All the csotcina.comedists heard of . Its works on articular physiology are present until in the medical bookstores of . But do you know it? He works with the Private clinic of the Yvette with and entrusted to csotcina.comedic Maîtrise.

 

 

. : Mr which are you?

. : With much from point of view, I am minority. Initially I have a name difficult to carry, but, with time, I realized that it is a remarkable name: it has a sonority and a history. I do not have anything against Durand, but finally, I prefer to be called . My father was surgeon and I inherited him scientific curiosity, intellectual probity, the surgical direction and also a certain direction of the businesses. It forwarded many things to me, much of gestures, and that belonged to the heritage that I qualify the timeless one. I.e. all that our parents give us in an invisible way by their behavior and their knowledge. The state will be able a day to perhaps seize us the totality of our financial heritage, but never it will not be able to seize this timeless heritage. As regards my mother, I inherited my artistic direction and by his father, who was mechanic, the direction mechanics. I thus received much from my family and this is why, ultimately, this name that I had of the evil to carry at the beginning, now, I assert it. I am very proud and I will try to forward it with plume. I hope to have communicated my concern of the dynasty to my son, who is also surgeon.

. : Who was your father?

. : My father Turkish, had been born in Greece and because it had made his conventional studies with the French college of Salonique, its family sent it to Paris to make her studies of medicine. He became doctor, then Intern of Paris. He was tried by a hospital career but, owing to the fact that he was foreign, the aforementioned was closed to him. He worked with famous surgeons, of which Sauvé with which he developed the famous technique of Saved-Kapandji. My father was not csotcina.comedist and it did many work of digestive surgery, on the biliary tracts in particular. But it is this “small” csotcina.comedic operation on radio-cubital lower, now used in the whole world, which gave him an unforeseen fame. He exerted in Paris in several private clinics at the same time. On the end of its life, it was naturalized French and it was proud. This “foreign” paternity is also one of the aspects of my minority personality.

. : Which are the other aspects?

.: I had during my medical studies of the political opinions “far lefts”. It was badly seen in medical environment. Since the things changed: I evolved/moved and the experiment learned to me much. But I do not regret this militant period of my life and this “left-wing” experiment which after the Release was tempting for all the young men who reflected a little on the policy. It enriched me with many point of view. Now, obviously, one does not find much any more of intellectuals of left….

. : How was held your surgical formation?

. : I was appointed Intern of Paris into 56 and I finished into 60. I made a boarding school of general surgery with primarily choices of digestive and I even made my thesis on the digestive one. During my boarding school, I was in infantile csotcina.comedy at Pierre Lance where I knew pol. , original and clever spirit. In fact, I “practiced” csotcina.comedy primarily in the department of general surgery of Felix Poilleux in , as Intern then as Senior registrar; I felt there well and I was particularly affected with csotcina.comedy simply by personal taste. That did not prevent me from doing work of “digestive” and I improved an aircraft which, at this time there, was very much used to assess the operation of the biliary tracts. It was the kinesimeter which I transformed into and on which several generations of interns “dribbled”. At the end of my , I tried to continue in vain in the hospital channel. At this time, for all kinds of reasons, I was in front of a closed gate.

. : Don't you think that your very original personality was the main obstacle?

. : Yes certainly; In addition this obstacle appeared clearly when I was at Pr Lucien Leger. He asked for one day to me of make him for “the following day midday, on my desk”, as he was accustomed to saying it, the worldwide bibliography on tyrolo-Bavarian echinococcosis. I must say that really did not connect me. I was to be taken part in work in the service, but on exciting ideas! He did not have as it wished it the worldwide bibliography on alveolar echinococcosis” He did not appreciate. I recognize that it was not “not well”… I think that this day there it fired a feature on my promotion.

In short, I had to reconvert me into the private career. Immediately, I told myself that I could not exert as my father had done it, while jumping of a private clinic to the other, because of the development of circulation in Paris. I also thought that its own work tools had to be created. With other very motivated colleagues and who became my friends, I thus realized, now 27 years ago, this private clinic in southern suburbs. That required of me many efforts, work and tenacity. Now, I have work tools which, in the content, are very powerful, at least as much as an hospital service. I deduced from it that the paths of the life are unforeseeable but always carry out you where you must go…

. And articular biomechanics?

