Trauma Program to Participate in Department of Defense-Funded Study That Explores Prehospital Whole Blood Administration in Trauma Patients

The Type O Whole blood and assessment of AGE during prehospital Resuscitation (TOWAR) Trial is designed to better understand the intricacies of giving whole blood— blood that is not separated into its components—to trauma patients while they are in a helicopter on the way to the hospital.

When someone donates blood, typically it gets separated it into parts—red cells, plasma, platelets—for long term storage and the parts can be used individually depending on patient need. But when someone is bleeding, they’re losing all of these parts. Trauma research has shown that if you leave these parts together and not separate them it can be beneficial to trauma patients or patients at risk of bleeding.

The whole blood used in the TOWAR study is low titer blood, meaning it contains low levels of antibodies and can be transfused to people of various blood types. Giving whole blood transfusions to trauma patients before they even arrive at the hospital could potentially provide better outcomes and reduce the risk of death and other problems.

The multi-center trial is funded by the U.S. Department of Defense. Dr. Brian Harbrecht, Professor of Surgery in the Department of Surgery at UofL and Director of Trauma Surgery at UofL Hospital will lead UofL's participation in a Department of Defense (DOD)-funded clinical trial.

The purpose of the trial is to answer three key questions:

• Does giving trauma patients whole blood in a prehospital environment improve survival outcomes at 30 days when compared to plasma, red blood cells or nothing at all?
• Does the age of whole blood impact patient survival rates?
• Does administering whole blood provide overall benefit to patients upon evaluation and arrival to the hospital?

The four-year study will use randomly selected trauma patients enrolled from emergency calls, but patients will be able to opt out of the trial in advance by calling 1-800-664-0557 or using the contact form on the LITES website.

The results of this study have the potential to change the way prehospital trauma care is provided,” said Harbrecht said. “If we can determine that whole blood is safe and effective for trauma patients during transport, we can improve the outcomes of these patients even before they arrive at the hospital.”

FACULTY SPOTLIGHT
Christopher Jones, MD
Division Director, Division of Transplantation and Associate Professor of Surgery
Medical Director, Trager Transplant Center

This article first appeared in the 2017 issue of Sutureline.

Christopher Jones, MD, decided to become a doctor because growing up, he did not see many people who resembled him in the medical community.

"There were African-American nurses, respiratory therapists and other medical technicians but no physicians," he said. "When I expressed my concern to my father, he took me to visit Eastern Virginia Medical School, where he introduced me to Dr. L.D. Britt. That meeting was life-changing for me. Soon thereafter I knew I wanted to be a surgeon just like Dr. Britt."

Dr. Jones attended medical school at Georgetown University, trained in general surgery at Vanderbilt University and completed a fellowship in adult and pediatric liver, kidney, pancreas and small intestine transplantation at UCLA, the nation’s premier transplant program.

"We were fortunate to recruit him to the University of Louisville where he has risen to the rank of Director of the Division of Transplantation," said Kelly McMasters, MD, PhD, Chairman of the Department of Surgery and Professor of Surgery. "Transplantation is enormously complex and multidisciplinary. It involves outstanding executive leadership skills and management across a wide array of clinical, business and regulatory environments. Dr. Jones has done a tremendous job for our program."

Dr. Jones chose to become a transplant surgeon in honor of a very special friend, Rose. When he was younger, he and his brother played with Rose every weekend when they visited their grandmother’s house, and she became like a sister to him. One weekend, when he was visiting, he saw an ambulance at Rose’s house.

"I can vividly remember Rose being wheeled out of her house on a stretcher, and the EMT saying to his partner ‘she needs a liver transplant, but she probably ain’t going to get one,’" Dr. Jones recalled.

Unfortunately, that was the last time Dr. Jones saw Rose alive, but at her funeral on December 4, 1982 he told her parents that he would never let anyone die that needed a liver transplant.

"It was at that moment that I dedicated my life to being a liver transplant surgeon," Dr. Jones said. "Each day I come to work I try to keep my promise to Rose’s parents."

Dr. Jones said his favorite part of his job is operating on patients and seeing them at their first post-operative appointment.

"Patients feel 100 times better after they receive their organ, and they are anxious to show us things they couldn’t do before," he said. "It’s a good feeling."

He said his least favorite part of his job is not being able to perform a transplant on everyone who needs one. Patients are not candidates for transplantation for three main reasons: insurmountable psychosocial issues, poor medical condition and financial issues.

"I can accept psychosocial issues and poor medical condition, but financial issues shouldn’t be a reason we don’t save a life. I would like to eradicate financial issues as being a barrier to receiving a life-saving organ transplant," he said. "To that end I am working with local and regional philanthropists to help shore up our patient assistance fund. I am also working with the United Network for Organ Sharing (UNOS) to develop more overarching plans to remove finances as a barrier."

When he is not working, Dr. Jones enjoys spending time with his family. His children are in multiple sports, and he can be seen cheering from the sidelines when he is not at the hospital. He also enjoys fishing.

"There’s something about the serenity that comes with fishing that you can’t find anywhere else. It gives my mind a break from all of the hustle and bustle of daily life," he said. "It is very cathartic for me, and it allows me to reset and focus on the important things." He enjoys taking his family to Cape Hatteras in North Carolina for vacation.

"It’s a special place for me because that’s where my dad would always take me and my brother for our ‘weekend for men.’ I only recently found out that my dad was giving my mother a break from us when we took our trips," he said. "I learned a lot on those weekend trips. The small house we stayed in had no special accommodations, not even a television. Needless to say, we did a lot of talking. My father was a minister so he could definitely talk, but he was a good teacher too. I think spending that time with my dad is what molded me into the person I am today."

Celebration of Life and Career of Dr. J. David Richardson - November 19, 2021

On Friday, November 19th at 7:00 am, the Department of Surgery will be hosting a Celebration of Dr. J. David Richardson's Life and Career.

You can participate in the virtual event via Bluejeans.

Below is the schedule of events.

	Dr. J. David Richardson A Celebration of His Life and Career Schedule of Events Friday, November 19, 2021 7:00 am – 10:00 am EST
7:00 am – 7:30 am	Opening Remarks and Special Announcements Kelly M. McMasters, M.D., Ph.D. Ben A. Reid, Sr. Professor and Chair The Hiram C. Polk, Jr., M.D. Department of Surgery, University of Louisville Hiram C. Polk, Jr., M.D. Professor of Surgery Ben A. Reid Sr. Professor and Chair of Surgery, Emeritus The Hiram C. Polk, Jr., M.D. Department of Surgery, University of Louisville Toni M. Ganzel, M.D Dean, University of Louisville School of Medicine Tom Miller CEO, UofL Health
7:30 am – 7:45 am	Dr. J. David Richardson and his contributions to the American College of Surgeons Patricia L. Turner, M.D. Executive Director-Elect, American College of Surgeons, Chicago David B. Hoyt, M.D. Executive Director, American College of Surgeons, Chicago
7:45 am – 8:10 am	J. David Richardson: A Biography R. Philip Burns, M.D. Professor and Chair of Surgery University of Tennessee, Chattanooga
8:10 am – 8:30 am	Changes in the Management of Injuries to the Liver and Spleen David V. Feliciano, M.D. Clinical Professor of Surgery University of Maryland Medical Center, Baltimore
8:30 am – 8:45 am	First Rib Fracture: A Hallmark of Severe Trauma Lewis M. Flint, Jr. M.D. Editor-in-Chief, Selected Readings in General Surgery Division of Education, American College of Surgeons, Chicago
8:45 am – 9:00 am	Pulmonary Disability Following Blunt Chest Trauma David H. Livingston, M.D. Professor and Chief, Trauma Division Rutgers New Jersey Medical School, Newark
9:00 am – 9:15 am	Will Future Surgeons Be Interested in Trauma Care? Results of a Resident Survey David A. Spain, M.D. Professor and Chief, Acute Care Surgery Stanford University
9:15 am – 9:30 am	Interventional Techniques Are Useful Adjuncts in Nonoperative Management of Hepatic Injuries Eddy H. Carrillo, M.D. Associate Medical Director, Trauma Services Program Program Director, General Surgery Residency Program Memorial Healthcare System, Hollywood, Florida
9:30 am – 9:45 am	Reevaluation of Diagnostic Procedures for Transmediastinal Gunshot Wounds Nicole A. Stassen, M.D. Professor and Director of Surgical Critical Care Fellowship Program University of Rochester Medical Center
9:45 am – 10:00 am	Closing Remarks

Department of Surgery Mourns the Loss of Dr. J. David Richardson

It is with a heavy heart that we share the news that Dr. J. David Richardson passed away this morning surrounded by family. He was 76 years old.

