How did you decide that ENT was the right fit for you?
In medical school, I found head and neck anatomy the most fascinating. Once clinical rotations started, I quickly realized I wanted to do a surgery subspecialty. I found ENT to be a great mix of clinic, surgery, and hospital time. It is a refined and elegant specialty, and I considered pursuing a career as a cosmetic surgeon. After my internship, I had the opportunity to do a year of research at Memorial Sloan-Kettering Cancer Center. I had incredible mentors both in research (Dr. Stimson Schantz) and clinically (Dr. Eliott Strong), and I returned to my ENT residency determined to pursue head and neck oncologic surgery and research.
What does a typical week look like for you (split between clinic, research, and personal life)?
For most of my career (23 years), I was at MD Anderson, where each week I had a full all-day clinic and two days in the OR. The rest of my time was managing a molecular epidemiology and HPV cancer research teams as well as various administrative responsibilities. For the past four years here at Baylor, I have a more relaxed clinical load with one day in clinic and usually two mornings in the OR with the remainder managing our HPV-related oropharyngeal cancer screening research and clinical trial. Most weekends I find time to work on various chores and projects at our place out in the country.
How did you become interested in HPV-related oropharyngeal cancer as a research topic?
I was intrigued early in my career by the number of patients seen at MD Anderson with head and neck cancer, who never smoked. Very shortly after joining the faculty, a senior oncologist recommended me to a major medical journal to peer-review a manuscript on HPV-related head and neck cancer. It turned out that the first author was an otolaryngologist, the design of the study was fantastic, and the paper became a milestone in the field. I decided to pursue this topic in the cohort of new head and neck cancer patients and cancer free control subjects that we were collecting at MD Anderson, and this led to our initial HPV publication in 2003 and subsequently many other related projects and ultimately a cancer screening clinical trial based upon HPV biomarkers.
Do you have any insights or advice to share with medical students interested in ENT?
Know your head and neck anatomy. The foundation of excellence as a surgeon is anatomy. As you go through training and come to the OR, you must know your patients and their problems, and the planned procedure; just as the staff surgeon’s responsibility is to be fully prepared and almost never surprised in the OR. Listen to your patients rather than talking at them. Learn to never seem rushed with patients, especially when meeting them the first time. Be honest to yourself and your patients; when you do not know or do not have experience with such seek the help of others.
What is your favorite surgery to perform and why?
Neck dissection: When done meticulously with care, the beauty of the anatomy is revealed, and the patient recovers with minimal impact.
What is one book every young person pursuing a career in medicine should read?
The House of God by Samuel Shem, but please understand that this is a novel based upon medical training in a different era. Its relevance remains, as most of your faculty in their 60s and older can relate to this in their own training.
