of things that you need to take into account. So you have the player, obviously, but then you have the athletic trainer, you have physical therapists, you have the coaches and then you have the players team. They've got their family, they've got their advisors and and I think you need to take all those inputs- in before you really communicate and make a decision on what you're going to do.
Dr. Ned Amendola:And so I think and that happens in life with everything, every decision that we make I think you should try and get as much information as possible. Like you prepared for the podcast today by looking into my history, I think we should be doing that with every encounter that we have, every patient that we have, and so then when you make a decision, you know that it's a well-informed decision, you get everybody on the same page and it really makes it comfortable going forward. So then you're going to do surgery. I think the last thing you want as a surgeon is to have any doubts in your mind if you're doing the right thing. You want to be sure that the decision you made has input from everybody. Everybody's on board, the athlete's on board, we got the rehabilitation protocol lined up, and so then you go into the actual surgery with a lot of confidence that we're doing the right thing, and so the only next thing to do is make sure that you do the surgery well and conduct the operation well.
Dr. Ned Amendola:Anyways, I think it's the same and I do. There's a lot of there's a lot of eyes at Duke. A lot of people pay attention to what you're doing, and that's another thing is to have that in the back of your mind and I tell patients that I say you're coming to Duke, it's a teaching institution. Some patients are concerned because it's a teaching institution. You're not going to be doing their surgery, but I usually tell them look, it's the other way around. There's all these eyes looking at the operation. They're making sure that I don't screw up and that I do the right thing, and so I think having a lot of attention and having a lot of people paying attention to what you do really makes you better at what you do on a daily basis.
Sam Rhee:Yeah, and I definitely want to talk about that pressure, because it is very unique for you guys, as high level sports medicine specialists, to deal with some of the athletes that you have to deal with. But before I do that, I want to talk a little bit about how you grew up, and you have such a unique story, and I've heard you say it a couple of times and I want you to maybe expound on it a little bit. You grew up in Southern Italy, in Calabria, is that right, correct? And is it the big city there, cataranso, is that how you pronounce it? Or was it somewhere else in Calabria that you grew up?
Dr. Ned Amendola:Well, I was born in Cosenza, in Calabria, and the Southern part of Italy was always a little bit underdeveloped, more of a agricultural part of the country, not a manufacturing or industrial part of the country, which was, you know, rome and north of Rome. And, yeah, very small town that we lived in was about just outside of Provenza. We lived in a small town, it was about a thousand people, so you knew everybody in the town, you had the same group of friends and really participated in all activities with relatives and friends around the town. It was quite enjoyable. Growing up as a kid I thought it was fantastic and then when we moved, I was very unhappy that we moved.
Sam Rhee:So for me, I have very little experience with Italy. So for me, I have very little experience with Italy, and when I think of you growing up there, I think of Godfather Part II, Al Pacino, exile to Italy, hanging out in a villa, like that sort of golden, huge rural countryside kind of thing. I don't know if that's true or not, but that's my mental image, that's exactly the what it was Okay, good, he got it right.
Sam Rhee:And then when you moved to Canada, to Ontario, in the third grade you mentioned it was very difficult. Your father was a laborer. This was in the late 60s and it was a really hard time. And I could hear when you talk about the emotion of adjusting to a new country, to new language, new cultures, new everything. And was there anything there that was really difficult or or a specific incident that you were like, wow, this sucks and it's really hard for someone from another country to to grow up and develop like this.
Dr. Ned Amendola:Yeah, it wasn't easy for the first few years because of the language barrier. When you don't grow up in a in a culture you really don't know, you know basically the social norms as a kid growing up and going to high school. That's really important to understand the social norms of the kids you're going to school with in terms of what people do when they hang out, what music they listen to. Sometimes you have sing-along songs and everybody knows the songs you're singing and I didn't know the songs. The stuff like that shows on tv that people watched and so that was pretty probably the hardest part was really basically becoming enshrined in the culture. So you understood what everything was about.
Dr. Ned Amendola:And my parents they had even more difficult time because of the language barrier and so that was another thing. They put a lot of responsibility on me to manage the household as a teenager. I went to school, I learned to read and write and could communicate. I could read parents' income tax forms from the age of 15 on, where I would fill their income tax forms, do all their bills and all that stuff.
Dr. Ned Amendola:A lot of responsibility at a young age but at the same time, because you're new to an environment, it really forces you to learn and look at people, listen to people, and that kind of philosophy has carried on, I think, to the present time. So now when I meet somebody on the golf course, even at my age, you listen to them and see where they're coming from, you look at their expression on their face and I think it does help you in everything you do and helps you deal with patients, help you deal with administrators, help you deal with trainees and coming from different backgrounds and different nationality, and so that experience as a child growing up in a new country really has carried on. So I just feel that it's really helped me along the way. So initially it was tough, it was difficult, but I think in the end is actually a very good thing for me and my and my maturing as a human being and as a surgeon.
