Please read our latest Surgical Log. We feature an alumni story in every issue.
Darren Malinoski, M.D., F.A.C.S.
"I feel as if I have found the right balance between clinical, academic, administrative, and family activities and that this is the best job I have ever had."
My family and I returned to Portland last June and we could not be happier to be back! The timing was perfect, as our children were about to start school and my wife, Sehra Sampson, M.D., and I had just found ideal jobs; Sehra joined the Emergency Medicine groups at OHSU and Providence Milwaukee and I was helping to launch a new Section of Surgical Critical Care at the Portland VA Medical Center, with the opportunity to also work with the Trauma Division at OHSU.
My path towards an academic and administrative career in surgical critical care and trauma was an interesting one, for it wasn't what I had planned when I set out on the general surgery residency interview trail. During my first year of medical school in Chicago, while I was walking up hill in the snow both ways to and from class, I figured that I wanted to be a pediatric cardiologist, for I had always enjoyed working with kids and I loved cardiac physiology. Two years later, I had just finished my third-year surgery rotation and I was home for Thanksgiving visiting my family, trying to explain to them how it felt to be in the operating room, suturing wounds, and holding the heart during a CABG. I felt a sense of pride when I was able to answer questions on the ward and in the operating room and was then rewarded with more responsibility assisting on cases and seeing patients by myself. It was then that I realized that I wanted, or "needed", to be a surgeon.
After two years of residency at OHSU, I had enjoyed working with Mark Silen, M.D. and Marvin Harrison, M.D. on the Pediatric Surgery Service and had two things drilled into my brain: "You get two points for a colostomy takedown" and "Don't eat the green jello." I still smile when I remember hearing these phrases on rounds… every day… for six weeks! I had learned a lot about surgery, medicine, and life from many attendings from all over town. I also discovered what made me tick, what motivated me, and the page that I was always excited to receive, no matter what time it was – "Level 1 trauma, GSW abdomen, eta 10 minutes." So, I did research with Richard Mullins, M.D. and Martin Schreiber, M.D. and pursued a trauma/critical care fellowship at LA County/USC.
My first job out of training was at UC Irvine and I received some guidance from my Chairman, David Hoyt, M.D., "if you are going to spend time on something, write about it." This proved to be sage advice, as I have been able to turn several quality improvement projects into research papers and presentations. This is especially true about organ donation, a field to which I was exposed during my fellowship and wound up dedicating a significant amount of time throughout my career. It is not something I ever contemplated as a student or resident, yet it became the focus of my academic career.
It is hard to know what kind of job you want until you've had one, or two, or several. It can also be challenging to know what makes you happy until you have lived life and matured beyond school and training. I can happily say that after having worked at two other medical centers, explored various research fields, and started a family, I feel as if I have found the right balance between clinical, academic, administrative, and family activities and that this is the best job I have ever had. My career has not taken the path that I anticipated and the piece of advice that I would give to others who are contemplating their future is to be open to discovering what really motivates you and contributes to your happiness, because it may not be what you originally thought.
Steven Mills, M.D.
"I certainly have a unique point of view… I'm a colorectal surgeon."
Too bad I don't get a dollar every time a patient asks, "How did you pick this line of work?" I can answer with a joke about seeing a sign for 18 holes-a-day and being surprised that I didn't need golf clubs. Or, I mention that whoever finishes at the bottom of the class has to stay at the bottom. But the real answer is that I chose this specialty because it gives me the opportunity to cure colon cancer with surgery alone or to relieve the unbearable pain of an anal fissure in a patient who was at first too embarrassed to even talk about the problem. Of course, I could certainly mention that my OHSU mentors (notably Karen Deveney, M.D., Mark Whiteford, M.D. and Dave Parsons, M.D.) influenced me and showed me the light in a dark hole… Dr. Deveney even referred to my year of residents as the "terrible twos" during our second year – thus demonstrating to me subtle encouragement (you were just kidding, right??).
