Before there were hospitals, prescriptions, or medicine as a science,
it was a calling, a promise to heal, to question, and to understand the human
body. Every discovery began with curiosity, and every breakthrough began
with someone asking why. From ancient remedies
to artificial intelligence, this
is where science meets compassion. Welcome
to the Aesculapian Society. Today, I'm
honored to welcome Dr. Perel Baral, a cardiothoracic surgeon with St. Clair
Medical Group Cardiac Surgery. Dr. Baral completed
her general surgery residency at
the University of Kansas Medical Center and
her cardiothoracic surgery fellowship at
Baylor College of Medicine. We're excited to
hear about her path into medicine, her
experiences in cardiac surgery, and her perspective
on the future of heart care,
including artificial intelligence and robotic surgery. Welcome, and thanks for
being on the show. Thanks for having me. So, let's move on to your personal
motivation and background. What are your earliest
memories of wanting to become a
doctor? So, I've wanted to be a doctor since
I was very, very young. My mother is
a physician. She's an internal medicine doctor,
and I was exposed to medicine and
being a doctor from a very young age. So,
my earliest memory of wanting to be a
doctor is probably when I was like two or three years old. Like, as soon as I
understood, like, what a doctor was and,
like, could say the word, that's what I
always said I wanted to be. So, how did watching her career influence your
interest in medicine? Um, I think I just
really, um, was fascinated by her, um,
talking about her patients and how she cared
for them and the kind of interesting
cases she saw. And, um, she was always like
a very, she just, I mean, she still
is, but she was always very interested in, you know, being a very astute
diagnostician and really getting at the core
of, like, what was, what a patient
was going through. Um, and also she would reiterate
a lot that being a doctor is not
even so much about being the smartest person in the room, but it's a lot about
using common sense and being compassionate. Um, and so, I think that
really influenced me a lot. So, you mentioned wanting to be a doctor from
about two or three years old. When did that interest changed into surgery?
Probably around high school. Um, I, up until that point, had always been
interested in being a pediatrician only because
I am the oldest of a lot of kids
and I've always really enjoyed working with
kids and being around children. And
so, that just seemed like the natural progression of being a doctor and liking
kids. And so, I was like, oh, I'll be a pediatrician.
Um, but I didn't really know
what a surgeon was probably until I was in
high school. Um, and then when I started
to learn about what a surgeon was and did,
I was like, oh, that's, that's for me.
That was much more my speed and was fascinating to me. Um, some of my earliest
exposure to the field of surgery was just about
learning about actually what a heart
surgeon was and what a heart surgeon did,
especially in the congenital world. Um,
and I just thought that was the most amazing thing, being able to change
patient's anatomy. Um, and I just thought that
was like the coolest thing ever. And
on that very, very basic level is how I became
interested in surgery. Um, and so I
went into general surgery residency, um, because
at the time that I was applying to
residency, there actually were a lot less, um,
integrated programs. And to be honest,
I don't know if I actually would have even
wanted to do an integrated program. I
don't know if, if you do know what that is, integrated residency versus
traditional. No. So, there's two pathways to becoming a cardiac surgeon,
essentially. One is by doing a general out
of medical school. So, you do medical
school like everybody does. And then you can
either do a general surgery residency
and then do a cardiothoracic fellowship after
that, which is what I did. Or you
can go straight from medical school into
an integrated cardiothoracic residency.
Um, and that takes you straight into cardiothoracic surgery. You cannot do any
other type of surgery. Um, so there are a lot more of those programs now that
pathway has, um, ballooned a lot in the last,
I would say maybe like seven years.
Um, and it didn't, but it didn't really exist so much. There was a couple of
programs, but much, much less. Um, but I really am so glad that I did general
surgery residency because it exposed me to
a lot of different surgical fields. It
gave me a lot broader, uh, experience in surgery,
a lot of, uh, more exposure with
trauma and vascular and GI issues, which are things that you deal with as a CT
surgeon as well. A lot of, I got a lot of critical
care experience. And so, um, I'm
really, really grateful for that. So, I have
no regrets about the pathway I took
and I, I loved my residency. I had an amazing, amazing residency. Well, thanks
for sharing about your residency, but what's the process you take before
residency about your undergrad and medical
school? Um, pretty typical, you know, you
can do undergrad, you know, four years of undergrad. Are you asking what I did
specifically or what a person should do?