Sam Rhee:Now I know and I wanted to ask later, but I want to just bring up quickly because you had. You have four children and one of them I saw is also an orthopedic surgeon in sports medicine at University of Nebraska. Now, Is that right?
Dr. Ned Amendola:That's correct.
Sam Rhee:Yeah, and which is pretty cool. I want to ask you about that. But when you think about yourself growing up and then you saw your children growing up and now your grandchildren, is it like, wow, these guys have it so easy. Maybe we need to toughen them up a little bit. Or was it like we're just really glad that they don't have to go through what I went through? How do you feel about that now that they are the second or third generation here in the United States?
Dr. Ned Amendola:It's an extremely rewarding part of my life. So family is the most important thing and so having four children that are doing well and grandchildren that are doing well, it's really. It really brings a lot of joy and it really fulfills my life. So, aside from all the orthopedic stuff and what you said earlier, this family and seeing your kids do well is really the most gratifying thing as far as what you asked.
Dr. Ned Amendola:So my parents were very demanding on me and as parents, I don't think we're as demanding on our children. We just let them decide on their own. So you know, I don't think I directly wanted my kids to go into medicine. So my son is an orthopedic surgeon in Nebraska, my daughter right now is doing a fellowship in sports medicine at Duke, and then the other two children are not in medicine One is an engineer and one is a software programmer for a company in Denver. But they're all great and we still support our kids as much as we can. So that's my parents were loving and even though they didn't have access to everything, they provided everything, tried to do whatever we, whatever we needed, and we still do that with our kids, our children, and we support them. And no, I don't ever think I actually don't ever think that you don't have it as tough as we did, because life is tough no matter what era you're in.
Sam Rhee:That's a really good approach as a parent. The only other question I have about your parents right now is you said they did everything. They made their own sauce or pasta sauce or in New Jersey it's gravy I don't know that. All my fellow Italians here and your father, every year would make wine like a 40 gallon barrel and you would help them with that as you were growing up. Do you ever want to do that? Do you ever want to do the things that your father did? Do some of those things that he did? At this point, yes, I would like to.
Dr. Ned Amendola:Again, everything is in perspective. You're trying to earn a living and do a good job, support your children, support your family, so some of these other hobbies and extra cook activities take a back seat sometimes, but now's the time to start taking some of those on. I learned to cook with my mother in the kitchen, so I still love to do that on the weekends. I would like to make some wine at some point. That's on my list of things that I like to do. You asked me a question before on how you became a better surgeon and I was thinking about that and I was actually thinking of my time with my parents Growing up. We did everything in our home. We made our own tomato sauce, so we went and picked the tomatoes, we cut them up, then we cooked them and got rid of the peel and the seeds and made tomato sauce. We also made our own cold cuts, meat, prosciutto, sausage and cutting up meat.
Dr. Ned Amendola:As a child, and then with my mother in the kitchen cutting up stuff for her to make vegetables and her dishes in the kitchen, I thought, well, that was probably the beginning of learning how to use a knife. So when I met my wife my current wife Allison. We'd been married for 43 years and she came to our house for the first time and Italian tradition usually is you have your meal, you have your espresso, at the end of the meal, some sweets and cake, and then after that you bring a bowl of fruit and my parents and me and my sister we got a knife and we're peeling our apple and we're cutting up an apple or a peach, and she's looking at us like all four of you are like knife experts. It's just a funny story. She was amazed that we were handling a knife like that, because they do that in their English family.
Sam Rhee:That's pretty cool. Now I know they passed, but did they ever get to see you do what you do? And what did they think about that if they were able to?
Dr. Ned Amendola:Yeah, I always try to include again. When you don't have much time at home, try to include my kids and everything we did. My parents were busy they didn't really, but they were very proud of me going into medicine. But my kids, I brought them with me to games on the sidelines, brought them to the making rounds on patients. On Saturday morning we go to bowl games and they hang around and be on the elevator with the athletes and they joke around and the athletes would make fun of me. So it was. It was, yeah, I tried to include them in everything we did.
Sam Rhee:Now you went to University of Western Ontario in London and you played football there for college. You're an engineering major on scholarship and this is what I read and I want you to confirm this for me. You switched and went into medicine after breaking a scaphoid bone which is in the wrist, and that team after spending time with a team physician and I know you've mentioned this team physician a number of times, Dr Jack Kennedy, who's one of the founding members of the American Orthopedic Society for Sports Medicine, and he was one of the people integral as a mentor to get you into sports medicine, as a mentor to get you into sports medicine, and so can you talk a little bit about Dr Kennedy and what that experience was like in terms of getting that switch turned on for you in terms of sports medicine?
