My grandpa fell in love with my grandma because of her creativity. They were in college and they both were attending a dance in a lodge with a fireplace. As soon as the fire was lit, the room began to fill with smoke. Grandpa climbed up on the mantle to investigate the problem and found that the flue wasn’t staying open. He called down into the crowd saying he was sure he could fix the issue if only someone would bring him some string. Soon a girl (Grandma) came over with a small length of white rope. “Will this do?” He saw that it was a string from a mop and he laughed.  It did the trick. He fixed the flue, they danced the night away and the rest is history.

I get really excited about creativity. I guess you could say it’s in my blood. I especially admire innovative problem solving. Albert Einstien famously said: “The definition of insanity is doing the same thing over and over and expecting different results”.

When I think about this quote I remember something that I watched happen while I was on a mission’s trip in the Dominican Republic. Our group was doing some demolition and construction work. Part of this involved using sledge hammers to break up an old cement staircase. We had some big strong guys in our group who were confident that they could handle the job. The biggest guy grabbed the heaviest hammer and swung it as hard as he could. It bounced off the cement without even making a dent. He swung again and again with only blisters on his hands to show for all the effort. Our translator, who was just a skinny little guy, shook his head when he saw what our strong men were doing and picked up a hammer to show how it was supposed to be done. He took one swing and chipped a huge piece off the edge of the top step, he took another and an even bigger chunk cracked away. He explained that cement is resistant to direct blows but if you hit it at an angle it becomes fragile.

I remember this every time I come up against a big obstacle. If at first you don’t succeed…Try the periphery. Walk the borders and look for another way in. Use glancing blows. Harness your creativity. This is what problem solving is all about.

I chose to work in the discipline of Orthotics for several reasons, but one of them was because I saw that it had problems that needed solving. In my undergraduate arrogance I was sure that I could fix the field singlehandedly. I couldn’t wait to get started. Now that I’m actually working in the profession I can still see those flaws, but they seem bigger and more complicated up close. One of the most challenging aspects of the field is its inertia. It’s a lot like an old decrepit concrete staircase that has been sitting around unchanged for the last 50 years.

Here’s an example: Below are 2 pictures of AFOs (Which stands for Ankle Foot Orthosis, “orthosis” means “brace”).  The type of metal brace pictured has been around since the Civil War, and believe it or not, people still wear them today. Can you imagine if all medical technology had not advanced since the Civil War days? We would still be performing operations with rusty old saws and dying from infections without the use of antibiotics. To be fair, that type of AFO is now referred to as the “old style” but “old style” in the same way that bellbottom pants are old style…they are still acceptable, just not considered cutting edge.

old AFO

pic from: http://www.orthomedics.us/Pages/ankle.aspx

The “New style” AFOs are made out of plastic. This type of AFO began to be used in the late 1960’s -1970s, and it really hasn’t changed since. Once again, just for a little perspective – Star Trek was a hit show when this type of brace was developed…to a young person like me this is ancient history. In the last 5 years the Orthotic industry has started to think about possibly accepting the computer fabrication, 3D printing and CAD CAM methods of making braces. But with characteristic glacial slowness, acceptance of this advanced technology hasn’t become very widespread.

Plastic AFO

Pic from: http://www.georgelianmd.com/cms/InformationLinks/Braces/tabid/124/Default.aspx

There are, of course, multiple reasons for how “stuck in a rut” the Orthotic field is. For one thing, only a few orthotic training programs exist in the country, and those are run by the old-school practitioners who continue to teach the “time tested” methods of brace making. For another thing, insurance companies use a series of L-Codes to categorize braces and determine how much money they are willing to pay for each type of brace. These L-codes were set up in the same Star Trek, bellbottom era as the plastic AFOs, and the system is limited largely to what was available back then. Practitioners can’t afford to make newer, more elaborate braces if they are still going to get paid 1970’s prices for their work. And that’s just the beginning of the reasons for the profession’s retarded development.

Realizing all of this has been a little daunting. I don’t think I will be able to wave my magic wand and fix this profession as quickly as I had planned. It’s going to take some work. I’m going to have to continue to swing my sledge hammer at the edges of the problem. Fortunately I am young and patient. The demographics of the Orthotics profession is changing, more young people like me are joining up. I hope they bring their creativity with them.

I have plans to pursue a PhD in the near future. This will allow me to do research in and around the Orthotics field. I can study the old methods and think of new solutions. There is only one problem…I’m going to have to be creative about finding a research institution that will equip me with the knowledge and skills I need to move forward. (In case you hadn’t guessed, I can’t exactly find a university with a graduate program tailor-made for problem solving within the Orthotic industry…try googling that. Nothing.)  It’s just another barrier to negotiate around. (Seriously, if you have suggestions on grad schools let me know.) Collaboration and an interdisciplinary approach is the key.

Some people are already coming up with creative solutions. Check out this website:

http://www.silverringsplint.com/about/

Here’s an example of someone taking an old clunky style brace like this:

Clunky finger splint

And making it into something modern and beautiful and functional like this:

Cool ring splint

That’s creative genius. That’s what I’m talking about.

It’s innovation like this that gets me fired up. We need to take the same imaginative problem solving into the rest of Orthotics. This is important, because if we don’t change our profession we will just continue on in the status quo. Extinct like the dinosaurs. Stuck in a time warp. Doing the same thing over and over again. How insane would that be?

Walk well (and think creatively!).

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