Hello, everyone. Welcome to another installment of the ANA Oral History Project, where we sit down and have conversations with ANA's greatest leaders. My name is Alan Zhang, and as a member of the ANA Technology and Communications Committee, it is my honor today to interview one of the true giants of our ANA community and in the field of arthroscopy in general, Dr. Richard Ryu. Just to give you a little bit of background, Dr. Ryu graduated cum laude from Yale University with a degree in biological sciences. He then attended UCSF Medical School, where he was elected to AOA and the National Medical Honor Society. He then completed residency in orthopedic surgery at UCSF, followed by fellowship in sports medicine and arthroscopy at the Kerlan-Job Clinic. Dr. Ryu has been in private practice in Santa Barbara since 1986, where he's been serving as a team physician of UCSB and numerous other schools in the area. He was also the president of ANA from 2009 to 2010, and has helped shape the organization in many ways over the past 25 years. Rick, it is a true honor for me to speak with you today, and thank you so much for taking time with us. Thank you, Alan, and it really is an honor to be a part of the oral history of ANA. Before I get started and before I start rambling and show my age, I just wanted to make sure the audience knows that Dr. Zhang is one of the true up-and-coming leaders in ANA, with a CV that is the most enviable. He's a professor at UCSF. I know he's a summa graduate of Rice. I know you've done your medical school at UCLA, your fellowship with Ben Ma at UCSF, and that you're the recipient of numerous research awards, including the Near Award from Shoulder and Elbow and a big grant from AOSSM. I tell you it's the other way around. It's an honor to be interviewed by you, and so I thank you. I appreciate it. Thank you. Thank you so much. One good compliment deserves another, so I'll just share a little personal story of when I first met Dr. Ryu. This was back in 2009, 2010. I was a junior resident R2 at UCLA, and Dr. Ryu, I was invited to come to speak with us for Grand Rounds. As part of his introduction to his talk, he had video testimonials from all of his patients, and I was starstruck by all of the famous celebrities and stars from Hollywood that personally vouched for Dr. Ryu and sang his praises. He became an instant orthopedic idol to me that day, and I'm so fortunate to have been able to continue to interact with him and learn from him as my career has grown. It really is an honor. Thank you. It cost me a fortune to get those testimonials. It wasn't cheap. It was expensive. All right. Well, good, good. Well, I'll have to learn those tricks from you someday as well. All right. Rick, let's get into this, but let me ask you first, what is your favorite aspect of being an ANA member? I'm going to probably wander here a little bit, and I'm going to start with a little story. When I went to Yale as an undergrad, my roommate, just by happenstance, happened to be a fellow by the name of Chris Cassells. Chris actually became an orthopedic surgeon, very talented, arthroplasty surgeon, who's I think recently retired. His father was Ward Cassells, who was, as you know, the first editor-in-chief of the Journal of Arthroscopy on the board. Along with Robert Jackson, others were essentially responsible for bringing arthroscopy from Japan to the US. As freshmen guys hanging around tend to do, asking about background and what your parents do, I asked him, Chris, what does your father do? He said, well, he's an orthopedic surgeon, and he's currently in Japan. He's looking at people's knees with a lead pipe and a lamp. I said, you know, you could just kind of told me something a little less bizarre, because that's pretty hard to believe, the whole notion that you're looking at someone's knee with a little lead pencil. Sure enough, it ends up being exactly what I love and what I've done for my entire life. This was sort of my freshman year in college. I had the chance to actually meet Ward Cassells, just the most dignified, the nicest man, and truly one of the great leaders in arthroscopy. I lead with that because I think what I like most about Anna is the fact that it just reeks of opportunity, that, you know, we are not a hierarchy that's based on where you do your fellowship, or who your chairman was, or who do you know. This is really a meritocracy, and the opportunity is just rampant. If you want to serve, and you want your message to be heard, and there are things that you can share, it doesn't matter whether you're two years out, whether you're 20 years out, wherever you are in your career, if you're willing to share and you're good at it, we welcome you with open arms. And so I think opportunity is the part that I enjoy the most, because it's a meritocracy. Everybody gets a chance to be somebody if they want to be. And along those lines, what's been very, I think, rewarding to me because of these opportunities, you