Speaker 1: This is me, Craig Ferguson. I'm inviting you to come
Speaker 1: and see my brand new comedy hour. Well it's actually
Speaker 1: it's about an hour and a half and I don't
Speaker 1: have an opener because these guys cost money. But what
Speaker 1: I'm saying is I'll be on stage for a while. Anyway,
Speaker 1: come and see me live on the Pants on Fire
Speaker 1: Tour in your region. Tickets are on sale now and
Speaker 1: we'll be adding more as the tour continues throughout twenty
Speaker 1: twenty five and beyond. For a full list of dates,
Speaker 1: go to the Craig Ferguson show dot com. See you
Speaker 1: on the road, my DearS. My name is Craig Ferguson.
Speaker 1: The name of this podcast is Joy. I talk to
Speaker 1: interesting people about what brings them happiness. Today, my friends,
Speaker 1: my guest on the podcast is Dr Maya Chung, who
Speaker 1: is a pediatric surgeon at Yale. That's pretty impressive in itself.
Speaker 2: She is also the chief medical officer of a group
Speaker 2: called kits R, which provides pediatric surgical opportunities for you know, children.
Speaker 1: That need it in areas where it's kind of difficult
Speaker 1: to get. So I'm going to let you talk to
Speaker 1: her through me, and I'm going to talk to her.
Speaker 1: I really like this one and she's very impressive. Enjoy. Hello, Maya,
Speaker 1: how are you?
Speaker 3: I'm great. Craig, how are you?
Speaker 1: I'm good. Are you in Yale today? Are you in
Speaker 1: new Haven today? I am.
Speaker 3: I'm just outside. Actually we're in Brandford.
Speaker 1: Now. Before we get into that, I just want to
Speaker 1: talk to you a little bit about because you're you're
Speaker 1: a surgeon at Yale, right.
Speaker 3: Yes, I've been for many years.
Speaker 1: Actually, now I want to talk to you a little
Speaker 1: bit about Yale before we talk about you and we
Speaker 1: talk about kids, oh are and we talk about surgery.
Speaker 1: Because Yale. I've done stand up shows at Yale, and
Speaker 1: I've stayed in New Haven. And the best description I
Speaker 1: can give of Yale is it's Hogwarts in the middle
Speaker 1: of downtown Detroit. Does that seem like a reasonable it does?
Speaker 3: It seems perfect, perfect description there. It's an interesting place.
Speaker 3: It's an interesting campus, for sure.
Speaker 4: Yeah.
Speaker 1: The campus seems very lovely and collegiate and all sorts
Speaker 1: of beautiful young people walking around with scarf sown and
Speaker 1: stuff like that and performing magic. But then you go
Speaker 1: outside and get things get a little crackier. In New Haven.
Speaker 1: I noticed a little bit more, a little bit more,
Speaker 1: but more lively. You know.
Speaker 3: It was one of the reasons I actually chose to
Speaker 3: come here back in the day for residency, because I
Speaker 3: wanted to take care of a lower resource population and
Speaker 3: really be in a little more urban area, but not
Speaker 3: be in New York City or Boston.
Speaker 1: Now that's interesting because two things I want to ask you,
Speaker 1: Why you wouldn't want to be in New York City
Speaker 1: and Boston. Let me ask you why you wouldn't want
Speaker 1: to be in New York City or Boston.
Speaker 3: Well, I'm from Kansas originally.
Speaker 1: Not enough, Yeah, yeah, I get it. Yeah, it's a
Speaker 1: little lively. So but what about why were you drawing?
Speaker 3: Uh?
Speaker 1: Well, I know this about you, but I'm kind of
Speaker 1: leaning the witness a little bit. But why were you
Speaker 1: interested in working with with lower income people? And does
Speaker 1: not actually happen at Yale anyway? The people come in
Speaker 1: and did they get out there?
Speaker 3: Yeah, I know absolutely. Yale and one of our sites
Speaker 3: in Bridgeport are really high numbers in terms of people
Speaker 3: who are on some type of assistance or who are
Speaker 3: maybe migrant workers, unemployed, lower income socioeconomic backgrounds. So we
Speaker 3: do have a lot more than certain areas. You know,
Speaker 3: I had worked with kind of lower resource populations for
Speaker 3: many years when I was in medical school, and before that,
Speaker 3: I spent some time abroad in the Middle East and
Speaker 3: Asia and was just really found a lot of fulfillment
Speaker 3: in being able to provide care or help of any
Speaker 3: kind to populations that maybe didn't have certain types of access.
Speaker 1: I mean, one would presume, and we'll get onto the
Speaker 1: kids who are charity in a minute, which both you
Speaker 1: and my wife are involved in, but the idea of
Speaker 1: going into a lower resource population, I assume for a surgeon,
Speaker 1: that would mean there's a lot of none of the
Speaker 1: financy equipment that you get in Yale Hospital, right.
Speaker 3: I mean, there's a very big difference, yes, between what
Speaker 3: I have access to at Yale versus when I'm operating
Speaker 3: and let's say Kenya or Uganda. My main clinical practice
Speaker 3: right now is actually at the Veterans Hospital in West Haven,
Speaker 3: and the VA hospital is also an interesting place in
Speaker 3: terms of minimized resources because obviously, as a government institution, right,
Speaker 3: there's a lot of a lot of restrictions and things,
Speaker 3: and that population especially is one that really seeks access
Speaker 3: through the VA because they don't necessarily have a lot
Speaker 3: of other options. So again a population of maybe more
Speaker 3: homeless people than one would traditionally think about.
Speaker 1: And what kind of surgeries that you perform and on
Speaker 1: people that are the trauma surgeries? Are they you know,
Speaker 1: like appendect mees, what's going on?
Speaker 3: So I did training in minimally invasive surgery and bariatrics,
Speaker 3: So I do a lot of belly surgery that's not cancer.
