Digital Storytelling IMC 634
Transcript of interview with plastic surgeon
A Well, I think that in our specialty, I think you develop a very intimate relationship with the patient more so, I think, than in many other surgical specialties because, at least in what I do, I meet most of my patients right after they’re born, and then I often take care of them until they’re teenagers and thereafter. So I get to know their parents even before the child is born, often with the technology today, with prenatal ultrasound and diagnoses, and then I follow them. Either they need operations along the way or perhaps they need them in infancy and then maybe something when they’re a teenager. Even if they don’t need any other surgical intervention, I tend to follow them at least on an annual basis and watch them grow. So I get to know the parents and the siblings as well.
A I think the bread and butter, if you can say, of my practice is the cleft lip and palate surgery.
A So cleft lip and palate is one of the more — one of the most common birth defects or birth deformities that occur. And it’s a misconception that these are deformities that occur in just Third World countries. It’s extremely common in this country and the reason why people think that this only happens in Third World countries — and it’s that picture that people see on the side of a bus — is because we take care of these things very early in life.
A Typically, if the baby is born full term and is gaining weight appropriately, the first surgery, the cleft lip and nose surgery, is performed typically about three to four months of age. So that stigma of what the baby looks like with a cleft lip and nose is taken away very early on. And the cleft palate procedure, again — and this is if everything is going well and the baby is gaining weight and was full term — is usually performed between nine and twelve months of age. So before the child is one year of age, they’ve had the majority of their surgery performed.
A I think that it’s very important to parents that I dedicate my career to this and to children. If you see my office, you’ll see that the entire place is just filled with toys and it’s very children friendly. I very rarely see my patients in an exam room. I think it makes them nervous. And the majority of my exams that I have to do, I can do with them sitting on my couch in my office, and then they can play with their toys and their siblings can play with the toys while I speak to the parents about the nuts and bolts of what we have to do going forward. Because I realized that if you’re in an exam room, the children are bored or anxious and then they’re crying and they’re bothering or tugging on the parents. And then the parents can’t focus on what I’m saying, and we’re talking about important things. Their child is about to have surgery. So I found that that environment really works well with my practice. So I see the majority of my patients in my office setting. And most of the time the kids are just playing and then the siblings aren’t left out. I mean, a lot of times with kids like this– a lot of times the siblings feel left out, that that one sibling is getting a lot of attention, so we try to incorporate the siblings into the visit as well. So there’s a lot of that that goes on.
A The touch. I don’t know. I think that’s part of it. I think I agree, but there is just this je ne sais quoi — I don’t know — this connection I have with them and it’s very easy. It doesn’t — and the parents comment on it a lot. And I think it’s important that they’re not anxious and they’re not scared because I see them a lot in the office and I don’t want their association with me or my office to be something negative because I want everything that comes out of my office, whether it’s from the surgery that I perform to just their visits that they come every month or every year, to be a positive experience.
A You know, I think one of the most satisfying things is not only seeing the effect that I can have on the family as whole and the parents and bringing the baby out from the operating room and having the parents hug me and cry and be thankful for the change that was made, but also when the kids are a little older and they can talk to me and they come in and at one point, they come in crying to me saying, “The kids at school are making fun of me,” and then after surgery they come back and they’re smiling and they’re not crying anymore and kids aren’t teasing them anymore. I think it’s just one of the most amazing things to transform a child’s life like that so that they’re not — that they don’t have a disadvantage in that regard and they’re not teased and that they can go to school and be full functioning and be a normal kid like they are.
A I think the onus is on the physician to stay current in our field and I think a way of doing that is attending these meetings and not only attending them but participating in them by presenting our work, getting feedback from our colleagues, and we have opportunities at these national meetings to give lectures. I think it’s very important and I think patients — it’s important to patients. I think that if you just practice in your own little microcosm of the world and you don’t get input from your colleagues nationally or internationally, I think you’re doing yourself and your patients a disservice.
A Well, I think that — when I was talking about plastic surgery being a wide range of things that you can do from operating on old people, young people, head to toe, cosmetic surgery to reconstructive surgery, I realized that the cases I looked forward to the next day and loved being in the operating room performing, liked reading about, liked studying, was this, was craniofacial surgery. So I paid attention to that as the years went by and the months went by. This is, you know — if I’m going to spend all of the rest of my life doing something, I want to love it and I want to love every case I do. I want to look forward to the cases that I do the next day. So that’s why I chose it because it was really distinct to me. I mean, I had colleagues that liked everything and therefore their practices are general practices where they perform all kinds of surgery. I wanted to be more focused. That’s my personality. And I think to really — I think it’s an area of plastic surgery that I feel you need to do a lot of to be very good at it. I don’t think it’s something you can dabble in. I don’t think it’s appropriate to do one cleft palate a year. I think it’s something you need to really dedicate your life to and to really make a difference and really to take the best care of kids.