know, I'm kind of the male clerk that made it to the C-suite. It has been my real honor and privilege to have been, you might call a mentor or an advisor to a number of young surgeons who, like yourself, who have been just outstanding and whose careers are just, you know, rocketed. And that gives me the greatest joy. And I'll go back to another story. A couple years after I finished my fellowship, I was invited to speak at the International Arthroscopy Association meeting in Hawaii, run by Norm Sprague at UCLA. And Norm, a great guy, unfortunately has passed away. And Wayne Christie, who is still, I know, going strong. He's kind of the ever-ready bunny rabbit. These guys just have so much energy. But they ran this course, and it was kind of a combination of folks from Japan, around the world, and some U.S. faculty. And they were kind enough to invite me. And I was pretty terrified, because I really didn't know very much. And I was sort of just kind of getting my feet on the ground in practice. And after I gave my talk, and believe it or not, it was on the arthroscopic management of massive rotator cuff tears in 1988. And everything I said is currently heresy. But back then, it seemed like some of these I was doing were a good idea. And so I've learned from my lessons. But I gave this talk, and, you know, just such a lightweight compared to the people that were there. And one of them was Dick Casperi, who is one of the truly monumental figures in arthroscopy. So I'm walking down the hallway of this kind of destination resort where the meeting was held. And it's a long, long hallway, and I'm walking by myself. And coming towards me is somebody else. And as I get closer, I realize this is Dr. Casperi. And I'm a little embarrassed, because I don't know if my talk was really, you know, worthy of being up there, whatever. And he pulled me aside, and he called me by my first name. And I'd never met him before. And he said, you know what? He goes, that was, that was just such a terrific talk. I got to tell you, you got to keep it up. This is, this is great. And we're so happy to have you here. He was truly one of the most generous, thoughtful, and considerate people you could imagine. And I walked away from him for that brief encounter, and I'm sure my feet were touching the ground. I was just so elated. And I said to myself, you know, if I ever have the chance to be in his situation, and I get to meet young surgeons who are gifted, and who want to contribute, and who are looking to be part of something bigger, that I wanted to be like this Dick Casperi. I wanted to be someone that could encourage them, someone that could make, make perhaps some doors open, so to speak. And I would say that I've had that opportunity on a few occasions. And it has been the most gratifying experience that you could imagine. So I have to say that that really has been the most, you know, remarkable thing for me, among many. You know, there are others as well, but it's that ability to be part of a bigger, something bigger. Yeah, well, piggybacking on top of that, what would be one of your favorite memories about your involvement with ANA? Well, you know, I, as I mentioned, I was essentially, you know, the mailroom clerk, and then made it up to the C-suite. And that process served on a number of committees. And believe it or not, I was actually chairman of the Ethics and Standards Committee, which has long since gone away. But from there, education, then I chaired education, then to the board, and the presidential line, and JBLT, and the Education Foundation. And it was all these wonderful opportunities for me. And they were all good. They were all like, very, I think, invigorating, and immensely, I think, fulfilling. However, there was one experience that was truly, truly remarkable. And you'll know about this, because you were part of it, but you'll be on the other end of the equation down the road, was I was the godfather for the Traveling Fellowship. And I have to tell you that that was the most rejuvenating experience coming later in my life, and I'm a little bit tired, a little bit long in the tooth, to have four wonderful young servant leaders. And I had Mike O'Brien, and Mary Mulcahy, Kevin Wilson, and Corey Edgar, this wonderful group of young people. And we spent, you know, two weeks together. It was absolutely invigorating. It just kind of, I got my batteries recharged, had more fun, never laughed harder, food never tasted better. And the science, and the lectures, and what we learned was never more fulfilling. And we got to learn from Rich Hawkins, J.T. Tokish, who was, as he is now, remarkable as well. Scott Levin, Joe Zuckerman, it was really, really special. And so I'll never forget that, in terms of an experience. And I know that down the road, I know you were Traveling Fellow, I believe, last year. Yeah, in the past, yeah. Yeah, in the past. And so I know that when the time comes, you'll be on the Godfather side of