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
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sam Rhee (00:05):
All right, welcome to another episode of Botox and
Burpees.
I have with me a most specialguest.
This is Dr Annunziato Amendola,if you're in Italy, or Dr Ned
Amendola, if you're in theUnited States.
Dr Amendola is the head teamphysician and chief medical
officer for Duke Athletics.
He is the director of sportsmedicine at Duke University,
(00:26):
professor of orthopedic surgeryand this is true one of the top
20 power players in orthopedicsurgery in the United States.
And this is from Becker Spine.
And, just so that he wasrecently appointed the first
vice president of AAOS, which isthe American Association of
Orthopedic Surgery, next in lineto be President of the
organization in 2025, and thepast President of the American
(00:49):
Orthopedic Society for SportsMedicine.
Now, just so that the contextin which these power players are
, one of them is Brian Kellyserves as the President and CEO
of HSS here in New York Hospitalfor Special Surgery.
Gary Mitchelson, who is networth $1.8 billion and is
included in the Forbes annualrichest people in the world.
(01:10):
And Dr Neil Elitrash, who justrecently did Shohei Itani's
elbow surgery, as well as ourNew York Jets Achilles tendon
repair for.
Aaron Rodgers.
You are in esteemed highcompany here, dr Amendola, I
would have been a little nicerto you.
See, played against each otherand I have to say the first
(01:46):
thing I remember about you, drAmendola, is that you were so
apologetic.
You had to play the front teesand they made you play the front
tees because you had hit acertain age, which obviously you
don't look like you did, andyou beat my ass.
But the way you beat my ass waslike none of listen.
Most of the golfers are notlike Tiger Woods or anything.
(02:09):
The back nine.
Every time there was a moneyshot, a shot that had to be made
, where I was hoping maybe DrAmendola might not get this one,
yeah, you hit it.
You hit the putts, you hit theshort game, you hit your.
Your driver was like there's noway I can catch up with this
guy.
So, welcome, Dr Amendola.
(02:29):
It's a pleasure to have you onthe podcast.
Dr. Ned Amendola (02:33):
Thanks, Sam, for the introduction.
That was very nice and Iappreciate it.
It was really fun playing golf.
I don't play golf because I'm acompetitive golfer, but I like
to play golf because it isrelaxing and it's a difficult
thing to master golf.
So we're talking about surgery.
(02:55):
When I see patients in themorning for surgery, sometimes
patients say, well, Dr Amendola,are you ready for this surgery?
I said, yeah, surgery issomething I can do.
It's not like golf, that's veryunpredictable it's.
It is a nice time relaxing andget to meet people like you.
Sam, Thanks for putting up withme on the golf course.
Sam Rhee (03:13):
I will say, for someone who is as big a name as
you are and actually there werea couple of guys like that who
we played with you have one ofthe more laid back personalities
.
I never would have guessed thatyou lead such a big team at
Duke in terms of heading upsports medicine their team
(03:34):
athletics.
You got some major leagueresponsibilities there and yet
you are one of the more low-keypeople that I've met in terms of
your personality.
How do you mesh that low-keyperson really just congenial
low-key guy personality with allof these big responsibilities,
management, people managementthat you have to do on a daily
(03:56):
basis?
Dr. Ned Amendola (03:58):
I think we're all the same.
I think we have to learn how tomanage our environment and,
personally, I think the best wayto manage everything around you
if you're a surgeon, or ifyou're a teacher, or if you're a
professor or whatever you are Ithink you have to recognize the
environment around you andreally listen to people and
(04:18):
listen to your collaborators,your team.
We're a team of teams andyou're never really on your own.
So, for example, if you'reseeing a high level athlete
who's going to be the number onepick in the NBA draft, there's
a lot of things that you need totake into account.
So you have the player,obviously, but then you have the
(04:40):
athletic trainer, you havephysical therapists, you have
the coaches and then you havethe players team.
They've got their family,they've got their advisors and
and I think you need to take allthose inputs- in before you
really communicate and make adecision on what you're going to
do.
And so I think and that happensin life with everything, every
(05:03):
decision that we make I thinkyou should try and get as much
information as possible.
Like you prepared for thepodcast today by looking into my
history, I think we should bedoing that with every encounter
that we have, every patient thatwe have, and so then when you
make a decision, you know thatit's a well-informed decision,
you get everybody on the samepage and it really makes it
(05:26):
comfortable going forward.
So then you're going to dosurgery.
I think the last thing you wantas a surgeon is to have any
doubts in your mind if you'redoing the right thing.
You want to be sure that thedecision you made has input from
everybody.
Everybody's on board, theathlete's on board, we got the
rehabilitation protocol lined up, and so then you go into the
(05:48):
actual surgery with a lot ofconfidence that we're doing the
right thing, and so the onlynext thing to do is make sure
that you do the surgery well andconduct the operation well.
Anyways, I think it's the sameand I do.
There's a lot of there's a lotof eyes at Duke.
A lot of people pay attentionto what you're doing, and that's
(06:09):
another thing is to have thatin the back of your mind and I
tell patients that I say you'recoming to Duke, it's a teaching
institution.
Some patients are concernedbecause it's a teaching
institution.
You're not going to be doingtheir surgery, but I usually
tell them look, it's the otherway around.
There's all these eyes lookingat the operation.
They're making sure that Idon't screw up and that I do the
(06:31):
right thing, and so I thinkhaving a lot of attention and
having a lot of people payingattention to what you do really
makes you better at what you doon a daily basis.
Sam Rhee (06:41):
Yeah, and I definitely want to talk about that
pressure, because it is veryunique for you guys, as high
level sports medicinespecialists, to deal with some
of the athletes that you have todeal with.
But before I do that, I want totalk a little bit about how you
grew up, and you have such aunique story, and I've heard you
say it a couple of times and Iwant you to maybe expound on it
(07:02):
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 inCalabria that you grew up?
Dr. Ned Amendola (07:13):
Well, I was born in Cosenza, in Calabria,
and the Southern part of Italywas always a little bit
underdeveloped, more of aagricultural part of the country
, not a manufacturing orindustrial part of the country,
which was, you know, rome andnorth of Rome.
And, yeah, very small town thatwe lived in was about just
(07:34):
outside of Provenza.
We lived in a small town, itwas about a thousand people, so
you knew everybody in the town,you had the same group of
friends and really participatedin all activities with relatives
and friends around the town.
It was quite enjoyable.
Growing up as a kid I thoughtit was fantastic and then when
(07:57):
we moved, I was very unhappythat we moved.
Sam Rhee (08:00):
So for me, I have very little experience with Italy.
So for me, I have very littleexperience 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 ruralcountryside kind of thing.
I don't know if that's true ornot, but that's my mental image,
that's exactly the what it wasOkay, good, he got it right.
(08:23):
And then when you moved toCanada, to Ontario, in the third
grade you mentioned it was verydifficult.
Your father was a laborer.
This was in the late 60s and itwas a really hard time.
And I could hear when you talkabout the emotion of adjusting
to a new country, to newlanguage, new cultures, new
everything.
(08:44):
And was there anything therethat was really difficult or or
a specific incident that youwere like, wow, this sucks and
it's really hard for someonefrom another country to to grow
up and develop like this.
Dr. Ned Amendola (08:56):
Yeah, it wasn't easy for the first few
years because of the languagebarrier.
When you don't grow up in a ina culture you really don't know,
you know basically the socialnorms as a kid growing up and
going to high school.
That's really important tounderstand the social norms of
the kids you're going to schoolwith in terms of what people do
(09:17):
when they hang out, what musicthey listen to.
Sometimes you have sing-alongsongs and everybody knows the
songs you're singing and Ididn't know the songs.
The stuff like that shows on tvthat people watched and so that
was pretty probably the hardestpart was really basically
becoming enshrined in theculture.
(09:38):
So you understood whateverything was about.
And my parents they had evenmore difficult time because of
the language barrier and so thatwas another thing.
They put a lot ofresponsibility on me to manage
the household as a teenager.
I went to school, I learned toread and write and could
communicate.
I could read parents' incometax forms from the age of 15 on,
(10:08):
where I would fill their incometax forms, do all their bills
and all that stuff.
A lot of responsibility at ayoung age but at the same time,
because you're new to anenvironment, it really forces
you to learn and look at people,listen to people, and that kind
of philosophy has carried on, Ithink, to the present time.
So now when I meet somebody onthe golf course, even at my age,
(10:30):
you listen to them and seewhere they're coming from, you
look at their expression ontheir face and I think it does
help you in everything you doand helps you deal with patients
, help you deal withadministrators, help you deal
with trainees and coming fromdifferent backgrounds and
different nationality, and sothat experience as a child
(10:52):
growing up in a new countryreally has carried on.
So I just feel that it's reallyhelped me along the way.
So initially it was tough, itwas difficult, but I think in
the end is actually a very goodthing for me and my and my
maturing as a human being and asa surgeon.
Sam Rhee (11:09):
Now I know and I wanted to ask later, but I want
to just bring up quickly becauseyou had.
You have four children and oneof them I saw is also an
orthopedic surgeon in sportsmedicine at University of
Nebraska.
Now, Is that right?
Dr. Ned Amendola (11:24):
That's correct .
Sam Rhee (11:31):
Yeah, and which is pretty cool.
I want to ask you about that.
But when you think aboutyourself growing up and then you
saw your children growing upand now your grandchildren, is
it like, wow, these guys have itso easy.
Maybe we need to toughen themup a little bit.
Or was it like we're justreally glad that they don't have
to go through what I wentthrough?
How do you feel about that nowthat they are the second or
third generation here in theUnited States?
Dr. Ned Amendola (11:55):
It's an extremely rewarding part of my
life.
So family is the most importantthing and so having four
children that are doing well andgrandchildren that are doing
well, it's really.
It really brings a lot of joyand it really fulfills my life.
So, aside from all theorthopedic stuff and what you
said earlier, this family andseeing your kids do well is
(12:16):
really the most gratifying thingas far as what you asked.
So my parents were verydemanding on me and as parents,
I don't think we're as demandingon our children.
We just let them decide ontheir own.
So you know, I don't think Idirectly wanted my kids to go
into medicine.
So my son is an orthopedicsurgeon in Nebraska, my daughter
(12:37):
right now is doing a fellowshipin sports medicine at Duke, and
then the other two children arenot in medicine One is an
engineer and one is a softwareprogrammer for a company in
Denver.
But they're all great and westill support our kids as much
as we can.
So that's my parents wereloving and even though they
didn't have access to everything, they provided everything,
(13:01):
tried to do whatever we,whatever we needed, and we still
do that with our kids, ourchildren, and we support them.
And no, I don't ever think Iactually don't ever think that
you don't have it as tough as wedid, because life is tough no
matter what era you're in.
Sam Rhee (13:19):
That's a really good approach as a parent.
The only other question I haveabout your parents right now is
you said they did everything.
They made their own sauce orpasta sauce or in New Jersey
it's gravy I don't know that.
All my fellow Italians here andyour father, every year would
make wine like a 40 gallonbarrel and you would help them
with that as you were growing up.
(13:40):
Do you ever want to do that?
Do you ever want to do thethings that your father did?
Do some of those things that hedid?
At this point, yes, I wouldlike to.
Dr. Ned Amendola (13:51):
Again, everything is in perspective.
You're trying to earn a livingand do a good job, support your
children, support your family,so some of these other hobbies
and extra cook activities take aback seat sometimes, but now's
the time to start taking some ofthose on.