Dr. Ned Amendola:Dr Kennedy was our team physician and, yeah, my first year at Western I broke my scaphoid so I was not able to practice or play for a few weeks. So I was on the sidelines with Dr Kennedy watching practice and he had his dog that he brought to practice and I would play with the dog and talk to him. And after a while he got to know me and he asked me about what I was doing. I had a scholarship in engineering. And he says you know, ned, you have the right personality, you should think about medicine, you should think about orthopedic surgery. Coming to our program, and I kind of mold that over and I says you know, you can keep your scholarship in engineering. Just take a few other courses, take biology, take some organic chemistry and then apply to medical school. And during my first year or two of engineering, which is very theoretical, when you're basically learning, you're taking exams, you're answering engineering questions and problems, formulas. I'm thinking maybe medicine would be a more practical specialty where you're applying what you're learning and taking care of people. And I was certainly grateful Dr Kennedy taking care of people and I was certainly grateful Dr Kennedy taking care of me and the other physicians that were working on the team and I thought maybe I'll do that. So I decided to apply to medical school just because I wanted to use my hands and apply my knowledge to something more practical.
Dr. Ned Amendola:My parents were not doctors. We had nobody in the family that were doctors. I'm the first physician and my whole family Italian family in Italy and Canada and anyways got into medical school. And the first couple of years of medical school were it was very interesting because it was like doing engineering, but then you're going into the exam room and applying what you're learning about pharmacology and organic chemistry and anatomy. We got to go to the anatomy lab and dissect.
Dr. Ned Amendola:I thought this is great. So I was really happy with my application of knowledge and skills in medicine and Dr Kennedy invited me to go do some research in his office. Third year medical school I worked for the summer in his office doing research and he's really a mentor to me and wrote me a letter to get into the residency program and the philosophy of Dr Kennedy was that. So he was Canadian, he was the first president of the American Orthopedic Society for Sports Medicine and his view was that our playground in sports medicine and medicine is not just Canada, it's also the United States. So we had to venture off and get involved in some of these American societies.
Dr. Ned Amendola:So you know, I became a member of the American Orthopedic Society for Sports Medicine. His successor, peter Fowler, was one of my true mentors and he became the second Canadian president of the AOSSM and then I became the third one, so really we had three Canadians become presidents of the American Orthopedic Society of Sports Medicine. There's been no other ones, and which is really a testament to mentoring, when you really respect your mentor and you respect what they do, and so I just followed in their footsteps and learned a lot from them.
Sam Rhee:You were in Canada for quite some time and you stayed at Western. You were medical faculty there. You covered the university, the Canadian national teams, like rugby. You were a consultant for the Raptors of the NBA, the NHL, and then you left and you spent it looks like about 14, 15 years at University of Iowa as director of sports medicine and their team physician there. And I have heard you talk about some of the frustrations with the Canadian medical system and advantages and drawbacks, but on the orthopedic side it seems like there are more frustrations working within the Canadian system than there is on the American system. Do you still feel that way in terms of now taking a long look at the two systems and having worked in both?
Dr. Ned Amendola:Yeah, I think the similar problems exist today in Canada. That existed when I left in 2001.
Dr. Ned Amendola:You know, the Canadian system essentially is a single payer system where the government pays for everything, and health care payer system where the government pays for everything in health care, and so, as a result, there's a budget and there's rationing of care, basically access to the operating room, access to imaging, access to care.
Dr. Ned Amendola:Again, don't get me wrong, I think everybody in Canada gets good health care. I think it's just rationed health care and in the US, because of private health insurance, I think it gives you much more options. So you have Medicare, medicaid and government supported health care here in the US and I think everybody gets care in the US. But because of private health insurance, people can get whatever level of care they desire and many more options. So the waiting list for everything for imaging, waiting list for surgery, access to care is much shorter in the US. So there's a lot of good things about Canada and, don't get me wrong, it was theth reunion of our medical school class and you know we love Canada, we love Canadians, we love Canadian philosophy. But the health care system, I think, continues to have some of the similar issues that have been in existence since it became a single payer system. I think there just needs to be some freedom of choice.
Sam Rhee:I know some people would play devil's advocate and say the excesses that you can see in the American health care system can be a little bit nutty. For example maybe not now, but I remember in residency and a little bit beyond, especially on the ortho side, the hardware for spinal implants. There was some major money. It's a multi-billion, it's like a $10 billion plus a year industry. I think there was a lot of advantage taken by hardware companies, by some of the physicians that were implanting these hardware systems. The financial incentives grew so huge in terms of managing some of the financial incentives that we see in all aspects of medicine probably.
Dr. Ned Amendola:No, I agree with you, sam. That is one of the issues. In American healthcare, and especially in orthopedic surgery, the cost of care in the US per capita is almost twice as much as the cost per capita in Canada. When you look at implants not just spinal implants, total hips, total knees, sports medicine implants that I use the cost per implant in Canada is much less than the cost per implant in the US. And so why does that happen, us? And so why does that happen?