.: That was my chance. One day a comrade of promotion which taught articular mechanics in a school of masseur-kinesitherapists proposed to me to succeed to him. I told yes with pleasure because I had taught much with the Pavillon of Anatomy: I had made innumerable drawings in the board during my two years of voluntary Aid of Anatomy which, in the passing, were not rewarded since I never could be appointed with the . At all events, I made these run to the physios by them abundantly illustrating and it is by teaching biomechanics of the human body that I learned it myself.

I read in all the directions the marvellous book of Duchenne of Boulogne which is really the ancestor of Biomechanics; he did not contain any drawing of anatomy. And I built all kinds of diagrams with the principle which each drawing was to express only one idea so that it is immediately comprehensible for which looks at. I was thus brought to conceive the teaching of biomechanics like a comic strip or, if one wants, the “Rich person Hours of Articular Mechanics”. I.e. a succession of drawings which result in acquiring the essential notions on operation of the muscles and the hinges. While making these exchange rates on this information system strategic plan, I told myself that it was a shame that all these drawings are not used by a greater number of pupils. I thus was to see with the model of a chapter, an editor who had already known a certain fortune with diagrams of anatomy and he agreed to follow me: I believe that it made “the good choice”.

I published my three books on Articular Mechanics: they knew a great success and they are read by all the kinesitherapists of France and , and probably by much of surgeons. They are translated into 6 languages of which Japanese. It is that now I am more known abroad than in France. As what one can benefit from his failures…

. You explain this success by the simple setting in images of the Duchenne of Boulogne?

. : I read only Duchenne of Boulogne. I read , I read and many other and I also had personal ideas. But it is Duchenne of Boulogne which was really my mentor. I reflected also much on operation of the muscles and the hinges starting from teaching and during the interventions of csotcina.comedy.

I thus discovered obviousnesses which had interesting consequences but that nobody had expressed hitherto. With regard to the mechanical party of the work, she is explained by my leaning for physics and the descriptive geometry heritage of my maternal grandfather. I thus implemented things which I had collected on the right and on the left during my conventional indoctrination. I never followed exchange rates to the School of the Arts-and-crafts or exchange rates of mechanics to Faculty; on the other hand, I read much. It is mechanics drawn from my experiment which is transferred in my books; it is thus a lived mechanics.

. : How did you carry out the drawings?

. : I made my drawings “with a pencil and paper”. Now, do them with my computer. My mother, who is , learned how to me to see, draw and reproduce on paper what I had in the head, but I had not made an occupation of it. Actually, I was discovered capacities of draftsman to the pavillon of anatomy when I made boards for the first-year students.

I have a facility which is to represent very well the things in space. I manage to translate on paper these visions into three dimensions. I believe that when one has provisions for the drawing, one sees initially the drawing in his head and then one projects it on paper. I even made in my the first two volumes of the “models” of articular mechanics, left cutting-folding-assemblies which are for me drawings in space…

. : You a little were reproached your absence of experimental source…

. : Yes… there are many people who asked me after having read my books “where is your laboratory?”.
Some said that I had made “biomechanics in room”. It is true. In addition in all modesty and on my small level, I do it parallel with the same question that one posed in Einstein: Where is your laboratory? It showed its pencil and its paper and it said “my laboratory, it is on my paper”. I made biomechanics in room, I acknowledge it and I do not have shame of it, because so only while reflecting on the forms of the bones and the hinges and the muscular managements of shares and , I found a certain number of things, I think that all that was already accessible to the others. In the content these books did nothing but translate my amazement in front of the beauty and the remarkable organization of the anatomy of the human body and nature in general. told “All is Harmonie in Nature…”.

Now, one makes biomechanics in over-equipped laboratories, with heaps of electronic devices, and one assists, under the pressure of the Anglo-Saxons, with a “technological perversion” where the alive structures disappear behind boards from figures…

In there reflective, with the passing of years, I ended up understanding the basic differences which exist between industrial mechanics and biomechanics. Many csotcina.comedic surgeons think in terms of industrial mechanics. I employ a voluntarily provocative term by saying that biomechanics is “potato”: its geometry is not strict, its axes are immaterial and evolutionary and its hinges contain a mechanical play “with the construction”, which far from being a defect brings additional functional possibilities. This play is an advantage only as long as surfaces are rebuilt: biomechanics is a science which integrates the dimension of “time”, because the living beings are “beings with four dimensions”, in perpetual development of the birth to death. As soon as wear is not compensated any more by the permanent rebuilding, we become again the prey of the entropy…

.: You did not have really of Master in csotcina.comedy?