I learned to cook with mymother in the kitchen, so I
still love to do that on theweekends.
(14:13):
I would like to make some wineat some point.
That's on my list of thingsthat I like to do.
You asked me a question beforeon how you became a better
surgeon and I was thinking aboutthat and I was actually
thinking of my time with myparents Growing up.
We did everything in our home.
We made our own tomato sauce,so we went and picked the
(14:35):
tomatoes, we cut them up, thenwe cooked them and got rid of
the peel and the seeds and madetomato sauce.
We also made our own cold cuts,meat, prosciutto, sausage and
cutting up meat.
As a child, and then with mymother in the kitchen cutting up
stuff for her to makevegetables and her dishes in the
(14:56):
kitchen, I thought, well, thatwas probably the beginning of
learning how to use a knife.
So when I met my wife mycurrent wife Allison.
We'd been married for 43 yearsand she came to our house for
the first time and Italiantradition usually is you have
your meal, you have yourespresso, at the end of the meal
(15:17):
, some sweets and cake, and thenafter that you bring a bowl of
fruit and my parents and me andmy sister we got a knife and
we're peeling our apple andwe're cutting up an apple or a
peach, and she's looking at uslike all four of you are like
knife experts.
It's just a funny story.
(15:38):
She was amazed that we werehandling a knife like that,
because they do that in theirEnglish family.
Sam Rhee (15:43):
That's pretty cool.
Now I know they passed, but didthey ever get to see you do
what you do?
And what did they think aboutthat if they were able to?
Dr. Ned Amendola (15:52):
Yeah, I always try to include again.
When you don't have much timeat home, try to include my kids
and everything we did.
My parents were busy theydidn't really, but they were
very proud of me going intomedicine.
But my kids, I brought themwith me to games on the
sidelines, brought them to themaking rounds on patients.
(16:12):
On Saturday morning we go tobowl games and they hang around
and be on the elevator with theathletes and they joke around
and the athletes would make funof me.
So it was.
It was, yeah, I tried toinclude them in everything we
did.
Sam Rhee (16:28):
Now you went to University of Western Ontario in
London and you played footballthere for college.
You're an engineering major onscholarship and this is what I
read and I want you to confirmthis for me.
You switched and went intomedicine after breaking a
scaphoid bone which is in thewrist, and that team after
spending time with a teamphysician and I know you've
(16:49):
mentioned this team physician anumber of times, Dr Jack Kennedy
, who's one of the foundingmembers of the American
Orthopedic Society for SportsMedicine, and he was one of the
people integral as a mentor toget you into sports medicine, as
a mentor to get you into sportsmedicine, and so can you talk a
little bit about Dr Kennedy andwhat that experience was like
in terms of getting that switchturned on for you in terms of
(17:11):
sports medicine?
Dr. Ned Amendola (17:15):
Dr Kennedy was our team physician and, yeah,
my first year at Western I brokemy scaphoid so I was not able
to practice or play for a fewweeks.
So I was on the sidelines withDr Kennedy watching practice and
he had his dog that he broughtto practice and I would play
with the dog and talk to him.
And after a while he got toknow me and he asked me about
(17:38):
what I was doing.
I had a scholarship inengineering.
And he says you know, ned, youhave the right personality, you
should think about medicine, youshould think about orthopedic
surgery.
Coming to our program, and Ikind of mold that over and I
says you know, you can keep yourscholarship in engineering.
Just take a few other courses,take biology, take some organic
(17:59):
chemistry and then apply tomedical school.
And during my first year or twoof engineering, which is very
theoretical, when you'rebasically learning, you're
taking exams, you're answeringengineering questions and
problems, formulas.
I'm thinking maybe medicinewould be a more practical
(18:19):
specialty where you're applyingwhat you're learning and taking
care of people.
And I was certainly grateful DrKennedy taking care of people
and I was certainly grateful DrKennedy taking care of me and
the other physicians that wereworking on the team and I
thought maybe I'll do that.
So I decided to apply tomedical school just because I
wanted to use my hands and applymy knowledge to something more
(18:40):
practical.
My parents were not doctors.
We had nobody in the familythat were doctors.
I'm the first physician and mywhole family Italian family in
Italy and Canada and anyways gotinto medical school.
And the first couple of yearsof medical school were it was
very interesting because it waslike doing engineering, but then
you're going into the exam roomand applying what you're
(19:03):
learning about pharmacology andorganic chemistry and anatomy.
We got to go to the anatomy laband dissect.
I thought this is great.
So I was really happy with myapplication of knowledge and
skills in medicine and DrKennedy invited me to go do some
research in his office.
(19:24):
Third year medical school Iworked for the summer in his
office doing research and he'sreally a mentor to me and wrote
me a letter to get into theresidency program and the
philosophy of Dr Kennedy wasthat.
So he was Canadian, he was thefirst president of the American
(19:45):
Orthopedic Society for SportsMedicine and his view was that
our playground in sportsmedicine and medicine is not
just Canada, it's also theUnited States.
So we had to venture off andget involved in some of these
American societies.
So you know, I became a memberof the American Orthopedic
Society for Sports Medicine.
(20:05):
His successor, peter Fowler,was one of my true mentors and
he became the second Canadianpresident of the AOSSM and then
I became the third one, soreally we had three Canadians
become presidents of theAmerican Orthopedic Society of
Sports Medicine.
(20:25):
There's been no other ones, andwhich is really a testament to
mentoring, when you reallyrespect your mentor and you
respect what they do, and so Ijust followed in their footsteps
and learned a lot from them.
Sam Rhee (20:38):
You were in Canada for quite some time and you stayed
at Western.
You were medical faculty there.
You covered the university, theCanadian national teams, like
rugby.
You were a consultant for theRaptors of the NBA, the NHL, and
then you left and you spent itlooks like about 14, 15 years at
(20:58):
University of Iowa as directorof sports medicine and their
team physician there.
And I have heard you talk aboutsome of the frustrations with
the Canadian medical system andadvantages and drawbacks, but on
the orthopedic side it seemslike there are more frustrations
working within the Canadiansystem than there is on the
(21:19):
American system.
Do you still feel that way interms of now taking a long look
at the two systems and havingworked in both?
Dr. Ned Amendola (21:28):
Yeah, I think the similar problems exist today
in Canada.
That existed when I left in2001.
You know, the Canadian systemessentially is a single payer
system where the government paysfor everything, and health care
payer system where thegovernment pays for everything
in health care, and so, as aresult, there's a budget and
(21:53):
there's rationing of care,basically access to the
operating room, access toimaging, access to care.
Again, don't get me wrong, Ithink everybody in Canada gets
good health care.
I think it's just rationedhealth care and in the US,
because of private healthinsurance, I think it gives you
much more options.
So you have Medicare, medicaidand government supported health
care here in the US and I thinkeverybody gets care in the US.
(22:13):
But because of private healthinsurance, people can get
whatever level of care theydesire and many more options.
So the waiting list foreverything for imaging, waiting
list for surgery, access to careis much shorter in the US.
So there's a lot of good thingsabout Canada and, don't get me
(22:42):
wrong, it was theth reunion ofour medical school class and you
know we love Canada, we loveCanadians, we love Canadian
philosophy.
But the health care system, Ithink, continues to have some of
the similar issues that havebeen in existence since it
(23:05):
became a single payer system.
I think there just needs to besome freedom of choice.
Sam Rhee (23:14):
I know some people would play devil's advocate and
say the excesses that you cansee in the American health care
system can be a little bit nutty.
For example maybe not now, butI remember in residency and a
little bit beyond, especially onthe ortho side, the hardware
for spinal implants.
There was some major money.
(23:36):
It's a multi-billion, it's likea $10 billion plus a year
industry.
I think there was a lot ofadvantage taken by hardware
companies, by some of thephysicians that were implanting
these hardware systems.
The financial incentives grewso huge in terms of managing
(23:57):
some of the financial incentivesthat we see in all aspects of
medicine probably.
Dr. Ned Amendola (24:16):
No, I agree with you, sam.
That is one of the issues.
In American healthcare, andespecially in orthopedic surgery
, the cost of care in the US percapita is almost twice as much
as the cost per capita in Canada.
When you look at implants notjust spinal implants, total hips
, total knees, sports medicineimplants that I use the cost per
(24:40):
implant in Canada is much lessthan the cost per implant in the
US.
And so why does that happen, us?
And so why does that happen?
And I think in the US is a drive, I'm sorry to say, for making
profits.
You know, from the insuranceside, from the technical side,
from the industry side and fromthe surgeon side, everybody
(25:00):
wants to make a good living.
So I think those are all issuesand problems.
So if you look at thegovernment side, the government
funding of health care andorthopedic surgery, all of
health care you look at thegovernment, every year they're
looking at a decreasingreimbursement to physicians.
So the government is trying tocorral care and you know, and I
(25:24):
think the same type of attentionneeds to be given to other
things and I think the same typeof attention needs to be given
to other things.
So you look at a lot of healthcare systems now are negotiating
with industry and orthopediccompanies to get lower prices on
implants and just bring thingsdown a little bit.
So I think these are all issuesthat need to be considered in
our profession.
(25:45):
This is what I'm going to bedealing with the American
Academy of Orthopedic Surgeons.
You know we have 40,000orthopedic surgeons that are
working hard trying to take careof patients, deliver excellent
care, musculoskeletal care, andyet we have this environment out
there that we don't really havecontrol over.
We don't have control overorthopedic costs, insurance
(26:07):
costs.
We don't have control overorthopedic costs, insurance
costs, government makingdecisions in Washington, and so
here we have a great profession,but there's all these other to
continue to try and get as muchsupport as we can to deliver
(26:31):
good care and make patientshappy.
So I personally think ourprofession as doctors and as
surgeons is a great profession.
I'm very grateful for my careerand everything I've done, and so
I'm going to spend the nextcouple of years trying to
support the rest of theprofession and representing us.
(26:54):
So I'll be spending more timein Washington, more time trying
to work with some of thesethings.
We have a large office inWashington, we have an advocacy
council, we have a politicalaction group that helps
negotiate some of these things.
Those are good questions, sam.
I don't have the answers ofwhat the best solution is, but I
(27:18):
think the Canadian system isnot perfect, the American system
is not perfect.
If we could somehow get thebest of both worlds, I think
we'd be in a much better place.
Sam Rhee (27:31):
That's good.
Someone like you who's in bothwould do a good job as a leader.
Now you spent time at Iowa andI was just looking at and I
don't follow Iowa sports, exceptmaybe football a little bit,
because I'm actually a Michiganfan but I really respect Kirk
Ferencz and his philosophy andthe fact that he's still
(27:52):
coaching probably the longestactive Division I football coach
and he had a pretty good recordwhile you were there.
I would say his best year wasone of his best years was 2009,.
11-2, going to the Orange Bowlwith a win.
What can you take away or whatdo you look back at for your
time at Iowa and what stands outto you there?
Dr. Ned Amendola (28:14):
That was a great year 2009,.
We won the Orange Bowl in Miamiagainst Georgia Tech Nice and
it was a great place to work andprobably dealing with the
coaches and athletics was reallythe best part of my job there.
And coaches like her parentsand you know, recently caitlin
(28:35):
clark had a lot of press and hercoach, lisa bluter, just
retired.
She was a great coach of thewomen's team and worked with her
while I was at iowa the brandsbrothers, brothers, the
wrestling coaches great coaches,very passionate, and it's
really fun to work with peoplethat really work to the greatest
(28:59):
extent to have success.