that equation, and you'll enjoy it even more. Yeah, well, great. That's, yeah, it's just such an amazing experience. So I definitely echo those sentiments. So in terms of the next question, I know you've had numerous, numerous, excellent, noteworthy contributions to Anna, but what do you feel is your greatest contribution to Anna? Well, you know, I don't want to sound, you know, you just sort of sound obnoxious, answering this question. I'm not sure I've made any great contributions, but I've had a few ideas, I think, that have been durable. And I think I'm most proud of that. I remember sitting in a room in 1998, in Vancouver, as part of the Education Committee, as a new member, and they were talking about different formats, and how do we teach, and how do we learn. And I was thinking to myself, if I were in the audience, and I was still a relatively young guy, wet behind the ears, wouldn't it be great to sit with someone who's really, really good at what they do, and watch them do something. So you could ask them questions, or stick your finger in the wound, or what have you. And so I basically developed a concept of the focus demonstration. So, and it's now used all over in terms of how do we teach. And back then, believe it or not, it was, we limited it to maybe five to ten people, made it very, very exclusive, so that it was really almost a one-on-one experience in a room with a cadaver, with a master surgeon. And it was, I thought, it's been very durable. We see that all the time from industry now, etc. And most of our teaching now is kind of centered that way. And then along the lines, back then, we also had the fall course. And the fall course, as you know, was our technical part of the arthroscopy's offerings. And the annual meeting was science. Fall was basically technique oriented. And I sort of helped develop the one-on-one mini fellowships. Again, the same notion that instead of having one instructor in five stations, that what people really wanted was to be with one person who was very good at what they did, to take them to an operation for them to really feel like they had, in a sense, conquered the concept and maybe some of the techniques. And again, what we see now more and more is that one-on-one experience is really what everyone wants in terms of a true learning experience. The other, it's a silly one, but it's also been durable. A couple of them. One is the fellows. So I developed fellows day during my presidential year because I thought the fellows were such an important lifeline to our organization and had just a blowout party with the fellows at the presidential suite at my annual meeting, which was, I thought, one of the most fun events I've ever been to. And it's been continued. And I think the fellows appreciate it. I know Anna appreciates it. And we have cultivated so many young leaders and so many young contributors because of that. And then the other thing I think about, again, durable, was the fellowship. The traveling fellowship used to be three weeks. And I said to myself, that would only allow an accommodation to do that. Somebody that can take time off with faculty covering for you. But if you're a young, non-academic surgeon, you cannot afford to take three weeks off, support your family, pay your rent, pay your mortgage, and go somewhere and learn something. And so I had the fellowship shortened to 10 days so that you would start on a weekend, you take a week, the next weekend, and then coincide with the annual meeting. So it would be maybe not quite two weeks out of the office, so kind of manageable. And then what we saw was a number of applicants started to really increase because it was doable. And I think in 10 days, and that's not to say three weeks or a month. I know there are other traveling fellowships that are longer, and I'm sure that the friendships that develop and the information exchange is just as valuable. But in that 10 days, I do think you have the opportunity to learn a lot, also bond with your colleagues, and I think get most of what you need out of that kind of experience. And so I think the 10-day rule has kind of opened that door and opportunity for others. And then I think another concept along with a Jim Lubowitz and the JBLT was arthroscopy techniques. So A-TECH now, which is very popular, and really a fine companion sort of technical journal to our journal, which is phenomenal under the guidance of Jim Lubowitz and Mike Rossi and Jeff Brand and obviously Gary Palin's contributions. But A-TECH, I think, has been terrific. And it's sort of been our competition to some of the other sites that offer technique videos. And we're very proud of that. It's actually, I think, income generating in addition to being very, very helpful to the young surgeons looking at technique videos. And then probably lastly would be Ana Somos. So, you know, the story of Ana Somos is it's not me, it's really JT Tokers and Matt Preventer. And I was invited to be one of the visiting