In December 2004, when transplant surgeon Stephen Bartlett was acting chair of the University of Maryland Department of Surgery, he was faced with the ultimate test of his abilities—performing a kidney transplant on then-Dean of the Medical School, Donald Wilson, who, at the time, also happened to be Barlett's boss. No pressure.
"I was the acting chair, and he was the dean, and he needed a kidney transplant," says Bartlett, smiling at the memory. "Just before the case started, he said to me, 'Steve, this may be the shortest tenure for an acting chair in history, so you better get it right!'"
Of course, Bartlett not only passed the "test" with flying colors, he went on to become permanent Chairman of the Department of Surgery at the University of Maryland School of Medicine, and Chief of Surgery at the University of Maryland Medical Center. To date, Bartlett presides over one of the largest and finest transplant programs in the country and is regarded as a leader in the field of kidney and pancreas transplants, defining the immuno-suppression protocol in the 1990's that led to greater success in pancreas transplantation. Bartlett also expanded the living donor program, making the University of Maryland the first medical center in the world to perform 1,000 laparoscopic kidney removals from live donors in efforts to ease kidney shortage.
A general and vascular surgeon by training, Bartlett's foray into transplantation while still a student at Johns Hopkins University in the 70's was serendipitous. "The vast majority of students were pre-med," says Bartlett, a father of three. "Some admitted it. Some didn't, but a lot of them were really nervous about getting into medical school and complained enough about their nervousness to pester the dean of students to create more exposure to the medical school to get a leg up on other students. So they created these tutorials where you could have one-on-one experience with some of the doctors in the School of Medicine." As luck would have it, Bartlett had a conversation with a friend at the gym who raved about his tutorial with then-Hopkins transplant surgeon Melville Williams, a pioneer in the field of American transplantation. "Mel took us through a chapter a week in the textbook," recalls Bartlett, "and it concluded with us going into the operating room and watching him do a kidney transplant. After that, I was hooked."
Twenty-two years later, Bartlett is still a clinician, performing pancreas and kidney transplants two days a week in addition to supporting scores of University of Maryland medical students and surgical residents and recruiting surgeons to come to University of Maryland. He's particularly proud of two recent recruits—Austrian cardiac surgeon Johannes Bonatti, one of only a few physicians in the world performing fully robotic bypass surgery and a world expert in minimally invasive bypass surgery (even with no incisions), and Adrian Park, a renowned general surgeon known for his minimally invasive laparoscopic procedures in gastrointestinal surgery.
While Bartlett is credited with revitalizing the University of Maryland transplant program, he is happy to let his staff enjoy the limelight. "I've learned that the best way to be successful is to make the people around you successful," says Bartlett, who spends weekends with his brood at a family farm in West Virigina. "My father, Donald, was a Navy officer, and he told me, 'There are two ways you can lead—from behind with a whip, or in front with a flag. And when you go to officer school, you lead in front with a flag.'"
"Come see the room I play in," says pediatric anesthesiologist and pediatric intensive care physician Aaron Zuckerberg, as he proudly takes a visitor on a tour of his procedure room on the third floor of Sinai Hospital. Zuckerberg's "playroom" is a wall-to-wall shrine to SpongeBob Squarepants—from SpongeBob scrubs from Australia to a SpongeBob T-shirt from Israel to a SpongeBob whoopee cushion, lunchbox, Frisbee, Pez dispenser, Barbie, and kite. While many of Zuckerberg's pediatric patients are delighted by the space, truth be told, Zuckerberg is probably the biggest fan of the endearingly oddball animated character.
What's the appeal for Sinai's Director of Pediatric Critical Care Medicine? "You have these two guys, Patrick and SpongeBob, and they are doing the best they can with limited abilities," says Zuckberg, whose clients includes many critical-care patients, "but their intent is always good, even if things don't always work out, even if they are not treated well by some of the more despicable creatures in their lives. They are the half-full guys. I think that's why I like them so much. I'm always the half-full guy, too. When there's bad news to be told, I have no problem telling it, but stats are just stats. If there's a 90 percent chance you're not going to make it, you still have that 10 percent chance."