And at Iowa, you know Iowa'sIowa it's not like New York City
and it's not Duke.
In some respects, I think thecoaches worked extremely hard to
have a good team and put a goodteam on the field.
The best part was that thecoaches totally respected the
(29:20):
sports medicine team.
We were part of the team.
They treated us as part of theteam.
Candid communication they couldcall any time.
I could call them anytime.
Sam Rhee (29:29):
If.
Dr. Ned Amendola (29:29):
I had a visitor come to Iowa.
I could walk into KirkFerentz's office and he would
immediately walk them in Withinthree or four questions.
He would find something incommonality with the visitor, no
matter if it was a surgeon fromFlorida or New York or whatever
, and so that was.
It was really, really fun, Ithink, as you get to a higher
stage and it's not the same,it's not the same everywhere,
(29:54):
but there is one story from 2009that I need to.
So Rick Stanzi was thequarterback for Iowa and he
played in the.
He played in the Orange Bowlgame.
He played a great game and wewon handily over this Vaunted.
Georgia Tech had this offensewith the triple back option.
(30:16):
All three backs had over 1,000yards and so it was a big
victory.
But anyways, rick Stanzi, iowawas 10-0, I think, to start the
season, 9-0 or 10-0 were in thetop two or three in the country
rank, and Rick Stanzi hurt hisankle against Northwestern and
he had the so-called high anklesprain, the TUA injury that he
(30:39):
had in 2019.
Yes, so this was 10 yearsbefore.
So this was 10 years before anduh, so we did that surgery and
on rick stanzi, with, uh, fourweeks left in the three or four
weeks left in the season and sofive weeks later he was able to
(31:00):
play in the orange bowl and thesurgery was very successful.
And anyways, I don't.
You can look that up.
He's got a video, rick Stanzithere's a video about Rick
Stanzi and Debra from thesurgery.
So that was one of the mostrewarding things is to see him
get on the field and play thewhole game, kind of the MVP of
(31:20):
the game, but after doing asurgery on him five weeks before
.
So I just that's a big memoryfrom 2009.
So it's a coincidental.
You brought it up.
Sam Rhee (31:29):
Yeah, no, it's crazy.
And that leads me into my nextsort of thought, which is the
amount of pressure as a highlevel sports medicine surgeon to
in terms of the athletes and Iunderstand all patients are
important, like I know that.
But when you're operating onsomebody who and for example,
(31:52):
let me just throw one that yourecently did and the first thing
is that most of our, most of usas surgeons, our patients are
not public, like they're not noone's announcing to the world
that I operated on somebody.
But when, back in March,houston Rockets announced that
forward, terry Easton underwentsuccessful surgery to treat a
(32:12):
benign growth in his lower leg,performed by Dr Ned Amendola at
Duke University and involvedexcising and bone grafting the
lesion, inserting an IMintramedullary rod into his
tibia to accelerate healing.
Now this is a guy who signed afour year $16 million contract
with the Rockets and his averageannual salary was $4 million
(32:38):
and this is a tremendousinvestment, not for the athlete
but for the organization, foreveryone around him.
And two days ago he was givingan update on his rehab process.
He's been playing in the DrewLeague, finished with 26 points,
nine rebounds, four assists.
Now, first of all, if I'm asurgeon, I got to be like I am
the man this is.
Look how effing awesome I am.
But the pressure placed on asurgeon, like you said, to
(33:03):
recover, to come back in as fastas possible and, as you said,
to perform at 120%.
This is not if I get thisprocedure.
I'm just happy if I canfunction on and do all my
activities of daily living.
I'm not looking to cut dunk,move at the highest level of
(33:23):
human capability and, as you'vementioned, it's not just the
athlete, it's a whole team ofpeople 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, ordoes it take someone very
(33:44):
special to be able to succeed atthat level?
Dr. Ned Amendola (33:50):
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 andyou perform plastic surgery.
This is you, this is what youdo, this is like your craft,
this is you know.
And so if I'm doing a surgerythat I do and I know I do it
well and I do it as well asanybody in the country I don't
(34:13):
think you have a lot of pressurebecause it's what you do.
This is who you know.
What defines you.
It's not as if you're doingsomething for the first time.
You're doing something that youknow you can do.
You know how to do it, theoutcomes do you know how to do
it?
The outcomes?
And sometimes you feel that waywhen you see patients.
You feel like I should do thesurgery because I'm the best guy
(34:37):
for the surgery, but you neversay that.
You never say that to thepatient, and so I think it's
knowing your crafts and knowingwhat you're doing and really
having been through it multipletimes before, having a lot of
experience and again, I've got alot of experience.
That was one advantage inCanada when I was there for my
first 10 years in practice, Idid a lot of surgery, like a lot
(35:01):
of, because it's such a longwaiting list for surgery, and if
you can just craft out time andfind time and use your
partner's time, and so you, youend up being a good surgeon,
knowing your craft well, and soI think if you do, if you know
that, then I don't think it's asmuch pressure as as some people
(35:22):
might think.
Number one and then number twois with those types of players.
You're speaking to everybodythe Houston Rockets, you got
their management, you got theirdoctors, you got the agent, and
then the family and you talkabout it.
You have a number of calls andsay, okay, we're coming up to
Duke and have the surgery andthey're very happy with the plan
(35:44):
.
You've discussed it and therewas three or four other opinions
.
With most of these cases theyget three or four other opinions
, of course, and then, after allthe 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 thepreoperative communication and
(36:06):
decision making.
Once it's done and the patientis coming to the operating room,
that's the easier part.
You just got to go through ittechnically and get it done.
Sam Rhee (36:16):
I remember you talking about you operating on Coach K
and his ankle and when he toldyou I would really like to hear
that again what he told youbefore you did his surgery, in
terms of what he also told histeam when he was coaching the
Olympics- yeah, no, I rememberdistinctly because, anyways,
(36:38):
coach K is unique and I learneda lot from Coach K from the
first day I came to Duke andworking with him and taking care
of the teams.
Dr. Ned Amendola (36:48):
His mind works differently, like before I came
to Duke, I heard the line leaveyour ego at the door so many
times.
And then, talking to Coach K,it's the opposite.
It says why would you ever wantto do that?
When you got these greatathletes, you want them to bring
the ego in.
Bring their ego, bring the bestshot they got into the room.
(37:11):
We figured out a way to use itand so when I did surgery on him
the day of surgery I'm seeingin the preoperative area he says
just bring your best stuff intothe room, don't leave anything
outside the room.
I know it's me you're operatingon, but just bring everything
you got I know you're the bestsurgeon and just bring your ego
into the room.
Don't leave anything outsidethe room.
I know it's me you're operatingon, but just bring everything
(37:32):
you got I know you're the bestsurgeon and just bring your ego
into the room and use it and dowhat you can do on my ankle.
So that was Coach K.
Sam Rhee (37:39):
That's great.
I will say he scares me a lot.
He reminds me of my old mentorsand they were amazing people
but they held really highstandards and if you pissed them
off, you bet if you weren'tprepared, if you didn't bring
your a game to the or you betterwatch out because things might
fly around the room a little bit.
(38:00):
So I feel like he.
He reminds me a lot of of theguys I used to train with back
in the day so I don't think.
Dr. Ned Amendola (38:06):
I don't think he was.
Yeah, he paid attention toeverything that was going on.
When I came to Duke he reallyyou could tell by our
communications that he waspaying attention to my actions,
my communication, the way Idealt with athletes, and it was
amazing.
I just thought it was amazingthat he kept track of all these
things and then when you'rehaving a coffee or you're
(38:29):
traveling with the team, hewould just come up and say, ned,
I really appreciate the way youdid this or the way you did
that, and you didn't have anyidea that he was paying
attention to that.
I think that's what makessomebody great is to really know
what's going on around you andhaving a pulse on the people,
the athletes around you.
Sam Rhee (38:48):
What do you still love to do?
What is your favorite operation?
I know you probably love allthe operations you do, but is
there one in particular that youhave a fondness, for whatever
reason?
Dr. Ned Amendola (38:59):
I like operations that are not
instrumented, Like you use acutting guide or a jig where you
put it on and you just followthe instructions.
I like operations where you dohave to use your God-given
talents, experience in doing thesurgery.
So there's a few operationslike that that you still need to
(39:23):
use art and use your technicalskill to do the surgery.
So meniscus transplantation,putting in a new meniscus into a
joint, I think takes a littlebit more technical skill.
There's not really a guide thatanybody can just go ahead and
just do it the first time around, and so you have to use a
(39:47):
little bit.
It's arthroscopic surgery.
It's arthroscopic surgery.
It's arthroscopically assisted.
You have to prepare the areaand then you have to put the
meniscus in.
You have to do a lot ofpreoperative preparation to get
the right size, get the rightpatient.
But it's not justcomputer-assisted or
instrumented surgery.
There's that one.
(40:07):
That's one of my favoritesurgeries to do.
The other one is realignmentsurgery of the limbs.
People have malalignment, Likethis intramedullary rod that you
mentioned earlier on thebasketball.
That's pretty straightforward.
There's just things that youjust step one, step two, step
three, and it's moreinstrumented, Whereas sometimes
(40:28):
if you have malalignment we haveknock knees or full-legged
knees or post-traumaticdeformity and you're going in.
I know you've done a lot ofbone surgery and reconstructive
surgery as well, Sam.
You have to do a lot ofpreoperative planning but then
the exposure, the anatomy,making the appropriate cut and
the bone and fixing it and usingthe appropriate fixation.
(40:51):
I think it's a very gratifyingsurgery and these patients come
in afterwards when they and youcan show them at the end of the
day, show them their limb beforeand after surgery.
We just did one of these verylarge correction this week and
showed this patient after theevening, took his dressing down.
He says, wow, this is reallystraight, it's like cosmetic
(41:17):
surgery.
Sam Rhee (41:19):
But way more functional.
Let's just put it that way thecurrent trends in ortho are
completely against the types ofsurgery you're talking about.
All the Mako systems, thecomputer guided systems this is
idiot.
Proofing some of the hip stuff,knee stuff, I don't know,
whatever the art of it, learningthe and there's a lot of that
(41:40):
also in craniofacial surgery too, where computer guided or
computer assisted types ofsurgery are taking a lot of that
art, or just the fact you needto get a lot of reps in order to
be able to do it well, do youfeel like that is a loss in
terms of how the surgicalspecialties are trending?
Dr. Ned Amendola (42:01):
No, I think you do have to make way for
modernization and moving forward.
I think the younger generationthey're really good, and even my
son uses a computer-assistedpreoperative 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
(42:24):
are good.
But I usually tell my traineesand fellows you should be able
to keep an eye on what's goingon, because sometimes it's not
foolproof.
If the Mako device or Epsomjust looks like it's not quite
the way you think it should be,you should reevaluate.
And so, even though you'reusing a computer-assisted system
(42:44):
or robotic assistance, I thinkas a surgeon you should be able
to know the surgery.
Without the robot, you shouldbe able to do the surgery, and
so you got to keep close eye onit, close track of what's going
on, to make sure that the robotis doing what it's supposed to
do.
Sam Rhee (43:01):
What do you listen to in the OR music-wise?
What do you like to listen to?
Dr. Ned Amendola (43:13):
listen to?
I usually classic rock.
I grew up in that era 70s and80s and yeah, I usually those
rock ballads and just it seemsto be soothing music.
Now you go into the locker roomwith the teams.
They got it's crazy music andwhen I played football in the
early 80s the mainstay wasrolling stones music where you
(43:34):
have the boom box and it was allit was in the one big boom box
in the room instead of but westill do that at duke.