Speaker 3: Is the easy way to put everything from gall letters, appendicitis,
Speaker 3: different types of hernias, weightless surgery. I do a lot
Speaker 3: of robotics. Actually, that was one of my specialized trainings.
Speaker 1: So yeah, do you use AI in your in the robotics?
Speaker 1: Now do you use that for surgery?
Speaker 3: So we use AI in a couple of ways. More,
Speaker 3: I think on the kind of academic side and looking
Speaker 3: at metrics that AI can help us learn from what
Speaker 3: we're doing in the operating room or what other people
Speaker 3: are doing in terms of kind of maximizing our efficiency
Speaker 3: with movement. Stuff like that.
Speaker 1: But thanks you so much, GP GPTC take that gold ladder.
Speaker 3: Yet, I'd be out of a job for sure.
Speaker 1: I don't. I don't think that's coming anytime soon. But
Speaker 1: maybe it is. I don't know. I mean when you
Speaker 1: when you go into a low resource population though, like say,
Speaker 1: for example, I know about the charity obviously kids who
Speaker 1: are and I know they have pediatric surgical sites in
Speaker 1: Uganda in particular, and some of these places are in
Speaker 1: rural Uganda. Is that right to say it's outside of Kampala? Yeah?
Speaker 3: Absolutely?
Speaker 1: So what what are you dealing with there? I mean,
Speaker 1: are you able to get appropriate levels of sanitation, are
Speaker 1: you able to get you know, you know, decent equipment.
Speaker 1: What are you doing?
Speaker 3: It's really a spectrum. So some of the places I've
Speaker 3: been you actually have minimally basive surgery laparoscopy. I was
Speaker 3: teaching some of that in Kenya last year, which was
Speaker 3: really phenomenal to work with the teams there. Other places
Speaker 3: you might have a very minimal equipment, not the right equipment,
Speaker 3: not a great opportunity to sterilize equipment for example. So
Speaker 3: your reprehainst to a lot of challenges. But I'm sure
Speaker 3: we'll get into this. But you know, a lot of
Speaker 3: what we're doing at Kids Operating and is trying to
Speaker 3: bridge that gap so that people in world Uganda don't
Speaker 3: have to be doing without and can really provide the best,
Speaker 3: safest care they can to kids around the world.
Speaker 1: And what kind of I mean, like the pediatric operating
Speaker 1: rooms that you're working in Uganda or in other parts
Speaker 1: of low resource areas, are they what kind of surgeries
Speaker 1: are you see? Are the emergency things? Are they both?
Speaker 3: So there's a lot of emergency operations that are happening.
Speaker 3: There's a lot of wait lists. You know, kids here
Speaker 3: might get a hernia fixed in a couple of weeks
Speaker 3: it might take years and a lot of other places,
Speaker 3: and the impact on a child's life and a family's
Speaker 3: life if that's the case, can be really devastating. We
Speaker 3: also see a lot of complex surgery, so it's amazing
Speaker 3: there's so much talent and all of these other places
Speaker 3: they're able. I mean, you've gone as a perfect example
Speaker 3: where they've been able to step right conjoined twins, and
Speaker 3: you know, we think of that as something that's so
Speaker 3: highly specialized, but the technique is there, the training is there.
Speaker 3: It's really just the equipment and a little bit of
Speaker 3: probably solar power, because that's another problem operating in these places.
Speaker 3: Power outages that can really make a difference.
Speaker 1: I know. George Youngston, doctor George Youngston, who is a
Speaker 1: friend of mine. George is one of the pioneers of
Speaker 1: the work getting done out there. That George said that
Speaker 1: when I first talked to him about kids who are
Speaker 1: he said that cleft palate, for some reason was something
Speaker 1: that a lot of people, they were dealing with a
Speaker 1: lot of kids with with a cleft palate surgery they
Speaker 1: were fixing. Is that true?
Speaker 3: Yeah, cleft palate, club feet, and you know those are
Speaker 3: things that a quick, simple surgery can be a one
Speaker 3: time fix, simple on the spectrum, right, but it's really life.
Speaker 3: I mean, we have case studies out of Kenya. Is
Speaker 3: one place, a refugee camp that we worked and there's
Speaker 3: a child there who was born with cleft feet and
Speaker 3: that would have been fixed within a matter of months
Speaker 3: and some simple procedures in the US or the UK.
Speaker 3: His parents carried him, you know, they physically carried him
Speaker 3: for years everywhere he had to go, and finally he
Speaker 3: was able to get care in one of our operating rooms.
Speaker 3: And now he plays on his local soccer team and
Speaker 3: runs around with them.
Speaker 1: Men U Jersey on Yeah, well, I'm not sure that
Speaker 1: I'm completely a fan of his Startorial Troit team. Yeah,
Speaker 1: but I mean that's an amazing thing to me. So
Speaker 1: I mean hearing about the people who are walking, because
Speaker 1: I did hear stories about this, about women who were
Speaker 1: carrying their babies twenty thirty, forty miles and more and
Speaker 1: physically walking through I don't know if it's jungle or
Speaker 1: what kind of area is, but walking to get to
Speaker 1: an op in room for the kids.
Speaker 3: Yeah, and I mean if you think about what that
Speaker 3: does to a family, also the impact on them. Sure,
Speaker 3: we did a lot of studies a while ago looking
Speaker 3: at how much families had to sell, like sell cattle,
Speaker 3: sell home goods, things like that to be able to
Speaker 3: even make the trip. I mean that impact on a family,
Speaker 3: And yeah, if it's only thirty miles, they're pretty lucky.
Speaker 3: In a lot of these places, there might only be
Speaker 3: one or two centers in the entire country that can,
Speaker 3: you know, address their child's needs. So I think you're
Speaker 3: a parent. I only have dogs, but you know the
Speaker 3: impact and the devastation that must be felt. I know
Speaker 3: i'd feel that for my puppies.
