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The Way Things Work

By Anselm Wong, MD

As a relatively newer hand surgeon, I have considered very many texts essential for my growth in skill, knowledge base, and techniques.  It is therefore difficult to pick just one book that I would say we all must read over the others.  I still use the same Netter’s I read on my first day of medical school.  Green’s is great, of course, as is Watsons’s book dedicated to the wrist.  Hunt’s atlas of operative techniques has been one of my must-reads before any case I’m not as intimately familiar with. Zenn and Jones have an outstanding text on flaps, as do Mardini and Wei.  These days, as my residents will be quick to tell you, you can even watch entire operations narrated on YouTube.  I have found that this trend does not necessarily make our textbooks obsolete but could either enhance our reading or lessen our dependence on our books – I imagine for most people, it ends up being somewhere in the middle.

I would submit, therefore, that the one book every hand surgeon should read is The Way Things Work, by David Macaulay1.  On its face, it has little to do with the hand or wrist, but deep down, I believe it has everything to do with our specialty.  Through cute and clever illustrations and easy-to-understand explanations, it takes simple mechanisms like screws and gearboxes up to more complicated things like parking meters, toilet tanks, pianos, and helicopters, showing you what’s on the inside and what’s actually going on that makes them do what they’re designed to do.  

When I discovered this book growing up, it really sparked my inquisitiveness and made me think about what makes everyday objects tick.  It wasn’t enough to take devices for granted and assume they’ll just function as they’re supposed to.  The Way Things Work took me on a guided tour of the inner workings and answered “what, how, and why?”  Consciously or not, we use this mentality every single day, whether it’s trying to understand carpal kinematics or the extensor mechanism, or drawing a pulley system in front of a patient to explain why his finger is triggering.  

I would encourage all my colleagues to check this book out.  There apparently is a newer, updated edition that I have not seen (yet), which I can only imagine takes what I grew up reading but adds 21st-century technology to the mix.  I hope it makes you smile, teaches you something new, and maybe even rekindles some of the curiosity that drew us into this specialty in the first place.

Anselm Wong, MD
University of Massachusetts, Worcester

1) Macaulay, David. The Way Things Work. Boston: Houghton Mifflin Company, 1988. Print.

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