They still have the music goingon, but it's it's more modern.
Yeah, modern, it's good, it'sgot a good beat, it's good to
listen, but it's more modern.
Yeah, modern, it's good, it'sgot a good beat, it's good to
listen, but it's not as soothingfor me.
When you grow up with music Doyou listen to?
Sam Rhee (43:53):
music Absolutely.
Sometimes I find I need lessmusic now.
When I was a resident, oh myGod, I used to just whatever the
attending would allow, as loudas I could, I would play, but
now it's it's a little bitdifferent.
I my go-to is always the 80s,though, you're right, but I also
try to appease the peoplearound me.
So if they want to playsomething else, I try to be a
(44:13):
little bit flexible with that aswell, or I'll ask the patient
even though they're asleep.
So I think it's an interestingtrend right now.
I think the sports medicine guysare the rock stars of medicine.
Like you, guys have so muchmore visibility, and I think for
a couple of reasons.
One is everyone is very active.
There's everyone's playingpickleball or, in my case,
(44:35):
crossfit or whatever it is.
So there are more active peopledoing active things older and
people gravitate towards highprofile sports medicine
specialists.
So you mentioned, your son is asports medicine guy and he
trained at Stedman for a sportsmedicine fellowship, and I know
(44:56):
nothing about sports medicinereally, but I know about Stedman
and Vail, colorado, and allthat, and James Andrews, I think
, was the first down in Alabama,and now Neil Eletrash in LA,
and you, you guys are now rockstars in the sense of high
profile surgeons.
And is that good?
Is that bad?
(45:17):
Is it driven?
I think some of it's driven bythe fact you guys are getting
better outcomes as well, versusmaybe 20 years ago.
20 years ago, these techniquesor 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 (45:39):
Yeah, it's a double-edged sword.
I think you hit the nail on thehead, sam.
For example, tommy John surgeryfor elbow injuries and baseball
players and pitchers.
So you mentioned Otani.
Had he had a redo surgery that?
was and uh, it's.
I think when you take somebodylike Neil LaTrosh, like he's the
go-to guy for all thesesurgeries and uh, he's doing
(46:02):
these pitchers and they're goingback to a very stressful sport
and throwing, and so when youhave so much success, that's
what happens.
So now you have high schoolkids.
We don't do as many baseballplayers here, but I have a
couple of partners that do thesame surgery that Neil Atrash
does on the elbow.
But we get high school kids nowthat have a little bit of elbow
(46:26):
pain and the parents areactually requesting that they
have that surgery so their elbowis stronger and able to throw
more and throw a higher speed.
And it is a double-edged swordin terms of there's too much
media attention and things areprobably thrown a little bit out
of whack with that.
I think the Rogers thing withthe Achilles repair I give all
(46:49):
the credit to Neil Elitrosh andhis team that did the surgery,
but it was like he's going to goback and play at four months.
We weren't able to really tellif he was going to be able to
play at four months, but it'sjust virtually.
Looking at the Achilles tendon,I do a lot of Achilles tendon
surgery and you look at allthese basketball players and
(47:12):
football players in the pastthat tore their Achilles, it
used to take a year to get backto full function.
Well, maybe Durant with hisAchilles tendon takes a whole
year or even more than a year toget back because the demand on
his Achilles is much more than ayear to get back because the
demand on his Achilles is muchmore, and maybe you'd be able to
get somebody back to playingfootball that doesn't need to
(47:32):
jump and dunk as much.
But I'm just saying having thatattention where here's an
Achilles repair and going backafter three or four months all
of a sudden the demands on thesports medicine surgeon is okay.
If I have an Achilles repair,I'm going to be able to play
basketball at six months, whichis really difficult.
It's just hard to get theneuromuscular control and it is.
(47:53):
You know, having attention andhaving that type of media
coverage on one hand is good,but on the other hand the
expectations get a little bitout of whack.
Sam Rhee (48:04):
Yeah.
Do you think that you guys, whodo these high level athletes
and have a lot of publicity arebetter surgeons than, say,
someone else who does thesesurgeries and that's why you
guys get the publicity and thenotoriety?
Or is it just them?
You happen to be right place,right time.
Don't leave your ego at thedoor right now.
(48:26):
Tell me the truth.
Do you do that surgery betterthan anyone else around?
And or ella trash or any ofthose guys, guys or Andrews back
in the day?
What is the difference?
Dr. Ned Amendola (48:38):
I don't think so.
I think there's a lot of goodsurgeons around.
I think we have a you know.
I think a lot of people can dothe same operation and do it
well.
I think it's just the pathwaythat develops.
If Otani's agent sees thatOtani's doing great and he's
hitting more home runs thananybody and he's representing 20
(49:01):
other baseball players, thenevery time they need something
he's going to send them to thesame surgeon, and at least
that's my impression.
There's like pathways of whoyou know, and the last time I
sent somebody here they didreally well and I would
recommend going to that surgeon,and you know so it's a lot
(49:23):
different.
So when you see a patient thatso sometimes I see patients from
Charlotte, for instance, whichis a two hour drive away.
Yeah, and they were recommendedOften the patient will say is
there anybody in Charlotte thatcan do the same surgery?
And so say they need an ACL orthey need a meniscus transplant.
(49:46):
Yeah, I say yeah, there'sseveral surgeons that I would
recommend in Charlotte and Iusually give the patient the
name of those surgeons and Idon't think you can tell the
difference, technically speaking, of the way things are done.
But I think the patient has toget that information in his eyes
.
They were recommended to comehere and they asked is there
(50:08):
somebody in?
Often the patient will saysince you're recommended, I'm
just going to come to Duke andhave it done at Duke.
But I think in pro sports it'smuch more of that, where the
athletes follow theirrecommendation and the pathway
that's been formed.
I think Dr Elitrash is a greatsurgeon and I've seen his
operations and his technicalskill and so I think he's able
(50:31):
to do the surgeries.
But he also has a greatreputation amongst the sports
medicine community, especiallyin those areas.
The Achilles tendon is was abit unusual with that because
he's not.
Sam Rhee (50:48):
I think he's not recognized in that area.
Yeah, if I need surgery for myfoot and ankle, I'm going to the
same one.
That doctor, the same surgeonDr Coach K chose, and I think I
would be okay with that.
So now you have two peoplegoing into sports medicine from
your family your son, who'salready a sports guy in Nebraska
.
And then you said you had adaughter who's finishing up her
(51:09):
sports medicine fellowship.
Dr. Ned Amendola (51:28):
Now, be honest , did they?
Did you kind of unconsciouslyput them into that sports
medicine mode?
Or and bringing them with me todo visits and visit athletes
and bring them to the trainingroom?
And yeah, so I think they and Ienjoy my job.
So if you're at home and I sayI love what I do and I tell them
(51:48):
about patients, and the otherthing that happened was they
make fun of this all the time.
My kid says, everywhere we gothere's people that know you.
We might be shopping at agrocery store or at a restaurant
and there'd be people coming upand say, oh, dr Amendola, you
did surgery on me three yearsago and you did this and you did
that.
So I think they, first of all,they knew that I enjoyed my
(52:12):
profession, I enjoyed what I do,and then, secondly, I did bring
them around to participate insome of my activities in sports
medicine and particularly mygames, athletes and going into
the training room.
Sam Rhee (52:25):
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 forwardfor orthopedic surgery being
president of V Vice and thenpresident eventually of AOS.
After that, what goals do youhave?
You are young or in your prime,I would say, as a orthopedic
(52:46):
surgeon.
I know I think Andrew's retiredat around 81.
So you got like the bulk ofyour career.
You got all the experience, allof the notoriety, the resources
available to you, like you canchange whatever it is around you
to make it fit what you want todo at this point, like growing
up in your career, you're alwaysmaking compromises about this,
(53:08):
that or the other thing, but nowit's like you can set an agenda
for what you really want to doin your life.
What is that going to be for,this advocacy and big position
in AOS?
Like what's your goals?
Dr. Ned Amendola (53:21):
That's a good question.
Nothing is etched in stone, sam, but you're right.
After this academy, a couple ofyears, I'll probably be looking
at what I'm going to be doingas the last phase of my career
and obviously family is a biggoing to be a big part of my
life and enjoying my childrenand grandchildren, and I still
(53:46):
feel like I have a lot to offer.
I have a lot of experience andI have a lot of things in my
head in terms of orthopedicsurgery and I think I'll
probably be doing someconsulting and giving advice in
certain areas.
I'd like to take up some ofthese other hobbies that you
mentioned earlier winemaking andart.
(54:06):
I've written quite a feworthopedic and sports medicine
textbooks or edited books andwritten 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.
When you look at what is it thatmakes people happy in life?
(54:29):
I don't necessarily think I'mjust going to finish and retire.
It's just going to becontinuing on and doing the
things I love to do.
But there's not too many thingsyou need in life to make you
happy.
I think you need somethingchallenging every day.
So right now I'm doingsomething challenging every day
and I'd like to continue doingsomething like that.
You need somebody that loves you, or family, which is obviously
(54:52):
very important.
And then the third thing isleaving a positive trail or a
legacy behind, and I feel likeI've done that, everything I've
done.
There's some positivity to itin Canada and Iowa and now at
Duke, and so you want to leave apositive legacy behind.
So I just want to make surethat everything is in my brain
(55:17):
about orthopedic surgery andsports medicine gets passed down
to the next group of trainees,which I've had fellows and
trainees for 30 years and theyknow everything.
But I just want to make surethat's all passed on.
But I don't know if that's goodenough for you.
Sam Rhee (55:33):
That's really good, I would say, the mentors that I
have had.
I think about almost every daywhen I'm in the operating room
or for whatever I do.
I think I hear their voices inmy head.
But I think it also isimportant for the stalwarts of
our generations in terms ofsurgery to pass down not just
individually to people who seethem, but collectively, because,
(55:55):
like you said, there's a lot ofthought processing, mental sort
of just mindset stuff that Ithink if you can somehow
encapsulate, verbalize orcommunicate to people is really
meaningful.
You have a pretty uniqueexperience in terms of what
you've done, what you're goingto do.
(56:16):
Everyone could be a benefit ofthat if they got more of it, and
I know you have a lot of otherthings like family, like your
hobbies, like everything elsethat you're doing.
But I think that's one of thereasons why I want to talk to
you is because I just wanted tohear a little bit more of what's
going on in your head and howyou think about approaching life
every day, and I reallyappreciate you taking the time
(56:36):
to do that.
That means a lot.
Dr. Ned Amendola (56:38):
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 hugeinterest to hear Ned Amendola's
story, but I do agree with youit's been a great ride.
I'm very proud of my Italianheritage, my Canadian experience
.
I love America and the abilityto fulfill your dreams in this
(57:02):
country are definitely possible,and so I'm very grateful for
everything that's gone on in mylife and but I appreciate
meeting people like you too, andhopefully that'll be part of my
future as well, having a fewmore golf matches with you.
Sam Rhee (57:16):
Yeah, I hope I can put up a better challenge next time
.
I really need to step up mygame in order to do, but I hope
I can do that.
Dr. Ned Amendola (57:25):
I'm sure you will, knowing your tenacity and
your desire to excel.
It'll be great Looking forwardto it All right.
Sam Rhee (57:32):
Thank you so much, Dr Amendola.
Dr. Ned Amendola (57:34):
No Looking forward to it.
All right, thank you so much,dr Amendola.
No, thank you, sam, and have agreat day you too Okay.