If Zuckerberg relates to the SpongeBob's sunny optimism, it's largely because the soft-spoken, diminutive doctor with an Inspector Gadget cell phone ring tone is a grownup kid himself. "I went into this field because it was obvious to me the best place for me was in taking care of children," says Zuckerberg who has three children of his own. "I like looking through the eyes of a 4-year-old."
As a child who suffered from migraine headaches, Zuckerberg recalls that his many visits to hospitals were often harrowing. "I had great doctors," recalls the Boston native, "but the experience wasn't always the best. I remember having a spinal tap and thinking the needle was longer than a baseball bat. Now, I see my job as figuring out what works for the kid as opposed to fitting the kid into what were trying to do. It's a contact sport. There is no insulation here. It's all about you and the kids."
As a result of his own experiences, Zuckerberg has also learned to soften the clinical experience for his patients by watching TV with them or having a syringe water fight before putting them under anesthesia. Even with his younger cases, Zuckerberg has been known to allow his patients to push their own medicine through the syringe to put themselves to sleep. "When kids and parents come into the hospital, they lose complete control," says Zuckerberg. "If there's any way I can give them back control, I do. I like to challenge dogma. Challenge authority. There are so many rules in medicine, why not?"
His unique approach has paid off. "Some of my patients are challenged children," says Zuckerberg. "I saw a young woman yesterday with developmental delay, cerebal palsy, and hypothyroidism, and she needs to have her blood work done every three months and the only way we get it done is by putting her to sleep. The first time she came in, I couldn't get her to lay in the bed or sit in a chair, so we sat on the floor and rocked, and I put her to sleep on the floor. [Two years later], she sits down on the chair next to me and gives me a hug, so it all worked out."
Zuckerberg seems to have learned as much from his patient's parents as his animated hero. "I am really humbled by the parents of many of my kids—parents whose children have rare or life-threatening diseases. They show an amazing ability to meet the challenge and move on and not to approach the world as if somebody or someone has given them the worst luck possible, but to actually look at the bright side. Every day I have an opportunity to be thankful for what I have and truly appreciate what these people go through."
If Debra Vachon is your colorectal surgeon, don't bother making scatological jokes or giving her a CD of the colorectal surgeon song that's been making the rounds on YouTube for several years now. "I've heard it all," says Vachon. "People e-mail things to me all the time. I've heard every joke in the book. And if I haven't heard it yet, someone will send it to me.'"
As Surgical Director of Mercy Medical Center's new Inflammatory Bowel Disease and Colon Rectal Center, Vachon has a spirited sense of humor about her chosen specialty which runs the gamut from giving colonoscopies and treating colon cancer and Chron's disease to treating hemorrhoids and anal fissures. "It wasn't like a lifelong dream to go into this line of work," says Vachon, who has been practicing for 18 years. "It wasn't like I was a little kid running around saying, 'I'm going to be a colorectal surgeon when I grow up,' because that would be really weird, and I don't know any little kids who say that."
While attending University of Maryland School of Medicine, the Frederick native first considered a career in internal medicine or pediatrics. "I did my surgery rotation first to get it over with, because I figured I wasn't going to like it," explains Vachon. "And I was surprised to find I liked it, but I thought I liked the surgery because I was so glad to be out of the classroom and actually seeing patients. I always ended up liking the colon operations so I decided to do extra training in that." So next she pursued a colorectal fellowship at the University of Medicine and Dentistry of New Jersey.
With her warm smile and mild manner, Vachon is perfectly suited to a profession in which many patients come through her doors nervous and embarrassed about their medical issues. "People come in here scared," says Vachon. "They think they have some body part the rest of us don't have and are afraid to talk about it. I tell them, 'You're probably not going to tell me anything I haven't heard before.' If I can lower their anxiety by really spending time talking with them, I find it very gratifying." And when her patients are on the mend, the most common response she hears: "They tell me, 'Nothing personal, but I never want to see you again,'" she says with a laugh. "I have thousands of patients who never want to see me again, and that's fine—I have a thick skin."
Not to mention a head firmly planted on her shoulders. "If you start getting all impressed with yourself that things aren't going to go wrong, no matter how hard you try, no matter what you do, things do go wrong," says Vachon. "When you hear about someone's patient having a complication, instead of saying, 'That's horrible, how can they do that?', you recognize bad stuff happens to everyone's patients, even under the best of circumstances. You always have to keep your feet on the ground and recognize you're not some superhuman."
