Volume 14, Issue 1, Spring, 2007
Alumni Speak Out
by Edward Boyle, Jr., M.D.
1999 General Surgery Program Graduate
It was an honor to be asked for my reflections as an Alumnus on my experiences training in Surgery at the UW. I arrived as an intern in 1992, and stayed until 2001, completing the General Surgery Residency, a Cardiothoracic Research Fellowship in the lab with Drs. Ed Verrier and Tim Pohlman, and ultimately completing the Cardiothoracic Residency. Since graduating, I have been in private practice in Bend, Oregon for the last five years.
Looking back, one of the highlights of my training as a junior resident was becoming the Trauma Doc in the ER at HMC. As the Trauma Doc, you are in charge of the surgical half of the ER at HMC, supervising a team of interns and medical students. The lessons I learned from the ER nurses (like Trauma Bob) and Dr. Michael Copass were invaluable, as the learning curve was quite steep.
I can still recall vividly my first day as Trauma Doc, in July, when I received a call that there was an unstable patient with a gunshot wound to the right lower chest at the VA. Apparently the guy had been shot and dumped off at the Patient Evaluation Center (PEC) at the VA by his “friends.” The VA, of course, did not have an ER, just a PEC (also known as the “PEC-er”). The call came from Tim Canty, who was the only surgeon on call in-house at the VA.
It was his first day ever as a doctor. Tim called and informed me the patient had a pressure of 60 and no breath sounds on the right. I immediately called 911 to dispatch a Medic Unit to pick the patient up and transfer him to HMC. “Don’t do anything to delay his getting into the Medic Unit and transferring to HMC,” I instructed him. At this point I had one phone up to one ear, talking to young Dr. Canty, and another phone to my other ear, talking to the Chief Resident, Kent Stephens. “You tell that intern to put in a chest tube before he sends the patient over!” Kent instructed me. Young Dr. Canty, however, over the phone informed me he had never put in a chest tube before, which I relayed to Dr. Stephens. “You tell him he cannot call himself a surgery resident if he cannot put in a chest tube!” Kent commanded, in his characteristic not-so-subtle way. “You tell him its time to be a Hero!”
About this time the Medic Unit arrived to transport the patient, and found Tim Canty methodically working his way through his first-ever chest tube placement, solo, following the instructions over the phone held to his ear about how to make the incision, how to make a sub-Q tunnel, etc. Of course Dr. Copass heard about this immediately and thus the “red phone” rang, revealing a commanding voice demanding to know what the #$%@$! was going on at the VA and what the @#$%$ that intern was doing by delaying the transport of the patient to HMC! The whole time I was working three phones, rotating phones between ears.
Finally, after what seemed like an eternity, but was probably only a few minutes, the patient was loaded in the Medic Unit with his newly placed chest tube and quickly transported to HMC. As we all waited in the trauma bay, NG tubes, Foleys and Trauma Shears in hand, we couldn’t wait to see just how well this chest tube had been placed. As the clothes were cut away we saw the tube placement: it entered immediately above the iliac crest! Our worst fears flashed through our heads: was the chest tube going through the bowels and liver?
The patient was taken quickly to the operating room. Later Kent Stephens came back to give us the news: In fact, the tube did not go into the abdomen. It had been perfectly placed in the chest and thus stopped the bleeding. It just happened to have the longest chest tube subcutaneous tunnel of all time! The young Doctor Canty had saved a patient’s life on his very first day of internship! In fact, we all contributed to saving the patient’s life, as we did for many others, night after night.
I am sure to this day these kinds of stories are still commonplace, where there are conflicts and “situations” and various other “Charlie Fox Trots” that become the legends spread through the junior corps, where they are recounted in the call rooms in between cases or during a lull on a long call night. These horror stories served not only as entertainment, but as the foundation of our learning the boundaries of what we could and could not do, or should and should not do. They also bound us together with a camaraderie that many of us still value immensely to this day.
Looking back, I consider myself very fortunate to have trained at the same time in the trenches with the likes of Tim Canty, Sean Lille, Burley McIntyre, Sam Arbabi, Eileen Bulger, Mitch Gold, Ron Woods, Christine Lee, Liz Morgan, Ben Maser, Brandon Reynolds, Cha Chi Kao, Kevin Johnson, Carol Cornejo, Michelle Wilson (Sinnett), Charlie Kuntz, Richard Santucci, Lisa Foster, Marion Johnson, Tony Rongione, and others. The chief residents and fellows at the time, like Tom Sato, Mike Caps, Drew McRoberts, Kent Stephens, Andrew Ting, Karen Kwong, Marty Schreiber, Andy Forbes, Mark Meissner, Gordon Cohen, Rob Burnett, & Charlie Mock, also had a huge impact on my experience and I am very grateful to have had a chance to train under their direction. There are many more junior residents who made the time great, and I am always pleased to hear through the grapevine how they are progressing through their careers.
With the benefit of hindsight, I can see now that my years at the UW were times of great change for surgery in general, and for our program especially, nearly all for the better. I arrived at the UW in 1992, about the time Dr. Carlos Pellegrini became the Chair, as the minimally invasive revolution was just taking hold. Over the years I was at the UW I witnessed Dr. Pellegrini and his faculty take the program from good to great, which was of great benefit for all of us.
It was an honor to have trained under Drs. Mark Meissner, Ron Maier, Jerry Jurkovich, Hugh Foy, Tim Pohlman, Steve Nichols, Kaj Johansen, Loren Engrav, & David Heimbach who, in their supervisory roles, gave us just enough rope to run, but not so much as to hang ourselves.
I was very fortunate to get to work with Dave Byrd at the UW, who taught me to “take off my trauma cap and put on my oncology cap.” as well as Patch Dellinger, Scott Helton, Carlos Pellegrini, Santiago Horgan, Gene Zierler, Alec Clowes, & Mika Sinanan. I sincerely enjoyed my time at the VA working with Lorrie Langdale, Ted Kohler, Tom Hatsukami, Dick Bell, Dana Lynge, Kevin Billingsley and, of course, Hub Radke.
I am sincerely indebted to Ed Verrier, Gabe Aldea, Doug Wood, Mike Mulligan, Eric Vallieres & Riyad Karmy-Jones, who trained me in cardiothoracic surgery. Dr. Verrier in particular served as a mentor to me and I am very grateful for the time I had working under his direction.
As for us, my wife Ida and I very much enjoy living and raising our family in Bend, Oregon. Due in part to the rapidly growing population in central Oregon, our practices are thriving. In addition, I have stayed involved in medical device development, with several active projects on minimally invasive thoracic surgery, which leads me to travel frequently to Seattle and the Bay Area. Along with our daughters Carolyn, 10, and Grace, 7 we are making the best of the lifestyle here with lots of skiing at Mt. Bachelor, mountain biking, and other high desert activities. We look forward to hearing how everyone else is doing, and welcome you to say hello if you are ever in this part of the country.