All right, welcome to another episode of Botox and
Burpees.
I have with me a most specialguest.
This is Dr Annunziato Amendola,if you're in Italy, or Dr Ned
Amendola, if you're in theUnited States.
Dr Amendola is the head teamphysician and chief medical
officer for Duke Athletics.
He is the director of sportsmedicine at Duke University,
(00:26):
professor of orthopedic surgeryand this is true one of the top
20 power players in orthopedicsurgery in the United States.
And this is from Becker Spine.
And, just so that he wasrecently appointed the first
vice president of AAOS, which isthe American Association of
Orthopedic Surgery, next in lineto be President of the
organization in 2025, and thepast President of the American
(00:49):
Orthopedic Society for SportsMedicine.
Now, just so that the contextin which these power players are
, one of them is Brian Kellyserves as the President and CEO
of HSS here in New York Hospitalfor Special Surgery.
Gary Mitchelson, who is networth $1.8 billion and is
included in the Forbes annualrichest people in the world.
(01:10):
And Dr Neil Elitrash, who justrecently did Shohei Itani's
elbow surgery, as well as ourNew York Jets Achilles tendon
repair for.
Aaron Rodgers.
You are in esteemed highcompany here, dr Amendola, I
would have been a little nicerto you.
See, played against each otherand I have to say the first
(01:46):
thing I remember about you, drAmendola, is that you were so
apologetic.
You had to play the front teesand they made you play the front
tees because you had hit acertain age, which obviously you
don't look like you did, andyou beat my ass.
But the way you beat my ass waslike none of listen.
Most of the golfers are notlike Tiger Woods or anything.
(02:09):
The back nine.
Every time there was a moneyshot, a shot that had to be made
, where I was hoping maybe DrAmendola might not get this one,
yeah, you hit it.
You hit the putts, you hit theshort game, you hit your.
Your driver was like there's noway I can catch up with this
guy.
So, welcome, Dr Amendola.
(02:29):
It's a pleasure to have you onthe podcast.
Dr. Ned Amendola (02:33):
Thanks, Sam, for the introduction.
That was very nice and Iappreciate it.
It was really fun playing golf.
I don't play golf because I'm acompetitive golfer, but I like
to play golf because it isrelaxing and it's a difficult
thing to master golf.
So we're talking about surgery.
(02:55):
When I see patients in themorning for surgery, sometimes
patients say, well, Dr Amendola,are you ready for this surgery?
I said, yeah, surgery issomething I can do.
It's not like golf, that's veryunpredictable it's.
It is a nice time relaxing andget to meet people like you.
Sam, Thanks for putting up withme on the golf course.
Sam Rhee (03:13):
I will say, for someone who is as big a name as
you are and actually there werea couple of guys like that who
we played with you have one ofthe more laid back personalities
.
I never would have guessed thatyou lead such a big team at
Duke in terms of heading upsports medicine their team
(03:34):
athletics.
You got some major leagueresponsibilities there and yet
you are one of the more low-keypeople that I've met in terms of
your personality.
How do you mesh that low-keyperson really just congenial
low-key guy personality with allof these big responsibilities,
management, people managementthat you have to do on a daily
(03:56):
basis?
Dr. Ned Amendola (03:58):
I think we're all the same.
I think we have to learn how tomanage our environment and,
personally, I think the best wayto manage everything around you
if you're a surgeon, or ifyou're a teacher, or if you're a
professor or whatever you are Ithink you have to recognize the
environment around you andreally listen to people and
(04:18):
listen to your collaborators,your team.
We're a team of teams andyou're never really on your own.
So, for example, if you'reseeing a high level athlete
who's going to be the number onepick in the NBA draft, there's
a lot of things that you need totake into account.
So you have the player,obviously, but then you have the
(04:40):
athletic trainer, you havephysical therapists, you have
the coaches and then you havethe players team.
They've got their family,they've got their advisors and
and I think you need to take allthose inputs- in before you
really communicate and make adecision on what you're going to
do.
And so I think and that happensin life with everything, every
(05:03):
decision that we make I thinkyou should try and get as much
information as possible.
Like you prepared for thepodcast today by looking into my
history, I think we should bedoing that with every encounter
that we have, every patient thatwe have, and so then when you
make a decision, you know thatit's a well-informed decision,
you get everybody on the samepage and it really makes it
(05:26):
comfortable going forward.
So then you're going to dosurgery.
I think the last thing you wantas a surgeon is to have any
doubts in your mind if you'redoing the right thing.
You want to be sure that thedecision you made has input from
everybody.
Everybody's on board, theathlete's on board, we got the
rehabilitation protocol lined up, and so then you go into the
(05:48):
actual surgery with a lot ofconfidence that we're doing the
right thing, and so the onlynext thing to do is make sure
that you do the surgery well andconduct the operation well.
Anyways, I think it's the sameand I do.
There's a lot of there's a lotof eyes at Duke.
A lot of people pay attentionto what you're doing, and that's
(06:09):
another thing is to have thatin the back of your mind and I
tell patients that I say you'recoming to Duke, it's a teaching
institution.
Some patients are concernedbecause it's a teaching
institution.
You're not going to be doingtheir surgery, but I usually
tell them look, it's the otherway around.
There's all these eyes lookingat the operation.
They're making sure that Idon't screw up and that I do the
(06:31):
right thing, and so I thinkhaving a lot of attention and
having a lot of people payingattention to what you do really
makes you better at what you doon a daily basis.
Sam Rhee (06:41):
Yeah, and I definitely want to talk about that
pressure, because it is veryunique for you guys, as high
level sports medicinespecialists, to deal with some
of the athletes that you have todeal with.
But before I do that, I want totalk a little bit about how you
grew up, and you have such aunique story, and I've heard you
say it a couple of times and Iwant you to maybe expound on it
(07:02):
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 inCalabria that you grew up?
Dr. Ned Amendola (07:13):
Well, I was born in Cosenza, in Calabria,
and the Southern part of Italywas always a little bit
underdeveloped, more of aagricultural part of the country
, not a manufacturing orindustrial part of the country,
which was, you know, rome andnorth of Rome.
And, yeah, very small town thatwe lived in was about just
(07:34):
outside of Provenza.
We lived in a small town, itwas about a thousand people, so
you knew everybody in the town,you had the same group of
friends and really participatedin all activities with relatives
and friends around the town.
It was quite enjoyable.
Growing up as a kid I thoughtit was fantastic and then when
(07:57):
we moved, I was very unhappythat we moved.
Sam Rhee (08:00):
So for me, I have very little experience with Italy.
So for me, I have very littleexperience 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 ruralcountryside kind of thing.
I don't know if that's true ornot, but that's my mental image,
that's exactly the what it wasOkay, good, he got it right.
(08:23):
And then when you moved toCanada, to Ontario, in the third
grade you mentioned it was verydifficult.
Your father was a laborer.
This was in the late 60s and itwas a really hard time.
And I could hear when you talkabout the emotion of adjusting
to a new country, to newlanguage, new cultures, new
everything.
(08:44):
And was there anything therethat was really difficult or or
a specific incident that youwere like, wow, this sucks and
it's really hard for someonefrom another country to to grow
up and develop like this.
Dr. Ned Amendola (08:56):
Yeah, it wasn't easy for the first few
years because of the languagebarrier.
When you don't grow up in a ina culture you really don't know,
you know basically the socialnorms as a kid growing up and
going to high school.
That's really important tounderstand the social norms of
the kids you're going to schoolwith in terms of what people do
(09:17):
when they hang out, what musicthey listen to.
Sometimes you have sing-alongsongs and everybody knows the
songs you're singing and Ididn't know the songs.
The stuff like that shows on tvthat people watched and so that
was pretty probably the hardestpart was really basically
becoming enshrined in theculture.
(09:38):
So you understood whateverything was about.
And my parents they had evenmore difficult time because of
the language barrier and so thatwas another thing.
They put a lot ofresponsibility on me to manage
the household as a teenager.
I went to school, I learned toread and write and could
communicate.
I could read parents' incometax forms from the age of 15 on,
(10:08):
where I would fill their incometax forms, do all their bills
and all that stuff.
A lot of responsibility at ayoung age but at the same time,
because you're new to anenvironment, it really forces
you to learn and look at people,listen to people, and that kind
of philosophy has carried on, Ithink, to the present time.
So now when I meet somebody onthe golf course, even at my age,
(10:30):
you listen to them and seewhere they're coming from, you
look at their expression ontheir face and I think it does
help you in everything you doand helps you deal with patients
, help you deal withadministrators, help you deal
with trainees and coming fromdifferent backgrounds and
different nationality, and sothat experience as a child
(10:52):
growing up in a new countryreally has carried on.
So I just feel that it's reallyhelped me along the way.
So initially it was tough, itwas difficult, but I think in
the end is actually a very goodthing for me and my and my
maturing as a human being and asa surgeon.
Sam Rhee (11:09):
Now I know and I wanted to ask later, but I want
to just bring up quickly becauseyou had.
You have four children and oneof them I saw is also an
orthopedic surgeon in sportsmedicine at University of
Nebraska.
Now, Is that right?
Dr. Ned Amendola (11:24):
That's correct .
Sam Rhee (11:31):
Yeah, and which is pretty cool.
I want to ask you about that.
But when you think aboutyourself growing up and then you
saw your children growing upand now your grandchildren, is
it like, wow, these guys have itso easy.
Maybe we need to toughen themup a little bit.
Or was it like we're justreally glad that they don't have
to go through what I wentthrough?
How do you feel about that nowthat they are the second or
third generation here in theUnited States?
Dr. Ned Amendola (11:55):
It's an extremely rewarding part of my
life.
So family is the most importantthing and so having four
children that are doing well andgrandchildren that are doing
well, it's really.
It really brings a lot of joyand it really fulfills my life.
So, aside from all theorthopedic stuff and what you
said earlier, this family andseeing your kids do well is
(12:16):
really the most gratifying thingas far as what you asked.
So my parents were verydemanding on me and as parents,
I don't think we're as demandingon our children.
We just let them decide ontheir own.
So you know, I don't think Idirectly wanted my kids to go
into medicine.
So my son is an orthopedicsurgeon in Nebraska, my daughter
(12:37):
right now is doing a fellowshipin sports medicine at Duke, and
then the other two children arenot in medicine One is an
engineer and one is a softwareprogrammer for a company in
Denver.
But they're all great and westill support our kids as much
as we can.
So that's my parents wereloving and even though they
didn't have access to everything, they provided everything,
(13:01):
tried to do whatever we,whatever we needed, and we still
do that with our kids, ourchildren, and we support them.
And no, I don't ever think Iactually don't ever think that
you don't have it as tough as wedid, because life is tough no
matter what era you're in.
Sam Rhee (13:19):
That's a really good approach as a parent.
The only other question I haveabout your parents right now is
you said they did everything.
They made their own sauce orpasta sauce or in New Jersey
it's gravy I don't know that.
All my fellow Italians here andyour father, every year would
make wine like a 40 gallonbarrel and you would help them
with that as you were growing up.
(13:40):
Do you ever want to do that?
Do you ever want to do thethings that your father did?
Do some of those things that hedid?
At this point, yes, I wouldlike to.
Dr. Ned Amendola (13:51):
Again, everything is in perspective.
You're trying to earn a livingand do a good job, support your
children, support your family,so some of these other hobbies
and extra cook activities take aback seat sometimes, but now's
the time to start taking some ofthose on.
I learned to cook with mymother in the kitchen, so I
still love to do that on theweekends.