A general, thoracic and trauma surgeon, and surgical educator, Dr. Richardson enjoyed a distinguished career as a surgeon and educator in the Department of Surgery for more than 30 years and served as Vice Chairman of the Department for more than two decades. In addition, he served as Chief of Surgery at University of Louisville Hospital since 2005. He has served as Program Director for the General Surgery Residency Program at the University of Louisville and in numerous leadership roles on a local, state and national level, including serving as the 96th President of the American College of Surgeons. He lectured throughout the country and across the globe.

In addition to treating the most difficult patients with great skill and compassion, Richardson has spent a lifetime constantly striving to discover and deliver the latest, most effective treatments. One of the best-known and most respected leaders in American Surgery who made enormous contributions on a national level Dr. Richardson published more than 375 scientific articles and book chapters. In fact, over the past several decades he was instrumental in setting standard protocols and approaches to treatment that now are used in trauma centers all over the country. He has touched the lives of innumerable patients, trainees and students – many of whom stayed in touch with him on a regular basis.

Dr. Richardson has left an indelible impression on the lives our staff, faculty, residents, students and alumni. We will share additional information related to services and a memorial in his honor at a later date.

Beloved Department Ambassador Debbie Krause Retires

Debbie Krause, cherished Department of Surgery senior coordinator for the past 47 years, retires today, January 8th. During her tenure with the Department, Debbie has completed a broad range of tasks in service to the University of Louisville with the greatest loyalty, professionalism, competence and grace.

The heart and soul of the Department, Debbie exemplifies the excellence we strive to achieve in the Department. Throughout the course of her career, Debbie has always paid meticulous attention to detail and planned well in advance for every possible contingency. She has been the consummate ambassador for the University, as she has been our liaison with countless other institutions and leaders in American Medicine and Surgery.

Debbie joined the Department of Surgery in 1974 as a receptionist. Her role grew over the years. Debbie coordinated Grand Rounds, visiting lectureships, the annual Chief Residents’ Graduation Dinner, retirement celebrations, and memorial services. She also organized the Louisville Surgical Society and the Hiram C. Polk, Jr., MD, Surgical Society and always helped out anywhere else she is needed.

Debbie exudes warmth for our medical students and residents, as well as faculty and co-workers. She remembers the names of their spouses and children, as well as special details about each and every one of them. For her role in coordinating our visiting lectureships and Grand Rounds programs, Debbie was the perfect host and continually receives letters of praise from visiting professors and their staff.

In 2018, Debbie received the inaugural University of Louisville School of Medicine Dean’s Lifetime Achievement Award, which was created by School of Medicine Dean Toni Ganzel, MD, as a special recognition for employees who have served the school with excellence for many years.

A heartfelt congratulations to Debbie on your retirement. We will miss you tremendously and wish you all the best in this next chapter of your life.

Chair of Department Named President of the Southern Surgical Association

Dr. Kelly McMasters has been named president of the Southern Surgical Association, one of the nation's leading surgical societies dedicated to furthering the study and practice of surgery. Dr. McMasters previously served a five-year term as secretary of the Southern Surgical Association.

Dr. Falcone Recognized for His Commitment to Medical Education

A champion of medical education and a patient advocate, clinical faculty member John L. Falcone, MD, MS, was recently recognized for his tremendous contributions as a surgical educator with the Association for Surgical Education Linnea Hauge, PhD Promising Educational Scholar Award. In addition, he has been selected to receive a University of Louisville Gratis Faculty Teaching Award.

At the University of Louisville Department of Surgery, Dr. Falcone has been an integral part of our teaching faculty in the community rotation at Owensboro, KY. The hospital in Owensboro has a regular rotation of general surgical residents who are actively mentored and trained in a comprehensive, community surgical experience. As many academic institutions now lack a meaningful community hospital rotation, Dr. Falcone's leadership of that program has been invaluable to the education of our surgical residents. His teaching evaluations from both the medical students who participate in that rotation as well as our surgical residents are always excellent.

Department Bids Farewell to Faithful Employee

Beloved former Department of Surgery employee John Edward McKiernan, Jr. passed away Friday, March 1, 2019. He was 78.

A graduate of Flaget High School class of 1958 and Western Kentucky University, John was a proud U.S. Navy veteran and long-time member of St. Barnabas parish.

In the late 1960s John taught commercial business at Seneca, Fairdale, Western and Southern high Schools. He was employed for 20 years at the L&N Railroad and later at the Kentucky Center for the Performing Arts Broadway Series. He retired from the University of Louisville Department of Surgery in 2009 after 12 years of service.

A seasoned world traveler, he was loved and remembered for his passion for dancing, Frank Sinatra music, his larger-than-life personality and generous heart. He possessed a natural gift for conversation and was interested in everyone who crossed his path. In his Flaget days he was the jitterbug king at just about every Catholic teen club in Louisville. He was especially proud of his Irish Catholic heritage and was admired and adored by everyone.

At John's request, expressions of sympathy may be made to Presentation Academy Development Office, 861 South Fourth Street, Louisville, KY 40202.

Department Coordinator Debbie Krause Wins Lifetime Achievement Award

Debbie Krause, Department of Surgery coordinator, received the inaugural Dean's Lifetime Achievement Award at the UofL School of Medicine Dean's Appreciation Reception, Nov. 13. The Dean's Lifetime Achievement Award was created by School of Medicine Dean Toni Ganzel, MD, as a special recognition for employees who have served the school with excellence for many years. Debbie has worked for the Department of Surgery for nearly 45 years. During her tenure, she has completed a variety of tasks in service to UofL with the greatest loyalty, professionalism, competence and grace.

"Debbie exemplifies the excellence we strive to achieve in the department. Throughout the course of her career, Debbie has always paid meticulous attention to detail and plans well in advance for every possible contingency. She is the consummate ambassador for the University, as she is our liaison with countless other institutions and leaders in American medicine and surgery," said Kelly McMasters, MD, PhD, Chair of the Department of Surgery. "She exudes warmth for our medical students and residents, as well as new and veteran faculty and co-workers. She remembers the names of their spouses and children, as well as special details about each and every one of them. For her role in coordinating our visiting lectureships and grand rounds programs, Debbie is the perfect host and continually receives letters of praise from visiting professors and their staff."

Surgery Chair Addresses Diversity and Sexual Harassment at National Meeting

This year's Society of Surgical Chairs meeting focused on two important topics: Diversity, Equity & Inclusion and Sexual Harassment & Misconduct. Department of Surgery Chair Dr. Kelly McMasters served as president of the Society of Surgical Chairs and organized this year's meeting.

Diversity, equity and inclusion don't happen by accident; a deliberate approach is needed. Similarly, creating an environment that diminishes the likelihood of sexual harassment and misconduct requires leadership, education and communication," Dr. McMasters said. "As the leaders in American surgery, it is important for the Society of Surgical Chairs to engage in ongoing conversations about these issues.

Dr. Mohan Rao Receives Faculty Excellence Award

Dr. Mohan Rao is the recipient of UofL School of Medicine's 2019 Faculty Excellence Award for Outstanding Education by Gratis Faculty.

Dr. Rao completed his General Surgery residency at the University of Louisville and has enjoyed a distinguished career as a general and critical care surgeon. He is a master surgeon with the heart of a teacher and has demonstrated exceptional loyalty and commitment to the University of Louisville School of Medicine.

For decades, Dr. Rao has been the most popular and effective educator in our student teaching program - all as a gratis faculty member. Our general surgery residents also rotate at Madisonville under Dr. Rao's mentorship, and he has truly influenced many to enter into careers in rural general surgery.

Dr. Rao puts forth extraordinary effort to make our student and resident teaching programs better in every way and is truly deserving of this award.

UofL Department of Surgery Announces First Patient Enrolled in NanoKnife® DIRECT Clinical Study for the Treatment of Stage III Pancreatic Cancer

University of Louisville Department of Surgery recently announced enrollment of the first patient in AngioDynamics’ NanoKnife® Irreversible Electroporation (IRE) "Data IRECancer Treatment” clinical study (DIRECT).