Oh, so what I did was, you know, I did
four years of undergrad, you know, I, my,
um, major was in biology, which is like
pretty boring, you know, in terms of like
standard, I guess, not boring, but, um,
you can major in anything as long as you have
all the prerequisites that you need
in order to apply to medical school. But,
um, I majored in biology and then I went
to medical school from college, um, you know,
did four years of medical school and
then residency. So, how'd you prepare for the
MCAT to apply? Oh man, let's see. How
did I prepare for the MCAT? Um, I think I took
a course actually, which was, yeah, I
took a course, um, which originally I was not
planning on taking an MCAT course. Um,
because it's like, oh, I'll just like studied on my own. The MCAT that I took
looks very different, I think, from the MCAT now because I took the MCAT in, I
don't know, maybe like 2010, I think, which is quite a while ago. Um, but, um,
the MCAT course really helped because the
MCAT was not just, and I think a lot of
multiple choice tests are like this. It's not necessarily as much about what
information you know, but it's about how to
take the exam. And the course taught me
how, like the strategy of taking the exam, which
helped immensely. Um, so I would say
that if you're someone who's thinking about
taking the MCAT, uh, definitely look
into MCAT courses. I think I took a Kaplan
course. So it's true that you left high
school early to spend time in Panama? Yes,
that is true. I am technically a high
school dropout. Um, I never graduated high
school and I never got a GED. Um, I was
basically encouraged to leave high school
early by my mother, who's always done
things a little nontraditionally. Um, and she just thought it would be a good
opportunity for me to do something a little
different and learn a new language.
And I was also kind of, I felt like I'd gotten
out of high school, what I needed
to get out of it. By that point, I'd kind
of gotten all the prerequisites I needed
in order to apply to college. Um, and so,
and I really wanted to learn Spanish. So
the best way to learn a language is to immerse
yourself in it, which is to go to
a country where they speak that language. So
that's what I did. And I did that for,
I spent about four months in Panama. Um, I
went to a Panamanian high school. I lived
with a host family. It was an amazing experience,
probably the, one of the most
useful things I ever did in my entire life,
because now I speak Spanish fluently
and I use it to communicate with patients.
And it's just generally like, I love
learning new languages. So it was a really
great thing to do. And it did not affect
my ability to get into college or med school
at all. So. Did you ever learn any
other languages that helped you with patient
care? Um, so my mother is Russian.
My mother was born in Russia. And so she, we
grew up speaking Russian. Um, I've used
Russian in patient care as well. Um, I learned Arabic, um, which I don't speak
really anymore, unfortunately, because, you
know, if you don't use a language, you
lose it. Um, and so I've forgotten most of
it since I learned it. Um, I never really
used that much in the U S. Um, I speak Hebrew fluently as well. Um, but that's
not that much of a need for that in patient
care in the U S either. Okay. So what was
more difficult for you being accepted into medical school or passing it?
Oh, being accepted to medical school for sure.
Once I was into medical school, it
was, I mean, it was hard, but, um, I would
say it's much harder to get into medical
school than it is to get through medical school.
Um, for me, medical school was an
environment where I really felt like it kind
of played to my strengths a little
bit. Like, you know, like you really medical
school is just a lot of reading, a
lot of studying, um, a lot of like group studying
and practice and stuff like that.
Um, and then patient interactions, which is
like really what I was there for. Um, I
loved my rotations like third and fourth
year. I just, I was in the hospital all
the time. It was very easy for me back then because I was not married and I
didn't have kids. So I was just able to focus fully a hundred percent on my
education. And, um, it probably would have
been a lot harder if, and I know a lot of
people who have done it with families and kids.
It's very hard. There were people in
my class who had, um, you know, who were married and had kids. Uh, but yeah, I
mean, I would say it's definitely harder to
get in for, for me, it was much harder
to get in and to get through. Looking back, is there anything you wish you had
done differently during your pre-med years
to help your chances? Um, probably I just
didn't know what I didn't know, uh, to get
into medical school. I didn't really know
like what medical schools were looking for.
I didn't really have like a pre-med
advisor. I didn't have anyone that was like
coaching me through what the process
would be or what medical schools were looking for. Um, if I'd had someone like
that kind of earlier on, then I think that
definitely would have helped. Um, but I
kind of just stumbled through it on my own
and thankfully it worked out. But I think
having a little bit more, especially now, I mean, like my understanding now of
getting into medical schools, it's just like
so cutthroat. Um, and you need like a
thousand extracurriculars and all this research.