Vachon is equally gratified by her role as a mother to 7-year-old son Gregory, whose photos are displayed all over her desk and office windowsill. "I have two full-time jobs that I love—being a mom and being a doctor—and they don't always mesh with one another," says Vachon, who sometimes puts in 70-hour work weeks, "but I love being a mom and being able to have a career that I enjoy doing every day is a great blessing. My parents didn't say, 'We want you to go to med school.' They said, 'You're the one who has to do it, so find what will make you happy and do it, and that's what I did.'"
As a reproductive endocrinologist, Jairo Garcia is accustomed to treating female patients from all over the globe, but seeing a 17-year-old boy on his patient schedule surprised him. "I thought, 'What's he going to do here?'" recalls Garcia, a world-renowned expert in his field who trained at the University of Antioquia in his native Colombia. "Then he introduced himself and said, 'I'm sorry, but I couldn't find any other way to do this—you helped my parents, and I am the product of that in vitro cycle. I have a school assignment, and my teacher asked me to talk about some aspect of reproduction for my biology class, so I came here to invite you to my classroom.' "
Of course, Garcia, Director of the In-Vitro Fertilization Program at Johns Hopkins Fertility Center and Associate Professor of Obstetrics at Johns Hopkins University School of Medicine, was more than happy to oblige. "Whenever I have the chance to educate, I will," says Garcia, who also established the IVF Program and Fertility Center at Greater Baltimore Medical Center. "It was an opportunity not only to teach these high school kids about reproduction and the fascination with life, but an opportunity to talk about how responsible you have to be."
Garcia has been teaching throughout his celebrated 30-year career and knows the difference a mentor can make. He himself trained with the best and the brightest. In 1979, as the protégé of the internationally renowned Dr. Georganna Seegar Jones and her husband, Dr. Howard Jones, at Johns Hopkins Hospital, Garcia joined the pioneering team at Norfolk's Eastern Virginia Medical School to develop the first IVF clinic in the United States. "At first, it was difficult to get training in such a field," says Garcia. "In the seventies, such a field did not exist, and I was lucky enough to find this magnificent pioneering couple."
To date, Garcia carries on the Jones' legacy as a pioneer in ovulation induction and has helped establish more than 50 IVF clinics throughout the world, from Japan to Spain to Argentina. Despite participating in more than 19,000 IVF trials (resulting in between 6,000 and 7,000 births), Garcia remains deeply connected to every one of his patients.
"For me, all the patients are very special," says Garcia, who recounts the story of one couple who ate hot dogs and lived in a trailer to save money for IVF, which wasn't covered by their health insurance at the time. "I really get very much involved with them. I could have five positive results and one negative, and I'm still down because I know how much effort—economically, mentally, and physically—those patients have been through. I have three children myself, and I know the joy they bring to my life and my wife. It is very hard for a couple that wants to have children to not have that opportunity. I am very sympathetic to the cause."
Garcia also feels it's his job to staunchly defend the rights of the unborn. "We as reproductive endocrinologists are in a unique position," he says. "We don't have two patients, we have three. I am careful to discuss with my patients that bringing a child into a relationship to cement that relationship doesn't work. Sometimes I have to tell them they need to work on issues themselves before having a child. A child will not solve problems."
The good doctor is also known for dispensing healthy doses of optimism when his patients feel defeat. "I try to find a solution to problems, and, therefore, many of my patients are the ones no one wants to see. I struggle with my patients, and I help them succeed. Having the opportunity to see a single cell unite with a sperm that turns into an embryo and a fetus and then a baby is just so magnificent to see."
After 32 years of working in the emergency room at St. Joseph Medical Center, Timothy Bessent is the quintessence of calm when it comes to handling myocardial infarctions, compound fractures, diabetic seizures, and baby deliveries (even out of a Miata in the St. Joseph's parking lot, of all places). Ironically, it's being singled out for our Top Docs issue that makes him squirm.
"Doing publicity is just not in his nature," says St. Joseph media relations manager Vivienne Stearns-Elliott. In fact, when Bessent's 34-year-old daughter, Alexandra Bessent Enright, worked as a producer at Channel 13, Bessent was known to turn the station down for interviews unless it was his daughter making the requests. "One time during a snowstorm, I was desperate and needed a doctor to interview. I was like, 'Please, will you do this for me, Dad?' and he said, 'Okay, but just for you.' He doesn't seek the limelight."