Dr. Ned Amendola:And I think in the US is a drive, I'm sorry to say, for making profits. You know, from the insurance side, from the technical side, from the industry side and from the surgeon side, everybody wants to make a good living. So I think those are all issues and problems. So if you look at the government side, the government funding of health care and orthopedic surgery, all of health care you look at the government, every year they're looking at a decreasing reimbursement to physicians. So the government is trying to corral care and you know, and I think the same type of attention needs to be given to other things and I think the same type of attention needs to be given to other things. So you look at a lot of health care systems now are negotiating with industry and orthopedic companies to get lower prices on implants and just bring things down a little bit. So I think these are all issues that need to be considered in our profession.
Dr. Ned Amendola:This is what I'm going to be dealing with the American Academy of Orthopedic Surgeons. You know we have 40,000 orthopedic surgeons that are working hard trying to take care of patients, deliver excellent care, musculoskeletal care, and yet we have this environment out there that we don't really have control over. We don't have control over orthopedic costs, insurance costs. We don't have control over orthopedic costs, insurance costs, government making decisions in Washington, and so here we have a great profession, but there's all these other to continue to try and get as much support as we can to deliver good care and make patients happy. So I personally think our profession as doctors and as surgeons is a great profession.
Dr. Ned Amendola:I'm very grateful for my career and everything I've done, and so I'm going to spend the next couple of years trying to support the rest of the profession and representing us. So I'll be spending more time in Washington, more time trying to work with some of these things. We have a large office in Washington, we have an advocacy council, we have a political action group that helps negotiate some of these things. Those are good questions, sam. I don't have the answers of what the best solution is, but I think the Canadian system is not perfect, the American system is not perfect. If we could somehow get the best of both worlds, I think we'd be in a much better place.
Sam Rhee:That's good. Someone like you who's in both would do a good job as a leader. Now you spent time at Iowa and I was just looking at and I don't follow Iowa sports, except maybe football a little bit, because I'm actually a Michigan fan but I really respect Kirk Ferencz and his philosophy and the fact that he's still coaching probably the longest active Division I football coach and he had a pretty good record while you were there. I would say his best year was one of his best years was 2009,. 11-2, going to the Orange Bowl with a win. What can you take away or what do you look back at for your time at Iowa and what stands out to you there?
Dr. Ned Amendola:That was a great year 2009,. We won the Orange Bowl in Miami against Georgia Tech Nice and it was a great place to work and probably dealing with the coaches and athletics was really the best part of my job there. And coaches like her parents and you know, recently caitlin clark had a lot of press and her coach, lisa bluter, just retired. She was a great coach of the women's team and worked with her while I was at iowa the brands brothers, brothers, the wrestling coaches great coaches, very passionate, and it's really fun to work with people that really work to the greatest extent to have success. And at Iowa, you know Iowa's Iowa it's not like New York City and it's not Duke. In some respects, I think the coaches worked extremely hard to have a good team and put a good team on the field. The best part was that the coaches totally respected the sports medicine team. We were part of the team. They treated us as part of the team. Candid communication they could call any time. I could call them anytime.
Sam Rhee:If.
Dr. Ned Amendola:I had a visitor come to Iowa. I could walk into Kirk Ferentz's office and he would immediately walk them in Within three or four questions. He would find something in commonality with the visitor, no matter if it was a surgeon from Florida or New York or whatever, and so that was. It was really, really fun, I think, as you get to a higher stage and it's not the same, it's not the same everywhere, but there is one story from 2009 that I need to. So Rick Stanzi was the quarterback for Iowa and he played in the. He played in the Orange Bowl game. He played a great game and we won handily over this Vaunted. Georgia Tech had this offense with the triple back option. All three backs had over 1,000 yards and so it was a big victory.
Dr. Ned Amendola:But anyways, rick Stanzi, iowa was 10-0, I think, to start the season, 9-0 or 10-0 were in the top two or three in the country rank, and Rick Stanzi hurt his ankle against Northwestern and he had the so-called high ankle sprain, the TUA injury that he had in 2019. Yes, so this was 10 years before. So this was 10 years before and uh, so we did that surgery and on rick stanzi, with, uh, four weeks left in the three or four weeks left in the season and so five weeks later he was able to play in the orange bowl and the surgery was very successful. And anyways, I don't. You can look that up. He's got a video, rick Stanzi there's a video about Rick Stanzi and Debra from the surgery. So that was one of the most rewarding things is to see him get on the field and play the whole game, kind of the MVP of the game, but after doing a surgery on him five weeks before. So I just that's a big memory from 2009. So it's a coincidental. You brought it up.
