S04E88 The Humble Origins of a Superstar Orthopaedic Sports Surgeon: Dr. Ned Amendola, Chief of Duke Sports Medicine

Discover the journey of Dr. Annunziato "Ned" Amendola, leading figure in orthopedic surgery and sports medicine, as he shares his experiences and insights with host Sam Rhee @bergencosmetic on the Botox and Burpees podcast @botoxandburpeespodcast.

From his vital roles at Duke University to his upcoming presidency at the American Association of Orthopedic Surgery @aaos_1, Dr. Ned Amendola offers a unique and insightful perspective on the balance of high-pressure responsibilities with a relaxed approach. Learn from his philosophy of teamwork and communication, which has been key in delivering exemplary patient care, especially for elite athletes and special patients such as former Duke Men's Basketball Coach K.

Dr. Amendola also opens up about his personal journey of immigrating from a small village in southern Italy to Canada and the impact it had on his values and professional life. The challenges of adapting to a new culture taught him invaluable life skills that shaped his approach to family and career.

Listen as he shares heartfelt stories of mentorship, pivotal career moments, and the legacy of his mentors that inspired his transition from engineering to orthopedic surgery. Family traditions and the influence of these experiences enrich his narrative, creating a tapestry of professional growth and personal fulfillment.

Join us as we navigate the evolving landscape of orthopaedic surgery with Dr. Amendola, exploring the integration of traditional techniques and modern advancements such as computer-assisted technology.

His anecdotes about high-stakes surgeries on prominent athletes provide a window into the pressures and rewards of sports medicine. As a leader in his field, Dr. Amendola reflects on his heritage and future challenges, offering a compelling vision for the next generation of surgeons.

This episode is a must-listen for anyone interested in the intersection of medicine, mentorship, and personal growth.

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S04E88 The Humble Origins of a Superstar Orthopaedic Sports Surgeon: Dr. Ned Amendola, Chief of Duke Sports Medicine

TRANSCRIPT

[00:00:00]

Dr. Sam Rhee: All right. Welcome to another episode of Botox and Burpees. I have with me a most special guest. This is Dr. Annunziato Amendola, if you're in Italy, or Dr. Ned Amendola, if you're in the United States. Dr. Amendola is the team, head team physician and chief medical officer for Duke Athletics. He is the director of sports medicine at Duke University, professor of orthopedic surgery.

And this is true, one of the top 20 power players in orthopedic surgery in the United States. And this is from Becker Spine, and just so that he was recently appointed the first vice president of AAOS, which is the American Association of Orthopedic Surgery, next in line to be president of the organization in 2025.

And And the past president of the American Orthopedic Society for Sports Medicine. Now, just so that, the context in which these power players are, one of them is Brian Kelly serves as the president CEO of HSS here in New [00:01:00] York. Hospital for special surgery, Gary Mitchelson, who is net worth 1.

8 billion and is included in the Forbes annual richest people in the world. And Dr. Neal. Ella Trash, who just recently did Sho Hayatani's elbow surgery, as well as our New York Jets Achilles tendon repair for Aaron Rodgers. You are in esteemed high company here, Dr. Amendola. I would have been a little nicer to you.

See, how I met Dr. Amendola was we were playing in K Academy, which is Dr. Sorry, Coach K's, uh, golf and basketball camp for those over age 35 for, so the aspiring still aspiring athletes of an older age. And we played against each other. And I have to say the first thing I remember about you, Dr.

Amendola, is that you were so apologetic. You had to play the front T's and they made you play the front T's because you had hit a certain age, which. Obviously you don't look like you did. [00:02:00] And, during and you beat my ass, but the way you beat my ass was like, none of, listen, most of the golfers are not like, Tiger Woods or anything.

The back nine, every time there was a money shot, a shot that had to be made where I was hoping maybe Dr. Amendola might not get this one. Yeah, you hit it. You hit the putts, you hit the short game, you hit your your driver. And I was like, there's no way, there's no way I can catch up with this guy.

So welcome Dr. Amendola. It's a pleasure to have you on the podcast.

Dr. Ned Amendola: Thanks, Sam, for the introduction. That was that was very nice. And, I appreciate it. It was really fun, playing golf. I don't play golf because I'm a competitive golfer, but I like to play golf. Because uh, it is uh, relaxing and, it's a difficult thing to master golf, so, we're talking about surgery, when I see patients in the morning for surgery, sometimes patients say well, Dr.

Amendola, are you [00:03:00] ready for the surgery? I said, yeah, surgery is something I can do. It's not like golf. That's very unpredictable. Yeah. It's it is a nice time relaxing and get to meet people like you, Sam. Thanks for uh, putting up with me on the golf course.

Dr. Sam Rhee: I will say for someone who is. As big a name as you are, and actually there were a couple of guys like that who we played with, you have one of the more laid back personalities. I never would have guessed that you lead such a big team at Duke in terms of heading up sports medicine, their team athletics.

It's, you got some major league responsibilities there, and yet you are one of the more low key people that I've met. In terms of your personality, how do you, me, like how do you mesh that low key person, really just congenial low key guy personality with all of these big responsibilities, management, people management that you have to do on a daily basis.

Dr. Ned Amendola: I think we're all the same. I think we have to [00:04:00] learn how to manage our environment. And personally, I think the best way to manage everything around you, if you're a surgeon or if you're, a teacher or if you're a professor or, whatever you are, I think you have to recognize the environment around you and really listen to people.

And listen to your collaborators, your team, we're a team of teams and you're never really on your own, so for example, if you're seeing a high level athlete who's going to be the number one pick in the NBA draft there's a lot of things that you need to take into account, so you have the player obviously, but then you have the athletic trainer, you have physical therapists, you have And then you have the players team, they've got their family, they've got their, advisors and and I think you need to take all those inputs in before you really communicate and make a decision on what you're going to do.