After completing my training at OHSU and fellowship at USC, I started working at the University of California, Irvine. As a fellowship program director and the medical student clerkship director, I have found that I have a great opportunity to repay my fantastic mentors by emulating them. I enjoy watching the metamorphosis from eager, though somewhat frightened, medical student to someone who we are recruiting for our general surgery residency, and then to a surgeon I am counseling (brain-washing) about a career in colorectal surgery. Being in this position has shown me just how fortunate I was to be trained at OHSU and just how tolerant everyone was during my training.
I have learned to balance a surgical career with real life. I got married during my 4th year of residency (a choice which I still rank as my all-time best!). We have 2 beautiful daughters and I make every effort to balance patient care and bedtime stories. I still live a surgeon's life, but refuse to have a traditional surgeon's lifestyle. We regularly go camping or and enjoy traveling around the globe. I love being able to see the world through young eyes; everything is exciting and new – whether it is hearing a Coqui frog in Puerto Rico, or seeing a stingray in Baja. Watching a 4 and 6 year-old zip line through Costa Rica together can be terrifying until you hear their giddy laughter. Indeed, that laughter and the big hugs I get every day make it all worthwhile.
To the students who ask me where I would recommend doing surgery residency, I always wax poetic and reminisce about a great half-decade in Portland at OHSU – forming such strong friendships and making fantastic memories. I could fill pages and pages with stories and quotes, though much of it would have to be censored due to content and to protect the identity of both the innocent and guilty. In truth, though we worked very long hours and were often exhausted, what I remember most is the fun we had doing the job we had competed for (and won!), the friendships that we forged and which are still strong today, and the awesome experience that is a surgical residency. Great training makes great physicians – we are all fortunate to have been trained by the best!
Elisa Burgess, M.D.
"Just when I think that I am truly a surface surgeon, I crave a good general surgery case and the smell of the abdomen."
If asked if I would do my general surgery training over again….I would have to answer "yes," especially if it were during the same period of my life. I have never had so much fun, combined with intellectual and personal growth. I started as a general surgery intern at UCSF and I can still smell the ER at San Francisco General. I feel as though I was following in the footsteps of those mentors that I love so dearly, Karen and Cliff Deveney and of course Donald Trunkey, M.D. My journey back to Oregon, allowed me to be molded by the OHSU general surgery program and my beloved mentors. I finished in general surgery with my fellow 7 male residents and one child. My son was strategically planned during a research year. The few hours that I slept in the hospital were more than I was getting at home with my child. Maybe the sleep deprivation only allows me to remember the good times in residency.
Regardless, I continued on to become a plastic surgeon, or as Richard Mullins, M.D. would say, "A surface surgeon". The challenges and 3-dimensionality of reconstructive surgery drew me to this field, along with the encouragement of Juliana Hansen, M.D. I have now been in practice for eleven years with a mix of both cosmetic and reconstructive surgery. In fact, these fields are not mutually exclusive and do complement one another in technique. I have a significant breast cancer reconstructive practice and we do Race for the Cure with our patients every year. Our group has easily grown to over 100 people. My mission is to educate the public on their breast cancer reconstructive options. Many do not know about the federal law that mandates coverage for breast cancer reconstruction if an insurance company pays for mastectomy.
As I enter a new phase in my life, I now have two teenage children and have been married to my orthopedic husband for 20 years. We have enjoyed hosting foreign exchange students and traveling abroad. Our next trip will be to Ecuador, where my husband and I will undertake our first medical mission trip in January 2013.
Just when I think that I am truly a surface surgeon, I crave a good general surgery case and the smell of the abdomen. I thought about giving up my board certification in general surgery and just keeping the plastic surgery certification, but in the end I couldn't give up all those great general surgery years. So I recertified in general surgery and have enjoyed the anatomy lab dissection with the medical students. I am thankful for my opportunities at OHSU and for the people that have truly changed my life.