(14:13):
I would like to make some wineat some point.
That's on my list of thingsthat I like to do.
You asked me a question beforeon how you became a better
surgeon and I was thinking aboutthat and I was actually
thinking of my time with myparents Growing up.
We did everything in our home.
We made our own tomato sauce,so we went and picked the
(14:35):
tomatoes, we cut them up, thenwe cooked them and got rid of
the peel and the seeds and madetomato sauce.
We also made our own cold cuts,meat, prosciutto, sausage and
cutting up meat.
As a child, and then with mymother in the kitchen cutting up
stuff for her to makevegetables and her dishes in the
(14:56):
kitchen, I thought, well, thatwas probably the beginning of
learning how to use a knife.
So when I met my wife mycurrent wife Allison.
We'd been married for 43 yearsand she came to our house for
the first time and Italiantradition usually is you have
your meal, you have yourespresso, at the end of the meal
(15:17):
, some sweets and cake, and thenafter that you bring a bowl of
fruit and my parents and me andmy sister we got a knife and
we're peeling our apple andwe're cutting up an apple or a
peach, and she's looking at uslike all four of you are like
knife experts.
It's just a funny story.
(15:38):
She was amazed that we werehandling a knife like that,
because they do that in theirEnglish family.
Sam Rhee (15:43):
That's pretty cool.
Now I know they passed, but didthey ever get to see you do
what you do?
And what did they think aboutthat if they were able to?
Dr. Ned Amendola (15:52):
Yeah, I always try to include again.
When you don't have much timeat home, try to include my kids
and everything we did.
My parents were busy theydidn't really, but they were
very proud of me going intomedicine.
But my kids, I brought themwith me to games on the
sidelines, brought them to themaking rounds on patients.
(16:12):
On Saturday morning we go tobowl games and they hang around
and be on the elevator with theathletes and they joke around
and the athletes would make funof me.
So it was.
It was, yeah, I tried toinclude them in everything we
did.
Sam Rhee (16:28):
Now you went to University of Western Ontario in
London and you played footballthere for college.
You're an engineering major onscholarship and this is what I
read and I want you to confirmthis for me.
You switched and went intomedicine after breaking a
scaphoid bone which is in thewrist, and that team after
spending time with a teamphysician and I know you've
(16:49):
mentioned this team physician anumber of times, Dr Jack Kennedy
, who's one of the foundingmembers of the American
Orthopedic Society for SportsMedicine, and he was one of the
people integral as a mentor toget you into sports medicine, as
a mentor to get you into sportsmedicine, and so can you talk a
little bit about Dr Kennedy andwhat that experience was like
in terms of getting that switchturned on for you in terms of
(17:11):
sports medicine?
Dr. Ned Amendola (17:15):
Dr Kennedy was our team physician and, yeah,
my first year at Western I brokemy scaphoid so I was not able
to practice or play for a fewweeks.
So I was on the sidelines withDr Kennedy watching practice and
he had his dog that he broughtto practice and I would play
with the dog and talk to him.
And after a while he got toknow me and he asked me about
(17:38):
what I was doing.
I had a scholarship inengineering.
And he says you know, ned, youhave the right personality, you
should think about medicine, youshould think about orthopedic
surgery.
Coming to our program, and Ikind of mold that over and I
says you know, you can keep yourscholarship in engineering.
Just take a few other courses,take biology, take some organic
(17:59):
chemistry and then apply tomedical school.
And during my first year or twoof engineering, which is very
theoretical, when you'rebasically learning, you're
taking exams, you're answeringengineering questions and
problems, formulas.
I'm thinking maybe medicinewould be a more practical
(18:19):
specialty where you're applyingwhat you're learning and taking
care of people.
And I was certainly grateful DrKennedy taking care of people
and I was certainly grateful DrKennedy taking care of me and
the other physicians that wereworking on the team and I
thought maybe I'll do that.
So I decided to apply tomedical school just because I
wanted to use my hands and applymy knowledge to something more
(18:40):
practical.
My parents were not doctors.
We had nobody in the familythat were doctors.
I'm the first physician and mywhole family Italian family in
Italy and Canada and anyways gotinto medical school.
And the first couple of yearsof medical school were it was
very interesting because it waslike doing engineering, but then
you're going into the exam roomand applying what you're
(19:03):
learning about pharmacology andorganic chemistry and anatomy.
We got to go to the anatomy laband dissect.
I thought this is great.
So I was really happy with myapplication of knowledge and
skills in medicine and DrKennedy invited me to go do some
research in his office.
(19:24):
Third year medical school Iworked for the summer in his
office doing research and he'sreally a mentor to me and wrote
me a letter to get into theresidency program and the
philosophy of Dr Kennedy wasthat.
So he was Canadian, he was thefirst president of the American
(19:45):
Orthopedic Society for SportsMedicine and his view was that
our playground in sportsmedicine and medicine is not
just Canada, it's also theUnited States.
So we had to venture off andget involved in some of these
American societies.
So you know, I became a memberof the American Orthopedic
Society for Sports Medicine.
(20:05):
His successor, peter Fowler,was one of my true mentors and
he became the second Canadianpresident of the AOSSM and then
I became the third one, soreally we had three Canadians
become presidents of theAmerican Orthopedic Society of
Sports Medicine.
(20:25):
There's been no other ones, andwhich is really a testament to
mentoring, when you reallyrespect your mentor and you
respect what they do, and so Ijust followed in their footsteps
and learned a lot from them.
Sam Rhee (20:38):
You were in Canada for quite some time and you stayed
at Western.
You were medical faculty there.
You covered the university, theCanadian national teams, like
rugby.
You were a consultant for theRaptors of the NBA, the NHL, and
then you left and you spent itlooks like about 14, 15 years at
(20:58):
University of Iowa as directorof sports medicine and their
team physician there.
And I have heard you talk aboutsome of the frustrations with
the Canadian medical system andadvantages and drawbacks, but on
the orthopedic side it seemslike there are more frustrations
working within the Canadiansystem than there is on the
(21:19):
American system.
Do you still feel that way interms of now taking a long look
at the two systems and havingworked in both?
Dr. Ned Amendola (21:28):
Yeah, I think the similar problems exist today
in Canada.
That existed when I left in2001.
You know, the Canadian systemessentially is a single payer
system where the government paysfor everything, and health care
payer system where thegovernment pays for everything
in health care, and so, as aresult, there's a budget and
(21:53):
there's rationing of care,basically access to the
operating room, access toimaging, access to care.
Again, don't get me wrong, Ithink everybody in Canada gets
good health care.
I think it's just rationedhealth care and in the US,
because of private healthinsurance, I think it gives you
much more options.
So you have Medicare, medicaidand government supported health
care here in the US and I thinkeverybody gets care in the US.
(22:13):
But because of private healthinsurance, people can get
whatever level of care theydesire and many more options.
So the waiting list foreverything for imaging, waiting
list for surgery, access to careis much shorter in the US.
So there's a lot of good thingsabout Canada and, don't get me
(22:42):
wrong, it was theth reunion ofour medical school class and you
know we love Canada, we loveCanadians, we love Canadian
philosophy.
But the health care system, Ithink, continues to have some of
the similar issues that havebeen in existence since it
(23:05):
became a single payer system.
I think there just needs to besome freedom of choice.
Sam Rhee (23:14):
I know some people would play devil's advocate and
say the excesses that you cansee in the American health care
system can be a little bit nutty.
For example maybe not now, butI remember in residency and a
little bit beyond, especially onthe ortho side, the hardware
for spinal implants.
There was some major money.
(23:36):
It's a multi-billion, it's likea $10 billion plus a year
industry.
I think there was a lot ofadvantage taken by hardware
companies, by some of thephysicians that were implanting
these hardware systems.
The financial incentives grewso huge in terms of managing
(23:57):
some of the financial incentivesthat we see in all aspects of
medicine probably.
Dr. Ned Amendola (24:16):
No, I agree with you, sam.
That is one of the issues.
In American healthcare, andespecially in orthopedic surgery
, the cost of care in the US percapita is almost twice as much
as the cost per capita in Canada.
When you look at implants notjust spinal implants, total hips
, total knees, sports medicineimplants that I use the cost per
(24:40):
implant in Canada is much lessthan the cost per implant in the
US.
And so why does that happen, us?
And so why does that happen?
And I think in the US is a drive, I'm sorry to say, for making
profits.
You know, from the insuranceside, from the technical side,
from the industry side and fromthe surgeon side, everybody
(25:00):
wants to make a good living.
So I think those are all issuesand problems.
So if you look at thegovernment side, the government
funding of health care andorthopedic surgery, all of
health care you look at thegovernment, every year they're
looking at a decreasingreimbursement to physicians.
So the government is trying tocorral care and you know, and I
(25:24):
think the same type of attentionneeds to be given to other
things and I think the same typeof attention needs to be given
to other things.
So you look at a lot of healthcare systems now are negotiating
with industry and orthopediccompanies to get lower prices on
implants and just bring thingsdown a little bit.
So I think these are all issuesthat need to be considered in
our profession.
(25:45):
This is what I'm going to bedealing with the American
Academy of Orthopedic Surgeons.
You know we have 40,000orthopedic surgeons that are
working hard trying to take careof patients, deliver excellent
care, musculoskeletal care, andyet we have this environment out
there that we don't really havecontrol over.
We don't have control overorthopedic costs, insurance
(26:07):
costs.
We don't have control overorthopedic costs, insurance
costs, government makingdecisions in Washington, and so
here we have a great profession,but there's all these other to
continue to try and get as muchsupport as we can to deliver
(26:31):
good care and make patientshappy.
So I personally think ourprofession as doctors and as
surgeons is a great profession.
I'm very grateful for my careerand everything I've done, and so
I'm going to spend the nextcouple of years trying to
support the rest of theprofession and representing us.
(26:54):
So I'll be spending more timein Washington, more time trying
to work with some of thesethings.
We have a large office inWashington, we have an advocacy
council, we have a politicalaction group that helps
negotiate some of these things.
Those are good questions, sam.
I don't have the answers ofwhat the best solution is, but I
(27:18):
think the Canadian system isnot perfect, the American system
is not perfect.
If we could somehow get thebest of both worlds, I think
we'd be in a much better place.
Sam Rhee (27:31):
That's good.
Someone like you who's in bothwould do a good job as a leader.
Now you spent time at Iowa andI was just looking at and I
don't follow Iowa sports, exceptmaybe football a little bit,
because I'm actually a Michiganfan but I really respect Kirk
Ferencz and his philosophy andthe fact that he's still
(27:52):
coaching probably the longestactive Division I football coach
and he had a pretty good recordwhile you were there.
I would say his best year wasone of his best years was 2009,.
11-2, going to the Orange Bowlwith a win.
What can you take away or whatdo you look back at for your
time at Iowa and what stands outto you there?
Dr. Ned Amendola (28:14):
That was a great year 2009,.
We won the Orange Bowl in Miamiagainst Georgia Tech Nice and
it was a great place to work andprobably dealing with the
coaches and athletics was reallythe best part of my job there.
And coaches like her parentsand you know, recently caitlin
(28:35):
clark had a lot of press and hercoach, lisa bluter, just
retired.
She was a great coach of thewomen's team and worked with her
while I was at iowa the brandsbrothers, brothers, the
wrestling coaches great coaches,very passionate, and it's
really fun to work with peoplethat really work to the greatest
(28:59):
extent to have success.
And at Iowa, you know Iowa'sIowa it's not like New York City
and it's not Duke.