And [00:05:00] so, I think, and that happens in life with everything, every decision that we make, I think you should try and get as much information as possible. Like you prepared for the. Podcast today by looking into my history. I think we should be doing that with every encounter that we have, every patient that we have.

And so then when you make a decision, you know that it's a well informed decision. You get everybody on the same page and it really makes it comfortable going forward. So then you're going to do surgery. I think the last thing you want as a surgeon is to have any doubts in your mind if you're doing the right thing.

You want to be sure that. The decision you made has input from everybody. Everybody's on board. The athlete's on board. We got the rehabilitation protocol, lined up. And so then you go into the actual surgery with a lot of confidence that we're doing the right thing. And so the only next thing to do is make sure that you do the surgery well and conduct the [00:06:00] operation well.

Anyways, I think it's the same and, at Duke, there's a lot of, there's a lot of eyes at Duke, you know, a lot of people pay attention to what you're doing. And that's another thing is to have that in the back of your mind. And uh, you know, I tell patients that, I said, I say, you're coming to Duke, it's a teaching institution.

Some patients are concerned because it's a teaching institution, you're not going to be doing their surgery. But I usually tell them, look, it's. The other way around is all these eyes looking at the operation. They're making sure that I don't screw up and that I do the right thing. And so, I think having a lot of attention and having a lot of people paying attention to what you do really makes you better at what you do on a daily basis.

Dr. Sam Rhee: Yeah, and I definitely want to talk about that pressure because it is very unique, for you guys as high level sports medicine specialists to, to deal with some of the athletes that you have to deal with. And but before I do that, I want to talk a little bit about how you grew up and you have such a unique story.

And I've heard you say it a [00:07:00] couple of times and I want you to maybe expound on it a little bit. You grew up in Southern Italy in Calabria, is that right?

Dr. Ned Amendola: Correct.

Dr. Sam Rhee: And is it the big city there Cotaranzo? Is that how you pronounce it? Or was it somewhere else in Calabria that you grew up?

Dr. Ned Amendola: I was born in Cosenza in Calabria. And the southern part of Italy is, it was always a little bit underdeveloped, more of a agricultural, part of the country, not a manufacturing or industrial part of the country, which was, you know, Rome and north of Rome. And yeah, very small town that we, we lived in was about just outside of Cosenza, we lived in a small town was about a 1000 people. You knew everybody in the town, you had the same group of friends, and really participated in all activities with relatives and friends, around the town. It was, it was quite enjoyable as a, as growing up as a kid, I thought it was fantastic. And then when we moved, I was very unhappy that we moved, but.

[00:08:00] That's

Dr. Sam Rhee: so for me, I have very little experience with Italy, and when I think of you growing up there, I think of Godfather Part II, Al Pacino, exiled to Italy, hanging out in a villa, like that sort of golden, huge rural, countryside kind of thing. I don't know if that's true or not, but that's my mental image.

And then

Dr. Ned Amendola: the way it was.

Dr. Sam Rhee: Okay, good. He got it right. And then when you moved to Canada, to Ontario in the third grade, you mentioned it was very difficult. Your father was a laborer. This was in the late sixties and it was a really hard time. And I could hear when you talk about the emotion of adjusting to a new country, to new language, new cultures, new everything.

And was there anything there that was really difficult or, Or a specific incident that you were like, wow, this sucks. And it's really hard for someone from another country to, to grow up and develop like this.

Dr. Ned Amendola: Yeah, it wasn't easy for the first, few years because of the [00:09:00] language barrier. When you don't grow up in a in a culture, you really don't know. Social norms, as a kid growing up and going to high school that's really important, to understand the social norms of the kids you're going to school with in terms of, what people do when they hang out, what music they listen to.

Sometimes you have sing along songs and everybody knows the songs you're singing and I didn't know the songs, the stuff like that shows on TV that people watched and so, that was really, probably the hardest part was really basically becoming, enshrined in the culture.

So you understood what, everything was about. And my parents, they had even more difficult time because of the language barrier. And so that was another thing, they put a lot of responsibility on me to manage the household as a teenager. I, I went to school, I learned to read and write and could communicate, I could read.

The, so I did, I did my [00:10:00] parents' income tax forms, from the age of 15 on, where I would fulfill their income tax forms, do all, pay all their bills and all that stuff. A lot of responsibility at a young age, but at the same time, because you're new to an environment.

It really forces you to learn and look at people, listen to people and that kind of philosophy has carried on, I think, to the present time. So now, when I meet somebody on the golf course even at my age, you listen to them and see where they're coming from. You look at their expression on their face, and I think it does help you in everything you do.

It helps you deal with patients, help you deal with administrators. Help you deal with trainees and, coming from different backgrounds and different, nationality. And so that, experience as a child growing up in a new country really has carried on. So I just feel that it's really helped me along the way.

So initially it [00:11:00] was tough and it was difficult, but I think in the end is actually a very good thing for me and my maturing as a human being and as a surgeon.

Dr. Sam Rhee: Now I know and I wanted to ask later, but I want to just bring up quickly because you had, you have four children and one of them I saw is also an orthopedic surgeon in sports medicine at University of Nebraska now, is that right?

Dr. Ned Amendola: That's correct.

Dr. Sam Rhee: Yeah. And which is pretty cool. I want to ask you about that. But.

When you think about yourself growing up and then you saw your children growing up and now your grandchildren, is it like, wow, these guys have it so easy, maybe we need to toughen them up a little bit or was it like we're just really glad that they don't have to go through what I went through? How do you feel about that now that they are the second or third generation here in the United States?

Dr. Ned Amendola: It's an extremely rewarding part of my life, so family is, the most important thing [00:12:00] and so having four children that are doing well and grandchildren that are doing well, it's really the, It really brings a lot of joy and it really fulfills my life, so aside from all the orthopedic stuff and what you said earlier, this, family and seeing your kids do well is really the most gratifying thing.