As a young boy growing up in the Original Northwood section of Baltimore, Bessent always knew medicine would be his calling. "I didn't think of anything else," says Bessent, who attended University of Maryland School of Medicine and completed his residency in internal medicine at UMD as well. "I always knew I wanted to be a physician," he says.
With his calm, unflappable nature, love of challenge, and interest in drawing from different disciplines of medicine, Bessent thrives in the ER. "In any other specialty, the physician knows what he's dealing with—the cardiologist is going to see a patient with shortness of breath, the hand surgeon will see upper extremity issues. One minute I can be an OB doc, the next moment I can be a cardiologist, the third moment I can be a psychiatrist. Each patient is a new case and a new opportunity."
Bessent's group, Osler Drive Emergency Physicians (ODEPA), a private practice that works exclusively at St. Joseph Medical Center (and, after 41 years, is the oldest emergency medicine group continuously operating at one institution in the country), grew out of a need to provide consistency, continuity, and better quality care for emergency room patients and doctors alike. "Traditionally, the least experienced emergency physicians were on the front lines," says Bessent. "They essentially had no backup and no experience. I can remember at University, I was put in the ER in my first rotation out of medical school, and the fellow who ran University basically said, 'I'm not your wet nurse—I don't want to hear anything from you guys unless your patient needs admitting to the hospital.' It was truly a baptism by fire."
Through the years, there have been some surprising emergencies even in a work environment where the only sure thing is to expect the unexpected. "Back in the 70's, one young nurse's diamond fell out of her ring, and we literally closed the ER," recalls Bessent with a laugh. "We didn't take that long, but everyone got down on the floor and the ER stayed closed for a few minutes until we found the diamond."
Bessent's own family, including wife Peggy (Bryn Mawr School's associate headmistress), two grown children, and two grandsons, provide the sparkle in his life. In his spare time, Bessent spends time at the Eastern Shore and gardens in his Homeland backyard. One activity that's off limits: watching NBC's "ER." "Since I work every Thursday evening, I don't think I've seen it more than once or twice," he says of the Emmy-award winning show now in its 14th season. "And unlike the way it is on TV shows, we don't meet our patients at the ambulance in the parking lot. We wait for them to come through the emergency room doors."
Stacy Fisher's autobiography is on the walls of her fifth-floor office at the Woodholme Medical Building in Pikesville. There is the obligatory wall of impressive credentials—diplomas, degrees, and certificates from the University of Maryland School of Medicine, a residency in Internal Medicine at Duke University Medical Hospital, and a cardiology fellowship at University of Rochester Medical Center where she also worked as Chief Cardiology Fellow. Another wall is decorated with plaques honoring her teaching at Sinai Hospital where she was awarded the Golden Apple Teaching Award four years in a row, while her windowsill and desk are littered with family photographs of sons, Ryan, 5, and Michael, 8.
But perhaps the most telling piece of her story is the 20-gallon tank with a single oversized goldfish that once belonged to a patient.
"This goldfish belonged to a patient who died two years ago trying to get a high-risk heart transplant" says Fisher, who is in private practice with Midatlantic Cardiovascular Associates, Director of Women's Cardiovascular Services at Sinai Hospital, and Co-Director of Sinai's Cardiac Critical Care Unit. "He died at Columbia University because he was not a candidate for getting a heart transplant at Maryland or Hopkins, but he was my primary patient, and he was able to live to 37 with an incredibly tough structural problem. Before the transplant, the patient said he had everything covered for transplant except for the fish. So I said, 'Fine we'll take the fish.' His dad showed up the next day with the tank. I thought he was kidding, but he wasn't. Now, I think of that patient every day."
While Fisher is known for her excellent clinical skills, it's her compassion and willingness to go above and beyond the call of duty that most distinguishes her. And it's a credo she tries to pass on to the 115 medical residents at Sinai Hospital she has mentored over the past seven years.
"I want to help guide physicians that I would want taking care of me," says Fisher. "I want the young physicians to take the responsibilities that I had to take, that the people before me had to take, that the system may not require. I want them to really understand what they need to do to take care of people and to get them through critical times."