Sam Rhee:Yeah, no, it's crazy. And that leads me into my next sort of thought, which is the amount of pressure as a high level sports medicine surgeon to in terms of the athletes and I understand all patients are important, like I know that. But when you're operating on somebody who and for example, let me just throw one that you recently did and the first thing is that most of our, most of us as surgeons, our patients are not public, like they're not no one's announcing to the world that I operated on somebody. But when, back in March, houston Rockets announced that forward, terry Easton underwent successful surgery to treat a benign growth in his lower leg, performed by Dr Ned Amendola at Duke University and involved excising and bone grafting the lesion, inserting an IM intramedullary rod into his tibia to accelerate healing. Now this is a guy who signed a four year $16 million contract with the Rockets and his average annual salary was $4 million and this is a tremendous investment, not for the athlete but for the organization, for everyone around him. And two days ago he was giving an update on his rehab process. He's been playing in the Drew League, finished with 26 points, nine rebounds, four assists.
Sam Rhee:Now, first of all, if I'm a surgeon, I got to be like I am the man this is. Look how effing awesome I am. But the pressure placed on a surgeon, like you said, to recover, to come back in as fast as possible and, as you said, to perform at 120%. This is not if I get this procedure. I'm just happy if I can function on and do all my activities of daily living. I'm not looking to cut dunk, move at the highest level of human capability and, as you've mentioned, it's not just the athlete, it's a whole team of people that are just yammering at you family trainers, agents, like we've seen movies about this sort of stuff. And so how do you handle, or does it take someone very special to be able to succeed at that level?
Dr. Ned Amendola:No, I don't think of myself as special. You really built that up, tim, but I'm sure you're the same when you take on a patient and you perform plastic surgery. This is you, this is what you do, this is like your craft, this is you know. And so if I'm doing a surgery that I do and I know I do it well and I do it as well as anybody in the country I don't think you have a lot of pressure because it's what you do. This is who you know. What defines you.
Dr. Ned Amendola:It's not as if you're doing something for the first time. You're doing something that you know you can do. You know how to do it, the outcomes do you know how to do it? The outcomes? And sometimes you feel that way when you see patients. You feel like I should do the surgery because I'm the best guy for the surgery, but you never say that. You never say that to the patient, and so I think it's knowing your crafts and knowing what you're doing and really having been through it multiple times before, having a lot of experience and again, I've got a lot of experience. That was one advantage in Canada when I was there for my first 10 years in practice, I did a lot of surgery, like a lot of, because it's such a long waiting list for surgery, and if you can just craft out time and find time and use your partner's time, and so you, you end up being a good surgeon, knowing your craft well, and so I think if you do, if you know that, then I don't think it's as much pressure as as some people might think.
Dr. Ned Amendola:Number one and then number two is with those types of players. You're speaking to everybody the Houston Rockets, you got their management, you got their doctors, you got the agent, and then the family and you talk about it. You have a number of calls and say, okay, we're coming up to Duke and have the surgery and they're very happy with the plan. You've discussed it and there was three or four other opinions. With most of these cases they get three or four other opinions, of course, and then, after all the discussions and all the communication, they say, okay, we're just going to come to Duke and do it as well as I do. The hard part is the preoperative communication and decision making. Once it's done and the patient is coming to the operating room, that's the easier part. You just got to go through it technically and get it done.
Sam Rhee:I remember you talking about you operating on Coach K and his ankle and when he told you I would really like to hear that again what he told you before you did his surgery, in terms of what he also told his team when he was coaching the Olympics- yeah, no, I remember distinctly because, anyways, coach K is unique and I learned a lot from Coach K from the first day I came to Duke and working with him and taking care of the teams.
Dr. Ned Amendola:His mind works differently, like before I came to Duke, I heard the line leave your ego at the door so many times. And then, talking to Coach K, it's the opposite. It says why would you ever want to do that? When you got these great athletes, you want them to bring the ego in. Bring their ego, bring the best shot they got into the room. We figured out a way to use it and so when I did surgery on him the day of surgery I'm seeing in the preoperative area he says just bring your best stuff into the room, don't leave anything outside the room. I know it's me you're operating on, but just bring everything you got I know you're the best surgeon and just bring your ego into the room. Don't leave anything outside the room. I know it's me you're operating on, but just bring everything you got I know you're the best surgeon and just bring your ego into the room and use it and do what you can do on my ankle. So that was Coach K.
Sam Rhee:That's great. I will say he scares me a lot. He reminds me of my old mentors and they were amazing people but they held really high standards and if you pissed them off, you bet if you weren't prepared, if you didn't bring your a game to the or you better watch out because things might fly around the room a little bit. So I feel like he. He reminds me a lot of of the guys I used to train with back in the day so I don't think.