As far as what you asked so my parents were very demanding on me. And as parents, we're, I don't think we're as demanding on our children. We just let them decide on their own. So, you know, I, I Don't think I directly, wanted my kids to go into medicine. So my son is an orthopedic surgeon in Nebraska.

My daughter right now is doing a fellowship in sports medicine at Duke. And then I, the other two children are not in medicine. One's an engineer and, one is a software, programmer for a company in Denver, but they're all great. And we still support our kids as much as we can.

So that's, my parents were loving. And even though they didn't have access to everything, they [00:13:00] provided everything, tried to do whatever we, whatever we needed. And we still do that with our kids, our children and we support them. Now, I don't ever think, I actually don't ever think that you don't have it as tough as we did because, yeah, life is tough no matter what era you're in.

Dr. Sam Rhee: That's a really good approach as a parent. The only other question I have about your parents right now is you said they did everything. They made their own sauce, or pasta sauce, or in New Jersey it's gravy, I don't know that all my fellow Italians here, and your father every year would make wine, like a 40 gallon barrel, and you would help him with that as you were growing up. Do you ever want to do that? Do you ever want to do the things that your father did Do some of those things that he did at this point,

Dr. Ned Amendola: Yes, I would like to. Again, everything is in perspective, you're trying to earn a living and, do a good job, support your children, support your family. So some of these [00:14:00] other, uh, hobbies and extracurricular activities take a backseat sometimes. But now's the time to start taking some of those on.

I, I learned to cook with my mother in the kitchen, so I still love to do that, on the weekends. I would like to make some wine at some point. That's on my list of things that I like to do. You asked me a question, before on, on how you became a better surgeon, and I was thinking about that and I was actually thinking of my time with my parents growing up.

We did everything in our home, we, so we made our own tomato sauce. So we got the, we went and picked the tomatoes. We cut them up. Then we cooked them and got rid of the peel and the seeds and made tomato sauce. We also got, we made our own cold cuts, meats, prosciutto, sausage, and cutting up meat as a child.

And then with my mother in the kitchen, cutting up stuff for her to, make vegetables and, her dishes in the kitchen. That was probably the beginning of [00:15:00] of, learning how to use a knife. So when I met my wife, my current wife, Alison we'd been married for 43 years and she came to our house for the first time and Italian tradition usually is you have your meal, you have your espresso at the end of the meal some sweets and cake.

And then after that, you bring a bowl of fruit and And my parents and me and my sister are, we got a knife and we're peeling our apple and we're cutting up an apple or a peach. And she's looking at us like, all four of you are like knife experts, anyways, it's just a funny story.

She was amazed that we were handling a knife like that because they didn't do that in their English family.

Dr. Sam Rhee: That's pretty cool. Did you now I know they passed, but did they ever get to see you do what you do? And and what did they think about that if they were able to?

Dr. Ned Amendola: Yeah, I always try to include her, again, when you don't have much time at home. Try to include my kids and everything we, we did. [00:16:00] My parents were busy. They didn't, really, but they were very proud of me going into medicine, but my kids I brought them with me to, games on the sidelines brought them to the, making rounds on patients on Saturday morning.

We go to bowl games and, they hang around and, be on the elevator with the athletes and. They joke around and, the athletes would make fun of me or, so it was it was, I tried to include them in everything we, we did.

Dr. Sam Rhee: Now, you went to University of Western Ontario in London and you played football there for college. You're an engineering major on scholarship. This is what I read, and I want you to confirm this for me, you switched and went into medicine after breaking a scaphoid bone, which is in the wrist, and that team, after spending time with a team physician, and I know you've mentioned this team physician a number of times, Dr.

Jack Kennedy, who's one of the founding members of the American Orthopedic Society for Sports Medicine, and he was one of the People [00:17:00] integral as a mentor to get you into sports medicine. And so I, can you talk a little bit about Dr. Kennedy and what that experience was like in terms of getting, getting that switch turned on for you in terms of sports medicine?

Dr. Ned Amendola: Dr. Kennedy was our team physician and yeah, my first year at Western, I broke my scaphoid. So I was not able to practice or play for a few weeks. So I was on the sidelines with Dr. Kennedy watching practice and he had a his dog that he brought to practice and I would, play with the dog and talk to him.

And after a while, he, he got to know me and, he asked me about what I was doing. I had a scholarship in engineering. And he says, you know, and I did, you know, you have the right personality. You should think about medicine. You should think about orthopedic surgery, coming to our program and, uh.

I kind of mulled that over and I said, you know, you can keep your scholarship in engineering, just take a few other courses, take biology, take some organic chemistry, [00:18:00] and and then apply to medical school. And during my first year or two of engineering, which is very theoretical, and you're basically learning you're taking exams you're answering engineering questions and problems formulas, I'm thinking, maybe I, medicine would be a more practical, specialty where you're applying what you're learning and taking care of people.

And I was certainly grateful Dr. Kennedy taking care of me and the other physicians that were working on the team. And I thought, maybe I'll do that. So I decided to apply to medical school just because I wanted to be, use my hands and apply my knowledge to something more practical.

My parents were not doctors. We had nobody in the family that were doctors. I'm, I'm the first physician and my whole family, Italian family in Italy and, in Canada. And Anyways, got into medical school and the first couple of years of medical school were, it was very interesting because it was like doing engineering, [00:19:00] but then you're going into the exam room and applying what you're learning about pharmacology and, organic chemistry and anatomy.

We got to go to the anatomy lab and I thought this was great. So I was really happy with. my application of knowledge and skills in medicine. And Dr. Kennedy invited me to go do some research, in his office. Third year medical school, I worked for the summer and his office doing research and uh, you know, he's really a mentor to me.