And like, it seems I probably, I
don't know, maybe I wouldn't get into medical
school now if I applied, you know,
in 2026. But, um, now I think you just need like a lot, you know, like the
competition is really fierce, but I think
if I'd had a little bit more mentorship,
probably that, that would have helped. I think
it helps to have that. Okay. Well,
thanks for sharing your experience and now
moving on to your day-to-day life. As a
cardiothoracic surgeon, do you still practice
on both the heart or the chest or
do you specialize in one area? I primarily
operate on the heart. Um, I do all the
kind of what we call bread and butter cardiac surgeries. So coronary bypasses,
valve replacements, aorta replacements. Um, I don't do lung cancer surgery or
esophageal cancer surgery, um, or any esophageal
or really lung surgery at this
point. Um, for that matter, I just, I love
the heart and I'm able to focus on the
heart, the position that I currently hold.
I'm very fortunate that I'm able to do
that. Um, and I do, that's what I do. Did you
study on both the heart and the chest?
Yes, of course. And, and cardiothoracic fellowship,
everybody in order to graduate
has to operate on both the heart and what
we call like thoracic structure. So long
esophagus, medius dynum. So what's the reason
most doctors either like specialize
in one area?
Because it's easier to specialize in one thing
than to do everything at this point,
you know, like 50, 60, 70, a hundred years
ago, a lot of doctors did everything, but
now there's just so much specialization and
there's just so much more knowledge
and things are a little bit more intricate now.
So most surgeons will specialize, um,
in one area or the other. Most fellowships
and training programs are tracked. So
meaning where I was, there were four fellows. It was a very big program. There
were four fellows per year. And three of those
spots were for cardiac focused, um,
trainees. So those who were already knew
that they really wanted to focus on the
heart. Um, and one spot was for thoracic. Um,
and so that's pretty typical. Um, it's
not usually that many per program. Most usually
it's like one or two fellows in
each program, but, um, that is pretty standard.
Okay. So what does a typical day
in your life look like from arriving to the hospital and going home? Oh man,
there's not really a typical day. Um, but
I would say, let's say if I, if I take a
day that I'm, um, that I'm operating, um, most
days that you operate here, the case
starts at 630. So meaning the patient rolls back to the operating room at 630.
And so I try to be in the hospital by six
o'clock so that I can go see the patient
before they go to the OR, make sure everything is all good, make sure I can
answer any last minute questions. I try to
say hello to the patient's family. Um, if
they have family that came to accompany them
to the hospital, just reassure them,
say I'm here. I, if you have any other questions
like last minute, I'm happy to
answer them. You know, here's where I'll find
you after the case. And just kind of,
um, I think that it's nice to like reassure patients that, you know, you're
there and to give them the opportunity to
ask any last minute questions and to see
you. Um, and then usually when a patient rolls
back at 630, it takes about an hour
to get them set up for the procedure itself.
It takes a lot of prep work to get
a patient ready for a cardiac operation.
So usually after about an hour, they're
ready, um, for incision. So I usually start
the case at around 730. Um, and then
it just depends on what I'm doing. So, you
know, if I'm doing like a three vessel
bypass, um, that takes a little bit longer
than just an aortic, like a simple aortic
valve replacement, for example. So, you know,
then you're operating for the next
few hours and then, um, you know, maybe I'm
done with the case anywhere between
like 1230, 1 PM, 3 PM. It just depends on
what's going on. Um, you know, finish up
with the operation. Usually I go straight from
the OR to the waiting room to talk to
the family and tell them how things went. Um, and then I go to my office and
usually, you know, chart the op report, check
up on other patients, things that
are going on. Um, and then I go to make sure
the patient gets settled nicely in
the ICU. Um, check on my other patients, usually
in that hour between 630 and 730,
I go around that my other patients also, if
I have other patients in the ICU. Um,
and then, yeah, if I'm on call, you know,
deal with any other stuff that comes up.
If I'm not on call, then usually I'll just
make sure everyone's settled and then go
home. Just, and what time I go home just really
depends on what's going on in the
hospital. Um, that can be anywhere from 430,
five o'clock, six o'clock, seven o'clock.
It just really depends. Um, if I'm not
operating, then I can come in, you know, see my patients. Usually I have some
clinic patients to see if it's a clinic day or, um, some days I have patients
added on if it's not a clinic day. Um, and
then I'm just available. We're all, you
know, all of us in the group are available
to help each other for, for cases or to
cover each other as needed. So, um, you just
kind of have to go with the flow. And
then when I go home, you know, then I'm, then
I'm the mom and the wife and I help
my husband out with the kids and, you know, get everyone fed and put them to
sleep and, and all that. And then I, you know,
spend some time, try to spend some
time with my husband. So could you walk me
through like a common surgical procedure
that you do in language that I could understand? Sure. Um, so I would say
coronary bypass is one of the operations I
probably do the most and I really enjoy
doing it. Um, essentially what that involves is the first part of the
operation is actually, uh, harvesting conduit, um, for the bypass itself. So
what a bypass is, is when a patient's heart,
which has arteries that supply the
heart muscle itself, um, sometimes those
little arteries get blocked. And so the
heart muscle is not able to receive the nutrients
and oxygen it needs. And so the
heart can become weak and that, you know, patients
can get heart attacks from that.
