Issue link: https://tmcpulse.uberflip.com/i/356141
t m c » p u l s e | a u g u s t 2 0 1 4 11 t m c » p u l s e | a u g u s t 2 0 1 4 important to me from the ministry of medicine, and the way he went about it. And then, you know, as I went along, residency, there were others that really influenced me. And then, I had a rotation in Australia, which was an extraordinary experience. The principle surgeon there was a guy named Roger Mee, and he really changed my profes- sional life as a pediatric heart surgeon. He was the guy who really taught me how to do it. Q | What do you look forward to most about the future? A | I do think that there are going to be incremental breakthroughs in tech- nology. I'm not personally betting on a mechanical solution for circulatory problems in childhood, because we have the problem of somatic growth. And I could be wrong about that, because when these pumps get more and more miniaturized, there is more opportunity for broader application. But you know how children fiddle with things, and being tethered to a machine is also problematic. So I'm still holding on to the biologic solution, and bioengineering, and tissue regenera- tion. And we have developed and main- tained an interest and collaborations. There is enormous unrealized collective potential here, and of course, collab- oratively across the world. But that's where I see some striking opportunities on the horizon. A tissue engineered heart valve for children would be transformative. I think that on the scientific side of things, I see the next decade in pediat- ric surgery linked with tissue regenera- tion and some forms of cell therapy for surgical problems. But frankly, I think the bigger incremental upside is in the organization of care. I really do. I don't think that patients get the right care out in the world. We do so much remedial surgery here. I would say that half of the surgery that we do is remediation. There is not broad knowledge. Of course, my field Q | Tell us about some of your mentors. A | I can go way back. In high school, I had some great teachers, great educa- tors. I had a great doctor in Midland, who I was very close to. I had a trau- matic spleen injury when I was about ten, so I had to have an operation and spent a lot of time in the hospital, and that actually changed my life. Because I couldn't play sports that summer, I ended up doing other things. And then in the fall, my dad didn't want me playing football, so I started playing tennis, and I became a tennis player. We actually lived right across the street from tennis courts, so I started hanging out over there and playing tennis. So that really changed the trajectory of my athletic life. Then I became very close to the doctor when I was sick, so he kind of mentored me through childhood. And then I had an amazing experi- ence in medical school. I had a couple of doctors who were very influential. But at that time, UTMB had, and still does I think, between your first and second year, you have two months off. It's the only time you have off in medial school there. And they really encour- aged the students to go out and do something practical. They had an office that would assign you places. So I got assigned to a hospital out in Andrews, Texas, which is far West Texas. It was a very unusual community, probably five or six thousand people, one hospital… I think we had two operating rooms, probably the whole hospital was 50 beds. It had an emergency depart- ment. I lived in the hospital, and worked for a general surgeon who was the most amazing man. And we did everything. We operated, we delivered babies, we took care of rattlesnake bites, we did breast augmentations, we did hyster- ectomies, we did children's surgeries, we went all over West Texas and did emergencies. It was unbelievable. I think about that experience as a rising second year student, and the things I got to see and do. And this guy was very i said, almost as soon as i got here, that i wanted to build a program that was the same when i'm here as when i'm not here. A program that i would bring my children to. And that's what we have. this place never closes. is super specialized, but there are a lot of super specialized enterprises in places like Texas Children's in cancer, in neuroscience. And I think that we can continue to push the world of structural integration, of outcomes, measurement, and the right care at the right place at the right time. And in medicine, we are still very disjointed. To toot the horn of Texas Children's a bit, I think that's an opportunity we have through our integrated deliv- ery system. This system of pediatric practices, our relationships now, extend across the state and hopefully eventually across the world. Where we communicated effectively electroni- cally, we have giant data repositories. We have a group of people that work on outcomes analysis. There are extraor- dinary things that we have been able to do and learn in the last few years. And for simple problems like appendecto- mies, we have been able to reduce the length of stay for appendectomies for this organization exponentially, just by looking at the way that antibiotics are administered, and the timing of antibi- otics, and diagnostic assessment. And I see that, again, if outlook at the scope of influence, much bigger than building a heart valve. A heart valve is really cool, and it is going to really help, but when you think about the coordination of care, I'm betting on that. Q | What are you most proud of when you look back on your career to date? A | That's an easy one. From a profes- sional standpoint, I'm most proud of all of the people that I get to associate with here every day. I said, almost as soon as I got here, that I wanted to build a pro- gram that was the same when I'm here as when I'm not here. A program that I would bring my children to. And that's what we have. This place never closes. I work with four surgeons who are the most extraordinary surgeons any- where. They are just brilliant technical surgeons, brilliant thinkers, and great people on top of that. And it just goes on and on. We have fantastic colleagues in anesthesia, in cardiology, in critical care, our administrative team, our nurs- ing team, our research team, and I look back, and none of it was here. So I am proud of the community that we have built. And I can't say that I built it, I just helped catalyze it in some ways. But it keeps growing. So that is enormously gratifying. It also keeps me coming back. There is something exciting going on every day. Q | How do you describe the Texas Medical Center to people who have not been here? A | With great challenge. I'll try not to be too trite about this, but I think the Texas Medical Center is Texas. Texas is a place that if you are from Texas, you are very proud of this side of things. If you are not from Texas, it can be thought of somewhat disparagingly. But it can be this unbelievable sea of opportunity. And that's the Texas Medical Center. It's just this swirling mass of opportunity. We don't always get it all right. I think Dr. Robbins would be the first to say there are some redundancies here that probably shouldn't be. On the other hand, there are things that have hap- pened here that probably wouldn't have happened any other place, and some of it probably has come from the redun- dancies and the internal horserace. It's just an energized place. It's pulsing all of the time. You can just feel it when you come here. And when I am trying to convince people to move here, that's kind of what I try to tell them. It's why I came here, frankly. There's just an opportunity replete environment here. If you are ambitious, and energized, you can do things here that you are probably not going to be able to do anywhere else, or certainly not at the pace that we do.