And wrote me a letter to get into the residency program. And The philosophy of Dr. Kennedy was that so he was Canadian. He was the first president of the American Orthopedic Society for Sports Medicine. And his view was that Our playground in sports medicine and medicine is not just Canada.

It's also the United States, so we had to, venture off and get involved in some of these [00:20:00] American societies. So, you know, I became a member of the American Orthopedic Society for Sports Medicine. His successor, Peter Fowler, was one of my, one of my true mentors, and he became the second Canadian president of the AOSSM.

And and then I became the third one, so really you had three, three Canadians become presidents of the American Orthopedic Society of Sports Medicine. There's been no other ones, and which is really a testament to mentoring, when you really respect your mentor. And you respect what they do.

And, so I just followed in their footsteps and learned a lot from them.

Dr. Sam Rhee: You were at, in Canada for quite some time and you stayed at Western. You were medical faculty there. You covered the university, the Canadian national teams like rugby. You were consultant for the Raptors of the NBA, the NHL, and then you left and you spent It looks like about 14, 15 years at University of Iowa [00:21:00] as director of sports medicine and their team physician there.

And I have heard you talk about some of the frustrations with Canadian, the Canadian medical system and advantages and drawbacks, but on the orthopedic side, it seems like there are more frustrations working within the Canadian system than there is on the American system. Do you feel, you still feel that way in terms of, now taking a long look at the two systems and having worked in both?

Dr. Ned Amendola: Yeah, I think the similar problems exist today in Canada that existed, when I left in 2001, um, you know, the Canadian system essentially is a single payer system, where the government. It pays for everything in health care. And so as a result, there's a budget and there's rationing of care.

Basically access to the operating room, access to imaging access to care. Again, don't get me wrong. I think everybody in Canada gets good health care. I think it's just rationed health [00:22:00] care. And In the U. S., because of private health insurance, I think it gives you much more options.

So you have Medicare, Medicaid, and government supported health care here in the U. S. And I think everybody gets care in the U. S. But because of private health insurance, people can get whatever level of care, they desire. And many more options. So the waiting list for everything, for imaging, waiting list for surgery Access to care is much shorter in the U.

S. So there's a lot of good things about Canada. And I, I don't get me wrong. It was The best time of our lives growing up in Canada, still, I'm going back in a couple months for our 40th reunion of our, our medical school class and um, you know, we love, we love Canada, we love Canadians, um, we love Canadian philosophy, but the health care system, I think, continues to have some of the [00:23:00] similar issues that have been in existence Thank you very much.

Since it became a single payer system. I think there just needs to be some freedom of choice.

Dr. Sam Rhee: I would, I could, I know some people would play devil's advocate and say the excesses that you can see in the American healthcare system can be a little bit nutty. For example, I'm not, maybe not now, but I remember in residency and a little bit beyond especially on the ortho side, the hardware for like spinal implants. There was some major money spent. It's a multi billion, it's like a 10 billion plus dollar a year industry. And so I think there was a lot of advantage taken, uh, by hardware companies, by some of the physicians that were implanting these hardware systems. The financial incentives grew so. Huge in terms of developing, marketing, and then using these [00:24:00] systems.

Do you feel that the appropriate checks and balances are in place? That we are doing a good job as a healthcare industry in terms of managing some of the financial incentives that we see in, in all aspects of medicine, probably.

Dr. Ned Amendola: No, I agree with you, Sam. That is one of the issues in American healthcare, and especially in orthopedic surgery. The cost of care in the U. S. per capita is almost twice as much as the cost per capita in Canada. When you look at implants, not just spinal implants, total hips, total knees sports medicine implants that I use, the cost per implant in Canada is much less than the cost per implant in the U.

S. And why does that happen? And I think in the U. S. is a drive, I'm sorry to say for, making profits, you know, from the insurance side, from the technical side, from, the industry side, and from the surgeon sides, [00:25:00] everybody wants to make a good living. So I think those are all issues and problems.

So if you look at the government side, the government funding of healthcare and orthopedic surgery all of healthcare. You look at the government every year, they're looking at decreasing reimbursement, to physicians. So the government, is trying to corral care and, you know, and I think the same type of attention needs to be given to other things.

So you look at a lot of health care systems now are negotiating with industry and orthopedic companies to get, lower prices on implants and, just bring things down a little bit. So I think these are all issues that need to be considered. in our profession. This is what I'm going to be dealing with the American Academy of Orthopedic Surgeons.

You know, We have 40, 000 orthopedic surgeons that are working hard trying to take care of patients, deliver excellent care, musculoskeletal care, and yet, we have this [00:26:00] environment out there that we don't really have control over. We don't have control over, orthopedic costs.

insurance costs, government making decisions and, and, in Washington. And and so here we have a great profession, but there's all these other forces around us that are shaping, you know, the way things that, that are happening around us. And so I, I don't have all the answers and I think we just need to continue to try and get as much support as we can, to deliver good care and, make patients happy.

So I, I personally think, our profession as doctors and as surgeons is a great profession. I'm very grateful for my career and everything I've done. And so I'm going to spend the next couple of years trying to support the rest of the profession and, and representing us. So, I'll be spending more time in Washington, more time, trying to.

Work with [00:27:00] some of these things. We have a large office in Washington. You, we have an advocacy council. We have a political action group that helps negotiate some of these things. Those are good questions, Sam. I don't have the answers of what the best solution is, but.

Dr. Sam Rhee: huh. Uh Huh.

Dr. Ned Amendola: system is not perfect. If we could somehow, get the best of both worlds, I think we'd be in a much better place.

Dr. Sam Rhee: That's good. Someone like you, who's in both, would do a good job as a leader. Now, you spent time at Iowa, and I was just looking at and I don't follow Iowa sports. Except maybe football a little bit. Cause I'm actually a Michigan fan, but I really respect Kirk Ferencz and his philosophy. And the fact that he's still coaching probably the longest active division one football coach.