Dr. Ned Amendola:I don't think he was. Yeah, he paid attention to everything that was going on. When I came to Duke he really you could tell by our communications that he was paying attention to my actions, my communication, the way I dealt with athletes, and it was amazing. I just thought it was amazing that he kept track of all these things and then when you're having a coffee or you're traveling with the team, he would just come up and say, ned, I really appreciate the way you did this or the way you did that, and you didn't have any idea that he was paying attention to that. I think that's what makes somebody great is to really know what's going on around you and having a pulse on the people, the athletes around you.
Sam Rhee:What do you still love to do? What is your favorite operation? I know you probably love all the operations you do, but is there one in particular that you have a fondness, for whatever reason?
Dr. Ned Amendola:I like operations that are not instrumented, Like you use a cutting guide or a jig where you put it on and you just follow the instructions. I like operations where you do have to use your God-given talents, experience in doing the surgery. So there's a few operations like that that you still need to use art and use your technical skill to do the surgery. So meniscus transplantation, putting in a new meniscus into a joint, I think takes a little bit more technical skill. There's not really a guide that anybody can just go ahead and just do it the first time around, and so you have to use a little bit. It's arthroscopic surgery. It's arthroscopic surgery. It's arthroscopically assisted. You have to prepare the area and then you have to put the meniscus in. You have to do a lot of preoperative preparation to get the right size, get the right patient. But it's not just computer-assisted or instrumented surgery. There's that one. That's one of my favorite surgeries to do. The other one is realignment surgery of the limbs.
Dr. Ned Amendola:People have malalignment, Like this intramedullary rod that you mentioned earlier on the basketball. That's pretty straightforward. There's just things that you just step one, step two, step three, and it's more instrumented, Whereas sometimes if you have malalignment we have knock knees or full-legged knees or post-traumatic deformity and you're going in. I know you've done a lot of bone surgery and reconstructive surgery as well, Sam. You have to do a lot of preoperative planning but then the exposure, the anatomy, making the appropriate cut and the bone and fixing it and using the appropriate fixation. I think it's a very gratifying surgery and these patients come in afterwards when they and you can show them at the end of the day, show them their limb before and after surgery. We just did one of these very large correction this week and showed this patient after the evening, took his dressing down. He says, wow, this is really straight, it's like cosmetic surgery.
Sam Rhee:But way more functional. Let's just put it that way the current trends in ortho are completely against the types of surgery you're talking about. All the Mako systems, the computer guided systems this is idiot. Proofing some of the hip stuff, knee stuff, I don't know, whatever the art of it, learning the and there's a lot of that also in craniofacial surgery too, where computer guided or computer assisted types of surgery are taking a lot of that art, or just the fact you need to get a lot of reps in order to be able to do it well, do you feel like that is a loss in terms of how the surgical specialties are trending?
Dr. Ned Amendola:No, I think you do have to make way for modernization and moving forward. I think the younger generation they're really good, and even my son uses a computer-assisted preoperative planning tool for osteotomies, limb correction, and I think it is an advance and it is moving things forward, and so I think all those things are good. But I usually tell my trainees and fellows you should be able to keep an eye on what's going on, because sometimes it's not foolproof. If the Mako device or Epsom just looks like it's not quite the way you think it should be, you should reevaluate. And so, even though you're using a computer-assisted system or robotic assistance, I think as a surgeon you should be able to know the surgery. Without the robot, you should be able to do the surgery, and so you got to keep close eye on it, close track of what's going on, to make sure that the robot is doing what it's supposed to do.
Sam Rhee:What do you listen to in the OR music-wise? What do you like to listen to?
Dr. Ned Amendola:listen to? I usually classic rock. I grew up in that era 70s and 80s and yeah, I usually those rock ballads and just it seems to be soothing music. Now you go into the locker room with the teams. They got it's crazy music and when I played football in the early 80s the mainstay was rolling stones music where you have the boom box and it was all it was in the one big boom box in the room instead of but we still do that at duke. They still have the music going on, but it's it's more modern. Yeah, modern, it's good, it's got a good beat, it's good to listen, but it's more modern. Yeah, modern, it's good, it's got a good beat, it's good to listen, but it's not as soothing for me. When you grow up with music Do you listen to?
Sam Rhee:music Absolutely. Sometimes I find I need less music now. When I was a resident, oh my God, I used to just whatever the attending would allow, as loud as I could, I would play, but now it's it's a little bit different. I my go-to is always the 80s, though, you're right, but I also try to appease the people around me. So if they want to play something else, I try to be a little bit flexible with that as well, or I'll ask the patient even though they're asleep. So I think it's an interesting trend right now.
Sam Rhee:I think the sports medicine guys are the rock stars of medicine. Like you, guys have so much more visibility, and I think for a couple of reasons. One is everyone is very active. There's everyone's playing pickleball or, in my case, crossfit or whatever it is. So there are more active people doing active things older and people gravitate towards high profile sports medicine specialists.
