What led you to specialize in surgery?
Ever since I was a kid, I’ve liked working with my hands. Surgery allows me to see the results of my work immediately, and that’s a huge attraction for me. I worked at a children’s hospital during my cardiothoracic residency and was exposed to the variety of problems and challenges in the field.
When I was training, which was in the late ’70s and early ’80s, cardiac surgery was exploding as far as new procedures and techniques, new things being discovered all the time. It was an exciting time.
Who influenced you during your training?
From a surgical standpoint, probably the individual who influenced me the most was Tirone David at the Western Hospital in Toronto. During my early training, he emphasized technical excellence, particularly in cardiac surgery. Planning and analyzing are important, but the technical aspects of the work are critical, as is developing a self-critical nature—one that inspires you to always improve.
I also met people who could focus on the technical aspects of surgery while remaining active in academic laboratory research. To do both things well is hard, so it was instructive to see it managed well. Laboratory research taught me how to ask questions, to be analytical, and to get to the core of a problem.
You grew up an immigrant in this country. How does that experience bear on your clinical work?
It gives me a sense of empathy for what the parents of many of my patients are going through. Empathy is important, but it’s not the only thing they’re looking for. They come to you for the solution to a problem.
Also, what I had learned during training about constant self-improvement resonated with me: that’s how my parents were. I think that lesson has served me well clinically and in research. I try to pass that idea on to those I’m now training—never assume that what you’re doing is perfect.
How do you prepare for difficult surgeries?
I try to prepare the parents first. They want to know what the problem is, how you propose to fix it, and what the risks are. I need to provide them with the details and prepare them for unexpected problems.
When I approach a surgery, I often find that the standard solution will not work well for my patient. I start thinking about ways to innovate, to come up with a better solution for that patient. This is where preparation and consulting with other surgeons becomes especially important. Working in Boston, no matter what problem comes through the door, there’s somebody who’s seen it before and can give you perspective.
What makes a good surgeon?
You have to care about what you’re doing. And I think above all, you must want to walk out of the operating room happy with what you’ve just done. If, however, things didn’t go as well as you’d hoped, you need to ask “Why? How can I do it better?” That can take you from being a good surgeon to being a great surgeon.
Image: John Soares