When I finished general surgery training I knew I wanted to be
a pediatric surgeon. During that training, I knew that I wanted
to focus mostly on fetal surgery.
I went to medical school after I did my PhD; it
was my interest in what I was studying scientifically that pushed me down this long road. I think
it’s always good for those surgeons just starting
their career to hear how people like you successfully conducted surgical research that led to clinical innovations. Did you always know you wanted
to become a surgeon, or is that something that
happened along the way?
My dad was a country doctor in a small town in the
state of Washington. I think I just always wanted to
be like him.
What about choosing pediatric surgery? Did this
area become an interest as you went into your
Yes. It is actually an interesting story because it
involves one of the other Jacobson recipients. W.
Hardy Hendren, MD, FACS, [2012 Jacobson Innovation Awardee] is a pediatric surgeon from Massachusetts General Hospital. I was a brand new, naive
intern, and my very first rotation was on his service
in pediatric surgery. I fell in love with it. I thought
it was amazing. Actually, an experience in that first
month of internship changed my whole life because
he operated on a child with a diaphragmatic hernia,
which was a beautiful operation. I got to sit with the
boy for the next day or so, and then he died, like most
of them do. That totally spurred my interest in [try-ing to fix complications] before birth.
When did you actually start engaging in scientific
I never considered myself a scientist. In those days,
When you finished your training, did you seek
you could take time after your first two years of train-
ing and do something else. I applied to the National
Institutes of Health (NIH) immunology lab and had
a great time for two years studying immunology.
That was my first exposure [to that kind of work],
and it was enriching. Afterward, I integrated my two
interests—pediatric surgery and the possibility of fetal
surgery—with a little bit of science and immunology.
The problem that really fascinated me and still hasn’t
been solved is why the mother doesn’t reject the fetus.
out a job that would allow you to incorporate
Absolutely. When I finished general surgery training I
knew I wanted to be a pediatric surgeon. During that
training, I knew that I wanted to focus mostly on fetal
surgery. It was the only job I would really consider,
so I looked around for institutions where this type of
surgery might be possible. That’s how I ended up in
San Francisco. It turns out that the pediatric surgeon,
cardiologists, and scientists were developing the fetal
lamb model to study congenital heart disease. I thought
that would be the way to do fetal repairs in the uterus.
That’s what we did. I came here, and we started operating on fetal lambs.
Were there a lot of naysayers at that time?
I often thought in retrospect that the circumstances
regarding this situation were incredibly lucky for
those involved. Well, part of it wasn’t luck because
we, my family, decided there were only two places
we could live along the west coast, and one of them
was San Francisco. It turned out to be incredibly fortunate that UCSF was developing this new field of
fetal surgery. They had incredible talent and the right
attitude. They were the new folks on the block. I have
often thought that I never could have done this or
developed this field in any really established center
like Harvard or Johns Hopkins [Baltimore, MD] or