.: Indeed, not: I am the “wire of anybody” and that was very awkward at one period of my life, when I made “my moult” of the situation of general surgeon to that of csotcina.comedist. But I was helped by Merle of ….
I was unfortunately not his pupil, but I went to see it one day with volume III of my work on the trunk and the rachis, which was not published yet. It was very interested by my manner of conceiving the mechanics of the human body. It was filled with enthusiasm and it wrote to me without any difficulty a foreword that I regard as very eulogistic and very favorable. Thereafter it always helped me in my progression in the csotcina.comedic medium and allowed me to be member of the French company of csotcina.comedy, then to make my path on the side of the hand surgery. Blackbird of was my first adoptive father…

. : Since your liberal installation, which were the managements of your surgical activity. ?

. : At the beginning of the private clinic, I was general surgeon and I exerted there like such during more than 10 years, with an csotcina.comedic polarity. But at one moment, I reported myself that I could not be credible as an csotcina.comedic surgeon if I continued to practice the general surgery. Extremely fortunately, I had joined several other colleagues who could assume the digestive surgery completely and thus, gradually, I could confine me with the csotcina.comedic surgery and obtain my qualifications near the competent jurisdictions.

. : Why the choice of the hand?

. : I was always fascinated by this extraordinary tool which is the hand. As soon as I heard of a small “company” which appointed then the Group of Study of the Hand, I had only one ambition, that to take part in his work. I had already a multi-field approach of the hand: artistic, anatomical, functional, surgical, and the idea of a group of study which is not restricted with the me had allured.

By forwarding original work, I could be allowed in this restricted circle which now became the French company of Hand surgery. I there was accommodated and guided by Raoul who is my second adoptive father, and for which I keep deep and affectionate reconnaissance. I did not cease looking further into the anatomy and the operation of the hand on which I published not badly work in particular with regard to the column of the inch with which biomechanics is full with astutenesss. There still, I go from amazement in amazement. In the Group of Study of the Hand, then in the French company of Hand surgery, I found a full blooming because it is a completely user-friendly medium; we are all friendly truths and we were not very numerous at the beginning, contrary to the which became now an enormous “machine”. I always published in the rather than in the .

. : And prono-supination?

. : I could almost say that it is my “hobby-horse”. It is a little hereditary besides since my father there was interested and conceived an operation to restore it. I was posed one day, the question of the utility of this movement and then that in the way in which phylogenesis had made it possible. The crucial question is thus: “Why the front armlever contains it two bones?”. That led me to make discoveries, and especially to understand that the means which appeared to me a priori simplest were most intricate. The system of the two bones of the front armlever is a completely extraordinary “invention” which goes back to the exit of fish of the sea, three hundred million years ago. The prono-supination is a movement which practically was used only at the end of development, if one can speak about development, and that raises fundamental philosophical problems. In more it is a movement which requires the integrity of two hinges which are joint, the higher and lower . I reflected especially on the lower of which I am impassioned; I even designed a prosthesis of it, still in period of clarification.

. : Your method of processing of the fractures of the wrist was a certain success.

. : It is still the result of my anti conformism. When I learned how to operate, me was always affirmed that one did not have to put screw or pins in the chambers of fracture. It was a species of taboo. One day, I realized that by transgressing it, one could give to a pin intra-focal distance a negotiable instrument of obstinate which prevented the secondary displacement of the fracture. My technique of processing of the fractures of the lower end of the radius is resulting from the violation of this taboo. From the moment when I started to put pins in the chamber of the fractures, I noted that fixing was much more solid and allowed an immediate rehabilitation.

I have, like many csotcina.comedic surgeons, the very acute conscience that the musculoskeletal system must function permanently. If you allow me the audacity of a neologism, I will say that the musculoskeletal system is made for “”. As soon as it is stopped, it starts to be degraded, because it is the movement which maintains it. The ideal in front of a fracture, it is thus from the beginning to obtain by means the least invasive possible, a correct reduction and a solid fixing which allow the immediate use of the segment member, without stopping the function.

. : How long does that take to make succeed an idea?