Speaker 1: Well, that's an interesting thing because I was going to
Speaker 1: ask you about this anyway that you see some stories
Speaker 1: by the nature of the work that you're drawn to.
Speaker 1: I mean, look, pediatrics of any kind is going to
Speaker 1: break your heart, and you know it's a calling which
Speaker 1: I'm you know, is beyond me. I admire it, and
Speaker 1: I don't know if I how are you emotionally equipped
Speaker 1: to deal with with the bad news diagnosis involved around children?
Speaker 1: It must be devastating, Yeah, it is.
Speaker 3: I think you know, as a surgeon that type a personality.
Speaker 3: We like to help people. We like to see a
Speaker 3: problem solve it feel like we had an impact that
Speaker 3: keeps you going. The harder things in surgery and probably
Speaker 3: medicine more broadly are when you can't help. So either
Speaker 3: you know, the right equipment isn't there, the tools are broken,
Speaker 3: the oxygen ran out, Maybe the patient gets there too
Speaker 3: late because their tumor has grown too much, or maybe
Speaker 3: because the mom had to walk, you know, for two
Speaker 3: days and so the child has gotten so much sicker.
Speaker 3: And I think that in those moments, it's that helplessness
Speaker 3: and just standing by the family where you know, you
Speaker 3: feel like if they'd just gotten there earlier, if you
Speaker 3: just had to feel more, a little bit more oxygen
Speaker 3: or a little bit more equipment, that maybe you'd be
Speaker 3: able to have a different outcome, and it is that
Speaker 3: helplessness that stays with you. But you know, ultimately that's
Speaker 3: that's why we do the work we do and you know,
Speaker 3: trying to fill that gap again so that no one
Speaker 3: has to feel that way. But surgeons, we just we
Speaker 3: have that need to see a problem, fix it. And
Speaker 3: I think it's that desire to ultimately alleviate suffering and
Speaker 3: make that impact that just keeps you going even when
Speaker 3: you have one one bad thing or you you know,
Speaker 3: it obviously changes you, it stays with you.
Speaker 1: Yeah, you learn from it. Yeah. I mean most surgeons
Speaker 1: that I've met, and I've met quite a few, and
Speaker 1: I know quite a few, most of them are quite
Speaker 1: sporty people, which I wasn't surprised, a quite kind of
Speaker 1: jocks a lot at the time. Do you are you?
Speaker 1: First of all, are you a jock? Are you a
Speaker 1: sporty person? Uh?
Speaker 3: Well, I'm the wife of a baseball coach, so I think, okay,
Speaker 3: my definition, I'm probably pretty sporty. Yeah, But surgery is
Speaker 3: shockingly physical. We stand for hours, we twist in different ways.
Speaker 3: You know. I actually her needed my back moving a
Speaker 3: patient a couple of years ago and had to have
Speaker 3: surgery myself. So there's a definite you're dehydrated all day,
Speaker 3: you're tired, you don't sleep that much, so there's a
Speaker 3: definite physical toll. And you know, I think both kind
Speaker 3: of mental health as well as physical health is really
Speaker 3: important to extend longevity of one's career. And I think
Speaker 3: we're now starting to acknowledge that, which we didn't do
Speaker 3: for a long time.
Speaker 1: Yeah, I was going to say the idea of acknowledging
Speaker 1: the mental health impact on surge is because even if
Speaker 1: even if you approach, you know, a problem in a
Speaker 1: sort of slightly more engineering frame of mind, like this
Speaker 1: is a problem in the human body, I'm going to
Speaker 1: I'm going to fix it or or approach it like
Speaker 1: like this is a challenge for me. You know, there's
Speaker 1: got to be a point where, you know, if there's
Speaker 1: a like almost like a sporting mentality in the surgeon,
Speaker 1: you're going to lose. Sometimes you're going to learn how
Speaker 1: to lose.
Speaker 3: And it's a team, right, So yeah, like trusting in
Speaker 3: my team, my nurses, my nsthesiologists, the patients trust in us,
Speaker 3: the families trust in us, and sometimes you lose. You know,
Speaker 3: in sports, they watch a lot of game tape and
Speaker 3: learn from maybe mistakes are also successes with robotics, that's
Speaker 3: one way for sure. We have the ability to record
Speaker 3: our surgeries to watch them back if something, you know,
Speaker 3: if there's a complication post operatively, we could actually review
Speaker 3: that tape and see is there some mistake that we
Speaker 3: made technically. And we spend a lot of time as
Speaker 3: a community reviewing what we used to call morbidity and
Speaker 3: mortality conferences, which we now call quality improvement, which are
Speaker 3: you know, and things don't necessarily go according to plan,
Speaker 3: but taking an opportunity to really holistically examine the pathway
Speaker 3: of what happens so that we can all learn from it.
Speaker 3: So I'm not just learning from, you know, my mistakes,
Speaker 3: but I get to learn from my colleagues they can
Speaker 3: learn from me. That way, hopefully we're not all making the.
Speaker 1: Same mistakes, right, you know, repeating the same thing. I mean,
Speaker 1: I think it's a smart it's a smart thing. I mean,
Speaker 1: you mentioned post operative care there as well, and I
Speaker 1: thought that's quite interesting because I remember talking again, talking
Speaker 1: to George Johnson years ago about why don't we just
Speaker 1: fly a bunch of doctors in the g four down
Speaker 1: in Uganda and fix all of these problems and then
Speaker 1: they can all leave. And he said, well we can,
Speaker 1: because we try that and it doesn't work because there's
Speaker 1: you've got to do follow ups, right, You got to
Speaker 1: you got to figure out what's going on. You have
Speaker 1: to have surgeants who are there all.
Speaker 3: The time absolutely first of all, to select the patients
Speaker 3: and figure out who are the patients that actually need
Speaker 3: care urgently or maybe who maybe need more specialized care
Speaker 3: from someone who's coming in the follow ups for sure.