Um, and so what I do is I don't remove the
blockages, the blockages stay where they
are. So, um, what I do is actually create a
new pathway around the blockage. Um, and
in order to do that, you need some sort of
tube, right? That can bring blood from a
source of blood, which is usually the aorta, um, or, uh, a vein, sorry, the
source of blood, which is the aorta. So you need some kind of like either an
artery or a vein. Um, and so we most typically use veins from the patient's
leg. Um, and then an artery from, uh, underneath the sternum or the breastbone
called the internal thoracic artery or the internal mammary artery. Um, and so
usually I have a physician's assistant that
will be harvesting the vein from the
leg while I am harvesting the artery from
underneath the breastbone. So the first
part of the operation is just obtaining that
conduit. Um, and then once that's all
done, um, the patient's ready to actually be put on bypass. So most cardiac
operations are done what we call on pump. Um, and what the pump is, is it's a
machine that takes over the function of the heart and lungs. Um, and why do we
need that? Well, a lot of times during a
cardiac operation, the heart has to be
stopped in order to be able to work on it.
Um, and so we need to be able to keep the
patient alive while the heart is not pumping blood. So what we do is, is we
hook the patient up to this heart-lung bypass
machine, which does the job of the
heart and the lungs. And it allows the heart and the lungs essentially to be
turned off. We turn the heart and lungs off.
The patient's heart and lungs are not
functioning while I do the operation. Um, and the machine is pumping the blood
through their body. So we hook the patient up to that machine. Once we put the
patient up to that machine, um, we stopped
the heart. Um, and then I make all the
little connections I make, I sew, um, the connections between that vein or the
artery that I harvested in the heart. Um, and
then once all the connections are, are
done, then I restart the heart, heart starts beating again. Um, you know, I'm
working very, very closely with the anesthesiologist. We have specialized
cardiac anesthesiologists, um, who are, uh,
specialized in working with patients
who are undergoing cardiac surgery. They can
do other things, but we only work with
anesthesiologists who specifically do cardiac
operations because they need to be
experienced in, uh, working with patients
who have heart disease and whose hearts
are stopped. And while the hearts are stopped, we work, you know, and while
they're on bypass, we work very closely with the perfusionist. And the
perfusionist is the specialist that runs
that heart-lung bypass machine. Um, so
there are a lot of people in a cardiac surgery
operating room. It's not just you
and the anesthesiologist. It's the surgeon, anesthesiologist. Usually there's
a, uh, like a CRNA, which is a nurse anesthetist. Um, that's there for most of
the case and the perfusionist. Um, of course the scrub tech is the one that
hands me the instruments during the case.
And they're really, I was going to say
instrumental and I didn't want that to be a
pun, but they are instrumental. Um, and
then there's usually a nurse or two, what
we call the circulator, um, whose job it
is to basically keep the room running because, you know, everyone that's
scrubbed in is sterile and we can't go and
like grab an instrument or grab a suture
or grab a, um, any other kind of, um, material that we need during the
procedure. So their job is to be able to keep
us is to allow us to be able to stay
sterile during the operation. So the nurses are really, um, really, really
important part, um, of any cardiac or any operating
room in general. Um, but I think
one of the new things about cardiac surgery is just really how closely the
whole team works together. It's really, really
important to, for everyone to be
able to communicate clearly. Um, and the surgeon
is kind of like the conductor of
that whole orchestra. So, um, but to go back
to what I was saying, so, you know,
we restart the heart, the heart starts beating again. I'm talking to the
anesthesiologist, making sure everything looks good. I'm talking to the
perfusionist, making sure on their end, things
look good. Um, and then once I feel
the patient's ready to be disconnected from the bypass machine, you know, the
heart's beating, the lungs are turned back on
again. So the patient's lungs are being
ventilated through the ventilator machine. Um,
then I disconnect the patient from the
heart-lung bypass machine. Um, and as long
as everything looks good, then you close
the patient up. We use typically wires, stainless steel wires to close the
patient's bone to put it back together. Um,
and then, you know, suture the skin
back up and that's it. And we get them off
the operating table and taking them back
to the ICU where they recover. So after the surgery is done, there's like two
outcomes, either the, either it's successful or unsuccessful. How do you
handle the emotional side of medicine that
includes complications and difficult
outcomes? Well, I think first of all, you
have to kind of, uh, maybe clarify what
you mean by unsuccessful. Um, I guess maybe that term applies differently in
different situations, but you know, if I'm doing a heart-lung bypass, sorry,
doing a coronary bypass procedure. Um, I guess success is measured by how well
those bypasses stay open. Um, and how well the
patient is able to avoid heart attacks
in the future and heart failure. Um, and so
by that measure, the vast majority of
coronary bypass procedures are successful.
