WIROC Show vs Substance in Academic Presentation?

 As I transformed from Academic Orthopedics to Administration, my attendance in Orthopedic meetings reduced but I kept up with the knowledge required to treat patients through peer interaction and doing cases within my limitations. The last two days have seen me attending the prestigious Western India Regional Orthopedic Conference which for those who are not in the field of Orthopedics has evolved to become the premier conference in India. The President of Bombay Orthopedic Society and Conference Chairman Dr. Mohan Desai was my houseman at Bhagwati Hospital Borivili in 1986-87. A nervous boy from a simple middle class Maharashtrian family, has grown to reach heights far beyond our dreams in those years. I am glad that I may have had a small part to play in this evolution. Before getting into the topic, I must talk about WIROC in general and how WIROC 24 has got its present form and format.

                                            Dr. Mohan Desai Organizing Chairman WIROC 24 with Yours Truly 

History of BOS shows how WIROC began in 1966 https://bombayorth.in/bos-history.html#:~:text=Since%20BOS%20was%20geographically%20situated,death%20of%20our%20member%2C%20Dr.

In the days when we were undergraduates it used to be a simple annual conference with a few lectures and free papers thrown in and a few accolades and pats on the back, generally to the favoured few. In 1992 it got transformed into a combination of show and substance. Dr. S. R. Mukhi was the organizer and I was his Lecturer and man Friday. Based on his experience of attending American Academy of Orthopedic surgeons conferences, he set about making a memorable WIROC. As with all things, the old guard resisted but Dr. S.R. Mukhi the surgeon who was trying to break the proverbial ice ceiling with his outspoken outrageous statements stood his ground and established WIROC  not just as a routine academic event but something different. He felt had to be made more interesting, competitive, fun and even commercial. So for the first time papers were not selected based on influence, hierarchy, pedigree but on blind selection by three non controversial stalwarts in Orthopedics. A section on my Worst case, Debates on two lines of treatment, discectomy vs laminectomy, JESS vs PMR in CTEV. Multiple free paper sessions bunched into subjects. The choice of a five star venue and scientific exhibition for pharmaceutical companies, vendors with every nook and corner exploited. ITC grand Maratha as a venue. I distinctly remember some disturbance led to a delay in starting conference so we packed 3 day program into two days and sessions went on till 9 pm and free dinner was thrown in. WIROC made a profit for the first time and in the BOS AGM it was proposed that rather than pay tax fee should be refunded. Generous gifts were given to delegates too. After that WIROCs went on improving, Katrak Oration, Young Surgeons forum, Talwalkar symposium and a lot more continued. 

From 1992 to 2024 it has become better and better and I feel the quality of AV support, research papers and participation from peripheral centers has become better. The major change is the overspecialization and the shrinking role of a general Orthopedician. Has show taken over substance in some cases? The answer sadly is yes in some cases. The cost of WIROC and the high fees are something worth relooking at especially if the Pharma stalls are so expensive. The emphasis on Entertainment has also grown disproportionately. I noticed that Rising star and Masalawalla Best Paper sessions had improved beyond recognition. Pre conference webinars and live workshops plus section on allied Orthopedic topics were good too. The problem of over specialization meant that we saw very few persons there in most sessions except the persons specializing in the subjects of their interest.I still feel that there should be more general Orthopods but i think the generalist will become extinct soon. 

In conclusion, I enjoyed meeting old friends and realized that I was getting respect from many friends and colleagues. I like to do simple cases, teach first principles and refer specialist work to my young and old colleagues and ensure my patients get right advise and are not harmed in any way. Besides, I realize that the more things change the more they do not. Sounds a paradoxical statement but it is as true as can be. Te principles of healing remain the same and till w fid three solutions Orthopedics as we know it for the last few decades will remain the same. They are as follows 

• An instantaneous super glue which can restore anatomy, alignment, strength of broken bones without altering the biology of healing. 
• A cartilage and bone defect substitute which will tackle arthritis make joint replacement obsolete. 
• A ligament substitute of strength and tension mimicking anatomy with machines which pace them perfectly. 

I know all these and more including disc replacements, spinal fusions and pain relief modalities are all breaking new frontiers but every year we will discuss fracture neck femur, non unions, osteomyelitis, bone tumours year after year and the exam answers remain the same. Do no harm? No completely right or wrong answer. Do what works best in your hands within the infrastructure you have to treat your patients. Last but not the least amongst this competitive world do not forget that your patient is a person and not a disease. These are just few random thoughts and ramblings. As an old vintage cricket commentator of my childhood days AFS Talyarkhan used to say. "Take it or Leave It". 

Vispi Jokhi