In some respects, I think thecoaches worked extremely hard to
have a good team and put a goodteam on the field.
The best part was that thecoaches totally respected the
(29:20):
sports medicine team.
We were part of the team.
They treated us as part of theteam.
Candid communication they couldcall any time.
I could call them anytime.
Sam Rhee (29:29):
If.
Dr. Ned Amendola (29:29):
I had a visitor come to Iowa.
I could walk into KirkFerentz's office and he would
immediately walk them in Withinthree or four questions.
He would find something incommonality with the visitor, no
matter if it was a surgeon fromFlorida or New York or whatever
, and so that was.
It was really, really fun, Ithink, as you get to a higher
stage and it's not the same,it's not the same everywhere,
(29:54):
but there is one story from 2009that I need to.
So Rick Stanzi was thequarterback for Iowa and he
played in the.
He played in the Orange Bowlgame.
He played a great game and wewon handily over this Vaunted.
Georgia Tech had this offensewith the triple back option.
(30:16):
All three backs had over 1,000yards and so it was a big
victory.
But anyways, rick Stanzi, iowawas 10-0, I think, to start the
season, 9-0 or 10-0 were in thetop two or three in the country
rank, and Rick Stanzi hurt hisankle against Northwestern and
he had the so-called high anklesprain, the TUA injury that he
(30:39):
had in 2019.
Yes, so this was 10 yearsbefore.
So this was 10 years before anduh, so we did that surgery and
on rick stanzi, with, uh, fourweeks left in the three or four
weeks left in the season and sofive weeks later he was able to
(31:00):
play in the orange bowl and thesurgery was very successful.
And anyways, I don't.
You can look that up.
He's got a video, rick Stanzithere's a video about Rick
Stanzi and Debra from thesurgery.
So that was one of the mostrewarding things is to see him
get on the field and play thewhole game, kind of the MVP of
(31:20):
the game, but after doing asurgery on him five weeks before
.
So I just that's a big memoryfrom 2009.
So it's a coincidental.
You brought it up.
Sam Rhee (31:29):
Yeah, no, it's crazy.
And that leads me into my nextsort of thought, which is the
amount of pressure as a highlevel sports medicine surgeon to
in terms of the athletes and Iunderstand all patients are
important, like I know that.
But when you're operating onsomebody who and for example,
(31:52):
let me just throw one that yourecently did and the first thing
is that most of our, most of usas surgeons, our patients are
not public, like they're not noone's announcing to the world
that I operated on somebody.
But when, back in March,houston Rockets announced that
forward, terry Easton underwentsuccessful surgery to treat a
(32:12):
benign growth in his lower leg,performed by Dr Ned Amendola at
Duke University and involvedexcising and bone grafting the
lesion, inserting an IMintramedullary rod into his
tibia to accelerate healing.
Now this is a guy who signed afour year $16 million contract
with the Rockets and his averageannual salary was $4 million
(32:38):
and this is a tremendousinvestment, not for the athlete
but for the organization, foreveryone around him.
And two days ago he was givingan update on his rehab process.
He's been playing in the DrewLeague, finished with 26 points,
nine rebounds, four assists.
Now, first of all, if I'm asurgeon, I got to be like I am
the man this is.
Look how effing awesome I am.
But the pressure placed on asurgeon, like you said, to
(33:03):
recover, to come back in as fastas possible and, as you said,
to perform at 120%.
This is not if I get thisprocedure.
I'm just happy if I canfunction on and do all my
activities of daily living.
I'm not looking to cut dunk,move at the highest level of
(33:23):
human capability and, as you'vementioned, it's not just the
athlete, it's a whole team ofpeople 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, ordoes it take someone very
(33:44):
special to be able to succeed atthat level?
Dr. Ned Amendola (33:50):
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 andyou perform plastic surgery.
This is you, this is what youdo, this is like your craft,
this is you know.
And so if I'm doing a surgerythat I do and I know I do it
well and I do it as well asanybody in the country I don't
(34:13):
think you have a lot of pressurebecause it's what you do.
This is who you know.
What defines you.
It's not as if you're doingsomething for the first time.
You're doing something that youknow you can do.
You know how to do it, theoutcomes do you know how to do
it?
The outcomes?
And sometimes you feel that waywhen you see patients.
You feel like I should do thesurgery because I'm the best guy
(34:37):
for the surgery, but you neversay that.
You never say that to thepatient, and so I think it's
knowing your crafts and knowingwhat you're doing and really
having been through it multipletimes before, having a lot of
experience and again, I've got alot of experience.
That was one advantage inCanada when I was there for my
first 10 years in practice, Idid a lot of surgery, like a lot
(35:01):
of, because it's such a longwaiting list for surgery, and if
you can just craft out time andfind time and use your
partner's time, and so you, youend up being a good surgeon,
knowing your craft well, and soI think if you do, if you know
that, then I don't think it's asmuch pressure as as some people
(35:22):
might think.
Number one and then number twois with those types of players.
You're speaking to everybodythe Houston Rockets, you got
their management, you got theirdoctors, you got the agent, and
then the family and you talkabout it.
You have a number of calls andsay, okay, we're coming up to
Duke and have the surgery andthey're very happy with the plan
(35:44):
.
You've discussed it and therewas three or four other opinions
.
With most of these cases theyget three or four other opinions
, of course, and then, after allthe 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 thepreoperative communication and
(36:06):
decision making.
Once it's done and the patientis coming to the operating room,
that's the easier part.
You just got to go through ittechnically and get it done.
Sam Rhee (36:16):
I remember you talking about you operating on Coach K
and his ankle and when he toldyou I would really like to hear
that again what he told youbefore you did his surgery, in
terms of what he also told histeam when he was coaching the
Olympics- yeah, no, I rememberdistinctly because, anyways,
(36:38):
coach K is unique and I learneda lot from Coach K from the
first day I came to Duke andworking with him and taking care
of the teams.
Dr. Ned Amendola (36:48):
His mind works differently, like before I came
to Duke, I heard the line leaveyour ego at the door so many
times.
And then, talking to Coach K,it's the opposite.
It says why would you ever wantto do that?
When you got these greatathletes, you want them to bring
the ego in.
Bring their ego, bring the bestshot they got into the room.
(37:11):
We figured out a way to use itand so when I did surgery on him
the day of surgery I'm seeingin the preoperative area he says
just bring your best stuff intothe room, don't leave anything
outside the room.
I know it's me you're operatingon, but just bring everything
you got I know you're the bestsurgeon and just bring your ego
into the room.
Don't leave anything outsidethe room.
I know it's me you're operatingon, but just bring everything
(37:32):
you got I know you're the bestsurgeon and just bring your ego
into the room and use it and dowhat you can do on my ankle.
So that was Coach K.
Sam Rhee (37:39):
That's great.
I will say he scares me a lot.
He reminds me of my old mentorsand they were amazing people
but they held really highstandards and if you pissed them
off, you bet if you weren'tprepared, if you didn't bring
your a game to the or you betterwatch out because things might
fly around the room a little bit.
(38:00):
So I feel like he.
He reminds me a lot of of theguys I used to train with back
in the day so I don't think.
Dr. Ned Amendola (38:06):
I don't think he was.
Yeah, he paid attention toeverything that was going on.
When I came to Duke he reallyyou could tell by our
communications that he waspaying attention to my actions,
my communication, the way Idealt with athletes, and it was
amazing.
I just thought it was amazingthat he kept track of all these
things and then when you'rehaving a coffee or you're
(38:29):
traveling with the team, hewould just come up and say, ned,
I really appreciate the way youdid this or the way you did
that, and you didn't have anyidea that he was paying
attention to that.
I think that's what makessomebody great is to really know
what's going on around you andhaving a pulse on the people,
the athletes around you.
Sam Rhee (38:48):
What do you still love to do?
What is your favorite operation?
I know you probably love allthe operations you do, but is
there one in particular that youhave a fondness, for whatever
reason?
Dr. Ned Amendola (38:59):
I like operations that are not
instrumented, Like you use acutting guide or a jig where you
put it on and you just followthe instructions.
I like operations where you dohave to use your God-given
talents, experience in doing thesurgery.
So there's a few operationslike that that you still need to
(39:23):
use art and use your technicalskill to do the surgery.
So meniscus transplantation,putting in a new meniscus into a
joint, I think takes a littlebit more technical skill.
There's not really a guide thatanybody can just go ahead and
just do it the first time around, and so you have to use a
(39:47):
little bit.
It's arthroscopic surgery.
It's arthroscopic surgery.
It's arthroscopically assisted.
You have to prepare the areaand then you have to put the
meniscus in.
You have to do a lot ofpreoperative preparation to get
the right size, get the rightpatient.
But it's not justcomputer-assisted or
instrumented surgery.
There's that one.
(40:07):
That's one of my favoritesurgeries to do.
The other one is realignmentsurgery of the limbs.
People have malalignment, Likethis intramedullary rod that you
mentioned earlier on thebasketball.
That's pretty straightforward.
There's just things that youjust step one, step two, step
three, and it's moreinstrumented, Whereas sometimes
(40:28):
if you have malalignment we haveknock knees or full-legged
knees or post-traumaticdeformity and you're going in.
I know you've done a lot ofbone surgery and reconstructive
surgery as well, Sam.
You have to do a lot ofpreoperative planning but then
the exposure, the anatomy,making the appropriate cut and
the bone and fixing it and usingthe appropriate fixation.
(40:51):
I think it's a very gratifyingsurgery and these patients come
in afterwards when they and youcan show them at the end of the
day, show them their limb beforeand after surgery.
We just did one of these verylarge correction this week and
showed this patient after theevening, took his dressing down.
He says, wow, this is reallystraight, it's like cosmetic
(41:17):
surgery.
Sam Rhee (41:19):
But way more functional.
Let's just put it that way thecurrent trends in ortho are
completely against the types ofsurgery you're talking about.
All the Mako systems, thecomputer guided systems this is
idiot.
Proofing some of the hip stuff,knee stuff, I don't know,
whatever the art of it, learningthe and there's a lot of that
(41:40):
also in craniofacial surgery too, where computer guided or
computer assisted types ofsurgery are taking a lot of that
art, or just the fact you needto get a lot of reps in order to
be able to do it well, do youfeel like that is a loss in
terms of how the surgicalspecialties are trending?
Dr. Ned Amendola (42:01):
No, I think you do have to make way for
modernization and moving forward.
I think the younger generationthey're really good, and even my
son uses a computer-assistedpreoperative 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
(42:24):
are good.
But I usually tell my traineesand fellows you should be able
to keep an eye on what's goingon, because sometimes it's not
foolproof.
If the Mako device or Epsomjust looks like it's not quite
the way you think it should be,you should reevaluate.
And so, even though you'reusing a computer-assisted system
(42:44):
or robotic assistance, I thinkas a surgeon you should be able
to know the surgery.
Without the robot, you shouldbe able to do the surgery, and
so you got to keep close eye onit, close track of what's going
on, to make sure that the robotis doing what it's supposed to
do.
Sam Rhee (43:01):
What do you listen to in the OR music-wise?
What do you like to listen to?
Dr. Ned Amendola (43:13):
listen to?
I usually classic rock.
I grew up in that era 70s and80s and yeah, I usually those
rock ballads and just it seemsto be soothing music.
Now you go into the locker roomwith the teams.
They got it's crazy music andwhen I played football in the
early 80s the mainstay wasrolling stones music where you
(43:34):
have the boom box and it was allit was in the one big boom box
in the room instead of but westill do that at duke.