Speaker 3: But I think you know, in the world we live
Speaker 3: in today, there's another reason why investing in the local
Speaker 3: teams and supporting them to do the work is important.
Speaker 3: And that's if you look at all of the conflicts.
Speaker 3: So you know, kids operating room now we've installed one
Speaker 3: hundred operating rooms thirty five countries from really challenging places
Speaker 3: like the Kakuma refugee camp in Kenya, Congo, Afghanistan, Haiti
Speaker 3: and Haiti is a perfect example where you know, all
Speaker 3: the aid organizations left with the current conflict, a lot
Speaker 3: of them don't have teams on the ground. So if
Speaker 3: you were only sending in teams, you'd have a whole
Speaker 3: cohort of children who wouldn't be able to get surgery.
Speaker 3: But in fact, our operating rooms Imported Prince are two
Speaker 3: of the only that are still working because they're stacked
Speaker 3: by local teams because what we've done is support and
Speaker 3: empower them. And so that means in all of these
Speaker 3: places where global aid organizations can't go, the local teams
Speaker 3: still have the capacity to care for those kids and ultimately,
Speaker 3: you know, that strengthens the entire country and the country's GDP.
Speaker 3: And so there's that component as well, which I think
Speaker 3: you know in today's world is even more important to recognize.
Speaker 1: Hello, this is Greig Ferguson and I want to let
Speaker 1: you know I have a brand new stand up comedy
Speaker 1: special out now on YouTube. It's called I'm So Happy,
Speaker 1: and I would be so happy if you checked it out.
Speaker 1: To watch the special, just go to my YouTube channel
Speaker 1: at the Craig Ferguson Show and is this right there?
Speaker 1: Just click it and play it and it's free. I
Speaker 1: can't look. I'm not going to come around your house
Speaker 1: and show you how to do it. If you can't
Speaker 1: do it, then you can't have it. But if you
Speaker 1: can figure it out, it's yours. It's an interesting thing
Speaker 1: because you talk about today's world, which is you know,
Speaker 1: there are a lot of very intense and very opposing
Speaker 1: political stances in all of the area, pretty much all
Speaker 1: of the areas you're talking about. If you're going into
Speaker 1: a war torne area, people are so mad at each
Speaker 1: other that they're killing each other. So there's conflict going on.
Speaker 1: How easy or difficult is it to navigate the political
Speaker 1: fundraising side of things, like if you're if you're raising
Speaker 1: money for kids who are which I don't think there's
Speaker 1: anybody on any site of any debate would say, you know,
Speaker 1: we don't want hospitals in there to look after children. Boo,
Speaker 1: that's a bad thing. But everything is politicized. So how
Speaker 1: do you how do you cope with it? How do
Speaker 1: you deal with it?
Speaker 3: I mean it's a real challenge in certain places obviously,
Speaker 3: you know, government agendas set a lot of the dictates.
Speaker 3: We have always been in a political organization and try
Speaker 3: to work wherever there's a need. Ukraine is a perfect
Speaker 3: example of that. We're finishing up fund raising now for
Speaker 3: six operating rooms in western Ukraine, and you know we
Speaker 3: work with the local teams, the ministries of health there,
Speaker 3: and we just try to focus on what you said,
Speaker 3: which is taking care of kids. Ultimately, I hope most
Speaker 3: people in the world are in favor of children and
Speaker 3: supporting kids getting access to care, and so we just
Speaker 3: try to maintain that real laser focus and explain that
Speaker 3: what we're doing also is, you know, strengthening health systems
Speaker 3: and creating security and empowering the economies and the families
Speaker 3: and all of the downstream effects that one actually has
Speaker 3: by being able to provide a child with surgery, they
Speaker 3: can go back to school, their parents can work, you know,
Speaker 3: there's a lot of things. So trying to focus on
Speaker 3: the societal impact and focus away from the political one
Speaker 3: is I think what we have to do right now.
Speaker 3: But it's always a challenge.
Speaker 1: Do you ever you ever find yourself losing your temper
Speaker 1: when you're there?
Speaker 3: I find myself losing my temper with well meaning but
Speaker 3: poorly thought out plans.
Speaker 1: Oh my god, you hate me. Why don't we just
Speaker 1: all fly down there? Are ticket? Yeah? Right?
Speaker 3: I mean, as a surgeon, you don't like surprises. When
Speaker 3: I go into a belly, I want to know what
Speaker 3: I'm going to find and what my plan is, and
Speaker 3: I think my patients want that plan as well.
Speaker 1: Sure, but I mean well that you mentioned that if
Speaker 1: you're going in like if you're in a lead low
Speaker 1: resource area, you haven't presumably you're not getting the scans
Speaker 1: that you would get and Yale, you're not looking at
Speaker 1: all the you may or even get the blood work
Speaker 1: that you want, So you might really begin a surprise.
Speaker 1: It may be you know, cut and find out, right.
Speaker 3: You might, although hopefully you know you're working with a
Speaker 3: local team who's used to working under those limitations, So
Speaker 3: there are lessons we can learn from them about how
Speaker 3: they work up or manage with very few resources without
Speaker 3: a cat scan, for example, and implement that in a
Speaker 3: safe way. I think that's really where the criticality of
Speaker 3: having local partners comes in, because they know what they're
Speaker 3: used to doing and what's worked in their own environment,
Speaker 3: and there's a lot of innovation that comes out of
Speaker 3: that as well. Right, Like, I've learned a lot of
Speaker 3: lessons about what they've done that I've put into my
Speaker 3: own practice, especially during the pandemic when we all had
Speaker 3: to really think about what the resources were that we
Speaker 3: were using.
Speaker 1: Here, did I have a major impact in what you
Speaker 1: were doing? And Yale during the pandemic. Who you could
Speaker 1: see and what you could do.
