As a retired surgeon (and obviously a knife guy), a sincere thanks, spoken or written, will be greatly appreciated. No reasonable surgeon would decline an appropriate gift given in appreciation of good care rendered. If you know him well enough, a gift reflecting his non-medical interest would be especially welcome. My most treasured gift was a hand-made bamboo fly rod given by an older gentleman who had learned that craft, and knew from conversation, that i was a fisherman. The office staff may be a source of gift ideas. A bottle of decent wine might work. One orthopedic surgeon I knew was an enthusiastic collector of beanie babies. Although never offered, I would have been uncomfortable accepting a gift too expensive or ostentatious. Not all surgeons are wealthy, even though their income may be decent. If he is less than 45 years old, he may well be carrying hundreds of thousands of dollars in educational debt. Most surgeons are not knife guys and most surgery is done with scissors or high tech energy delivery systems once the skin incision has been made. Orthopedic surgeons work with tools that would not look out of place in a woodworking shop.