Growing up in Silver Spring with dreams of being a doctor, Fisher encountered resistance in her passion for medicine. "My Dad always told me that women didn't belong in medicine," she says, "and they weren't paying for medical school, so I did things to make sure I really wanted to pursue that route." At 16, she worked two jobs—as a lab assistant at the National Institute of Mental Health doing electroconvulsive therapy on rats, and as a waitress at Chi Chi's Mexican restaurant. "I worked at Chi Chis so I could keep the car and pay for gas," she says with a laugh. "And I spilled a margarita on someone on New Year's, which they took very poorly." A job in a fruit-juice lab at the Environmental Protection Agency led to other adventures. "We tested fruit juice to see if it was tainted with lemonade or tangerine or really had the fruit they said it did," recalls Fisher. "We would buy fruit juice at different area grocery stores and test it, and whatever we didn't open, I would bring home to drink. My parents would open the refrigerator and find orange juice with lab numbers on it and get very upset."
As for her own sons and their potential career aspirations? "I want them to go to work and be happy every day," says Fisher. "I don't care what they do, but I want them to feel at the end of the day they are happy with themselves, and they made a difference."
When Union Memorial hand surgeon Peter Innis isn't treating patients with trigger finger and tennis elbow or performing replants, he can be found building stone walls on his 10-acre horse farm in Northern Baltimore County. "I used to work construction every summer because my Dad did construction," says the Boston-born Innis. "I started sweeping parking lots for 25 cents an hour in some of the parking plazas where my Dad did construction and then worked construction all through college. One summer, I worked with just the stone masons and brick layers and fixed cement and moved rocks. Another summer, I did landscaping, and another summer I got to do finish work with cabinetry."
While Innis considered a career in construction, his father, Richard, had different ideas. "I had always done well in school," says Innis, "and my Dad tried to talk me out of it. His workers said, 'This may seem fun in the summer, but when it's 30 degrees outside in the winter, there are ways to make a living with your head instead of your hands.' "
Of course, as an orthopaedic surgeon who specializes in hand surgery with Lutherville's Greater Chesapeake Hand Specialists, Chief of Union Memorial Hospital's Medical Staff, and former President of the Maryland Orthopaedic Association, Innis uses both head and hands. His background in construction (not to mention a medical degree and residency from Johns Hopkins University School of Medicine) has proven the perfect preparation for a career in hand surgery. "I tell my patients I'm just a well-paid carpenter, especially some of the circulation stuff we do with replants and revascs," says Innis. "It's just fancy plumbing. A good auto mechanic or electrician or finish carpenter who does gorgeous cabinetry work can have the same skill set as most surgeons."
Innis was first drawn to the intricacies of hand surgery while researching at Hopkins during his residency. "I was doing research in the rat lab," recalls Innis, "and we were doing leg transplants on rats. I realized then I liked the smaller stuff—kind of like watch-making rather than the hammer-and-chisel work of orthopaedics. I also like the approach where people come in, they're broken, you fix them, and then they're better."
After 18 years in practice, Innis's favorite cases have also been the most challenging. "I recently saw a kid I took care of when he was one year old, and he's now about 15," says Innis. "He was born with just a thumb and short nubbins for his other fingers. I took a bone out of his toe, and put it in each of the little skin sleeves, waited until they grew some and then lengthened them out. With a second operation, I cut the bones and slowly stretched them out so that ultimately, although he didn't have joints, he had fingers long enough to hold the handlebars of his bike. He came back recently for something minor, and it was so neat to see how well he was doing."
With wife Katie, daughter Angelina,17, and son Christopher, 14, Innis spends his days off shoveling manure and clearing trails for his children to ride their three horses and assorted four-wheelers. "I have no patience for golf," says Innis, who drives a white Ford F 250 pickup truck with a bumper sticker reading, "A golf course is just a waste of pasture land."
The biggest challenge of all? Balancing his professional and personal life. "A lot of us have a tendency to check off the list of what we've accomplished, and, too often, it's related to work and not just spending time on relationships," says Innis. "I meet a lot of people who come through training, and I tell my wife, 'I don't care if they're smart, I don't care if they have great hands, I want them to care about people."