guests at Somos in Hawaii. And I was listening carefully and the rates of complication in the military were a bit higher than the civilian population. And we were discussing this and, you know, it's very simple that many of the military surgeons, despite their skill level and knowledge base, don't have an opportunity to pursue advanced training in terms of fellowships because they get deployed or the number of fellowships is very limited the year they come out. And so we thought, is there a way that we might supplement that a little bit? And so we had a lot of beer, a lot of chatting, and Ana Somos was born. And this was, and I think the first time was in 2009 or 2010, we had our inaugural collaboration. And I think it's one of the strongest collaboration Ana has ever had and has maintained, you know, Rob Hunter and others have been instrumental in obtaining funding for this course. And now I think, I can't say in perpetuity, but for I think as long as Ana and Somos want to collaborate, we'll be able to do that and help these young surgeons, help the, you know, service members who need the very best care that can be delivered. So that I think I'm very, very proud of and honored to be part of that. And again, I was just a small part of it. It was more of Matt and JT. Yeah, that's amazing. I mean, these are truly some very durable contributions indeed. And we all know you've shaped the society in so many ways, but just to hear how these kind of thoughts came about and became organized and your personal account of it is just really, really valuable and true value of this oral history project. So it's great for me to be here to hear this from you. Well, you know, this is how I remember it. I'm probably taking credit for a bunch of stuff that I'd actually never did, but until, you know, I guess proven otherwise in a court of law, I'm going to stick to my guns here. I mean, that's what history is anyways, right? All right. Well, good. So then going through all of these things you've learned and contributed through Ana, what would be one of your favorite lessons that you've learned yourself through Ana would like to pass on to others? You know, it's difficult because, you know, the way in which we train, the environments which we now currently live in, it's different, you know, and as you know, as a professor at UCSF, you have to be very cautious about how you approach your trainees, your residents and fellows. And, you know, it's a learned skill and one that I think you have to, we all have to develop. When I train, they can still hit you with the clamp if they didn't like how you were retracting and, you know, things have changed a little bit. And so I think back over time and, you know, what could I give that would be advice that's actually helpful no matter what area you trained in or what your background in. And I would say, be authentic. You know, if you're ambitious, be ambitious. You know, it's okay to have big dreams and it's okay to want things, all of those things, be authentic, work hard, you know, work your butt off, work hard, be honest, show integrity. And, you know, whether it's karma or whatever you like to call it, you get rewarded. Whether it's a year later, five years later, 10 years later, the body of the work that you create, when you do it for the right reason, you'll be rewarded. And whether that's a patient who comes from 10,000 miles away because they were aware of an article you wrote or the results you achieved, or whether it's an award from a society, whatever it might be, you know, you get rewarded. So be authentic. With that, I would also say, let it come to you. In other words, be ambitious, but it has to, you have to let it come to you. And that if you're ambitious, you want to be thoughtful about being ambitious. It just can't be grabbing and not giving something back. It can't be just reaching for something and not giving something back, you know, let it come to you. And I, and I think, can't say it's always going to happen, but I would say most of the time it will come to you. That's, that's excellent advice. So yeah, I say something along those lines to my kids that I don't think they grasp that to my intent, at least. And how old are your kids again, Alan? Eight and five. Yeah. They're the perfect age for indoctrination. You're starting at the right age. Yep. Yeah. So hopefully they'll listen to something that I say through the years. All right. Well, good, good. So moving on from just the realm of Anna, tell us about what you think is one of the most impactful innovations in orthopedics during your tenure. Orthopedics in general? Yeah. In general, arthroscopy, sports medicine, orthopedics. So, so I have to tell you again, go back story. So when I was training at UCSF, you're, where you currently are training, teaching now, arthroscopy was not an accepted technique, specialty, whatever you want to call it, it was considered a fad. And it was certainly frowned upon by the faculty. And