The DIRECT Study supports a proposed expanded indication for the NanoKnife System in the treatment of Stage III pancreatic cancer.

"We are pleased to be the first enrolling site. The DIRECT Study represents an important milestone in the standardization of care for patients with Stage III pancreatic cancer. Our goal is to generate important data that should standardize and optimize the use of IRE in the treatment of locally advanced pancreatic cancer, significantly improving outcomes for patients with this late-stage diagnosis," said Dr. Robert C.G. Martin, Co-Principal Investigator of the DIRECT Study, Director, Division of Surgical Oncology and Professor of Surgery at the University of Louisville and surgical oncologist with UofL Physicians – Surgical Oncology.

AngioDynamics’ DIRECT clinical study features a comprehensive data collection strategy that will provide meaningful clinical information to healthcare professionals, support a regulatory indication for the treatment of Stage III pancreatic cancer, and facilitate reimbursement for hospitals and treating physicians. The next-generation study is classified as a Category B IDE by the FDA, which allows participating sites to obtain coverage for procedures performed in addition to any related routine costs.

"The enrollment of our first patient soon after receiving FDA approval is a strong signal that clinicians are eager to evaluate treatment alternatives that improve the dismal prognosis for Stage III pancreatic cancer patients," said Brent Boucher, AngioDynamics Senior Vice President and General Manager of Oncology. "We look forward to confirming that our proprietary NanoKnife technology offers a compelling alternative to the current standard of care and believe that this study will provide a pivotal dataset for claims and reimbursement purposes."

The DIRECT Study comprises a Randomized Controlled Trial at up to 15 sites, as well as a Real-World Evidence, next-generation registry at up to 30 sites, each with a NanoKnife System treatment arm and a control arm. AngioDynamics expects each NanoKnife arm to consist of approximately 250 patients with an equal number of control patients. The primary endpoint of the study is overall survival.

Department Creates Division of Immunotherapy

Department of Surgery is proud to announce the Division of Immunotherapy, which is leading the way to improve our understanding of the role of immunotherapy in the treatment of cancer and other diseases. Our team of researchers is engaged in pioneering research designed to trigger our bodies' own immune system to fight disease.

Trauma Program to Participate in Department of Defense-Funded Clinical Trial Designed to Improve Survival for Trauma Patients

Dr. Brian Harbrecht, Professor of Surgery in the Department of Surgery at UofL and Director of Trauma Surgery at UofL Hospital, and Dr. Raymond Orthober, Assistant Professor of Emergency Medicine and Medical Director of Louisville Metro EMS, will lead UofL's participation in a Department of Defense (DOD)-funded clinical trial aimed at improving survival among people who have difficulty breathing after a trauma.

UofL will join nearly two dozen emergency medical service agencies across the country in the prehospital Airway Control Trial (PACT), which is an $8.8 million, four-year study, beginning at the end of 2019 that will test different strategies to help patients breathe at the scene of a trauma to see if one works better than another at increasing survival.

This is an “exception from informed consent” trial, which means that since the trial requires performing a potentially life-saving procedure in traumatically injured patients who are too injured to give consent to the trial, they will be automatically enrolled if they fit the criteria. Once patients are stable, they and/or their families will be notified that they were enrolled, and they can opt out of continued participation at that point. Learn more at https://www.litesnetwork.org/pact-efic/.

Dr. Dylan Adamson Joins Division of Transplantation

The Department of Surgery is excited to welcome alumni Dylan Adamson, M.D., Assistant Professor of Surgery, Division of Transplantation. Dr. Adamson attended medical school at University of Toledo College of Medicine. He then completed his general surgery residency at University of Louisville and a fellowship in Abdominal Organ Transplant and Hepatobiliary Surgery at The Mount Sinai Hospital in New York.

Chair of Department Gave Presidential Address at the Southern Surgical Association Annual Meeting (2019)

Watch Dr. Kelly McMasters' presidential address.

Tyler Ellis, M.D., MSCR Joins Colon & Rectal Surgery Faculty

The Department of Surgery is excited to welcome Tyler Ellis, MD, MSCR, to the Colon and Rectal Surgery Section of the Division of General Surgery. Dr. Ellis attended medical school at Medical University of South Carolina in Charleston, SC. He then completed his general surgery residency at University of North Carolina at Chapel Hill and a fellowship in colorectal surgery at University of Massachusetts in Worchester, MA. He also has a fellowship in clinical research from Medical University of South Carolina.

Gunshot Victims Thank Trauma Team for Saving Their Lives

Christopher 2X Game Changers along with gunshot wound survivors treated at UofL Hospital recognized the trauma team at UofL for their life-saving care for gunshot wounded victims from 2003-2019.

The trauma team at UofL includes numerous trauma surgeons, nurses and staff who dedicate their lives to saving others. Since 2003, they have treated more than 3,000 victims of gun violence.

All four local news stations ran stories on the event. Click below to watch the coverage:

• Gunshot victims reunite with UofL trauma team that saved their lives - WAVE3
• University Hospital ER, trauma staff honored for treating gunshot victims - WLKY
• Victims of gun violence present award to UofL Hospital's trauma team - WDRB
• Hidden Heroes: Shooting survivors to honor UofL Hospital trauma team - WHAS

Department to Offer Vascular Surgery Fellowship

The Division of Vascular Surgery in the Department of Surgery at University of Louisville School of Medicine is proud to announce that we will offer a fellowship in Vascular Surgery in the very near future. Check back here for updates. The Division of Vascular Surgery and Endovascular Therapeutics is a dynamic academic division of the Department of Surgery. It has a tripartite mission that includes the provision of clinical care and services, conduct of clinical and translational research, and education, which includes undergraduate medical, graduate, and continuing medical education.

Department Resident Appears on Wheel of Fortune

UofL Department of Surgery's very own Administrative Chief Resident Annie Nagengast, MD appeared on Wheel of Fortune. She had some great things to say about the Department. Click below to watch.

Nine Department Faculty Members Voted Top Docs In Their Specialty

Congrats to the following physicians named Louisville Magazine's Top Docs in their respective categories:

GENERAL SURGERY

• Matthew V. Benns, M.D.
• Keith Miller, M.D.

PLASTIC SURGERY

• Terry M. McCurry, M.D.
• Jarrod A. Little, M.D.

SURGICAL ONCOLOGY

• Michael E. Egger, M.D.
• Robert C.G. Martin II, M.D.
• Kelly M. McMasters, M.D.
• Charles R. Scoggins, M.D.

VASCULAR SURGERY

• Amit J. Dwivedi, M.D.

View the full list of Top Docs on Louisville Magazine's website.

Dr. Tobin To Receive KMA 2019 Distinguished Service Award

Dr. Gordon Tobin, professor of plastic and reconstructive surgery, will receive Kentucky Medical Association's 2019 Distinguished Service Award on Sept. 21, 2019. Dr. Tobin is recognized for his significant contributions to the field of medicine.

Dr. Tobin's career encompasses surgical education, pioneering medial research, care for the underserved at home and abroad and physician leadership in local, state and national organizations. Professor of Surgery and former Plastic Surgery Director, he founded a robust research laboratory that developed many new reconstructive techniques and pioneered hand and face transplantation. He is Director of Craniofacial Transplantation at UofL and an original member of the team that laid essential research foundations and performed the world's first successful hand transplant in 1999.

Dr. Benns Elected Vice Chief of Staff for University of Louisville Hospital

Dr. Matthew Benns, Assistant Professor of Surgery, Division of General Surgery, has been elected as Vice Chief of Staff at University of Louisville Hospital. The active medical staff members were asked to nominate individuals who were practicing physicians and full-time faculty members of the UofL School of Medicine but not a department chair. Dr. Benns' position has a three-year term.

Dr. Bond Receives 2016 KMA Educational Achievement Award

Dr. Sheldon Bond has been selected to receive the 2016 KMA Educational Achievement Award. Dr. Bond has been Director of Student Teaching Programs in the Department of Surgery for the past decade. He also serves as Assistant Dean for Clinical Education. He is a Professor of Pediatric Surgery.