Speaker 3: Yeah, a bit. So, you know, new Haven not that
Speaker 3: far from New York City, and there was a lot
Speaker 3: of overflow. I was based in Bridgeport, Connecticut, which is
Speaker 3: part way between New Haven and New York, and we
Speaker 3: had a ton of overflow. We actually had a huge
Speaker 3: medical tent set up in the courtyard of the hospital
Speaker 3: and it sounded a lot like a big airplane hangar
Speaker 3: because all of all the ventilation and you know, we
Speaker 3: were really just trying to triage and save the lives
Speaker 3: that we could save, and we didn't have a lot
Speaker 3: of resources then. We also didn't know a lot about
Speaker 3: COVID then, and so there was a lot of fear
Speaker 3: and anxiety in general. But it definitely made us more
Speaker 3: conscious about what resources are we using, everything from ppe
Speaker 3: to blood. How should we think about prioritizing or triaging
Speaker 3: resources as well. So there's a lot of things that
Speaker 3: we that we all learned and were able to implement
Speaker 3: into our own practices, for good and for worse.
Speaker 1: You know, you make mistakes, That's how you learn, I guess.
Speaker 1: But when the stakes are that high where you're dealing
Speaker 1: with the mortality of human beings. It's it's terrifying to me.
Speaker 1: The idea of you've talked a lot about local using
Speaker 1: local people when you're in a low resource area. If
Speaker 1: there are local teams, the question I've got to ask
Speaker 1: is what do they need from you? You know, when
Speaker 1: you go in there, if there's a doctor who's a
Speaker 1: pediatric surgeon in Uganda or is there is there a doctor,
Speaker 1: I mean other doctors? Do you train them? Do you
Speaker 1: do kids? Who are you know? Do you guys go
Speaker 1: in and I think you mentioned earlier that you were
Speaker 1: training people. There is that like a teaching hospital situation.
Speaker 3: So we do a variety of different things. We provide
Speaker 3: scholarships to train more surgeons and as caesiologist. So you know,
Speaker 3: when you and Megan first engaged with us back in
Speaker 3: Uganda ten years ago, there was only one pediatric surgeon
Speaker 3: in the country. Now there are nine. There are still
Speaker 3: other countries that might have zero or one or two
Speaker 3: for an entire population of like forty million children.
Speaker 1: So we do in for schotlarship is worth stopping for
Speaker 1: a minute and saying there was one pediatric surgeon in
Speaker 1: the whole country.
Speaker 3: Yeah, that's that's and no operating room for him, so
Speaker 3: he was working after hours, he was working whenever he
Speaker 3: could get space. And a lot of these countries, right,
Speaker 3: we look at a population and in the US or
Speaker 3: the UK, we're very used to kind of like a
Speaker 3: very even curve. But in a lot of these places,
Speaker 3: more than fifty percent of the population our children. So
Speaker 3: we're not really talking about pediatric health. We're talking about
Speaker 3: the nations health and the issues with that. But you know,
Speaker 3: we also offer a lot of training courses. So I've
Speaker 3: taught training courses myself in Uganda and Chad. We have
Speaker 3: developed partnerships with nursing programs to teach nurses an incredibly
Speaker 3: important part of the post operative care that you spoke about, right,
Speaker 3: We all see what a critical role nurses play here,
Speaker 3: especially for like family sure when the kids go home.
Speaker 3: So we do a lot of hands on training. We
Speaker 3: do a lot of We have an e learning program
Speaker 3: that a lot of our collaborators work with, and ultimately
Speaker 3: our goal is to just help maybe provide a little
Speaker 3: bit of upskilling or some opportunities to learn about some
Speaker 3: specialized things like laparoscopy or that minimally basive equipment. I
Speaker 3: talked about But there are really great providers in all
Speaker 3: of these countries, and each country's a little different, so
Speaker 3: sometimes we need to provide more scholarships. Sometimes we don't.
Speaker 3: Ukraine has a huge health workforce, but they don't have space.
Speaker 3: They need their operating rooms to care for their children,
Speaker 3: and so we you know, really direct our focus in
Speaker 3: that country more on the infrastructure side.
Speaker 1: It's fascinating to me. I mean talking about you as
Speaker 1: a doctor that you come from Kansas, right, yeah. And
Speaker 1: do you come from a medical family? Do you come
Speaker 1: from you know?
Speaker 3: Definitely not no, my, because you went you went a Deeca.
Speaker 1: I mean it's it's not just like, oh, I'd like
Speaker 1: to be, you know, I know, a small town doctor.
Speaker 1: I mean you're you're a surgeon at Yale, you know.
Speaker 1: I mean you're the chief medical officer for kids who
Speaker 1: are dangerous parts of the world. What draws you to that?
Speaker 3: A little bit of luck, a little bit of timing,
Speaker 3: I think, you know, my definitely not a medical family.
Speaker 3: My mom and dad were the first in their families
Speaker 3: to go to college and get advanced degrees. I wasn't
Speaker 3: sure what I wanted to do leaving high school. I
Speaker 3: wanted the liberal arts education. So I went to Middlebury
Speaker 3: in Vermont and wanted to explore a little bit of this,
Speaker 3: a little bit of that. Was always kind of preferally
Speaker 3: interested in medicine. But you know, the second day of
Speaker 3: school for me as an undergrad was September eleventh, two
Speaker 3: thousand and one, and I thought, gosh, I know nothing
Speaker 3: at all about the Middle East, and a lot of
Speaker 3: us really didn't. At the time, there was no such
Speaker 3: thing as a Middle Eastern studies major. So I was
Speaker 3: studying Italian in architecture, and then started studying Arabic and
Speaker 3: Middle Eastern studies, a lot of political geography. And then
Speaker 3: I was abroad in the Middle East after I graduated,
Speaker 3: and I worked at a women's and children's health clinic
Speaker 3: there and started to see some of the issues of
Speaker 3: healthcare in little resource settings. And I had spent some
Speaker 3: time in China also as a kid. My dad's from
Speaker 3: Hong Kong, so I traveled a lot and seeing kind
Speaker 3: of healthcare in different countries. And then, you know, after
Speaker 3: I came back from the Middle East, I thought, oh,
Speaker 3: I want to be involved in like human rights and
Speaker 3: I want to work with people. So I decided I
Speaker 3: would be a Paralleague at a law firm doing international
Speaker 3: law for a year and realized that actually that is
Speaker 3: just paperwork and bureaucracy and so not the kind of
Speaker 3: like hands on helping I wanted to do. So I
Speaker 3: ended up going back to do a post back and
Speaker 3: then to med school, and the luck that comes into
Speaker 3: it was just kind of the opportunities that I found.