It's very, very, very, very rare, um, for
none of the bypasses to be open or for the
patient to get a heart attack right after
the procedure or very soon after the procedure. It's very uncommon. It does
happen. It's very uncommon. Um, but there
are other complications that can happen.
Um, and I tell patients that before every
surgery, because every surgery has risks
and you, I only operate when I feel that
the benefits outweigh the risks. Um, so
every surgery involves complications such as
infection, bleeding. Um, if someone has
enough bleeding, sometimes they have to go
back to the operating room for another
operation to stop the bleeding and to wash,
wash them out. Um, you can have lung
complications. Patients can get pneumonia.
Um, patients can require oxygen for an
extended period of time after surgery. Patients can have kidney complications,
um, meaning they might have some degree of
kidney failure afterwards to have that be
a very serious thing is very rare, but it does
happen. Um, and stroke, um, is one of
the other things that can happen after a cardiac surgery as well. All of these
complications on an individual level are very
rare. Um, all of them together also
are not as common, but they are things that definitely happen. Um, and it can
definitely be frustrating when they happen
because you only want the best for your
patient and you're operating on them because
you want them to have a longer and
or better quality of life than they had before.
Um, and so you don't want that to
be complicated by having to deal with, you
know, prolonged ICU stay, infections, um,
you know, stroke complications, things like that, but it does happen. And the
main way that I tried to deal with complications like that is just by
treating the patient, you know, you can't get frustrated about something that
happens with the patient, you know, that starts
to become evident that the patient
is having, um, you know, a need for dialysis or something like that. You can't
just be like annoyed about it. You have to be like, okay, we got to treat the
patient. We're going to get nephrology on
board. We're going to get them access.
We're going to do what we need to do in order to get them treated and get them
better. And the vast majority of time, the
patients recover from these complications
as well, which is great. Um, but you know, even
small things, for example, like let's
say a patient comes back to clinic and it's,
I can see on their x-ray, their kind
of post-op, their two-week post-op x-ray
that they have, um, a fluid collection
around their lungs, which happens, doesn't
happen all the time, but it happens. It's
frustrating. Like, I don't want them to have
another little procedure to have that
fluid removed, but like, you just have to treat
the patient, you know, just be like,
okay, we're going to get this drained. You're
going to get better. And it's going
to be done. Like, we can't just be like upset
about it. You know, there's no use
crying about it. You just got to treat the
patient and get them better. You know,
that's why you're their doctor. So that's
how I try to try to think about it. So
during surgery, do you use AI and robotics
to help you? Not during the operation.
During the operation, things are still relatively
old school. You know, it's just
you and your hands and the instruments and your
brain, um, you know, doing things the
way that we've been doing them more or less for the last, I don't know, 20, 30
something years. I mean, with updates, you know, obviously there's like new
techniques and new instruments and new materials.
Um, but right now in the open
heart space, we don't use a lot of, um, like AI or some people do robotics. I
mean, where I trained in fellowship, we did
robotic heart surgery. Um, I don't do
that here, but, um, there are places that do
it. That's still like a little bit more
niche. Um, one way that I do use AI sometimes is just in, um, doing research,
prepping for a case. You know, if I have a
patient that, excuse me, I encounter in
consult, um, who, you know, every patient
is different. So sometimes you'll have a
patient who, um, presents a challenge in terms
of trying to figure out like what's
the best option for them, surgical or non -surgical,
or what's the best surgical in
terms of a few different types of operations. And so I do use AI, um, to
help me gather data. Um, and then I can make
a better decision by, you know, being
up to date on guidelines and things like that,
because things are changing a lot.
And sometimes I'm like, you know, I don't really
know. I don't remember exactly like
what was the guideline on this particular issue or, um, have there been other
instances or other cases of this and where
it used to be that I would do like a
PubMed search on that. And it would take a
long time because you're sifting yourself
through all these different papers. Um, but
now there's different AI models that
will help you gather and synthesize that data. So that can help a lot. Heart
surgery is often viewed as one of the most technically
difficult careers in medicine.