They still have the music goingon, but it's it's more modern.
Yeah, modern, it's good, it'sgot a good beat, it's good to
listen, but it's more modern.
Yeah, modern, it's good, it'sgot a good beat, it's good to
listen, but it's not as soothingfor me.
When you grow up with music Doyou listen to?
Sam Rhee (43:53):
music Absolutely.
Sometimes I find I need lessmusic now.
When I was a resident, oh myGod, I used to just whatever the
attending would allow, as loudas I could, I would play, but
now it's it's a little bitdifferent.
I my go-to is always the 80s,though, you're right, but I also
try to appease the peoplearound me.
So if they want to playsomething else, I try to be a
(44:13):
little bit flexible with that aswell, or I'll ask the patient
even though they're asleep.
So I think it's an interestingtrend right now.
I think the sports medicine guysare the rock stars of medicine.
Like you, guys have so muchmore visibility, and I think for
a couple of reasons.
One is everyone is very active.
There's everyone's playingpickleball or, in my case,
(44:35):
crossfit or whatever it is.
So there are more active peopledoing active things older and
people gravitate towards highprofile sports medicine
specialists.
So you mentioned, your son is asports medicine guy and he
trained at Stedman for a sportsmedicine fellowship, and I know
(44:56):
nothing about sports medicinereally, but I know about Stedman
and Vail, colorado, and allthat, and James Andrews, I think
, was the first down in Alabama,and now Neil Eletrash in LA,
and you, you guys are now rockstars in the sense of high
profile surgeons.
And is that good?
Is that bad?
(45:17):
Is it driven?
I think some of it's driven bythe fact you guys are getting
better outcomes as well, versusmaybe 20 years ago.
20 years ago, these techniquesor 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 (45:39):
Yeah, it's a double-edged sword.
I think you hit the nail on thehead, sam.
For example, tommy John surgeryfor elbow injuries and baseball
players and pitchers.
So you mentioned Otani.
Had he had a redo surgery that?
was and uh, it's.
I think when you take somebodylike Neil LaTrosh, like he's the
go-to guy for all thesesurgeries and uh, he's doing
(46:02):
these pitchers and they're goingback to a very stressful sport
and throwing, and so when youhave so much success, that's
what happens.
So now you have high schoolkids.
We don't do as many baseballplayers here, but I have a
couple of partners that do thesame surgery that Neil Atrash
does on the elbow.
But we get high school kids nowthat have a little bit of elbow
(46:26):
pain and the parents areactually requesting that they
have that surgery so their elbowis stronger and able to throw
more and throw a higher speed.
And it is a double-edged swordin terms of there's too much
media attention and things areprobably thrown a little bit out
of whack with that.
I think the Rogers thing withthe Achilles repair I give all
(46:49):
the credit to Neil Elitrosh andhis team that did the surgery,
but it was like he's going to goback and play at four months.
We weren't able to really tellif he was going to be able to
play at four months, but it'sjust virtually.
Looking at the Achilles tendon,I do a lot of Achilles tendon
surgery and you look at allthese basketball players and
(47:12):
football players in the pastthat tore their Achilles, it
used to take a year to get backto full function.
Well, maybe Durant with hisAchilles tendon takes a whole
year or even more than a year toget back because the demand on
his Achilles is much more than ayear to get back because the
demand on his Achilles is muchmore, and maybe you'd be able to
get somebody back to playingfootball that doesn't need to
(47:32):
jump and dunk as much.
But I'm just saying having thatattention where here's an
Achilles repair and going backafter three or four months all
of a sudden the demands on thesports medicine surgeon is okay.
If I have an Achilles repair,I'm going to be able to play
basketball at six months, whichis really difficult.
It's just hard to get theneuromuscular control and it is.
(47:53):
You know, having attention andhaving that type of media
coverage on one hand is good,but on the other hand the
expectations get a little bitout of whack.
Sam Rhee (48:04):
Yeah.
Do you think that you guys, whodo these high level athletes
and have a lot of publicity arebetter surgeons than, say,
someone else who does thesesurgeries and that's why you
guys get the publicity and thenotoriety?
Or is it just them?
You happen to be right place,right time.
Don't leave your ego at thedoor right now.
(48:26):
Tell me the truth.
Do you do that surgery betterthan anyone else around?
And or ella trash or any ofthose guys, guys or Andrews back
in the day?
What is the difference?
Dr. Ned Amendola (48:38):
I don't think so.
I think there's a lot of goodsurgeons around.
I think we have a you know.
I think a lot of people can dothe same operation and do it
well.
I think it's just the pathwaythat develops.
If Otani's agent sees thatOtani's doing great and he's
hitting more home runs thananybody and he's representing 20
(49:01):
other baseball players, thenevery time they need something
he's going to send them to thesame surgeon, and at least
that's my impression.
There's like pathways of whoyou know, and the last time I
sent somebody here they didreally well and I would
recommend going to that surgeon,and you know so it's a lot
(49:23):
different.
So when you see a patient thatso sometimes I see patients from
Charlotte, for instance, whichis a two hour drive away.
Yeah, and they were recommendedOften the patient will say is
there anybody in Charlotte thatcan do the same surgery?
And so say they need an ACL orthey need a meniscus transplant.
(49:46):
Yeah, I say yeah, there'sseveral surgeons that I would
recommend in Charlotte and Iusually give the patient the
name of those surgeons and Idon't think you can tell the
difference, technically speaking, of the way things are done.
But I think the patient has toget that information in his eyes
.
They were recommended to comehere and they asked is there
(50:08):
somebody in?
Often the patient will saysince you're recommended, I'm
just going to come to Duke andhave it done at Duke.
But I think in pro sports it'smuch more of that, where the
athletes follow theirrecommendation and the pathway
that's been formed.
I think Dr Elitrash is a greatsurgeon and I've seen his
operations and his technicalskill and so I think he's able
(50:31):
to do the surgeries.
But he also has a greatreputation amongst the sports
medicine community, especiallyin those areas.
The Achilles tendon is was abit unusual with that because
he's not.
Sam Rhee (50:48):
I think he's not recognized in that area.
Yeah, if I need surgery for myfoot and ankle, I'm going to the
same one.
That doctor, the same surgeonDr Coach K chose, and I think I
would be okay with that.
So now you have two peoplegoing into sports medicine from
your family your son, who'salready a sports guy in Nebraska
.
And then you said you had adaughter who's finishing up her
(51:09):
sports medicine fellowship.
Dr. Ned Amendola (51:28):
Now, be honest , did they?
Did you kind of unconsciouslyput them into that sports
medicine mode?
Or and bringing them with me todo visits and visit athletes
and bring them to the trainingroom?
And yeah, so I think they and Ienjoy my job.
So if you're at home and I sayI love what I do and I tell them
(51:48):
about patients, and the otherthing that happened was they
make fun of this all the time.
My kid says, everywhere we gothere's people that know you.
We might be shopping at agrocery store or at a restaurant
and there'd be people coming upand say, oh, dr Amendola, you
did surgery on me three yearsago and you did this and you did
that.
So I think they, first of all,they knew that I enjoyed my
(52:12):
profession, I enjoyed what I do,and then, secondly, I did bring
them around to participate insome of my activities in sports
medicine and particularly mygames, athletes and going into
the training room.
Sam Rhee (52:25):
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 forwardfor orthopedic surgery being
president of V Vice and thenpresident eventually of AOS.
After that, what goals do youhave?
You are young or in your prime,I would say, as a orthopedic
(52:46):
surgeon.
I know I think Andrew's retiredat around 81.
So you got like the bulk ofyour career.
You got all the experience, allof the notoriety, the resources
available to you, like you canchange whatever it is around you
to make it fit what you want todo at this point, like growing
up in your career, you're alwaysmaking compromises about this,
(53:08):
that or the other thing, but nowit's like you can set an agenda
for what you really want to doin your life.
What is that going to be for,this advocacy and big position
in AOS?
Like what's your goals?
Dr. Ned Amendola (53:21):
That's a good question.
Nothing is etched in stone, sam, but you're right.
After this academy, a couple ofyears, I'll probably be looking
at what I'm going to be doingas the last phase of my career
and obviously family is a biggoing to be a big part of my
life and enjoying my childrenand grandchildren, and I still
(53:46):
feel like I have a lot to offer.
I have a lot of experience andI have a lot of things in my
head in terms of orthopedicsurgery and I think I'll
probably be doing someconsulting and giving advice in
certain areas.
I'd like to take up some ofthese other hobbies that you
mentioned earlier winemaking andart.
(54:06):
I've written quite a feworthopedic and sports medicine
textbooks or edited books andwritten 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.
When you look at what is it thatmakes people happy in life?
(54:29):
I don't necessarily think I'mjust going to finish and retire.
It's just going to becontinuing on and doing the
things I love to do.
But there's not too many thingsyou need in life to make you
happy.
I think you need somethingchallenging every day.
So right now I'm doingsomething challenging every day
and I'd like to continue doingsomething like that.
You need somebody that loves you, or family, which is obviously
(54:52):
very important.
And then the third thing isleaving a positive trail or a
legacy behind, and I feel likeI've done that, everything I've
done.
There's some positivity to itin Canada and Iowa and now at
Duke, and so you want to leave apositive legacy behind.
So I just want to make surethat everything is in my brain
(55:17):
about orthopedic surgery andsports medicine gets passed down
to the next group of trainees,which I've had fellows and
trainees for 30 years and theyknow everything.
But I just want to make surethat's all passed on.
But I don't know if that's goodenough for you.
Sam Rhee (55:33):
That's really good, I would say, the mentors that I
have had.
I think about almost every daywhen I'm in the operating room
or for whatever I do.
I think I hear their voices inmy head.
But I think it also isimportant for the stalwarts of
our generations in terms ofsurgery to pass down not just
individually to people who seethem, but collectively, because,
(55:55):
like you said, there's a lot ofthought processing, mental sort
of just mindset stuff that Ithink if you can somehow
encapsulate, verbalize orcommunicate to people is really
meaningful.
You have a pretty uniqueexperience in terms of what
you've done, what you're goingto do.
(56:16):
Everyone could be a benefit ofthat if they got more of it, and
I know you have a lot of otherthings like family, like your
hobbies, like everything elsethat you're doing.
But I think that's one of thereasons why I want to talk to
you is because I just wanted tohear a little bit more of what's
going on in your head and howyou think about approaching life
every day, and I reallyappreciate you taking the time
(56:36):
to do that.
That means a lot.
Dr. Ned Amendola (56:38):
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 hugeinterest to hear Ned Amendola's
story, but I do agree with youit's been a great ride.
I'm very proud of my Italianheritage, my Canadian experience
.
I love America and the abilityto fulfill your dreams in this
(57:02):
country are definitely possible,and so I'm very grateful for
everything that's gone on in mylife and but I appreciate
meeting people like you too, andhopefully that'll be part of my
future as well, having a fewmore golf matches with you.
Sam Rhee (57:16):
Yeah, I hope I can put up a better challenge next time
.
I really need to step up mygame in order to do, but I hope
I can do that.
Dr. Ned Amendola (57:25):
I'm sure you will, knowing your tenacity and
your desire to excel.
It'll be great Looking forwardto it All right.
Sam Rhee (57:32):
Thank you so much, Dr Amendola.
Dr. Ned Amendola (57:34):
No Looking forward to it.
All right, thank you so much,dr Amendola.
No, thank you, sam, and have agreat day you too Okay.
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