And he had a pretty good record while you were there. I would say [00:28:00] his best year was two, one of his best years was 2009, 11 and two going to the orange bowl with a win. What can you take away or what do you look back at for your time at Iowa and and what stands out to you there?

Dr. Ned Amendola: That was a great year. 2009 we won the Orange Bowl in Miami against Georgia Tech.

Dr. Sam Rhee: Nice.

Dr. Ned Amendola: And was was a great place to work. And probably dealing with the coaches and athletics was really the best part of my job there. And coaches like Burt Ferentz and you know, recently, Caitlin Clark, had a lot of press and her coach, Lisa Bluter just retired.

She was a great coach of the women's team and worked with her while I was at Iowa. The Brands brothers, the wrestling coaches great coaches, very passionate. And it's really fun, to work with people that really work to the greatest [00:29:00] extent to, to have success. And, at Iowa, you know, Iowa's, Iowa, it's not, it's not like New York City and it's not Duke in some respects.

I think the coaches work extremely hard and to have a good team and put a good team on the field. And the best part was that they. The coaches totally respected the sports medicine team. We were part of the team. They treated us as part of the team, candid communication. They could call anytime.

I could call them anytime. If I had a visitor come to Iowa, I could walk into Kirk Ferentz's office and He would immediately welcome them and within three or four questions, he would find something in commonality with the visitor, no matter if it was, a surgeon from Florida or New York or whatever.

And so that was, it was really, really fun. I think as you get, To a higher stage, and it's not the same. It's not the same everywhere. But there is 1 story from 2009 that I need to so Rick Stanzi was the [00:30:00] quarterback for Iowa and, he played in the he played in the Orange Bowl game.

He played a great game and we won handily over this vaunted they had this. Georgia Tech had this offense, with the triple back option. All three backs had over a thousand yards. And so it was a big victory. But anyways, Rick Stanzi. We were Iowa was 10 and 0, I think to start the season.

9 and 0 or 10 and 0 were like in the top two or three in the country ranked. And, Rick Stanzi hurt his ankle and against Northwestern and he had the so called high ankle sprain.

The Tua injury that he had in 2019.

Dr. Sam Rhee: Yes.

Dr. Ned Amendola: So this was 10 years before. And so we did that surgery on Rick Stanzi with four weeks left in the three or four weeks left in the season.

And, so five weeks later, he was [00:31:00] able to play in the Orange Bowl and the surgery was very successful. And anyways I don't, you can look that up. He's got a video. Rick's and there's a video about Rick Stanzi and recovered from the surgery. So that was one of the most rewarding things is to see him get on the field and play the whole game.

Kind of the MVP of the game after doing a surgery on him five weeks before. So I just yeah, that's a big memory from 2009. So it's a coincidence that you brought it up.

Dr. Sam Rhee: yeah. No, it's crazy. And that leads me into my next sort of thought, which is the amount of pressure as a high level sports medicine surgeon to, in terms of the athletes and I understand all patients are important, like I know that, but when you're operating on somebody who. And for example, let me just throw one that you recently did.

And the first thing is that most of our, most of us as surgeons, our patients are not [00:32:00] public. Like they're not, no one's announcing to the world that I operated on somebody, but when. Back in March, Houston Rockets announced that forward Terry Easton underwent successful surgery to treat a benign growth in his lower leg performed by Dr.

Ned Amendola at Duke University and involved excising and bone grafting the lesion, inserting an IM intramedullary rod into his tibia to accelerate healing. Now, this is a guy who signed a four year, 16 million contract with the Rockets. And His average annual salary was four million and this is a tremendous investment, not for the athlete, but for the organization, for everyone around him.

And two days ago, he was giving an update on his rehab process. He's been playing in the Drew League, finished with 26 points, 9 rebounds, 4 assists. Now, First of all, if I'm a surgeon, I got to be like, I am the man. This is look how effing awesome I am. But the pressure [00:33:00] placed on a surgeon, like you said to recover, to come back in, in as fast as possible.

And as you said, to perform at 120%, this is not. If I get this procedure, I'm just happy if I can function on and do all my activities of daily living. I'm not looking to cut, dunk, move, at the highest level of human capability. So as you've mentioned, it's not just the athlete, it's a whole team of people that are just yammering at you.

Family, trainers, agents, like we've seen movies about this sort of stuff. And so how do you handle, or does it take someone very special to be able to succeed at that level?

Dr. Ned Amendola: No I don't think of myself as a special you really built that up, Tim, but I'm sure you're the same, when you take on a patient and you perform plastic surgery, This [00:34:00] is you. This is what you do. This is like your craft. This is, you know, um, And so, if I'm doing a surgery that I do, and I know I do it well, and I do it as well as anybody in the country, I don't think you have a lot of pressure, because it's what you do.

This is who def you know, what defines you. It's not as if you're doing something for the first time. You're doing something that you know you can do, you know how to do it, the outcomes, and, and sometimes you feel that way when you see patients, you feel like I should do the surgery because I'm the best guy for the surgery, but you never say that, you never say that to the patient.

And so I think it's it's knowing your crafts and knowing what you're doing and really having been through it multiple times before, having a lot of experience. And again, I've got a lot of experience. I, That was one advantage in Canada. When I was there for my first 10 years in practice, I did a lot of surgery.[00:35:00]

Like a lot of, because it's such a long waiting list for surgery and if you can just craft out time and find time and use your partner's time and do, so you, you end up being a good surgeon knowing your craft well. And so I think if you do, if you know that then I don't think it's as much pressure as.

As some people might think, number one. And then number two is, with those types of players, you're speaking to everybody, the Houston Rockets, you've got their management, you've got their doctors, you've got the agent and then the family and uh, you talk about it, you have number of calls and say, okay, we're coming up to Duke and have the surgery.