"Reflections from the Other Side"

Commencement Address

University of Louisville School of Medicine, Class of 2017

Kelly M. McMasters, MD, PhD

It is my great honor to give the commencement address for the UofL SOM class of 2017. Twenty-eight years ago, I graduated from medical school, and I remember the overwhelming sense of pride and accomplishment in finishing medical school, the relief of never having to study the Krebs cycle again, the excitement of moving to a different city in a different state far from home to begin residency training, of having to start fresh to develop a whole new set of friends and colleagues, the thrill of finally becoming a real doctor balanced against the anxiety and fear of that solemn responsibility—of the knowledge that my decisions and actions could save lives, and my mistakes could cost them. I remember that tangled mass of emotions like it was yesterday. But what I do not remember at all, I assure you, is who the commencement speaker was at my graduation, or what he or she said. I’m holding all of you to a higher standard.

Each year at my house, we host a party for the new interns. Faculty and residents generally attend, drink a couple beers, eat too much food, and help the new interns celebrate the last few hours of their freedom before starting a challenging 5 to 8 year general surgery residency program. As tradition would have it for the past dozen years, the new interns all volunteer to participate in a (mandatory) low-stakes poker game—Texas Hold ‘em.

Why do we ask the new interns to play in a poker game just before they take their first night on call, when they will hold the fate of patients in their hands, when their thoughts and deeds could mean the difference between life and death? Shouldn’t they be studying anatomy or the Krebs cycle or something important? Perhaps there are many hidden lessons to be learned from this simple game of poker.

In poker, there are only 3 possible actions--3 possible choices: check (do nothing), bet (or raise, which is just betting more than the player before you), or fold—check, bet, or fold, those are your only options. It would seem that the person with the best poker hand should always win. Ahhh, but if that were true, poker would just be a game of chance. In fact, the person with the best hand frequently loses, because it is much more important how well you play the cards you are dealt than how good your cards actually are. The most dramatic moment of a game of Texas Hold ‘em is when the player pushes all of his chips to the center of the table, betting all of his remaining money, and goes "all in." At this moment, the player going "all in" realizes that there is no turning back, that she is committed to action that likely will result in either doubling her money (at least), or losing it all.

What is the point of this poker game, you might be asking yourselves? All of human interaction is a negotiation of sorts—for resources, attention, recognition, prestige, status, power, and even love. The three basic choices--check, bet, or fold--are fundamentally synonymous with all of the important decisions you will ever make, and form the basis for all human interaction. Perhaps I’m overanalyzing the cosmic significance of a poker game, since I only get to play once a year with interns, but here goes:

Poker Lesson #1. You win more pots by betting than by checking, and you never win if you fold.
Sometimes it is better to decide upon a course of action and pursue it, even if the end result is unsatisfactory. It is frequently said that: "More harm is done by a timid surgeon than a bold one." Surgeons are also often said to be "frequently wrong but never in doubt." Action usually trumps inaction, and no decision is frequently worse than the wrong decision. The same holds true of many of the other decisions you will make in life and in your career. Be bold, be decisive, and never quit as long as you have a chip and a chair, or your patient has a pulse and a blood pressure.

Poker Lesson #2. You have to play the cards you are dealt.
You don’t get to choose what cards you are dealt any more than you get to choose who your patients are, what their comorbidities are, or who their families are. You don’t get to choose the circumstances and obstacles that come your way. Sometimes you are dealt a losing hand that you can win. Sometimes you are dealt a winning hand that you lose. Play the cards you are dealt, and decide when it’s time to check, bet, or fold. If you always fold when you are dealt 10-2 offsuit—that is, if you can’t sometimes find a way to turn bad circumstances into opportunity—you will have a difficult time in your career and in your personal life.

Poker Lesson #3. You never win if you fold, but sometimes it’s better to live to play another hand.
Decisions in life to go "all in" should be made judiciously—you have to be prepared to lose it all. Choose your battles carefully, don’t wage war on too many fronts, and don’t fight battles you can’t win. When facing difficult situations, I often ask myself: "is this the hill I want to die on?" Sometimes strategic inaction is better than action, although this is an acquired skill for surgeons.

Admittedly, my poker analogies were really just a way of easing into the more difficult part of this commencement address, which is entitled: "Reflections from the Other Side." I neglected to say: from the other side of what? I’m fairly sure you didn’t expect me to talk about reflections from the other side of the poker table. And no, I haven’t seen the light at the end of the tunnel, nor have I had a glimpse at what is on the other side of this life. Nevertheless, I certainly have had some time to reflect on what is important in this one—especially on what is important to being a good doctor and decent person. I make no claim to be either. The only thing I claim is that at least I have had a few years longer than you to consider these issues, in the hope that I can learn from them.

So here are the lessons I want to highlight for you today:

When walking the tightrope, don’t lose your balance.
I am a Surgical Oncologist—I operate on patients with cancer for a living. I have spent my entire adult life either training to be a cancer surgeon or being one. Surgical Oncologists focus on doing whatever it takes to cut out cancer. We excise, resect, ablate, and otherwise extirpate cancer. Surgery is still the most effective cancer therapy ever invented. We appreciate the help of our medical oncology and radiation oncology colleagues to help improve the odds of curing patients, but make no mistake—surgery is the primary treatment for most types of cancer. Perhaps that will change in the future, and I certainly hope so.

Surgical oncologists focus intensively on doing what needs to be done to cut out the cancer. There is something innately gratifying in grappling with tumors and removing them with your bare hands (Ok, maybe with a few instruments, and with gloved hands). You get the point. Surgical steel vs. tumor—the battle is on. Many patients recover from surgery uneventfully and are cured of their cancer. Occasionally, patients will die because of the operations we perform. Not uncommonly, patients experience major complications and problems. We sometimes take big risks to achieve big rewards. Or sometimes we push "all in" and lose.

Before we see our cancer patients, we look at their x-rays. We want to see pictures of the cancer and stare it down--take its measure. We assess the patient’s comorbidities and risks of surgery. At times, it can seem as if we are treating a cancer that just happens to have a person attached to it. Physicians (even surgeons) are human. We protect ourselves using primal defense mechanisms because no human being could withstand complete empathy with an entire office full of patients suffering from cancer. No matter what specialty you are entering, you must resist the natural tendency to treat the disease and not the patient.

I remember when this realization first smacked me in the face. I’m going to tell you a story that I have never told to anyone. I was a surgical oncology fellow at MD Anderson Cancer Center in Houston. The fellows thought we were like Tom Cruise in the movie "Top Gun," learning to be the biggest, baddest cancer surgeons in the country. We bragged to each other about the complex, difficult cancer operations we performed.

I had performed a forequarter amputation on a patient with sarcoma. Forequarter amputation is removing the entire arm and shoulder, in this case, part of the chest wall and rib cage as well. Now that was just the kind of big, gruesome cancer operation I went there to learn how to do.

The patient was a 19 year-old young lady from Spain. She didn’t speak English, and I didn’t speak Spanish. She was beautiful in every way. She had shimmering dark hair, striking perfect features, and piercing, soulful dark eyes. She was immensely courageous, and prepared herself for this life-changing cancer operation with uncommon grace, dignity, and fortitude.

While making morning rounds on postoperative day #1, I examined the patient, checked her incisions, witnessed the mutilation we had caused, then looked into those dark eyes, and saw that the light in those eyes had dimmed—her soul was crushed. Overcome with emotion, I exited quickly and walked to the nearest stairwell and sobbed piteously, having glimpsed into the eyes of this girl who spoke a different language but communicated so well. I wept in anguish and disgust for what we had done to this young lady, knowing that we had little choice but to attempt to remove her limb to try to save her life. I don’t know what became of her, but I think of her often.

At the time, I was ashamed of my stairwell breakdown. Surgeons don’t cry. Human beings do. These days, I would be ashamed if I hadn’t felt this emotion so strongly, and would be concerned if this no longer bothered me.

There is often a very fine line in medicine between benefit and harm. No matter what field of medicine you practice, you will be faced with impossible choices. You must decide when to check, bet, or fold. You will make mistakes, and they will have serious and sometimes fatal consequences. The mark of a physician’s character is in how he or she deals with his or her mistakes. Own your mistakes, admit them, learn from them, and use them to become better. You will lose your share of battles. Soldier on, and continue to fight the good fight.

We as physicians are forced to walk this tightrope on a regular basis.