Speaker 3: I think I always tell people, the worst thing anyone's
Speaker 3: going to do is just say no to you. So
Speaker 3: Tony Fauci gave a talk when I was doing a
Speaker 3: post back, and I didn't really know who he was,
Speaker 3: and he wasn't that famous then, but I managed to
Speaker 3: go up to him afterwards, and I did an internship
Speaker 3: for the year and then spent some time abroad and
Speaker 3: had some great opportunities that just kind of all connected
Speaker 3: in a way that I started to see this path forward,
Speaker 3: and even connecting with you know, what became Kids' Operating
Speaker 3: Room was really just luck. I was working in Uganda
Speaker 3: doing some work and teaching a trauma course, and that
Speaker 3: was back in the day when that first operating room
Speaker 3: was being installed that you and Meghan were involved with.
Speaker 3: So things just kind of it happens, you know.
Speaker 1: It's a funny thing. Though. The idea of being drawn
Speaker 1: into medicine from liberal arts is kind of a reach.
Speaker 1: It's like, I don't know how a person makes that jump.
Speaker 1: I mean, were you squeamish when you I mean, like
Speaker 1: the first time you go into an operating room, do
Speaker 1: you like, like just to operate? I mean I could
Speaker 1: handle it. I just could.
Speaker 3: Some people can't take blood. No, I've always liked breaking
Speaker 3: my hands, and I played the violin. I was always
Speaker 3: interested in the intricacies of like when we did anatomy
Speaker 3: in high school, dissecting frogs and things like that, so
Speaker 3: that never really bothered me. And I think I just
Speaker 3: really liked the idea that I could help solve a
Speaker 3: problem directly in front of me, and that for me
Speaker 3: was really appealing.
Speaker 1: It's an interesting thing. Were you you graduated where Dotford
Speaker 1: Dartford Medical schools? Yeah, Darts Yeah, that's right. Yeah, which
Speaker 1: is uh, that's pretty swanky school.
Speaker 3: It's a bit swinky. I think your wife knows the
Speaker 3: area gotta yeah.
Speaker 1: Yeah. But it's kind of like it's an interesting thing
Speaker 1: for me because I would have thought that the trajectory
Speaker 1: of someone going through that level of ivy league, education
Speaker 1: and stuff would have been actually in New York or
Speaker 1: Los Angeles. You know that these kind of leg but
Speaker 1: clearly there is another side that pushes you to it.
Speaker 1: It's not just problem solve when it can't be, or
Speaker 1: you wouldn't be putting yourself in these situations because presumably
Speaker 1: some of the places you go to are there's personal
Speaker 1: jeopardy involved as well.
Speaker 3: Yeah, there is. I mean we try to minimize that.
Speaker 3: Obviously for women, there's probably more. You know, I was
Speaker 3: lucky my parents had spent a lot of time traveling
Speaker 3: in the nature of their own work and were incredibly supportive,
Speaker 3: sometimes shockingly so I'm not sure how many parents would
Speaker 3: have allowed their you know, freshly graduated daughter to go
Speaker 3: to the Middle East and kind of have a one
Speaker 3: week hotel reservation and then not really know what she
Speaker 3: was going to do after that. But i'd you know,
Speaker 3: my family was always really involved in different types of
Speaker 3: initiatives and nonprofits. When I was in high school, my
Speaker 3: mom started a nonprofit with a colleague that looked at
Speaker 3: solar powered cookers in Tibet. So they were produced in
Speaker 3: Tibet and they allowed children to not have to gather
Speaker 3: yak dung, which is what was the traditional source of fuel,
Speaker 3: and then the kids could actually go to school and
Speaker 3: they got an education. So again the kind of like
Speaker 3: downstream effects of what some other nonprofits we've been involved
Speaker 3: in were able to do. And I think that I
Speaker 3: was just really lucky to be exposed to a lot
Speaker 3: of those things globally and feel like there was a
Speaker 3: place to be able to and also I think a
Speaker 3: responsibility to contribute if I can.
Speaker 1: You are you a religious person or it's your family religious?
Speaker 1: Is that is that now? Is the impose that from there?
Speaker 3: No, not at all.
Speaker 4: It's interesting to me the said desire to be what
Speaker 4: what do you mention that your parents that traveled, the
Speaker 4: love for the work they were and what did they
Speaker 4: do if you unless they were spies, in which case
Speaker 4: you probably shouldn't tell me.
Speaker 3: Wouldn't that be fun? My mom was an archaeologist, so
Speaker 3: she was on a dig over in Europe when I
Speaker 3: was born. I was born in Switzerland, but she spent
Speaker 3: a lot of time in the former USSR and in Europe.
Speaker 3: And my father was born and raised in Hong Kong.
Speaker 3: Came to the US for college, and he worked for
Speaker 3: the National Animal Disease Center. He was a scientist, but
Speaker 3: he spent a lot of time again after the breakup
Speaker 3: of the USSR, working and mentoring former Soviet scientists and
Speaker 3: creating a lot of mentorship opportunities and working on different projects.