I remember that my chairman at the time, Dr. Murray, Bill Murray, who was an arthroplasty guy, pulled me aside and I'm going to leave some of the expertise out because that's only how he spoke. He called me in his office and asked me what I wanted to do. And this was essentially at the beginning of my fourth year so that I could prepare for a fellowship. And I told him that I wanted to do arthroscopy. And he lit me up. And I mean, called me names, thought I was just, you know, love shiny things and was just, you know, fool's gold. And after he basically lit me up one side and down the other, he said, do you really want to do this? And I said, I really do. And right around then, the Kerwin-Jobe Fellowship was available, but there weren't many, there were very few sports fellowships available. There might've been like four or five. And they had five spots and 150 people applying for them. And I went down to interview with no, and at UCSF, we had no real arthroscopic education. Dill was just getting started. And then there was a private guy who was not part of the faculty, but would come to the county hospital with all of his equipment. And we would basically look at a fat pad for two hours, maybe three hours. And teaching scope, you know, the extended lens, it was pretty rudimentary. And I'm still fascinated by it because once we had a glimpse of the meniscus, I gotta tell you, I was so excited that I'd sit another three hours just to get another fleeting glimpse of the meniscus. So that was my mindset. I went down to Kerwin-Jobe and I don't think I was as qualified as most of the people who were applying, but they took me and they took me and they said the reason they had to take me was because of the letter that had come from my chairman and said that they had to take me. And so, you know, it's a story I tell and it's made kind of a good old boy network type story. But when it came to arthroscopy, even though my chair was very unhappy with my decision-making, he went ahead and supported me. And then as I had my doubts in general, there was a fellow by the name of Jerry Van Meter. Jerry's also a UCSF guy. He's now in Hawaii and retired. Great guy, very good friend. And when I struggled during my residency about wanting to do this, and he was one of the sort of guest attendings at the university, and he was also one of the people very instrumental in saying, hey, stay the course. Don't let anyone dissuade you from doing what you wanna do. Arthroscopy's real, stick with it. And arthroscopy from, you know, I've been doing this 35, 40 years now, it is unbelievable what we could do now compared to looking at a fat pad for 30 minutes. You know, taking out a meniscus back in the early 80s, you were a genius. I mean, you were Einstein. And now, you know, we are just this short of putting in an arthroplasty all arthroscopically. You know, the things we do, when you look at some of the folks, and they're doing brachial plexus dissections arthroscopically, they're doing nerve, they're doing things, and it's absolutely fascinating for me. So without a doubt, the whole concept of minimally invasive, which has been sort of my mantra, you know, can you do it? The mantra has been number one, can you do it in the most minimally invasive way? And number two is, can you restore normal anatomy as opposed to distorting it to get a result? And those have been the two things that have sort of been guiding me as to how I want, you know, my legacy to be, so to speak. And the arthroscope, again, has been so good to me in terms of just, you know, what I do for a living, but in terms of the amount of elation and satisfaction, it has been just the best, best decision I could have ever made. That's great, that's great. Yeah, I definitely feel the same way. The advancements, even in the last, you know, 20, 10, 20 years have been just amazing for arthroscopy, so really great. And it's gonna, I think we're gonna keep on, you know, expanding the, you know, there will not be limits to what we do in moving down the road. And as you know, certainly we got some help from the urologists, you know, in terms of a cystoscopy and things like that, but at the end of the day, we were the leaders. And the general surgery, OB-GYN, you look at the neurosurgeons, they took our lead. Hand surgeons, they were all frowning on the notion that these things could be done with, you know, arthroscopic incisions and minimally invasive approaches, and now it's de rigueur for all of them. And this is arthroscopy persisting, despite all of the bad press, despite all of the voodoo, you know, we're here and we're not just the technique, we're actually a philosophy, which I think is, you know, important. You know, and I should add, and I think this is important for the Arthroscopy Association, the history is, when we first started, I, at least in, you know, and I'm not one of the earliest by any means, but it ended up being a little bit of a contest. Who could do something