So remember, when walking the tightrope, don’t lose your balance.

As many of you know, my son, Owen, died last year after a 5-year battle with leukemia. When he was first diagnosed, I knew virtually nothing about leukemia. I remembered nothing about it from medical school. All I knew was that leukemia was one of those cowardly blood cancers that surgeons couldn’t cut out.

As far as I can tell, the strategy for treating childhood leukemias is to give every toxic drug that a child could possibly tolerate in the hope that the child is stronger than the cancer. The treatment regimen was brutal. Innumerable chemotherapy drugs that made his hair fall out multiple times over the years, made him sick and weak, prone to life-threatening infections that he dealt with multiple times, drug reactions, intrathecal chemotherapy injected into the spine on a regular basis, high-dose steroids that made him bloated and miserable. The vicious cycle of apparent remission followed by relapse. Many days and nights, every major holiday it seemed, spent in the hospital. Bone marrow transplant that didn’t cure the cancer. More chemotherapy, more toxicity, experimental therapy--eventually peace.

So yes, I’ve seen the other side—the other side of the patient’s room, looking out of the doorway instead of looking in. I had never really been the patient before. I had never been the family member before. I had only been the doctor.

Here are some other lessons I learned from the other side of the patient’s room:

Any night on a flat surface is a good night
My wife, Beth, and I have spent countless nights sleeping in a pediatric hospital room—well over 100, I have no idea how many. We were confined to a hospital room or ICU room, often for weeks at a time. I was one of those family members you have seen when making rounds in the morning darkness, in your way as you try to examine the patient--asleep in a chair, on the floor, in a cot, or every conceivable type of contraption that hospitals provide for family members to sleep on. The chair-type things are impossible to sleep in, like sleeping in the center seat in the coach section of a red-eye flight. I was the family member with crumpled clothing, uncombed hair, unwashed and unshaven in the morning. You might have found me snoring ignobly, dead to the world. When Owen needed me in the middle of the night, he often had to throw something at me to wake me up. Fortunately, he kept throwable objects close by at all times. More often, however, I would be waiting for you--residents and fellows--wanting to make sure that you had all the important information about Owen’s status since the prior day. I always tried to be cordial, professional, or even friendly in these interactions with the health care team. It was a lot easier to be congenial if I had gotten a couple of hours sleep on a flat surface.

Remember, family members are under an enormous amount of stress caring for their loved ones. Sometimes the stress is too much, and they will seem accusatory, frustrated, angry, or full of contempt. They might become overwhelmed with emotion and need to find a stairwell. Don’t mistake their disheveled appearance, anxiety, fear, and questions and label them as "difficult patients" or "difficult families." They are concerned about their loved ones. The louder and more agitated they get, the softer and calmer you must be. You will be in their shoes some day.

And remember, any night on a flat surface is a good night

An ounce of empathy is worth a thousand pounds of apathy.
For any of you who will enter the field pediatric oncology or be involved in treating children with cancer, you have my deep admiration. As a surgical oncologist, I treat mostly old people with cancer. That is child’s play compared to treating childhood cancer. Owen was fortunate to have wonderful doctors, almost without exception. Throughout the course of his disease, we experienced the difference between empathy and apathy. It does not take much effort to express a little bit of empathy. A little eye contact, smile, kind word or gesture is all it takes. It is immensely soothing to patients and their families. If you are looking at the chart, or these days typing into an electronic medical record, and not looking at the patient, you are making a big mistake. Patients and families can smell your apathy from a mile away. On your worst days, when you have been up all night, and have given everything you have to give, you must still act professionally, even if sometimes it is just an act. Sometimes you just might need to bluff.

Also, never forget that you are not on the front line in terms of the exchange of emotional energy. Doctors make rounds, and have limited time with patients and families--often just a few minutes per day. Doctors write orders, nurses care for patients. Nurses know about empathy. Respect that.

And remember, an ounce of empathy is worth a thousand pounds of apathy.

Sweat the small stuff.
At one point in his treatment, Owen developed a pneumothorax--a collapsed lung--requiring a chest tube. This recurred a couple more times. Because of a persistent air leak, this last chest tube stayed in for a couple of weeks. The new doctors in the audience understand that it is not pleasant to live with a chest tube. Owen’s doctors responsible for this would check in periodically, but not every day, because he still had an air leak and the chest tube obviously needed to stay in.

It turned out that the air leak wasn’t from Owen’s lung. It was a leak from the tubing connections. The chest tube stayed in for much longer than necessary because of inattention to detail. I was very angry with myself for not figuring this out sooner. But I was just the parent. I shouldn’t have to figure it out.

The moral of this story is that the little things matter. Meticulous attention to every detail of patient care, every test, every x-ray, and actually performing a history and physical examination. As we frequently see in Surgery Morbidity and Mortality Conference, there is no procedure so trivial, no detail so small, that it can’t make a big difference in patient outcomes. During my training, I got in the surgical habit of making rounds early in the morning every day. Many people no longer do this. It is a routine, an act of discipline that gets my day off to a good start—to make sure my patients are OK and deal with any problems they may have before anything else happens that day. See your patients every day. Develop good habits. When you are on your way home and you get that nagging feeling that you should have gone back to check on that patient one more time, turn around and go see the patient. When you are on call and the nurse calls you about a patient and the easy thing is to give a verbal order and go back to sleep, get up and go see the patient.

And remember, sweat the small stuff, because it makes a difference. If you can’t handle the small stuff, you will not be prepared for the big stuff.

Don’t avoid the hard conversations
I have taken care of cancer patients my entire life. I tell my patients with serious cancers that I will follow them until I die. We develop a long-term relationship. Many are cured by surgery. Some are not. When the cancer recurs, they usually come back to see me to ask my advice about treatment. I tell them that if it gets to the point that further treatment (chemotherapy) is not going to help, I will tell them. When it gets to that point, I do tell them. Part of my job--often the most difficult, but the most rewarding part--is to ease patients to the other side with dignity.

You would be amazed how often no other doctor is willing to have this conversation with the patient. Hope is a precious thing for patients to cling to, but false hope is just that—false. Learn the difference. It shouldn’t be so hard for physicians to tell the truth. Patients and their families want to hear the truth, and they are eternally grateful to you for telling it. You don’t have to bludgeon people with bad news; learning to deliver bad news with compassion requires some practice. I was never ready to hear the truth about Owen, but I’m grateful to have had a doctor who could tell it.

So remember, don’t avoid the hard conversations.

Aim small, miss small
Each of you is about to embark on an exciting journey to define the purpose of your life. You have studied long and hard, have prevailed against many obstacles, and have demonstrated exceptional tenacity and determination to accomplish the goal of graduating from medical school.

And now, all of that is meaningless.

What I mean by this is that it doesn’t matter where you grew up, where you went to college, where you went to medical school, or whether you were at the top or the bottom of your medical school class. From here on, the slate is wiped clean. You will be on equal footing with all of your fellow residents. You have equal opportunity to excel, to be mediocre, or to fail.

Residency is hard. Life is hard. But none of you has chosen an easy path, and all of you understand the value of self-sacrifice to achieve your goals.

It is easy to get lost in the crowd and never aspire to be anything but average--to be just good enough. Each of you is capable of achieving great things in your chosen specialty--of making a lasting difference in your community, your region, your country, your world. Most people will tell you to aim high. But if you aim high and miss your target, you fail. I would say: aim small, miss small. That means, if you focus intensively on your target, even if you miss the target, you get close enough to be successful. Set big goals, but focus on small targets.

Excellence is the result of discipline, study, hard work, practice, and the drive to become the best. You have come too far to just become an average doctor. You now have the opportunity to make a difference. Don’t squander it.

Good enough is not good enough. Aim small, miss small.

I confess that even though I have seen the other side, I need constant reminders to try to apply these lessons in my own life. So I will take no offense if--many years from now, or even just a couple of hours from now--you have no recollection of this address or who gave it. But maybe, just maybe, you will hold onto a few bits and pieces of this commencement address, and, despite all of the pressures of medical practice and complexities of your personal lives, will remember why you went to medical school in the first place, and what it means to be a good doctor. Remain mindful of what is on the other side.

It has been my great honor to deliver this commencement address. I played for you the cards I was dealt. I showed you my hand. Now you must decide how to play yours. I wish each of you success and happiness in your personal and professional lives.