And. They're very happy with the plan. You've discussed it. And there was 3 or other, 3 or 4 other opinions with with most of these cases, they get 3 or 4 other opinions.

Dr. Sam Rhee: Of course.

Dr. Ned Amendola: And and then after all the discussions and all the communication, they say, okay, we're just going to come to [00:36:00] Duke and do it.

As well as I do, the hard part is the preoperative. Communication and decision making. Once it's done and the patient is coming to the operating room, that's the easier part. Yeah, you just gotta go through it technically and get it done.

Dr. Sam Rhee: I remember you talking about you operating on Coach K and his ankle. And what he told you, I would really like to hear that again. What he told you before you did his surgery, in terms of what he also told his team when he was coaching. Do

Said?

Dr. Ned Amendola: yeah, no, I remember distinctly because anyways, Coach K is unique and I learned a lot from Coach K, from the first day I came to Duke and working with him and taking care of the teams. His mind works, differently, like before I came to Duke. I heard the line, leave your ego at the door so many times.

And then talking to Coach K, it's the [00:37:00] opposite. This is, why would you ever want to do that when you got these great athletes? You want them to bring the ego in, bring their ego, bring the best shot they got into the room, we'll figure out a way to use it. And so when I did surgery on him, the day of surgery, I'm seeing in the preoperative area.

He says, now just, bring your best stuff into the room. Don't leave anything outside the room. I know it's me you're operating on, but just bring everything you got. I know you're the best surgeon and just bring your ego into the room and, use it and do what you can do on my ankle.

So that was coach K.

Dr. Sam Rhee: That's great. I will say, he scares me a lot. He reminds me of my old mentors, and they were amazing people, but they held really high standards, and if you pissed them off you better, if you weren't prepared, if you didn't bring your A game to the OR, you better watch out, cause might fly around the [00:38:00] room a little bit.

So I feel like he, he reminds me a lot of of the guys I used to train with back in the day.

Dr. Ned Amendola: I don't think, I don't think he was, yeah he paid attention to everything that was going on. When I came to Duke, you really, you could, you could tell by our communications that he was paying attention to every, my actions, my communication, the way I dealt with athletes and, it was amazing.

Yeah, I just thought it was amazing that he kept track of all these things and then When you're having a coffee or, you're traveling with the team, he would just come up and say, Ned, I really appreciate, the way you did this or the way you did that. And you didn't have any idea that he was, paying attention to that.

I think that's what makes, somebody great is to really know what's going on around you and having a pulse on the people, the athletes around you.

Dr. Sam Rhee: What do you still love to do? What is your favorite operation? One I know you, you probably love like all the operations you do, but is there one in particular that you're, you have a fondness for whatever reason?

Dr. Ned Amendola: I like [00:39:00] operations that are not instrumented like you use, a cutting guide or a jig where you put it on and you just follow the instructions. I like operations where you do have to use your, god given talents and experience in doing the surgery. So there's a few operations like that that you still need to use art and use your technical skill to do the surgery.

So, meniscus transplantation, putting in a new meniscus into a joint, I think takes a little bit more technical skill. There's not really a surgery. a guide that you can, anybody can just go ahead and just do it, the first time around. And so you have to use a little bit, it's arthroscopic surgery, it's arthroscopically assisted.

You have to prepare the area and then you have to put the meniscus in. You have to do a lot of preoperative preparation, and get the right size, get the right [00:40:00] patient and but, It's not just computer assisted or instrumented surgery. There's that one.

That's one of my favorite surgeries to do. The other one is

Dr. Sam Rhee: I'm

Dr. Ned Amendola: realignment surgery of the limbs. People have malalignment. Like this intramedullary rod that you mentioned earlier, in the basketball, that's pretty straightforward. There's just, Things that you just step one, step two, step three, and and it's more instrumented.

Whereas, sometimes you have, if you have malalignment, we have knock knees or bowlegged knees or post traumatic deformity and you're going in. I know you've done a lot of bone surgery and reconstructive surgery as well, Sam. You have to You know, do a lot of preoperative planning, but then the exposure, the anatomy, making the appropriate cut and the bone and fixing it, and using the appropriate fixation.

I think it's a very gratifying surgery and these patients come in afterwards when they, and you can show them the, at the end of the day, [00:41:00] show them their limb before and after surgery. We just did one of these very large correction this week. and I showed this patient after, in the evening, took his dressing down, he says, wow, this is really straight. You it's like cosmetic surgery.

Dr. Sam Rhee: But way more functional, let's just put it that way. The current trends in ortho are completely against the types of surgery you're talking about. All the Mako systems, the computer guided systems, this is idiot proofing some of the hip stuff, knee stuff, I don't know, whatever. The art of it, learning the And there's a lot of that also in craniofacial surgery, too, where computer guided or computer assisted types of surgery are taking a lot of that art, or just the facts.

You need to get a lot of reps in order to be able to do it well. Do you feel like that is a loss in terms of how you're doing it? Yeah. Yeah. The surgical specialties are trending,

Dr. Ned Amendola: [00:42:00] No, I think you do have to make way for modernization and moving forward. I think the younger generation, they're really good and I, I, like even my son uses a computer assisted, preoperative planning tool for osteotomies, for limb correction.

Yeah, and I think it is an advance, and it is moving things forward, and so I, I think all those things are good, but I usually tell, my trainees and fellows, you should be able to keep an eye on what's going on, because sometimes it's not foolproof, so if the Mako device, for instance, just looks like it's not quite.

The way you think it should be, you should reevaluate. And so even though you're using a computer assisted system or robotic assistance, I think as a surgeon, you should be able to know the surgery without the robot. You should be able to do the surgery. And so you got to keep close eye on it, close track of what's going on to make sure that the robot is doing what it's supposed to [00:43:00] do.

