20/07/2026
This is such an important post. As clinicians we know that MRIs can be very useful but if the findings are not explained with context they can be extremely damaging. An MRI is only a part of the jigsaw puzzle and that’s why it’s so important not to ‘treat the scan’ but ‘meet and treat the person’, and give context to the findings and the reality of what they mean for the individual. MRIs have their place but they can add to more suffering, more fear and more disability if not explained.
Sometimes, the most powerful thing we can say to a patient is:
"You're not broken."
Yet far too often, people leave medical appointments with fear instead of clarity.
They hear words like "bone on bone," "degeneration," "meniscus tear," or "you'll need a new knee soon," and they assume the worst. They stop walking. They stop exercising. They stop doing the things they love, not because they can't, but because no one told them they still could.
One of the hardest lessons I've learned as an orthopedic surgeon is that I can't predict when someone will need a knee replacement. I tried for years and never came close. As I discuss in my book, X rays and MRI scans tell us what a joint looks like. They do not tell us how it feels, how well it functions, or when it should be replaced. Biology is far more complex than an image.
Here's what I wish more surgeons told their patients...
"Pain doesn't always mean damage."
"Arthritis isn't a life sentence."
"You have options beyond surgery."
"Strength, movement, and better overall health can change your trajectory."
"Let's talk about what matters to you, not just what your MRI shows."
But it's not just about the words. It's about how we listen.
Medicine has become increasingly high tech and increasingly rushed. We have more imaging than ever, yet often less conversation. Sometimes patients don't need another scan. They need more time, better questions, and honest reassurance.
Because many people aren't sitting in our exam rooms because of pain alone.
They're there because they're scared. Scared that every ache means something is seriously wrong. Scared they'll make things worse if they stay active. Scared that their body is failing them.
Those patients don't just need to see their images.
They need to be seen.
I remember a patient I'll call Bill.
Bill loved to run. Not for medals or marathons, but because running made him feel like himself. After developing knee pain, an MRI showed a meniscus tear. He was told he didn't need surgery, but that was the end of the conversation.
No one told him what he could do.
So he stopped running.
Not because of pain, but because of fear.
Six months later, we had a different conversation. We talked about his goals, not just his MRI. I explained that many runners have meniscus tears without any symptoms and that these age related changes often don't prevent people from returning to running once they're comfortable and have rebuilt their strength.
Bill gradually returned to the trails.
Seven months later, he came back after injuring his shoulder in a fall. Before we even discussed his shoulder, he smiled and said, "That conversation changed everything."
Moments like that remind me that surgery isn't the only thing that changes lives.
Education changes lives.
Reassurance changes lives.
Being heard changes lives.
Surgery is a powerful tool. But so are empathy, time, and honest conversation. When people feel understood and empowered, they make better decisions, move with more confidence, and often achieve better outcomes. Sometimes the most important treatment we provide isn't a scalpel.
It's hope.
