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