Can you briefly describe your own career path?
I came to Trinity from high school with the notion that I wanted to go into medicine; so I knew as a freshman that I wanted to be a doctor. I also knew that to become a doctor I had to work very hard at Trinity.  So my career path at Trinity was to take Biology since there was no pre-med major.  I knew I wanted to be in the biological sciences and I was more comfortable in them than in the Humanities.  The requirements for the BS in Biology had a fairly limited number of courses so I had plenty of time to take elective courses.  Thus, I took Mythology, English, French and so on, which really rounded out my career. As an undergraduate I was also a scholarship student, so I had to work to get scholarships.  I was also active politically. I was Class President for a couple of years, a member of the Student Government Association and a member of Medusa.  I also belonged to a fraternity and was involved in track and field so my life as an undergraduate was very fulfilling. In the fall of my senior year I applied to medical school and I took the MCAT, which is the standard exam to get into medical school.  At the time the board didn’t release the results.   

You took the MCAT without ever knowing your score?
Medical schools would tell you, as a way to limit the applicant pool, “you did well or you didn’t do well.”  The first school I applied to, which was my backup school, rejected me.  So I was pretty worried at that point.  However, I got into the school that was my first choice, which is Columbia Presbyterian College of Physicians and Surgeons in New York City.  Three of my classmates and a couple in the class ahead of me were also there so there was a wonderful transition to New York.   I felt challenged because the level of courses was very difficult and I was surrounded with very intelligent people.   At some point in my senior year I decided that I wanted to become a heart surgeon.  Having made this determination, I knew I had to get a surgical residency and internship so I applied to a number of them and was accepted at the Dartmouth Medical School’s surgery department and did my training there, which was five years.   From there, I went to Toronto General Hospital in the University of Toronto to do my cardiac training, which is three more years.  At that time, I had an obligation to the federal government to give them three years of military service.  So that brought me from up to 1981 when all my training was finished.  So that was fifteen years after graduating from Trinity to start my practice.  Along the way, I got married and by the time I was finished with training I had three children – two of  whom have graduated from Trinity too.

Can you give us an overview of your job?
Cardiac surgery can be divided into congenital heart surgery -- is operating on kids with congenital heart diseases, or adults who have we call “acquired diseases.”  That is the bulk of our business, but we are also trained to do thoracic surgery, which is to operate on the lungs, the esophagus, the chest walls and the tissues around the heart and lungs and the blood vessels.

Are there more failures or successes?
That is a good question because what we try to do now is “risk-adjust.”  That is, everyone does not have the same degree of illness or the same degree of potential complicating factors.  Twenty years ago, we wouldn’t even dream of operating on a 85 year old.  Nowadays it is common to operate in that age group because we can figure ways to help them through the operation.  Nevertheless, an 85 year old carries a higher risk of dying, just because of his age, than lets say a 50 year old.  So age, or whether they have diabetes, kidney failures or high blood pressure are all risk factors.  So we calculate what the impact of these factors can have on the survival.  So in general about 97% of the people who need heart surgery survive and it you look at why the 3% died you would not be very surprised.

What could one expect form a lifestyle in the medical field?
I have a great lifestyle and the most important thing is to have a wonderful family life.  You have to make your family your priority.  I think that the most successful physicians are those made family first and career second.  Having done that, my professional life as a physician and as a cardiac surgeon has been very rewarding.  I love everyday that I go to work and I am active in more policy making and helping legislators who set policy in healthcare to make the right decisions for patients and for the doctors.

What are the major trends currently affecting healthcare and the field of medicine?
The economic factors are more important.  What I mean by that is that the cost of delivering healthcare is going up faster than the cost of living or the GDP in general. The main reason is that technology and an aging society increase the demand for the services.  While the services are more effective (mortality for heart surgery is going down every year because we are getting better at it), the cost to society, that is you and me, is getting higher and higher. In healthcare we don’t think about how it is going to be paid for, but it is going to be paid for out every individual’s pocket and we haven’t come to terms with how to link payment with service.

What traits and skills do you look for in a new employee?  What opportunities are available to new graduates today?
The same economic factors will determine choices that people who get into medical school will have to make once they get out of school.  Once in med school, they make a choice as to what kind of residency they want to take or what kind of specialty to head in. Some of those choices are guided by the availability of the types of residencies available and the kinds of payments the government and insurers will pay for different kinds of specialties.  We have an emphasis in this country in providing more primary care physicians and fewer specialists.  Having said that, again with the aging population, unless we find another way to treat heart diseases, we are going to need people who can perform bypass surgery as a service for the next 25 years.  I think there are many opportunities if someone is thinking about going into medicine now.

What is your favorite and what is your least favorite part of you job?
Surgeons in some way are like athletes.  They love the physical part of doing the surgery, the technical aspect, and the thrill of making the right decision at the right time and doing it well.  That is the most satisfying part of what I do as a surgeon.  The most challenging part is to be on-call at nights and on weekends.  You get all kinds of calls at all kinds of hours and some of them are silly questions and some of them are serious, but most of it is an intrusion into your living and breathing and sleeping and is exhausting over time.

Do you ever get emotional? I mean, are you concerned when, for example, you about to perform a surgery and you know that the risks are very high?  Is it tough for you?
I am very engaged emotionally at what I do.  My partners and I take our job very seriously and we are very proud of our skills.  The pain and agony is in a patient who doesn’t survive.  Having to watch them not benefit from the surgery and having to work with the family and help them deal with the coming death and deal with grief is very difficult.

Could you please describe what keeps you happy with where you are today?
The experiences that keep me happy from day to day… I would start with my family again. It is coming home to my wife at the end of the day every day.  That makes going to work a pleasure because I come home to a wonderful environment and having a lovely home is very important.  Professionally, the small things matter a lot.  An appreciation from a nurse for something I have done to help in caring for a patient, a card of appreciation from a happy family or a family who lost a patient, etc.  These things matter a lot.

Do you have any advice for anyone who wants to enter this field?
It has to come from within.  Increasingly, medicine is becoming more entrepreneurial. Management of medicine is important in the future of healthcare.  Physicians will have decreased autonomy and, to some extent, decreased authority. In order to endure the external pressure and external financial and other forces, it is going to be that engagement with the patient that matters the most.