How much of succeeding in the profession depends
on academic ability and how much
depends on communication? Um, well, I think
you mentioned three different things
because you mentioned, uh, technically challenging
or technically demanding, um,
academics and communication. I think those
are three very different things. Um,
because, uh, academics, meaning like how well
you can answer a question on a test,
um, that can be taught. Um, and some patients—some people are
not very inherently good at that. Um, and it
doesn't mean that they're not smart. It
just means that their brain is just not wired
as well for multiple choice tests.
Um, and those same people can be very, very good at interacting with patients,
have excellent bedside manner, have a lot
of common sense, have excellent clinical
judgment. Um, and with that also goes like
really good communication. Um, and then
there's the skill aspect, which just has to
do with like how dexterous you are and
how well you are able to like execute all
the fine movements that are needed in
order to do a cardiac operation, which, yeah, I would say, I would agree that
cardiac surgery is probably one of the more technically demanding surgical
specialties. Um, and I think that skill can be improved upon. I think it
definitely helps to have some innate ability and some innate dexterity. Um,
and, but having common sense, compassion, um,
good clinical judgment, I think all of
those things are really hard to teach. And
those are some of the things that are
actually the most important in being a good cardiac surgeon, because I have
worked with surgeons in the past who are technically
very good. They can do a very
technically beautiful operation, but they have
very poor clinical judgment, meaning
that they will operate on people who really should not have surgery and they
can do a lot of harm in that way. Um, and
so I think a really important part of
being a heart surgeon, a really important
part of being any type of surgeon or any
type of doctor is knowing when to do something
and when not to do something and
allowing yourself to execute that, uh, sort
of judgment. Um, and communication of
course is always like a huge part of it. I
would say in CT surgery, probably even
more than in other specialties, because we work
so closely with other specialties as,
uh, a general surgeon, perhaps I would say we work a lot less with medicine
specialties. Um, and it's, it doesn't make
as much of a difference to have like a
really close relationship with the anesthesiology, but, um, CT surgeons work
very closely with cardiology, work very closely
with anesthesia, um, very closely
with critical care. Um, and so I think that
being able to communicate and be part
of that bigger multidisciplinary team is really,
really, really important. It makes
a huge difference for your patients. So, um,
I think recognizing that you're part
of a bigger team is, is really important. Okay.
So are there any sacrifices of this
career that students do not hear about often enough? Um,
there are huge sacrifices. Uh, I don't know
if students hear about them or not. I
would say that I, I probably did not understand
the magnitude of the sacrifices
that I would have to make in order to do this job. You know, like I made the
decision to be a heart surgeon when I was very
young and I just kind of pursued that
very persistently, um, without really understanding what exactly it involved.
Um, I think that there are really big sacrifices
in terms of your personal life,
your social life, your family life, um, that
have to be made. I think as a woman
in surgery, there's no avoiding the fact that you're going to make really big
sacrifices in terms of family. Um, I think
that I don't feel that I've ever been
discriminated against, um, as a woman surgeon. I never felt that I was ever
discriminated against as a resident or as a fellow. I feel, again, this is my
personal experience that I was always treated
with a lot of respect, um, and was
treated by my attendings and my co -residents, um, no differently because I
was a woman. However, um, I think that people don't appreciate or understand
really like, it's just very, it's very, very difficult if you want to have a
family, if you want to have kids being pregnant,
doing this job, having a newborn
doing this job is extremely difficult. Um,
and I'm doing it. I'm, I'm currently, I
have two young children and I'm expecting a
third in about five weeks. Um, and it's
very hard, but it's definitely doable. Um, if you, it's helps to have a very
supportive and involved partner. Um, my husband's amazing. Um, but it's very,
very, very, very, very hard. And I am not,
I would encourage anyone that wants to go
into the specialty to, you know, pursue it
and talk to as many people as possible.
Um, but you know, so that you can get a sense
of if this is really something that
you want to do. Um, but you know, I love
my job. I'm very, very fortunate that I
get to help people in this way every day.
And I really value being able to be part
of the people's lives that I helped in the way
that I am. Um, and it can be extremely
gratifying. Um, but yeah, it's very hard. You
make a lot of sacrifices. I spent the
entirety of my twenties, you know, studying and in the library, I was
probably not at all as good at having like
more of a social life as I could have
been. There's definitely people who are in
med school who are not studying all the
time. Like people are in med school and have
lives outside of med school and you
can 100% do that. Um, I just like, didn't really
know how to do that. I didn't know
that that was like an option. So I sacrificed like, you know, a decade or
more. I mean that, you know, my entire twenties
I spent like in school, you know,
so, and as a resident. So, um, you know, but
I don't have any regrets and I just, I
think that it's good for people to know what
the options are and like what they're
getting themselves into. Well, first, congratulations. And, uh, Thank you.