arthroscopically? Who could do it faster? Who could do this, that, or whatever? Lots of innovation. I mean, truly amazing people, Snyder, you had Goebel, you had Lanny Johnson, you had Casperi, I mean, incredible surgeons, incredible thoughts, GMS, Steve Burkhardt. And then what happened was, I think we kind of got ahead of ourselves in terms of the science. We didn't have science to back up what we were doing, and I think we took a hit for that. And so now I think the organization has realized how important it is to have good science backing up whatever we do technically. And I think we made that change in our science, scientific program for annual meeting is as robust as you can imagine in terms of basic research, clinical papers, what have you. And I think that's been one of the real important transformations that's also accompanied the evolution of arthroscopy and minimally invasive surgery, as opposed to just saying, oh, hey, look how good I am, look what I can do. And that, unfortunately, we had a little bit of that, but we'd have that in a sense, but now it's backed up by our research. And I think that's just such a critical part of supporting the concepts that we're all utilizing. Absolutely, that's great. So then touching base on your younger self, what piece of advice would you give your younger self if you could? I think that everybody, I think everyone would probably say the same thing that you would wanna slow down a little bit, smell the roses, spend more time with your family, enjoy what you're doing. And as you all know, with two kids and being a professor and all the obligations, and I know you're running the fellowship as well, it's sometimes easier said than done. My daughter, whom I'm very, very, very proud of, and she's an orthopedic surgeon as well, and doing sports in Seattle. She has two young kids now, and her husband's an orthopedic surgeon at Harborview, and you talk about work-life balance. And I'm not sure we used that term 20 years ago. It was like, just kinda get over it or whatever. Now it's, how do you get that work-life balance? And I think I probably would pay more attention to that. Maybe not to the extent that it's paid attention to now, but I think more so, so that I could, I think, be maybe a better dad, better husband, a better person, all those things. But I think you hear that from most of the older folks like me that we kinda bombed through and work kind of overtook some of the other aspects. And unfortunately, I think a lot of my colleagues paid a price for it, and I'm lucky enough that my wife has low expectations. And so I've managed to stay married all these years, but I think I would probably tell myself, hey, pay more attention to some of the other things besides the work that you do. Yeah, I think that's sage advice, definitely. So agree with that 100% also. Now, in terms of career advice, what's the best piece of career advice that anyone has given you? And I've actually passed this on to others, and it is that every one of us has been in the crucible, that from the day that, whether you start college or high school, whatever, you're competing. And whether you're competing against yourself, against others, a national norm, you name it, we're competing. And we'll handle it differently, but we're in the crucible, we're competing. And then what happens is as you narrow down and decide on, let's say, medicine or science, and then medicine, and then orthopedics, as you know, that funnel just gets smaller and smaller and smaller, and the number of people getting through that gets less and less, and you're just competing harder and harder. And then when you're finally an orthopedic surgeon, you have been competing for a long time and you have succeeded. And there you are, you're a freshly minted orthopedic surgeon, and I would say to you, bet on yourself. Every single time an opportunity arises, whether that's, you know, whatever it might be, whether it's whether you wanna buy a house, whether you wanna start a surgery center, whatever, are you gonna take on debt, or are you gonna take on responsibilities, or this or that, and it's all overwhelming, it's all difficult, it's daunting, it's challenging, I would say, bet on yourself because a very, very good chance you're gonna do very, very well. And I think that that's what I was told once, and every time I've had to bet on myself, I have, and I've been fortunate, I guess, mostly, but it has, in the long run, paid off. Yep, yep. And then speaking of mentorship, who is one of your most influential mentors and what did you learn from them? You know, I think mentoring is a process, and, you know, it is not, to me, it's not age-dependent. And so I have been mentored by a lot of people, and if you looked at some of the older category, people that kind of preceded me, you know, I would tell you that Whit Ewing comes to mind, Dick Casperi, certainly, I think, Walter Shelton from Mismock, who I think is just one of the