Dr. Sam Rhee: What do you listen to in the OR music wise? What do you like to listen to?

Dr. Ned Amendola: Usually classic rock. I grew up in. That era, 70s and 80s. And yeah, I usually, those rock ballads and, just it seems to be soothing music. Now, you go into the locker room with the teams, they got, it's crazy music. And when I played football, in the early 80s the mainstay was rolling Stones, using we, you have the boombox and, it was all, it was in the, one big boombox in the room instead of every, but we still do that at duke.

They still have the music going on, but it's it's more modern. Yeah. Modern music. It's good. It's got a good beat. It's good to listen to, but it's not as soothing for me. When you grow up with music, it's do you listen to music?

Dr. Sam Rhee: Absolutely. Sometimes I find I need less music now. When I was a resident. [00:44:00] Oh my God. I used to just Whatever the attending would allow, as loud as I could, I would play. But now it's it's a little bit different. I, my go to is always the 80s though, you're right. But I also try to appease the people around me.

So if they want to play something else I try to be a little bit flexible with that as well. But or I'll ask the patient, even though they're asleep. So I think it's an interesting trend right now. I think the sports medicine guys are the rock stars of medicine. Like you guys have so much more visibility.

And I think for a couple of reasons, one is everyone is very active. There's, everyone's playing pickleball or in my case, CrossFit or, whatever it is. So there are more active people doing active things older. And people gravitate towards high profile sports medicine specialists.

So you talked to your you mentioned your your son is a sports medicine guy and he trained at Stedman for a sports medicine fellowship. And I know nothing about sports medicine really, but I know about [00:45:00] Stedman and Vail Colorado and all that. And James Andrews I think was the first down in Alabama and now Neil Ella Trash in LA, and you you guys are now rock stars in the sense of high profile surgeons. And is that good? Is that bad? Is it driven? I think some of it's driven by the fact you guys are getting better outcomes as well as, versus maybe 20 years ago. 20 years ago, These techniques or surgeries were fraught with peril, I think, in some instances, and now the expectation is that, yeah, you get surgery, you're going to be better than you were before sometimes.

Dr. Ned Amendola: Yeah, it's a double edged sword. I think you hit the nail on the head Sam. Example, Tommy John surgery for, for on, 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 somebody like Neil Atrash, like he's the go to guy [00:46:00] for all these surgeries, and he's doing these pitchers they're going back to a very stressful, sport and throwing.

And And so when you have so much success, that's what happens. So now you have high school kids, don't do as many baseball players here, but I have a couple of partners that do the same surgery that Neal Atrash does on the elbow. And but we get high school kids now that, have a little bit of elbow pain and the parents, actually requesting that they have that surgery.

So their elbow is stronger and able to throw more and throw a higher speed. And and it is a double edged sword, and in terms of there's too much media attention and and things are probably thrown a little bit out of whack, with that, I think the Rogers thing with the Achilles repair, I give all the credit to Neil Elitrosh and his team that did the surgery, but, it was like, he's going to go back and play at four months.

We [00:47:00] weren't able to really tell if he was going to be able to play at four months. But it's just virtually looking at the Achilles tendon. I do a lot of Achilles tendon surgery, and you look at all these basketball players and football players in the past that tore their Achilles, and usually take a year, to get back to full function.

So maybe, Durant with his Achilles tendon takes a whole year or even more than a year to get back because the demand on his Achilles is much more. And maybe you'd be able to get somebody back to playing football that's not, doesn't need to jump and dunk as much. But I'm just saying having that attention, where here's an Achilles repair and going back after 3 or 4 months, all of a sudden the demands on the sports medicine surgeon is, okay, if I have an Achilles repair, I'm going to be able to play basketball at 6 months, which is really difficult.

It's just hard to get the neuromuscular control. And yeah, it is uh, you know, having attention and having that type of media coverage on one hand [00:48:00] is good, but on the other hand, the expectations get a little bit out of whack.

Dr. Sam Rhee: Yeah. Do you think that you guys who do these high level athletes and have a lot of publicity are better surgeons than, say, someone else who does these surgeries? And that's why you guys get the publicity and the notoriety? Or is it just You happen to be right place, right time. Don't leave your ego at the door right now.

Tell me the truth. Do you do that surgery better than anyone else around, or Ella Trash, or any of those guys, or Andrews back in the day? What is the difference?

Dr. Ned Amendola: I don't think so. I think there's a lot of good surgeons around, I think we have a, yeah. I think a lot of people can do the same operation and do it well. I think it's it's just the pathway that develops. If Otani's agent, sees that Otani's doing great, and he's hitting more home runs than anybody, and he's [00:49:00] representing, 20 other baseball players, then every time they need something, they're gonna, he's gonna send them to the same surgeon.

And at least that's my impression, there's like pathways of, who, you know, and the last time I sent somebody here, they did really well, and I would recommend going to that surgeon. And uh, you know, so it's, it's a lot different, so when you see a patient that, so sometimes I see patients from Charlotte, for instance, which is a two hour drive away.

And and they were recommended, often the patient will, will say, is there anybody in Charlotte that can do the same surgery? Can, so say they need an ACL or they need a meniscus transplant. Yeah, there's, I said yeah there's several surgeons that I would recommend in Charlotte.

And I usually give the patient the name of those surgeons. And I don't think you, I don't think you can tell, the difference, [00:50:00] technically speaking, of the way things are done. But, I think the patient has to get that information and decide. If they were recommended to come here and that they asked, is there somebody in, often the patient will say since you're recommended, I'm just going to come to Duke and have it done at Duke.