Speaker 3: So they traveled a lot for both conferences as well
Speaker 3: as work, and really I think, you know, wanted to
Speaker 3: expose us to other parts of the world. When I
Speaker 3: was in my mom was on a dig in China
Speaker 3: when I was in second grade, so we actually lived
Speaker 3: in Beijing for a year when she was doing archaeological
Speaker 3: work there. So, you know, experience is that not everyone gets.
Speaker 1: Yeah, no, it's a fabulously glamorous, almost like Wes Anderson
Speaker 1: type childhood. But there seems to be an altruistic impulse
Speaker 1: that in you, like your father's doing, you know, help
Speaker 1: mentoring people coming out of the fall of the Soviet
Speaker 1: Union then and what you ended up doing, and it
Speaker 1: seems like there is a I mean, I don't want
Speaker 1: to push you to it, but is there a spirit
Speaker 1: all need for it? Is there is? Is there a
Speaker 1: need for it that goes beyond because I find it
Speaker 1: hard to accept that it's just about the mechanics of
Speaker 1: solving a problem in front of you.
Speaker 3: Yeah, I mean, there's not a spiritual impulse we are.
Speaker 3: I think my dad's family is kind of Buddhist, you know.
Speaker 3: My mom was raised some type of Christianity that she
Speaker 3: never practiced, not Catholic, right, some type of Protestantism. And
Speaker 3: I think if anything, it was that like spirituality that
Speaker 3: was probably just instilled by them, and then probably their
Speaker 3: upbringing in terms of like both coming from incredibly you know,
Speaker 3: poor backgrounds, really having to make everything that they did
Speaker 3: for themselves, and then believing that because they succeeded, they
Speaker 3: needed to give back, and if we succeeded, we needed
Speaker 3: to give back as well. My dad was one of
Speaker 3: like ten or eleven kids, and he used to sleep
Speaker 3: under the table in Hong Kong. That's where he slept.
Speaker 3: My mom, her mom pass away when she was young,
Speaker 3: and she ran the whole farm, and the farm was
Speaker 3: for to survive, you know, it wasn't a wasn't it
Speaker 3: like a high producing dairy farm or something, right, So
Speaker 3: I think it was really that.
Speaker 1: Where does it leave you? When you see You're going
Speaker 1: to see some pretty heartbreaking things and some pretty unpleasant things.
Speaker 1: You're going to see some wonderful things too, things that
Speaker 1: you know people would say it's a miracle and stuff.
Speaker 1: So does it Where does it leave you personally with
Speaker 1: the idea of where we are the universe? Is there
Speaker 1: a are you an atheist that you are? You a theist?
Speaker 1: That you do you not think about it? Do you
Speaker 1: just completely steer your mind away from it and stay
Speaker 1: engineering focused? What do you do?
Speaker 3: I think I like to believe that there are maybe
Speaker 3: spirits out there, whether they be ancestral or or whatnot,
Speaker 3: who are looking over us or guiding us in some way.
Speaker 3: You know, there are definitely times in my life where
Speaker 3: I've prayed to a higher being, maybe in times of
Speaker 3: like extreme sadness or anxiety or something like that. So
Speaker 3: it's not that I don't acknowledge it. And I and
Speaker 3: I would also say that I think sometimes it's really
Speaker 3: important for my patience and to acknowledge a belief that
Speaker 3: they have in some presence or being out there that's
Speaker 3: looking over them and providing safety. But it doesn't really,
Speaker 3: you know, come into my mind on a daily basis.
Speaker 1: No, You've never, like, have you ever in a last
Speaker 1: resort case with a problem you could solve ask for
Speaker 1: some kind of divine intervention.
Speaker 3: Well, I think that I probably have, But I think
Speaker 3: that sometimes that divine intervention might come in the way
Speaker 3: of either you know, asking that question to a mentor
Speaker 3: or someone calling you, or somehow that answer is given
Speaker 3: to you in the universe, and whether it's come to
Speaker 3: me because I asked for it. You know that kind
Speaker 3: of story about the flood and the guy on the
Speaker 3: roof who's asking for help and asking God to help him,
Speaker 3: and guy keep sending him boats until finally he drowns.
Speaker 1: There's a great old joke I love about a priest
Speaker 1: and a rabbi going to see a boxing match together
Speaker 1: and before the fight, one of the boxes crosses himself
Speaker 1: and the rabbi says to the priest, what does that
Speaker 1: mean when he crosses himself? And the priest says, if
Speaker 1: he can't fight, not a fucking thing, which I kind
Speaker 1: of love. But it would seem to me though, that
Speaker 1: not only your own belief system, but you're going to
Speaker 1: places maybe delivering children or performing procedures which you're going
Speaker 1: to run into other people's belief systems that might be
Speaker 1: a problem. Like you know, have you run into that
Speaker 1: where there is a local religion or a belief system
Speaker 1: or tradition that will not allow you to do the
Speaker 1: work you need to do to help someone we have.
Speaker 3: You know, there are plenty of kind of faith healers
Speaker 3: in different parts of the world, and there's definitely been
Speaker 3: instances where maybe a child shows up with let's say,
Speaker 3: a very big belly, and they're very sick, and they
Speaker 3: might have cuts on their belly. There are some faith
Speaker 3: healers who believe that, you know, that is a treatment.
Speaker 3: And I think ultimately the experience that I've had is
Speaker 3: that when they've come to me or the people that
Speaker 3: I'm working with, or at our kids' operating rooms, they've
Speaker 3: actually shown up to a health center. They've shown up
Speaker 3: for care. So the parents have gotten to the point
Speaker 3: where they have either overtly or not overtly, said to themselves,
Speaker 3: we are willing to set aside our own belief system
Speaker 3: and the hopes that this other intervention, modern medicine could
Speaker 3: actually save our child. I think that we don't experience
Speaker 3: it as much on the initial standpoint, right because we're
Speaker 3: only seeing the kids who are brought to us where
Speaker 3: that decision has already been made. But there's definitely those instances.