Second, you mentioned you had a family and
you need to support that. So for you
personally, what percent of being a doctor
is about the money versus helping people?
I mean, I would say like, don't go into the,
don't go into this if money is your
only motivation, because it's going to be
very disappointing. I would say, I'm not
going to lie and say, as a CT surgeon, I don't
make good money. I make good money.
CT surgeons are some of the most highly paid
physicians. Um, so I think that I'm
very fortunate in that aspect. Um, but a lot
of other specialties are not as well
paid at all. Um, and it doesn't mean that
they don't work as hard. Um, it doesn't
mean that they don't help people as much or
more than I do. Um, it's just the way
the system works, unfortunately, and the way
that, uh, healthcare reimbursement in
this country goes. Um, so I would say that
a very, I would say it's more helping
people versus the money, because if it was
just the money, then I would do something
else. You know, like there's a lot of other ways to make a lot more money than
to be a heart surgeon. I mean, like for the money alone, it is not worth the
stress and the time. I mean, like being a
heart surgeon is unbelievably stressful.
Um, your patients are very, very, very, very sick. Um, and being on call as a
heart surgeon, I mean, you have to be ready
to just drop everything you're doing
at the, you know, at a moment's notice. Um,
and that is very stressful. So yeah, I
would say if you want to do this, you have
to be very strongly motivated to help
people. Um, and only minimally motivated
by the money because the money alone is
not going to get you there. So if a student has the passion, do you believe
medicine is still a good career if they need to borrow money to complete their
education? Yeah, of course. I mean, I had to
borrow money to complete my education.
I'm still paying off my student loans and,
you know, that's just a part of my life.
But, um, if someone has the passion and the
drive and the, um, the willingness to
do the work that it takes, then I 100% think
that medicine being a physician is,
is a good path to take. Um, but I think it's
the, the landscape of healthcare is
changing a lot. So I'm not sure how, you know, where it's going to go over the
next, you know, 10, 15, 20 years. Um, but I,
you know, there's already a shortage of
physicians in this country and that shortage is only going to get worse. So I
think it's, it's still a very worthy field
to pursue. So do you see AI and robotic
surgery as threats to medical careers or tools
that will change for the future of
medicine? I don't think it's a threat. I think it's a tool that will change
medicine and in a lot of ways can make, make it, make our ability to help
patients. It'll expand our ability to help patients.
So it'll make it better. Um, and
I think as with all technological advances, like it's not worth fighting
because it's going to happen whether you like
it or not. And so you might as well
get on board and figure out how it can benefit
your ability to help patients, um,
rather than just, you know, taking a stand
and refusing to allow yourself to be, you
know, um, helped because it's just not the
way technology goes, you know, people who
are, people who refuse to, you know, use
technology or just, it just, it doesn't
help you. So if your children someday told
you that they want to be a cardiothoracic
surgeon, would you encourage them, warn them
about the sacrifices or do a bit of
both? Well, I have two girls, um, and the baby
I'm currently pregnant with as a boy.
Um, I do think that makes a difference to
be honest. Um, but regardless of who it
is, if the boy or the girls told me they wanted
to be a heart surgeon, I would 100%
just, I would, I think they would see the
sacrifices already growing up with me as
their mother, but I would, yeah, I would
tell them about the sacrifices I would
tell them about. I would make sure that they
understood like how difficult it is.
Um, I wouldn't discourage them from it. Um,
I think that I would try to help them
make the best decision possible. Um, and I
would make sure that they understood that
you don't have to be only a heart surgeon to
be able to help people. I think it's a
wonderful thing to do. Um, and I think that
women make incredible surgeons and I
wish that we were a little bit better supported
in this country. Um, from like a
family standpoint, um, because I think that fewer women would leave, um, the
workforce or, um, be discouraged from going into certain specialties if we had
better support, um, as mothers essentially, because most, most women
still want to be mothers. I mean, a lot of people
don't, but most women still do. Um,
but in certain specialties, that number is
a lot lower. Um, and I'm not saying that
everyone has to have kids at all. Like that's
a very personal decision, but for
the people that do, I think they need better support because those same people
can still be really, really, really good doctors
and surgeons. But, um, you know,
when they're fighting against a system that doesn't support them, it becomes
very, um, counterproductive. What made you
feel that St. Clair would support, would
support you as both a surgeon and mother? What
made me feel that way? Well, from the
very first interview I had with, um, Dr. Andy
Kiser, I knew that he would do that
because one of the very first questions he
asked me was, tell me about your family,
tell me about your personal life, tell me
about your husband, tell me about your
kids. Um, and I knew that he cared not just
about me as a surgeon, but he cared
about me as a person and supporting me, um,
as someone who's not just part of his
team, but part of his community, you know,
and so he wanted to make sure that I was
supported, um, on all those fronts. And so
that is a huge part of why I took this
position because that support is very rare
to find. So how do you physically remain
present for your husband and children when
you might need to be at the hospital at
unpredictable hours?