phenomenal leaders, and then Steve Snyder, who, although has never been in the presidential line, has been one of the truly remarkable contributors, Jim Esch, who's kind of like a grandfather figure to me, and Jim Tasto, again, all phenomenal people. And then I look at maybe some of the folks that were sort of in my era, so to speak, and I look at Buddy Savoie, and Rick Angelo, and Nick Sagaglione, and Jeff Abrams, and those are four people that, and Jack Burt, these are, you know, five people that I consider, like, I'll be honest with you, like family, and they have been so influential in helping me get through difficult times, so supportive, offering sage advice, and I'll always be grateful to them, and I know I'm probably leaving somebody out on that side of the equation, but on the other side of the equation, there are people like you, there are people like J.T. Tokish, there are people like Mark Edelman, who are younger than me, not generationally, but younger than me, who I have watched, who I have spoken with, and who have taught me a lot. Mark here is president of, and I think it's one of the most remarkable years that a president could ever have. J.T. is currently in his presidential year. I don't know of a greater leader of men and women of orthopedic surgeons. His thought process is, I think, just one of a kind, and I am, I learned from him, and I learned from Mark, and others, again, younger than me, Kevin Bonner, I think outstanding, Rachel Frank, these people teach me things, and so I have lots and lots of mentors, and they don't all have gray hair, and so I, you know, I think I left out Jim Stone, and Jim was kind enough during his presidential year to call me on a few occasions to just kind of ask for my advice, and I thought to myself, you know, I should have, when I was in his situation, been more thoughtful, and gotten more opinions, and been more consensus building, and so, you know, I learned a lot from Jim as well, just in terms of how you conduct yourself, how do you, you know, run an organization, so the list could go on and on, because I tell you, you know, I lack in so many ways that there's so many gaps to fill that there are just no shortage of people who've helped fill those gaps, but again, lots of mentors, and a lot of them got a lot younger than me. Well, great, well, that's a really great account, and as we are finishing up and wrapping up our hour here, towards the end here, I would love to hear a little bit about your personal experiences as an Asian American orthopedic surgeon. I think it's really important for our membership and community to recognize some of the different challenges that doctors from different backgrounds might face, so maybe during your training, or even into your career, have you encountered any adversity or bias due to race, and how you handled that? You know, thank you, Alan, for asking that, as you know, this is a very touchy and delicate topic when you talk about DEI-related topics, and experiences, and what have you, and there are a lot of, I think, a lot of divisiveness, a lot of angry voices, and I think a lot of them rightfully so, but I think, you know, once the shouting kind of settles down, I think we'll have a clearer path of how we might treat each other and move forward. I remember very clearly when I was a resident at UCSF, and I was doing a pre-op physical, back then, if you had a hip replacement, you were admitted two days before the surgery for a physical, and lab work, and the whole nine yards, and then you stayed a week, and went home, and, you know, that kind of thing. So I was doing a physical on this gal who was gonna be operated by the chief, and when I finished my physical, and I was at that point in R3, she said to me that I spoke English very well, and I thought that was, you know, a little condescending, and I didn't really say much because, in all honesty, it really wouldn't serve any purpose to say anything other than, you know, I just kind of shook it off. So I think, you know, there are perceptions out there, and that's one of the blander ones, but, you know, this is kind of the, I think, discrimination that many people face. Asian Americans are not alone, but I think Asian Americans in medicine, and in orthopedic surgery, are oftentimes treated a bit differently because we've had a little more success from the standpoint of admissions to medical school, into residencies, into fellowships, things like that, and so we tend to be, quote, unquote, the model minority so that it's almost that we're forgotten a bit, and I don't wanna say that, oh, gosh, you know, our plight is as bad as, let's say, women in orthopedic surgery who've really been mistreated, and I think that's getting better, but I would say that, you know, as Asian Americans, I think we have faced it. You know, Asian Indians, I think the same thing, and I look around, and I see that, despite some of these hurdles, and despite glass ceilings for, let's say, women or