Department Holds Inaugural R. Neal Garrison MD Lectureship

The Department of Surgery held the inaugural R. Neal Garrison MD Lectureship Feb. 15 and 16, 2018. The speaker was Charles M. Miller, MD, program director for liver transplantation at the Cleveland Clinic.

Dr. Garrison was a Professor of Surgery and Professor of Physiology and Biophysics in the Department of Surgery for 35 years.

During his distinguished career, Dr. Garrison served as Chief of Surgery for 12 years, Associate Dean for Veterans Affairs & Acting Chief of Staff at the Veterans Administration Medical Center. In addition he directed the Department of Surgery Undergraduate Surgical Education curriculum for eight years. In the eighties, he was instrumental in developing the abdominal organ transplant program for the Department of Surgery. He was the co-founder of the Kentucky Organ Donor Affiliates (KODA) in 1987 and continued as its Medical Director. He was named a University of Louisville Distinguished University Scholar from 2008 - 2015.

Dr. Garrison was an active clinical surgeon in the fields of general, vascular and trauma surgery. In addition, he maintained an active bench research laboratory focused on organ blood flow during shock and infection. He received multiple peer-reviewed grants from the National Institutes of Health, American Heart Association, Surgical Infection Society, Department of Defense, and VA Merit Review since 1983. In the laboratory he mentored more than 40 research fellows, surgical residents and doctoral candidates. Throughout his career Dr. Garrison published more than 300 peer- reviewed scientific articles, abstracts & book chapters and has served on the Editorial Board or as reviewer for 12 scientific journals. In 2012, he received the Excellence in Research Award at the Jewish Hospital & St. Mary's Foundation Doctors' Ball.

Dr. Garrison has been a member of 28 medical/surgical professional organizations & an officer of more than half of them. He was President of the Association for Academic Surgeons and served as Chair or Vice- Chair of committees for virtually all of these groups. He completed a six-year term as Governor of Kentucky to the American College of Surgeons. He received multiple honors & awards including the Hiram C. Polk Jr. Award for Resident Teaching Excellence on three occasions and was elected by the Louisville Surgical Society as the 2006 Yandell Lecturer and Medal recipient.

In 2015, KODA pledged $100,000 to establish the R. Neal Garrison, M.D. Endowed Surgical Lectureship Fund in honor of Dr. Garrison's role in co-founding KODA and the important work he has accomplished related to transplantation in Kentucky.

Dr. Gomez-Gutierrez Proposal Accepted for NIH Grant

Jorge G. Gomez-Gutierrez, Ph.D.'s project entitled “Targeting melanoma hypoxia with lactic acid bacterium L. lactis” has been selected for a National Institutes of Health grant. Hypoxia is a component of the tumor microenvironment, which reduces efficacy of both immuno- and chemo-therapies resulting in poor clinical outcome.Dr. Gomez-Gutierrez will exploit the hypoxic microenvironment as a target for gene therapy, utilizing commensal facultative anaerobic bacteria. The overall goal of this project is to develop an effective and safe delivery system for cancer gene therapy by targeting the hypoxic tumor microenvironment with food-grade lactic acid bacteria (LAB) Lactococcus lactis (L. lactis). Dr. Gomez-Gutierrez is an Assistant Professor in the Division of Surgical Oncology.

Dr. Jarrod Little Performs First-of-its-Kind Procedure on Identical Twins

A woman who survived a rare childhood cancer successfully underwent a first-of-its-kind procedure to help restore her appearance.

Dr. Jarrod Little, Assistant Professor, Division of Plastic and Reconstructive Surgery, used fat grafting from Janna Coleman's identical twin, Jessie, to reshape Janna's face from the damaging effects of radiation and chemotherapy. While fat grafting has been done for years, there are no instances in medical literature of it taking place from one person to another and never before on identical twins. While tissue from twins has been used for organ transplants, soft tissue procedures between twins are rare, said Dr. Little.

The surgery took place at University of Louisville Hospital over about three hours and was a success.

"It will make a huge difference for her," said Dr. Little. "She looks like a new person. I'm very happy with the results."

Janna, 28, was diagnosed with an aggressive rhabdomyosarcoma at the age of 7. Childhood rhabdomyosarcoma is a disease in which malignant cells form in muscle tissue, and Janna's formed behind her jaw. She was successfully treated, but the surgery, radiation and chemotherapy to her head and neck left lasting effects, damaging her pituitary gland, which disrupted her growth, most noticeably around her face. Her jawbone never grew to an adult size.

While Janna is an identical twin, her sister, Jessie, did not have the same condition. Though they once looked so much alike even their father had trouble telling them apart, after her treatment Janna no longer looked as much like her sister.

"The cancer was the easy part, the aftermath is what's been hard," Janna said.

Janna went through more than 10 reconstructive surgeries over the years to help but without much success. After moving to Louisville and working as an oncology nurse, she heard of Dr. Little and went to him to see if there was anything else that could be done.

With the jawbone in her face damaged and stunted from radiation, Dr. Little determined reconstruction of her jaw was not an option. Fat grafting to help re-shape her face was, but Janna did not have enough fat and was unable to gain weight because of her development issues. But when Dr. Little learned Janna was an identical twin, he came up with the idea to take fat from Jessie and transplant it into Janna's face. The procedure was also unique in that many people with Janna's condition and location of her tumor do not survive to adulthood.

By increasing volume to the face and repairing some of the damaged tissues, the goal of the procedure was to give Janna's face a more natural volume and contour so the size of the jaw bone will not be as noticeable, Dr. Little said.

Fat was also a good option for Janna because it has a high concentration of stem cells, which are beneficial because they can form into new types of cells. When they are introduced to a new area, they can regenerate surrounding soft tissue. And with the twins having a nearly 100 percent genetic match, the probability of success was high.

"I just want to look like my sister and more like a twin," Janna said. "It is hard being her twin. She's gorgeous."

To donate fat, Jessie had to make an effort to gain weight.  For months, the normally health-conscious Jessie ate high-calorie foods - including ice cream, pizza and fast food - to develop enough fat that could be removed by liposuction for Janna.

"She's my sister, my twin," Jessie said before the surgery. "Of course I'm going to do anything I can to help."

It will take several months to assess the full effects of the procedure. One or two more sessions may be needed before the reconstruction is complete.

"I want her to be more confident in herself and be proud to say we're twins and not be shy about it because we're exactly alike."

Dr. McMasters Named President of Western Surgical Association

Dr. Kelly McMasters was recently elected President of the Western Surgical Association at the Western's Annual Meeting in Coronado, Calif. Dr. McMasters is the Ben A. Reid, Sr, M.D. Professor and Chair of the Department of Surgery. The Western Surgical Association is dedicated to the cultivation, promotion, and diffusion of the art and science of surgery, to the sponsorship and maintenance of the highest standards of practice and to the delivery of the best possible care for the public.

Dr. Kelly McMasters Named New Editor-in-Chief for Annals of Surgical Oncology

The Society of Surgical Oncology announced Kelly M. McMasters, MD, PhD as the new Editor-in-Chief of Annals of Surgical Oncology (ASO) effective March 2018. Dr. McMasters becomes only the second Editor in the journal’s nearly 25-year history to assume the role. He will oversee the print and online editions of ASO and with Mark Roh, MD, Executive Editor, will lead a prestigious editor roster of expert leaders in surgical oncology, including more than 20 section editors and associate section editors from around the world, as well as U.S.-based associate and deputy editors. Dr. McMasters begins his position on March 23, 2018 in conjunction with the journal’s 25th anniversary and the retirement of Charles M. Balch, MD, who established the prominence of the publication in the field of surgical oncology. Dr. McMasters will report directly to the SSO Executive Council and will carry out editorial responsibilities from his office in Louisville, KY.

"Annals of Surgical Oncology has a rich heritage as the premier source of clinical and translational science related to cancer surgery and multidisciplinary care. It is an honor and a privilege to lead an outstanding editorial board into the future," said Dr. McMasters.