Sam Rhee:So you mentioned, your son is a sports medicine guy and he trained at Stedman for a sports medicine fellowship, and I know nothing about sports medicine really, but I know about Stedman and Vail, colorado, and all that, and James Andrews, I think, was the first down in Alabama, and now Neil Eletrash in LA, and you, you guys are now rock stars in the sense of high profile surgeons. And is that good? Is that bad? Is it driven? I think some of it's driven by the fact you guys are getting better outcomes as well, versus maybe 20 years ago. 20 years ago, these techniques or surgeries were fraught with peril, I think in some instances, and now the expectation is that, yeah, you get surgery, you're going to be better than you were before sometimes.
Dr. Ned Amendola:Yeah, it's a double-edged sword. I think you hit the nail on the head, sam. For example, tommy John surgery for elbow injuries and baseball players and pitchers. So you mentioned Otani. Had he had a redo surgery that?
Dr. Ned Amendola:was and uh, it's. I think when you take somebody like Neil LaTrosh, like he's the go-to guy for all these surgeries and uh, he's doing these pitchers and they're going back to a very stressful sport and throwing, and so when you have so much success, that's what happens. So now you have high school kids. We don't do as many baseball players here, but I have a couple of partners that do the same surgery that Neil Atrash does on the elbow. But we get high school kids now that have a little bit of elbow pain and the parents are actually requesting that they have that surgery so their elbow is stronger and able to throw more and throw a higher speed. And it is a double-edged sword in terms of there's too much media attention and things are probably thrown a little bit out of whack with that.
Dr. Ned Amendola:I think the Rogers thing with the Achilles repair I give all the credit to Neil Elitrosh and his team that did the surgery, but it was like he's going to go back and play at four months.
Dr. Ned Amendola:We weren't able to really tell if he was going to be able to play at four months, but it's just virtually.
Dr. Ned Amendola:Looking at the Achilles tendon, I do a lot of Achilles tendon surgery and you look at all these basketball players and football players in the past that tore their Achilles, it used to take a year to get back to full function.
Dr. Ned Amendola:Well, maybe Durant with his Achilles tendon takes a whole year or even more than a year to get back because the demand on his Achilles is much more than a year to get back because the demand on his Achilles is much more, and maybe you'd be able to get somebody back to playing football that doesn't need to jump and dunk as much. But I'm just saying having that attention where here's an Achilles repair and going back after three or four months all of a sudden the demands on the sports medicine surgeon is okay. If I have an Achilles repair, I'm going to be able to play basketball at six months, which is really difficult. It's just hard to get the neuromuscular control and it is. You know, having attention and having that type of media coverage on one hand is good, but on the other hand the expectations get a little bit out of whack.
Sam Rhee:Yeah. Do you think that you guys, who do these high level athletes and have a lot of publicity are better surgeons than, say, someone else who does these surgeries and that's why you guys get the publicity and the notoriety? Or is it just them? You happen to be right place, right time. Don't leave your ego at the door right now. Tell me the truth. Do you do that surgery better than anyone else around? And or ella trash or any of those guys, guys or Andrews back in the day? What is the difference?
Dr. Ned Amendola:I don't think so. I think there's a lot of good surgeons around. I think we have a you know. I think a lot of people can do the same operation and do it well. I think it's just the pathway that develops. If Otani's agent sees that Otani's doing great and he's hitting more home runs than anybody and he's representing 20 other baseball players, then every time they need something he's going to send them to the same surgeon, and at least that's my impression. There's like pathways of who you know, and the last time I sent somebody here they did really well and I would recommend going to that surgeon, and you know so it's a lot different. So when you see a patient that so sometimes I see patients from Charlotte, for instance, which is a two hour drive away. Yeah, and they were recommended Often the patient will say is there anybody in Charlotte that can do the same surgery? And so say they need an ACL or they need a meniscus transplant.
Dr. Ned Amendola:Yeah, I say yeah, there's several surgeons that I would recommend in Charlotte and I usually give the patient the name of those surgeons and I don't think you can tell the difference, technically speaking, of the way things are done. But I think the patient has to get that information in his eyes. They were recommended to come here and they asked is there somebody in? Often the patient will say since you're recommended, I'm just going to come to Duke and have it done at Duke. But I think in pro sports it's much more of that, where the athletes follow their recommendation and the pathway that's been formed. I think Dr Elitrash is a great surgeon and I've seen his operations and his technical skill and so I think he's able to do the surgeries. But he also has a great reputation amongst the sports medicine community, especially in those areas. The Achilles tendon is was a bit unusual with that because he's not.
Sam Rhee:I think he's not recognized in that area. Yeah, if I need surgery for my foot and ankle, I'm going to the same one. That doctor, the same surgeon Dr Coach K chose, and I think I would be okay with that. So now you have two people going into sports medicine from your family your son, who's already a sports guy in Nebraska. And then you said you had a daughter who's finishing up her sports medicine fellowship.
