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Carl L. Nelson, MD 1933-2005

B., R.D.

doi: 10.2106/JBJS.8709.ob2
Obituaries
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Dr. Carl Nelson passed away on January 12, 2005, after suffering a massive stroke. His death was sudden and unexpected. His colleagues, patients, and family were stunned and stricken with grief. His passing was observed at a memorial service on Friday, January 14, at the Arkansas Cancer Research Center in Little Rock. University Chancellor I. Dodd Wilson, Dean Albert Reece, faculty, and colleagues had a chance to pay tribute to Dr. Nelson before a packed auditorium.

A native of Indiana, Dr. Nelson graduated from Purdue University in 1955 and from Indiana University School of Medicine in 1959. Following internship at Los Angeles County General Hospital in Los Angeles, he completed residencies in general surgery and orthopaedic surgery at The Cleveland Clinic Foundation in Cleveland, Ohio. After two years in the Army, he was Nuffield Scholar at the Nuffield Orthopaedic Center in Oxford, England, in 1968-69. He returned to the Cleveland Clinic and stayed on the faculty as head of the Section of Orthopaedic Research until 1974.

In 1974, he was recruited to Arkansas to organize the orthopaedic training program. Although a Midwesterner by birth, he was able to carve a niche for himself in the southern state of Arkansas by his affable, hard-working, no-nonsense manner. When he arrived, he was the second of two on the orthopaedic faculty. He took it upon himself to build a strong orthopaedic residency and a name for himself. He began the task of program-building by recruiting, providing excellent patient care, establishing a research program, and systematic orthopaedic education.

Carl Nelson was a lifelong scholar. He read voraciously and encouraged his colleagues and residents to do the same. He endeavored to stay up-to-date on what was happening in orthopaedics. He loved to verbally joust with other learned individuals over dinner and never backed down from a debate. He loved the term “paradigm shift” and used it whenever he could. He described himself as a “pragmatist” and “an enlightened cynic.” He belonged to a legion of professional societies and was a leader of many. Dr. Nelson was surgeon, administrator, teacher, and researcher. Although an acknowledged expert in joint replacement surgery, he lectured nationally and internationally and wrote on orthopaedic education, musculoskeletal infection, psychomotor skills, and bloodless surgery. He contributed to more than 200 scientific publications.

Carl Nelson was a devoted teacher. Educating orthopaedic residents never took a back seat to anything. He taught by the Socratic technique as well as by example. He kept a tight rein on his residents and did not accept any slack. Though he was quite firm at times, he was the residents' strongest advocate. He protected them from burdensome service commitments, believing that “the residents are here not just to work, but to learn.” Although he commanded excellence in academics and patient care from his residents, he always preached “family first” and was the first to send a resident home if there was a family illness or crisis.

Carl Nelson was a leader. He was Chairman of the Department of Orthopaedic Surgery at the University of Arkansas for Medical Sciences from 1974 continuously until his death. He personally oversaw the education of 122 orthopaedic surgeons—many of whom have stayed on to practice in Arkansas. During his tenure, the orthopaedic faculty grew from two to a team of fifty professionals devoted to orthopaedic research, education, training, and patient care. He charismatically led the nonphysician departmental staff as well. He was careful to protect their interests. He treated them like family, and they, in turn, were devoted to him. Dr. Nelson was a good negotiator and stood his ground protecting the mission of orthopaedics in various turf battles in the University community. He liked to read and preach about leadership, and he proudly served as mentor for the American Academy of Orthopaedic Surgeons' Leadership Fellows Program.

Carl Nelson was an expert surgeon. He became one of the nation's foremost specialists in hip and knee replacement. He developed the first practice in Arkansas dedicated to joint replacement surgery. He was proud to be a member of both the Hip Society and the Knee Society. As a technician, he was superb. Many residents were astounded when, during particularly difficult surgery for which there seemed little likelihood of a satisfactory outcome, Dr. Nelson would pull something from his bag of tricks and salvage a good result. Outside the operating room, he was a savvy clinician and an expert in human relations. He was a tireless advocate for his patients.

Carl Nelson was an innovator. He developed a psychomotor skills lab for the residents years before his colleagues did the same. It was his conviction that if the surgeon could run through a procedure “in the mind's eye” before an operation, he or she could perform the case with ease at the actual time of surgery. He developed innovative techniques for managing orthopaedic infections—particularly with regard to total joint replacements. He developed and refined techniques for blood conservation, leading to so-called “bloodless surgery,” which enabled even Jehovah's Witness patients to benefit from joint reconstructive surgery. He was quick to incorporate emerging technologies that he believed were likely to succeed. He adopted robotic surgical techniques and minimal incision techniques in the twilight of his career.

Dr. Nelson was a researcher. He was involved in orthopaedic research throughout his entire career. He was not content to carry out his studies in isolation; rather, he realized that the future of orthopaedic research depended on a multi-disciplinary approach. He was thus instrumental in creating the Center for Orthopaedic Research at the University of Arkansas for Medical Sciences. In this setting, basic scientists and clinicians from many areas work together on projects relevant to orthopaedics. Dr. Nelson expected his residents to be active in research and included them in his projects. He insisted that each resident complete a research project before graduation, and he established the annual Arkansas Orthopaedic Forum to showcase their work.

Dr. Nelson was a celebrated individual. He received numerous honors over the years, including the Walter Selakovich Outstanding Teaching Award; the Arkansas Caduceus Club's Distinguished Faculty Award, and the Jeanette Wilkins Award from the Musculoskeletal Infection Society, and he was recognized as one of the “Best Doctors in America” in 2002 and by Town & Country Magazine as one of the “Best Medical Specialists in the USA.” Dr. Nelson was formally recognized for his accomplishments in 2000 with the Carl L. Nelson Endowed Chair in Orthopaedic Surgery. The chair was established at the University of Arkansas for Medical Sciences in an effort to continue the standard of excellence set by Dr. Nelson and was designed to support research in orthopaedic disease and musculoskeletal injuries.

Carl Nelson approached life with a serious mind but always kept his sense of humor. He generally started each speaking engagement with a humorous story. He was always a sportsman. He was proud to have played rugby as a young man and frequently related stories about his sports adventures. He was an avid competitor and loved to win. He played tennis throughout his adult life. Duck hunting was a passion for him, and the times he spent in the duck blinds of South Arkansas with friends and colleagues were among his best memories.

Nelson is survived by his wife, Mindy Morrell; his sons, Eric Nelson and Jason Neidhardt of Little Rock; his daughters, Kristine Harms of Pea Ridge and Kathleen Nelson of Little Rock; and his grandchildren, Kambrea and Kerry Nelson of Prairie Grove, Kachet Nelson of Springdale, and Katie Harms of Pea Ridge. He was preceded in death by his parents, Alma and Carl Nelson, and his son, Kurt Nelson of Prairie Grove.

Carl Nelson managed to touch the lives of many. Students, residents, and patients will all remember him for his vision, energy, and commitment to the cause. His sudden departure leaves us with a sense of void, but his legacy lives on.

Copyright © 2005 by The Journal of Bone and Joint Surgery, Incorporated