It's a, it's a. But I think in pro sports, it's much more of that, where the athletes follow their recommendation and the pathway that's been formed. I think Dr. Elitrosh is a great surgeon and, I've seen his his operations and his technical skill. And so I think he's able to do the surgeries, but he also has a great reputation amongst the sports medicine community, especially in those areas.

Dr. Sam Rhee: I'm

Dr. Ned Amendola: The Achilles tendon was a bit unusual, with that, because he's not, I think, he's not, recognized in that area.

Dr. Sam Rhee: Yeah. If I need surgery for my foot and ankle, I'm going to the same one that Dr. The same surgeon, Dr. Coach K chose. And I think that I probably would, I would be okay with that. [00:51:00] So now you have two people going into sports medicine from your family your son who's already at a sports guy at in Nebraska, and then you said you had a daughter who's finishing up her sports medicine fellowship.

Now be honest. Did they, did you kind. Unconsciously put them into that sports medicine mode or or, how did they decide to follow in their father's footsteps and do basically what you're doing?

Dr. Ned Amendola: Yeah, I think it was probably, it wasn't direct, but indirectly affected them by, getting them involved in my job, and bringing them with me to, do visits and visit athletes and bring them to the training room. And, yeah, so I, I think they, and I enjoy my job.

So if you're at home and, I say, I love what I do and I tell them about patients. And The other thing that happened was they make fun of this all the time. My kids says everywhere we go, there's people that know you we might be, in, at [00:52:00] shopping at a grocery store or at a restaurant, and there'd be people coming up and say, oh, Dr.

Amendola, you did surgery on me three years ago, and you did this, and you did that. So I think they, First of all, they knew that I enjoyed my profession, I enjoyed what I do, and then secondly, I did bring them around to, participate in some of my activities in sports medicine, and particularly, in games, athletes, and going into the training room.

Dr. Sam Rhee: So I can tell what you're going to be doing at least for the next year or two, which is a lot of advocacy and representing, the face forward for orthopedic surgery being present vice and then face forward. President eventually of AAOS. After that, what goals do you have? You are young or in your prime, I would say as a orthopedic surgeon.

I know I think Andrew's retired at around 81. So you got like the bulk of your career. You got all the experience, all of the notoriety the resources available to you. Like you can [00:53:00] change. Whatever it is around you to make it fit what you want to do at this point. Like growing up in your career, you're always making compromises about this, that, or the other thing.

But now it's like you can set an agenda for what you really want to do in your life. What is that going to be after, this advocacy and big position in AOS, like what's your goals?

Dr. Ned Amendola: That's a good question. Nothing is etched in stone, Sam but you're right. After this, academy. A couple of years I'll probably be looking at, what I'm going to be doing as, the last phase of my career. And obviously family is a big, going to be a big part of my life and enjoying my children and grandchildren.

And I still feel like I have a lot to offer, I have a lot of experience and I have a lot of things in my head in terms of orthopedic surgery and I think I'll probably be, doing some consulting and, giving advice in certain [00:54:00] areas. But I'd like to take up some of these other hobbies that you mentioned earlier, winemaking and art.

I've written I've written, quite a few orthopedic and sports medicine textbooks or edited books and written a lot of chapters. But, I also have another book on Personal book I'm, I like to finish and publish. So I got a few things in mind. When you look at what is it that makes people happy, in life I don't necessarily think I'm just going to, finish and retire, it's just going to be continuing on and doing the things I love to do.

But there's not too many things you need in life. To make you happy. I think you need something challenging every day. So right now I'm doing something challenging every day, and I'd like to continue doing something like that. You need somebody that loves you, or family, which is obviously, very important.

And then the third thing is leaving a positive trail, or. A legacy behind [00:55:00] and I feel like I've done that, everything I've done, it's, there's some positivity to it in Canada and, Iowa and now at Duke. And so you want to leave a positive legacy behind.

So I just, I just want to make sure that everything is in my brain about orthopedic surgery and sports medicine gets passed down to the next group of trainees, which, I've had fellows and trainees for 30 years and. They know everything, but I just want to make sure that's all passed on.

But I don't know if that's good enough for you,

Dr. Sam Rhee: That's really good. I would say the mentors that I have had, I think about almost every day when I'm in the operating room, for whatever I do I think I hear their voices in my head. But I think it also is important for the stalwarts of our generations in terms of surgery to pass down, not just individually to people who see them, but collectively, because like you said, there's a lot of.

Thought processing, mental sort [00:56:00] of, just mindset stuff that I think if you can somehow encapsulate, verbalize, or communicate to people is really meaningful. You have a pretty unique experience in terms of what you've done what you're going to do. Everyone could be a benefit of that if they got more of it.

And I know you have a lot of other things like family, like your hobbies, like everything else that you're doing, but I think that's one of the reasons why I want to talk to you is because I just wanted to hear a little bit more of what's going on in your head and how you think about approaching life every day.

And I really appreciate you taking the time to do that. That means a lot.

Dr. Ned Amendola: I, anyways, thanks, Sam. Thanks for all the kind words. And it's really been nice talking to you. I'm not sure, it's a huge interest, to hear Ned Amendola's story, but I do agree with you. It's it's been a great ride. I'm very proud of my Italian heritage.

My Canadian experience, I love America and the [00:57:00] ability to fulfill your dreams in this country are definitely possible. And so I'm very grateful for everything that's gone on in my life and But I appreciate meeting people like you too. And hopefully that'll be part of my future as well.

Having a few more golf matches with you.

Dr. Sam Rhee: Yeah, I hope I can put up a better challenge next time. I really need to step up my game in order to do but I hope I can do that.

Dr. Ned Amendola: I'm sure you will knowing your tenacity and your desire to excel it'll be great. Looking forward to it.

Dr. Sam Rhee: All right. Thank you so much, Dr. Amendola.

Dr. Ned Amendola: No, thank you, Sam. And have a great day.

Dr. Sam Rhee: You too.