ASO is the worldwide journal of choice of surgical oncologists and is the official journal of the Society of Surgical Oncology and the American Society of Breast Surgeons. According to Thompson-Reuters, in the 2016 impact factor ranking among all surgical oncology scholarly periodicals, ASO has the most citations of all surgical journals in the world, the highest number of source items, and a current impact factor of 4.041. The journal promotes clinical and translational cancer research, with an emphasis on clinical trials. Leading subject areas of ASO include Gastrointestinal Oncology, Breast Oncology, Hepatobiliary Tumors, Colorectal Cancer, Thoracic Oncology, and Translational Research. ASO strives to enhance the quality of life and survival of the surgical patient with cancer and to improve the practice environment in which high-quality surgical oncology care is delivered. ASO also facilitates the career development of surgical trainees and their transition into academic and community-based practice and publishes timely articles about public policy and patient advocacy issues related to the surgical patient with cancer.

Dr. McMasters Named the Ephraim McDowell Physician of the Year

Kelly M. McMasters, MD, PhD, will be awarded the Ephraim McDowell Physician of the Year at the 2016 Jewish Hospital & St. Mary’s Foundation’s Doctors' Ball, which will be held Saturday, Oct. 15 at the Marriott Louisville Downtown.

The Ephraim McDowell Physician of the Year honors a physician who has made significant contributions to the field of medicine, provided humanitarian service, and demonstrated the highest ethical standards. This is typically a physician who has shown long-term service to the community.

Dr. McMasters leads the Department of Surgery with more than 50 full-time faculty members, two residency and six fellowship programs. A prolific researcher, dedicated educator, and seasoned administrator, Dr. McMasters greatly enjoys caring for complex surgical oncology patients. He has a busy clinical practice that spans most of the field of surgical oncology, including melanoma, breast cancer, sarcoma, gastrointestinal malignancies, as well as liver, pancreatic and biliary tumors.

“This field is full of opportunities – to do research, to teach, to provide care – but at the end of the day, there is just something good about cutting someone’s cancer out. It’s that simple. Many more solid tumors have been cured because a surgeon cut out the cancer than by all of the chemotherapy and radiation therapy put together,” he said.

Dr. McMasters graduated with honors from Colgate University. He completed the M.D./Ph.D. program at the University of Medicine and Dentistry of New Jersey Rutgers Medical School, with a Ph.D. in Cell and Developmental Biology from Rutgers University. After completing general surgery residency at the University of Louisville, he performed a fellowship in Surgical Oncology at the University of Texas-M.D. Anderson Cancer Center in Houston. In 1996, he joined the faculty of the University of Louisville as the Sam and Lolita Weakley Professor of Surgical Oncology. In 2005, he became the Ben A. Reid, Sr., M.D. Professor and Chair of the Department of Surgery.

Dr. McMasters is the author and principal investigator of the Sunbelt Melanoma Trial, at the time the world’s largest melanoma study (involving more than 3,600 patients). He also initiated the University of Louisville Breast Cancer Sentinel Lymph Node Study, a 4000+ patient multi-institutional study that helped bring widespread acceptance of this minimally invasive procedure for the staging of breast cancer. His laboratory research interest has been in developing gene therapy approaches for the treatment of cancer, as well as discovery of cancer biomarkers. His research has been funded by the American Cancer Society, the NIH, and other organizations over the past 20 years.

Dr. McMasters has published nearly 400 articles in the peer-reviewed literature, over 20 book chapters, and a book on hepatocellular carcinoma. He has presented his research at a multitude of national and international meetings and has served as a visiting professor at many of the world’s finest institutions. He served as the 2009-2010 President of the Southeastern Surgical Congress. He is currently President-Elect of the Society of Surgical Oncology, Secretary of the Southern Surgical Association, Recorder of the Western Surgical Association, Secretary-Treasurer of the Society of Surgical Chairs, and Deputy Editor of Annals of Surgical Oncology. He is a member of many other professional and scientific societies, including the American Surgical Association, American College of Surgeons, Society of University Surgeons, Association for Academic Surgery, American Association for Cancer Research, American Society of Clinical Oncology, Surgical Biology Club, Halsted Society, and International Surgical Group, among others.

Dr. Kelly McMasters Contributes to Major Report that Sets Out to Accelerate Cancer Care and Research

A fundamental shift in how cancer research is conducted and how cancer care is delivered in the United State is required in order to deliver on the US Cancer Moonshot initiative, according to a major new report published today in The Lancet Oncology journal.

The report sets out a detailed roadmap to deliver on the Blue Ribbon Panel recommendations, including a focus on prevention, a new model for drug discovery and development, a vast expansion of patient access to clinical trials, and an emphasis on targeted interventions to improve cancer care for underserved groups, specifically children, cancer survivors and minority groups. The report emphasizes the importance of addressing health disparities in all recommendations.

The Lancet Oncology Commission on Future Research Priorities in the USA is authored by more than 50 leading oncologists in the United States, including Dr. Kelly M. McMasters and other members of leading US cancer organizations, and sets out 13 key priority areas, each with measurable goals, to focus the $2 billion of funding released to the National Cancer Institute as part of the 21st Century Cures Act.

It highlights how technological advances, including understanding and mapping pre-cancer biology and the rapid adoption of big data, as well as new collaborations across industry, patient groups, academia, government and clinical practice will be critical to advancing research, and ultimately improving patient care.

"Among the thousands of technical details necessary for the success of an actual Moonshot, some fundamental principles remained the same; chief among them was the necessity of reaching the moon. The Commission brought together experts from across the spectrum of oncology research to help define the proper trajectory for the mission ahead," says McMasters, President, Society of Surgical Oncology and Ben A. Reid, Sr., MD Professor and Chair, The Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine.

The Commission was launched on Nov. 1 at an event on Capitol Hill, Washington, DC and will be presented on Nov. 3 at the United Nations Association of New York Humanitarian Awards, where former Vice President Joe Biden is being honored for his work on improving cancer outcomes as part of the US Cancer Moonshot Initiative.

For access to the report, please visit: www.thelancet.com/commissions/usa-oncology

Chair of Department Named President of Society of Surgical Chairs

Dr. Kelly McMasters has been named president of the Society of Surgical Chairs (SSC), an international organization comprised of chairs of departments of surgery and surgical specialty departments of medical schools, academic medical centers and teaching hospitals of the United States and Canada. The purpose of the SSC is to cultivate and enhance academic surgery. The SSC is a managed program of the American College of Surgeons.

Department Loses a Beloved Son

Owen Frederick McMasters, 16, passed away Feb. 15, 2016 at home surrounded by his loving family following a courageous four-year battle with leukemia. He will always be remembered for his dedication to helping other children with cancer.

Click here to read Owen’s obituary.

Click here to read Dr. McMasters’ eulogy to his son, which was shared at his funeral.

Brown Cancer Center Creates Owen’s Wish Fund for Cancer Immunotherapy Research

Chair of the Department of Surgery, Dr. Kelly McMasters, announced on October 17, the Owen’s Wish Fund for Cancer Immunotherapy Research of the J. Graham Brown Cancer Center.

His son Owen died February 15, 2016 following a courageous four-year battle with leukemia.

"Owen died of leukemia knowing that the science that could have cured him of his cancer was right at our doorstep," McMasters said. "Owen’s wish was that no other children (or adults) would have to endure the ravages of cancer and its treatment without a meaningful chance to be cured."

Cancer immunotherapy has revolutionized the treatment of many types of cancer by harnessing the power of the human body's immune system to eradicate cancer. The Owen’s Wish Fund will allow the Brown Cancer Center to develop a world-class group of scientists and physicians dedicated to advancing the field of cancer immunotherapy and providing state-of-the-art immunotherapy care for patients in our region.

To donate, please visit click here. Under "Designations," click on "Select the fund(s) for your gift," which is in red. Then click "Other," and then in the line under that type "The Owen's Wish Fund."

Price Institute of Surgical Research Celebrates 60 Years, Holds Reunion

The Price Institute of Surgical Research held a reunion Sept. 7 - 9 in honor of its 60th Anniversary. More than 30 people attended, including former Price fellows from all over the world. Additionally, a former Fulbright scholar returned from Moldova. Attendees gave scientific presentations and talks about the benefits of having done research at the Price Institute.

Dr. Jason Smith Wins 2015 J. Bradley Aust Award

Dr. Jason Smith, Dr. Hiram C. Polk, Jr. and Mrs. Lily Banerjee Professor and Chair in Surgery, Division of General Surgery, has been selected as the winner of the 2015 J. Bradley Aust Award for his abstract and presentation entitled, "Direct Peritoneal Resuscitation Reduces Inflammatory MiRNAs After Hemorrhagic Shock." He made the presentation at the Annual Scientific Sessions of the 2015 Western Surgical Association in the fall.