Dr. Ned Amendola:Now, be honest, did they? Did you kind of unconsciously put them into that sports medicine mode? Or and bringing them with me to do visits and visit athletes and bring them to the training room? And yeah, so I think they and I enjoy my job. So if you're at home and I say I love what I do and I tell them about patients, and the other thing that happened was they make fun of this all the time. My kid says, everywhere we go there's people that know you. We might be shopping at a grocery store or at a restaurant and there'd be people coming up and say, oh, dr Amendola, you did surgery on me three years ago and you did this and you did that. So I think they, first of all, they knew that I enjoyed my profession, I enjoyed what I do, and then, secondly, I did bring them around to participate in some of my activities in sports medicine and particularly my games, athletes and going into the training room.
Sam Rhee:So I can tell what you're going to be doing, at least for the next year or two, which is a lot of advocacy and representing the face forward for orthopedic surgery being president of V Vice and then president eventually of AOS. After that, what goals do you have? You are young or in your prime, I would say, as a orthopedic surgeon. I know I think Andrew's retired at around 81. So you got like the bulk of your career. You got all the experience, all of the notoriety, the resources available to you, like you can change whatever it is around you to make it fit what you want to do at this point, like growing up in your career, you're always making compromises about this, that or the other thing, but now it's like you can set an agenda for what you really want to do in your life. What is that going to be for, this advocacy and big position in AOS? Like what's your goals?
Dr. Ned Amendola:That's a good question. Nothing is etched in stone, sam, but you're right. After this academy, a couple of years, I'll probably be looking at what I'm going to be doing as the last phase of my career and obviously family is a big going to be a big part of my life and enjoying my children and grandchildren, and I still feel like I have a lot to offer. I have a lot of experience and I have a lot of things in my head in terms of orthopedic surgery and I think I'll probably be doing some consulting and giving advice in certain areas. I'd like to take up some of these other hobbies that you mentioned earlier winemaking and art. I've written quite a few orthopedic and sports medicine textbooks or edited books and written a lot of chapters, but I I also have another book, personal book I'd like to finish and publish. So I got a few things in mind.
Dr. Ned Amendola:When you look at what is it that makes people happy in life? I don't necessarily think I'm just going to finish and retire. It's just going to be continuing on and doing the things I love to do. But there's not too many things you need in life to make you happy. I think you need something challenging every day. So right now I'm doing something challenging every day and I'd like to continue doing something like that.
Dr. Ned Amendola:You need somebody that loves you, or family, which is obviously very important. And then the third thing is leaving a positive trail or a legacy behind, and I feel like I've done that, everything I've done. There's some positivity to it in Canada and Iowa and now at Duke, and so you want to leave a positive legacy behind. So I just want to make sure that everything is in my brain about orthopedic surgery and sports medicine gets passed down to the next group of trainees, which I've had fellows and trainees for 30 years and they know everything. But I just want to make sure that's all passed on. But I don't know if that's good enough for you.
Sam Rhee:That's really good, I would say, the mentors that I have had. I think about almost every day when I'm in the operating room or for whatever I do. I think I hear their voices in my head. But I think it also is important for the stalwarts of our generations in terms of surgery to pass down not just individually to people who see them, but collectively, because, like you said, there's a lot of thought processing, mental sort of just mindset stuff that I think if you can somehow encapsulate, verbalize or communicate to people is really meaningful.
Sam Rhee:You have a pretty unique experience in terms of what you've done, what you're going to do. Everyone could be a benefit of that if they got more of it, and I know you have a lot of other things like family, like your hobbies, like everything else that you're doing. But I think that's one of the reasons why I want to talk to you is because I just wanted to hear a little bit more of what's going on in your head and how you think about approaching life every day, and I really appreciate you taking the time to do that. That means a lot.
Dr. Ned Amendola:Anyways, thanks, sam. Thanks for all the kind words, and it's really been nice talking to you. I'm not sure it's of huge interest to hear Ned Amendola's story, but I do agree with you it's been a great ride. I'm very proud of my Italian heritage, my Canadian experience. I love America and the ability to fulfill your dreams in this country are definitely possible, and so I'm very grateful for everything that's gone on in my life and but I appreciate meeting people like you too, and hopefully that'll be part of my future as well, having a few more golf matches with you.
Sam Rhee:Yeah, I hope I can put up a better challenge next time. I really need to step up my game in order to do, but I hope I can do that.
Dr. Ned Amendola:I'm sure you will, knowing your tenacity and your desire to excel. It'll be great Looking forward to it All right.
Sam Rhee:Thank you so much, Dr Amendola.
Dr. Ned Amendola:No Looking forward to it. All right, thank you so much, dr Amendola. No, thank you, sam, and have a great day you too Okay.