. : To make accept an idea, that takes time, patience… one can even say eagerness. Time, they is sometimes 10 years. It is necessary to be obstinated. I always at the head have the image of the usher of whose maxim was “ in ”.

It is thanks to this obstinacy that I did many things in my life, in particular the private clinic. is not needed.

. : Did you have ideas which did not succeed?

. : Yes, for example the trapézo-metacarpal prosthesis. I was one of the first to carry it out about at the same time as Of its first prosthesis of the spherical type realized. I always thought that this hinge, which functions with two axes and two degrees of freedom, was to be modelized by a gimbal joint. Then I drew a flexible silicone prosthesis whose interest is to reproduce very exactly the physiology of themetacarpal one.

But this prosthesis was put “at the wall cupboard” by a firm which sold other prosthesis, so that it is practically not known, although it functions the others as well as: I posed myself of it about thirty with good performances. Thereafter it wiped the discredit which stuck to . But I have in my cartons a model which has the same function exactly, on the same principle of the gimbal joint, but metal and I do not despair to forward it one day. For me, the failure is never but temporary…

. : You referred to the dogmas in csotcina.comedy which, although useful to forward the knowledge, are sometimes obstacles with creation.

. : Sciences always progress thanks to the minority ones, it is as in policy… They are the minority ones which makes progress. In general, they are badly received because they “disturb” because they do not go in the direction of the allowed ideas; however, with time, they are able to introduce new concepts. One progresses thanks to a little sulfurous ideas. To put pins in a chamber of fracture it is a very sulfurous idea and which is not accepted yet by all!

. : Yes, but there are many frankly bad minority ideas!

. : Yes, it is true. The problem is to discover behind the incongruous idea, the rational implementation which will give him its interest and its effectiveness. The dogma has, of course, a justification which is that of the transmission of the experiment. In csotcina.comedy as in all the branches of the knowledge, there is a problem of transmission. Humanity accumulates a knowledge on which the successive generations bring each one their layer. That joined the problem of the heritage which I referred to at the beginning of this conversation. It is necessary to forward…

There are things which one can write in the books, in the items, and there are things which are intransmissible differently than by the experiment. The experiment is lived with the daily newspaper, in contact with somebody who has it already and who infuses it into young person, that one could call, without any pejorative intention, an apprentice. I think that it is very important in csotcina.comedy to keep this trade-guild. Each csotcina.comedist must transmit his knowledge to at least a companion, who has his turn will be able to develop it and transmit it to the following: it is a chain reaction.

I wrote on this subject a poem; it has as a Stradivarius subject which died by carrying the secrecy of its famous varnished which made so marvellous violins. I think that there is a great sin against the spirit: for the transmission of the knowledge, we must be anti-Stradivarius.

. : What do you think of the transmission of the csotcina.comedic knowledge today?

. : There is an absolutely alarming inflation of the congresses. Maintaining with the national congresses and international will superimpose the European congresses. One cannot attend any more all these congresses It is sure that one learns much from thing in a congress. But one also learns by the contact with other surgeons, and to make turns of Europe, round the world tours to learn csotcina.comedy in other Masters appears an important thing to me. There is not currently the possibility for a young csotcina.comedist of doing that. As soon as it finished its , the life pushes it to settle to be made a professional situation: it does not have time to travel.

There remains the possibility of informing itself near those which are already installed. But if one can attend operations, one cannot operate oneself and the transmission is done less better. In addition, the private clinics are not recognized like “ground” of training course, therefore an important part of the knowledge is lost.

. : You think that it would be necessary, at least for a party, to give to the private structures, the possibility of teaching?

. : Yes, there are many things which are lost because precisely as from the moment when one is “alone in his corner”, one has nobody with whom to forward.

When one joins a young colleague who leaves a service where he very learned, one rather easily has the appearance of an “old croûton”. It is difficult to transmit its experiment to a younger associate, whereas on the other hand, one can benefit from his fresh knowledge on the new techniques. One cannot transmit that to a pupil, who is in situation of pupil. The organization of this formation in a liberal structure is certainly difficult. The contact with the patient is a singular conference and the presence of another interferes ineluctably. But there are private structures which perfectly succeeded in integrating all these data; I think for example of the French Institute of the Hand, where French or foreign pupils come to be formed.

It is not question of making of all the private surgeons of the teachers, but those which have something to say or to forward should be able to do it in an official way, integrated in official teaching.