Final Results of the Sunbelt Melanoma Trial Published in Journal of Clinical Oncology

"Final Results of the Sunbelt Melanoma Trial: A Multi-Institutional Prospective Randomized Phase III Study Evaluating the Role of Adjuvant High-Dose Interferon Alfa-2b and Completion Lymph Node Dissection for Patients Staged by Sentinel Lymph Node Biopsy" has been published in the Journal of Clinical Oncology. Click here to review an early release of the article online.

Dr. Kelly McMasters is the principal investigator of this large clinical study. He is the Ben A. Reid, Sr., MD Professor and Chair of The Hiram C. Polk, Jr., MD Department of Surgery at the University of Louisville School of Medicine. Dr. McMasters initiated The Sunbelt Melanoma Trial, at the time the world’s largest melanoma study (involving more than 3600 patients), in 1997.

Final Results of the Sunbelt Melanoma Trial Selected for 2016 Best of the Journal of Clinical Oncology Annual Meeting Edition

"Final Results of the Sunbelt Melanoma Trial: A Multi-Institutional Prospective Randomized Phase III Study Evaluating the Role of Adjuvant High-Dose Interferon Alfa-2b and Completion Lymph Node Dissection for Patients Staged by Sentinel Lymph Node Biopsy" has been selected to be included in the 2016 Best of the Journal of Clinical Oncology Annual Meeting Edition.

Dr. Kelly McMasters is the principal investigator of this large clinical study. He is the Ben A. Reid, Sr., MD Professor and Chair of The Hiram C. Polk, Jr., MD Department of Surgery at the University of Louisville School of Medicine. Dr. McMasters initiated The Sunbelt Melanoma Trial, at the time the world’s largest melanoma study (involving more than 3600 patients), in 1997.

Click here to link to the article.

Surgery on Sunday Named Honoree by National Colorectal Cancer Roundtable Award honors individuals and organizations that contribute to ongoing progress in the fight against colorectal cancer

Surgery on Sunday Louisville, Inc., a nonprofit organization that provides free colonoscopies and outpatient surgical procedures to uninsured and underinsured residents of Kentucky, was named an honoree by National Colorectal Cancer Roundtable. Each winner will be recognized on a live broadcast on March 1, 2017.

Surgery on Sunday Louisville is built on a collaborative model in which every hospital in the Louisville area shares a responsibility in providing in-kind services to offer colonoscopies to members of the community who could not otherwise afford colorectal cancer screening. These individuals are also at increased risk. In Kentucky, patients who lack insurance have more than twice the odds of being diagnosed with advanced colorectal cancer. Since its founding in 2013, Surgery on Sunday Louisville, Inc. has recruited more than 500 volunteers to treat more than 270 patients, leading to the treatment of more than 125 polyps and two cancers. The organization is now assisting communities in other states to replicate their successful model of partnering to deliver pro bono care to the patients that need it most.

Dr. Erica Sutton, assistant professor of surgery, is President and Founder of Surgery on Sunday Louisville.

The National Colorectal Cancer Roundtable (NCCRT) is an organization co-founded by the American Cancer Society and the Centers for Disease Control and Prevention whose mission is to increase colorectal cancer screening rates across the United States.

Dr. Sutton to Receive Excellence in Community Service Award

Erica Sutton, MD, will receive the Excellence in Community Service at the 2016 Jewish Hospital & St. Mary’s Foundation’s Doctors' Ball, which will be held Saturday, Oct. 15 at the Marriott Louisville Downtown. Dr. Sutton, assistant professor of surgery with expertise in minimally invasive procedures and surgical endoscopy, was recently named director of community engagement for the Department of Surgery. She volunteers her services with Surgery on Sunday, an organization that provides in-kind outpatient surgical and endoscopic care to income-eligible members of the Louisville community who are uninsured or under insured.

Gordon Tobin, MD, Named 2017 Ephraim McDowell Physician of the Year

Gordon Tobin, MD, was awarded the Ephraim McDowell Physician of the Year at the 2017 Jewish Hospital & St. Mary's Foundation Doctors' Ball.

The Ephraim McDowell Physician of the Year honors a physician who has made significant contributions to the field of medicine, provided humanitarian service, and demonstrated the highest ethical standards. This is typically a physician who has shown long-term service to the community.

Born and raised in Idaho, Dr. Tobin completed his undergraduate degree at Whitman College in Washington and his medical degree at the University of California School of Medicine, San Francisco. He completed residencies and General Surgery and Plastic Surgery at the University of Arizona before coming to Louisville.

Dr. Tobin career encompasses surgical education, pioneering medial research, care for the underserved at home and abroad and physician leadership in local, state and national organizations. Professor of Surgery and former Plastic Surgery Director, he founded a robust research laboratory that developed many new reconstructive techniques and pioneered hand and face transplantation. He is Director of Craniofacial Transplantation at UofL and an original member of the team that laid essential research foundations and performed the world's first successful hand transplant in 1999.

Dr. Tobin is a member of the Jewish Hospital and UofL Cardiac Innovation Institute Pancreatic Islet Transplantation Team, which seeks a cure for diabetes. He also studies and writes extensively on medical ethics and medical history. He has written more than 300 scientific and medical papers, book chapters and books.

As founder of the UofL Plastic Surgery Research Laboratory, Dr. Tobin's early research provided many breakthroughs in reconstructive surgery for cancer, burns and trauma. His technique of pelvic and vaginal reconstruction after radical pelvic cancer has become the preferred method worldwide. He pioneered reconstruction of cardiac and thoracic surgery defects, as well as early excision and coverage of burns. He also developed methods of vital organ coverage in separation of conjoined (Siamese) twins, working with UofL Pediatric and Cardiac Surgery teams.

Throughout his career, Dr. Tobin has embraced medical missions abroad and at home. In 1991, he co-founded the Vietnam Burn Care Mission to bring modern burn care to Southeast Asia. The mission team made repeated medical care and teaching visits to Vietnam burn centers over the subsequent decade, leading to vastly improved burn survival. He is a care provider and Board Member of Healing the Children, and he supports the volunteer efforts of Surgery On Sunday. His long-standing support of The Healing Place has helped the recovery program reach beyond alcohol-dependency recovery to address the current opioid and heroin epidemic.

Dr. Tobin is also a long-standing supporter of Kentucky's Supplies Over Seas (SOS) organization. He led the 2005 SOS effort for Afghanistan and is involved in current relief effort for Syrian refugee camps. In 2015, he obtained a grant from the Kentucky Medical Association Foundation to test and refurbish costly, high-tech equipment. This effort recycles sophisticated equipment worth millions of dollars for impoverished overseas hospitals while keeping tons of metal and toxic electronics out of U.S. landfills. He has received multiple humanitarian service awards and election to humanitarian honor societies.

Dr. Tobin has served in local, state and national roles in various medical societies. He is Past President of both the Greater Louisville Medical Society (GLMS) and the Kentucky Medical Association (KMA) and continues service on the KMA Foundation Board. His key advocacies are promoting health-enhancing behavior, protecting a health-sustaining environment and finding consensus solutions to fully insure health care for all citizens.

Dr. Jessica Weaver Awarded John M. Houchens Prize

Dr. Jessica Weaver was awarded the John M. Houchens Prize, which is awarded to the doctoral student who represents the most meritorious dissertation for the December commencement. The John M. Houchens Prize honors a former Registrar of the University. In the fall and spring of each year doctoral dissertations are submitted to the School of Interdisciplinary and Graduate Studies for consideration. If one is deemed to be of special merit, a committee may recommend that its author be awarded the Houchens Prize. Dr. Weaver is a fourth year general surgery resident.

Dr. Jessica Weaver Receives Committee on Trauma Basic Science Regional Paper Award

Dr. Jessica Weaver won the American College of Surgeons Committee on Trauma Regional Paper Competition, Basic Science Section. She now will be eligible to compete at the National Paper Competition. Her paper is entitled, "Direct Peritoneal Resuscitation Reduces Macrophages and Neutrophils in Kidneys after Brain Death." Dr. Weaver is a fourth year general surgery resident.