Speaker 3: There's also I would say, the challenge of kind of gender,
Speaker 3: and in some parts of the world, for example, you
Speaker 3: really need a female provider, a female doctor for a
Speaker 3: female patient, otherwise they might not get care. So there
Speaker 3: are those things and they can be really challenging, and
Speaker 3: you do the best you can to apply logic to
Speaker 3: the situation, make that connection with the patient or the family,
Speaker 3: try to explain to them, meet them halfway, understand where
Speaker 3: they're coming from, Explain to them where you're coming from,
Speaker 3: and ultimately hope in the end that you've been still
Speaker 3: the enough trust in them to be able to trust
Speaker 3: in you for what needs to happen. Doesn't always work out,
Speaker 3: and that can.
Speaker 1: I was going to say, have you ever had you know,
Speaker 1: have you ever had that denied to you. Have you
Speaker 1: ever had someone say you're a woman, you can't treat me,
Speaker 1: you can you can't help me, you can't help my son.
Speaker 3: Yeah, but I've even had that at the in the US,
Speaker 3: like at the VAAL. Yeah, sure, a lot of those biases.
Speaker 3: They exist in the US as well and in the UK. Right.
Speaker 3: And then I've had patients who have said they don't
Speaker 3: want one of my residents treating them perhaps because of
Speaker 3: their their gender or because of their ethnicity. And again
Speaker 3: we try to use those as teaching moments and explain
Speaker 3: to the patient why they need care, why this person
Speaker 3: can provide excellent care. But you don't win every argument,
Speaker 3: and and I think sometimes those are just ones you
Speaker 3: at some point have to let go. And the same
Speaker 3: with you know, preferences for blood transfusions or avoiding blood transfusions.
Speaker 3: I mean there's a lot of.
Speaker 1: Right, yeah, the idea that you can wasn't there a
Speaker 1: core order done? Recently someone didn't want their kid to
Speaker 1: have a blood transfusion which would save the life, and
Speaker 1: the court was like, Okay, fuck it, we're doing it
Speaker 1: and you'll just have to deal. I mean, it does
Speaker 1: seem yeah, I mean, you want to respect people's belief systems,
Speaker 1: but you.
Speaker 3: Do you also want to believe that like logic and
Speaker 3: data went out at the end, but that is.
Speaker 1: Not the for everyone, for everyone I know. And also compassion.
Speaker 1: I feel that seems so odd to me that because
Speaker 1: everything is is so on fire politically or or socially,
Speaker 1: the genuine compassion will be treated with suspicions like what
Speaker 1: do you want? What do you want? And people are
Speaker 1: so beat up by I don't know their life or
Speaker 1: the world or what's happened to them that they can't
Speaker 1: accept the hand when it's reached out to them. Does
Speaker 1: that happen much?
Speaker 3: I think maybe initially. But what I've found is that
Speaker 3: you know when you're I'm One of the things about
Speaker 3: being a surgeon, right, especially if it's something that's emergent,
Speaker 3: is that you have to build that trust with the family,
Speaker 3: with the patient in a matter of minutes, because you're
Speaker 3: asking them literally to put a life in your hands,
Speaker 3: and so being able to meet them on a human level,
Speaker 3: being able to just listen answer their questions, usually I
Speaker 3: can get people to the ultimate outcome of like agreeing
Speaker 3: to let me do surgery. I think, like anyone, if
Speaker 3: you just push back and are immediately stand offish and
Speaker 3: patriarchal and demanding, no one responds well to that. I
Speaker 3: don't think anyone automatically changes their mind, whether you're trying
Speaker 3: to get them to eat a hamburger or get them
Speaker 3: to have an emergent surgery. And so that human element
Speaker 3: becomes really important, and as you said, the humanity aspect
Speaker 3: of listening to them and understanding where they're coming from
Speaker 3: and asking questions like why is this the case? And
Speaker 3: sometimes you have to compromise. Sometimes I have to agree
Speaker 3: that I'm not going to give the blood transfusion in
Speaker 3: the case of an emergency, but at least being able
Speaker 3: to attempt understanding where they're coming from and have them
Speaker 3: understand where I'm coming from and ultimately making a decision
Speaker 3: that is hopefully best for the patient.
Speaker 1: Yeah, I mean, I guess because the legalities of it
Speaker 1: as well. You'll be dealing with minors a lot of
Speaker 1: the time, who the permission has to come from a
Speaker 1: parent or guardian, and that might gosh. I feel like
Speaker 1: I don't know how well I would do in that situation.
Speaker 1: No one as me, but I mean the idea of,
Speaker 1: you know, trying to help a kid and you've got
Speaker 1: someone in the way, I think must be very frustrating.
Speaker 3: And I think even when everyone agrees, you know, I
Speaker 3: always try to make sure, especially teenagers, they should have
Speaker 3: a voice and I want them to be in agreement
Speaker 3: with what we're planning on doing, even if they're not
Speaker 3: the one signing the forum. I think if you lose
Speaker 3: trust in your surgeon or in your physician, you're starting
Speaker 3: from a really bad place, and the possibility of everything
Speaker 3: going wrong from that point on is just huge. It
Speaker 3: really needs to be based on trust. So even when
Speaker 3: everyone's in agreement, I will always ask the kid as well,
Speaker 3: do you understand what we're doing? Do you want to
Speaker 3: do this? Is it's okay with you? You know you
Speaker 3: want to have that that trust and rapport.
Speaker 1: Well, you've got my vote, doctor, and I wish you
Speaker 1: continued success with kids who are well. Put up a
Speaker 1: link for everybody year as well if they want to
Speaker 1: know more about it or maybe help out where they
Speaker 1: can go to do that. Keep doing what you're doing,
Speaker 1: and it's a pleasure as always to talk to you.
Speaker 3: Thank you, thanks so much Craig for your time. I
Speaker 3: really appreciate it very by catch it