It’s Not About The Biceps

Document Type: CASE REPORT


1 Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands Department of Orthopaedic Surgery, Academic Medical Center Amsterdam, The Netherlands

2 Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands

3 Comprehensive Care Dell Medical School University of Texas, Austin, TX, USA


In the biomedical paradigm all symptoms and limitations are ascribed to discrete pathophysiology. However, a
biopsychosocial health model that accounts for the important influence of mind-set and circumstances on illness may
be preferable in the vast majority of cases. Some of the shortcomings of the biomedical model include an overreliance
on tests and treatments. One major issue of the biomedical model is the raging epidemic of opioid misuse and opioid
related overdose deaths as previously reported in North America.
Emblematic of these issues is a 56-year-old male that had surgery for a rupture of the distal biceps in our clinic with
psychosocial aspects of the illness that were underappreciated by the care team and had disastrous opioidcentric
attempts at pain control leading to threats to hospital staff, and finally resulting in forcible removal by hospital security
from the ward and national police from the hospital. One might argue that there is no higher priority than rejecting the
biomedical model, understanding illness is its full complexity, and learning from the world’s mistakes so that we don’t
repeat them.
Level of evidence: V


Main Subjects