whatever, we're seeing more and more women break through to become chairman of programs. We know the number of women in orthopedics is expanding rapidly, especially in our field, sports medicine, which I think is terrific, and I mentioned my daughter's one of them, and then I look around, and I see people like you, and I see Ben Ma, and I should mention that Ben Ma is also one of my mentors, and we've kind of mentored each other back and forth over the years, and he is truly a genius, great surgeon, and as you know, your mentor, and I see people like you and Ben. I see Emily Chung and Jeff Yao at Stanford who are running their departments, Jason Ko at Chicago, who is, again, as top-notch as you get, and we got Brian Lau at Duke, and Luke Oh at, I think, at Rothman, and Albert Lin at Pitt, and Tiger Lee at BU, and Miho Tanaka at Harvard, and Cassie Lee at UC Davis, all stars, and I mentioned these people because they're not just on my radar, they're everybody's radar, and they have made themselves known as outstanding surgeons, researchers, teachers, and so I'm very optimistic about the future of Asian-Americans in orthopedic surgery, but especially in arthroscopy and sports medicine, and I would want to feel that way about everybody, whether it's African-American, Hispanic, women, whatever. The opportunity should exist for all of us, and I'm only speaking of Asian-Americans because of the nature of the question, but I'm optimistic, and I think that we need to remain optimistic, but vigilant. There are still barriers, there are still some biases, but I think that sort of mentality's fading away a bit, and I think that a more nuanced and educated approach to welcoming those who don't look like us is coming to pass, and I want to mention that I have a young partner, Jervis Yao, who trained at Yale, and he is one of my partners, and again, very outstanding young orthopedic surgeon, but we just hired a fellow to my practice, and he is on the white spectrum, about as Caucasian as you can be, Ira Catholic, and he is one of the, I think, just most outstanding people, energetic, thoughtful, outstanding surgeon, compassionate, all those things, and it just always reminds me, it's not really the color of your skin that leads you to somebody, it's really the content of the character, so to speak, and so I try not to limit myself to necessarily having the color prism on, so to speak, looking for color. I'm really looking for who the person is, and sometimes it works out that that person has the color or gender that we can promote, which is great, but sometimes the best person is the best person regardless of the color of the skin, and I think my new partner, Dr. Jimmy Bailey, is a great example of that, and so I don't want to see everything through the lens of color or ethnicity or gender or orientation. I'm hoping down the road that I can just see everything based on merit. What have you done? Where do you stand? And we have ways to go to give people those chances to show that merit, and that's where we are now, but down the road, I'm excited that we'll be able to pick and choose, and it won't be based on color or gender. It's really gonna be how good are you? What have you contributed? What can you bring to the community? Yeah, well, thank you so much for sharing your thoughts on that subject. You know, as a fellow Asian American surgeon, I've really looked up to you as a very inspiring figure in the community, and to see and listen to your take on our society and our membership and your thoughts for the future is just very, very inspiring, so really great to hear that. Well, thank you, Alan. I am grateful for this opportunity, and for Anna offering me this opportunity, and to be interviewed by you is special. I think the first time we met was in a airport lounge. Both of us coming back for some lecturing in China, and I remember being so impressed by our conversations, and I knew you were gonna be a rock star, and it has come to pass, so congratulations. I don't wanna sound patronizing, but very proud of you and all that you've accomplished. That means a lot to me, and thank you. And I was lucky that you're stuck with me for 16 hours on that flight. You couldn't get away, so I got to spend some quality time with you, so really appreciated that. All right, well, you know, thank you so much again, Dr. Ryu, for your time on this oral history conversation. The last hour, I've personally learned so much from you and have had such a valuable experience, I'm sure that Anna membership, once they listen to this recording, will echo those sentiments. But again, it's been an honor talking with you, and thank you so much for everything you've done for Anna and for the society as well. I'm grateful for the opportunity, Alec, and to spend some time with you. It's been my pleasure, so thank you very much. Thank you.

Dr. Richard Ryu

arthroscopy

orthopedic surgery

sports medicine

mentorship

diversity

Asian American surgeons

inclusivity