Well, when I'm at the hospital, I'm not physically
present with them at all. So, I
mean, you know, you just have to make sure
that your partner is aware of the fact
that you're on call, that you have to leave at any moment, um, try to have
backup childcare available if possible. We are definitely struggling with that
because we don't have any family here in Pittsburgh,
but, um, you know, so you kind
of have to get, you know, your village and
neighbors and babysitters and nannies and
stuff like that. Um, but yeah, it's, I mean,
when I'm on call and I'm at home, I
try to be at home as much as possible. I, when
I'm not on call, I leave my phone in
a different room. I don't look at my phone. Um, when I'm on call, I have to
have my phone, you know, nearby so that I
can hear if someone calls or something
like that. But, um, you know, I try to be as
present with them as possible when I'm
there. And then if I have to leave, I have
to leave and that's it. And my husband
understands and he supports me and, you know,
you just, you figure it out. Um, and
you just take, take it one day at a time, a
lot of coordination, a lot of planning,
a lot of organization. I mean, when I say
one day at a time, I mean, like mentally
you take it one day at a time, but, um, you know, my husband is very, very
organized and on top of things. So we plan
things out well in advance. Well, the
final question, what piece of advice do you wish you had heard when you're an
early teen like me?
Um, I would say, I don't know if I would
have followed this advice, but I would
probably say, um, when you're in college,
try to not just sit in the library all
day, every day, you know, try to get out
there, enjoy your life, spend time with
friends. If you're in college in a city that you haven't lived in before, go
explore the city, go meet new people, try to
get out there. Um, and don't just have
this mentality of like, I'm a pre-med student.
The only thing I can do is study
and be a pre-med, you know, student. I think it's really important to get out
there. And that's also part of why, like, I
went to Panama, I went to learn Arabic,
I got to do these different things. But, um,
I definitely was a little more single
-minded than I should, but that I could have been, you know, like I could have
probably gotten out there a lot more, but
I just didn't know. I was, I didn't know
like what, what the world was like. So, um, yeah, I mean, like, well, the main
piece of advice I would say is like, spend as
much time as possible outside, I guess,
like do sports, move your body, um, be outdoors,
throw your phone in the garbage.
Like, don't be on your phone. Like, I can't stress that enough. Like, don't be
on your phone, I guess. That wasn't so much
of an issue when I was younger. And
like, now I'm like, it's, uh, yeah, just be, be present in the real world. You
know, I think you'll learn a lot more, um,
from that than, you know, from a lot of
stuff that you see on the internet. Okay. Well,
thank you so much for agreeing to be
interviewed. I am currently weighing my options on what type of doctor slash
surgeon to become. So I really appreciate
all the information you've given me. Of
course. Can I just say you, what grade are
you in? I'm in eighth grade. I'm in the
summer transition, transitioning to ninth. Okay.
I would say don't make any decisions
right now. That's maybe one other piece of advice
I would give. Like, I didn't make a
decision to be a heart surgeon until I was halfway
through residency. You know, like,
it's very difficult. You can't make that decision
right now. Um, I would say like,
allow yourself to be open to different specialties. Um, you're so young and so
inexperienced. And I don't say that to like,
insult you. I'm saying that to allow
you to understand that your options are limitless.
Like you have so much potential
and so much ability to do whatever you want. So don't pigeonhole yourself too
quickly. Um, no one's forcing you to make
that decision right now. There's no need
for you to feel like you have to decide right
now what kind of doctor you want to
be, or if you even want to be a doctor. So
I would say just try to keep your, try to
keep your mind open. Um, and I think you'll be really pleasantly surprised
about like how much that opens you to new
experiences. Okay. I won't decide. Thank
you. All right. You're welcome. Take care.
Enjoy the rest of your summer. Yep. Good
luck with everything.