Before there were hospitals, prescriptions, or medicine as a science, it was a calling,

a promise to heal, to question, and to understand the human body.

Every discovery began with curiosity, and every breakthrough began with someone asking

why. From ancient remedies to artificial intelligence, this is where science meets compassion.

Welcome to the Aesculapian Society. Today, I'm honored to welcome Dr. Perel Baral, a

cardiothoracic surgeon with St. Clair Medical Group Cardiac Surgery. Dr. Baral completed

her general surgery residency at the University of Kansas Medical Center and her cardiothoracic

surgery fellowship at Baylor College of Medicine. We're excited to hear about her path into

medicine, her experiences in cardiac surgery, and her perspective on the future of heart

care, including artificial intelligence and robotic surgery. Welcome, and thanks for being

on the show. Thanks for having me.

So, let's move on to your personal motivation and background. What are your earliest memories

of wanting to become a doctor? So, I've wanted to be a doctor since I was very, very young.

My mother is a physician. She's an internal medicine doctor, and I was exposed to medicine

and being a doctor from a very young age. So, my earliest memory of wanting to be a doctor

is probably when I was like two or three years old. Like, as soon as I understood, like, what

a doctor was and, like, could say the word, that's what I always said I wanted to be.

So, how did watching her career influence your interest in medicine?

Um, I think I just really, um, was fascinated by her, um, talking about her patients and how she

cared for them and the kind of interesting cases she saw. And, um, she was always like a very,

she just, I mean, she still is, but she was always very interested in, you know, being a very astute

diagnostician and really getting at the core of, like, what was, what a patient was going through.

Um, and also she would reiterate a lot that being a doctor is not even so much about being the smartest

person in the room, but it's a lot about using common sense and being compassionate. Um, and so,

I think that really influenced me a lot.

So, you mentioned wanting to be a doctor from about two or three years old. When did that interest

changed into surgery? Probably around high school. Um, I, up until that point, had always been

interested in being a pediatrician only because I am the oldest of a lot of kids and I've always

really enjoyed working with kids and being around children. And so, that just seemed like the natural

progression of being a doctor and liking kids. And so, I was like, oh, I'll be a pediatrician.

Um, but I didn't really know what a surgeon was probably until I was in high school. Um, and then when I

started to learn about what a surgeon was and did, I was like, oh, that's, that's for me. That was much

more my speed and was fascinating to me. Um, some of my earliest exposure to the field of surgery was

just about learning about actually what a heart surgeon was and what a heart surgeon did, especially

in the congenital world. Um, and I just thought that was the most amazing thing, being able to

change patient's anatomy. Um, and I just thought that was like the coolest thing ever. And on that very,

very basic level is how I became interested in surgery. Um, and so I went into general surgery

residency, um, because at the time that I was applying to residency, there actually were a lot

less, um, integrated programs. And to be honest, I don't know if I actually would have even wanted

to do an integrated program. I don't know if, if you do know what that is, integrated residency

versus traditional. No. So, there's two pathways to becoming a cardiac surgeon, essentially. One is by

doing a general out of medical school. So, you do medical school like everybody does. And then

you can either do a general surgery residency and then do a cardiothoracic fellowship after that,

which is what I did. Or you can go straight from medical school into an integrated cardiothoracic

residency. Um, and that takes you straight into cardiothoracic surgery. You cannot do any other

type of surgery. Um, so there are a lot more of those programs now that pathway has, um,

ballooned a lot in the last, I would say maybe like seven years. Um, and it didn't, but it didn't

really exist so much. There was a couple of programs, but much, much less. Um, but I really

am so glad that I did general surgery residency because it exposed me to a lot of different

surgical fields. It gave me a lot broader, uh, experience in surgery, a lot of, uh, more exposure

with trauma and vascular and GI issues, which are things that you deal with as a CT surgeon as well.

A lot of, I got a lot of critical care experience. And so, um, I'm really, really grateful for that.

So, I have no regrets about the pathway I took and I, I loved my residency. I had an amazing,

amazing residency. Well, thanks for sharing about your residency, but what's the process you take

before residency about your undergrad and medical school? Um, pretty typical, you know, you can do

undergrad, you know, four years of undergrad. Are you asking what I did specifically or what a person

should do? Oh, so what I did was, you know, I did four years of undergrad, you know, I, my, um,

major was in biology, which is like pretty boring, you know, in terms of like standard, I guess, not boring,

but, um, you can major in anything as long as you have all the prerequisites that you need

in order to apply to medical school. But, um, I majored in biology and then I went to medical school

from college, um, you know, did four years of medical school and then residency.

So, how'd you prepare for the MCAT to apply?

Oh man, let's see. How did I prepare for the MCAT? Um, I think I took a course actually,

which was, yeah, I took a course, um, which originally I was not planning on taking an MCAT

course. Um, because it's like, oh, I'll just like studied on my own. The MCAT that I took looks very

different, I think, from the MCAT now because I took the MCAT in, I don't know, maybe like 2010,

I think, which is quite a while ago. Um, but, um, the MCAT course really helped because the MCAT

was not just, and I think a lot of multiple choice tests are like this. It's not necessarily as much

about what information you know, but it's about how to take the exam. And the course taught me how,

like the strategy of taking the exam, which helped immensely. Um, so I would say that if you're someone

who's thinking about taking the MCAT, uh, definitely look into MCAT courses. I think I took a Kaplan course.

So it's true that you left high school early to spend time in Panama?

Yes, that is true. I am technically a high school dropout. Um, I never graduated high school and I

never got a GED. Um, I was basically encouraged to leave high school early by my mother, who's

always done things a little nontraditionally. Um, and she just thought it would be a good opportunity

for me to do something a little different and learn a new language. And I was also kind of,

I felt like I'd gotten out of high school, what I needed to get out of it. By that point,

I'd kind of gotten all the prerequisites I needed in order to apply to college. Um, and so, and I

really wanted to learn Spanish. So the best way to learn a language is to immerse yourself in it,

which is to go to a country where they speak that language. So that's what I did. And I did that for,

I spent about four months in Panama. Um, I went to a Panamanian high school. I lived with a host

family. It was an amazing experience, probably the, one of the most useful things I ever did in my

entire life, because now I speak Spanish fluently and I use it to communicate with patients. And

it's just generally like, I love learning new languages. So it was a really great thing to do.

And it did not affect my ability to get into college or med school at all. So.

Did you ever learn any other languages that helped you with patient care?

Um, so my mother is Russian. My mother was born in Russia. And so she, we grew up speaking

Russian. Um, I've used Russian in patient care as well. Um, I learned Arabic, um, which I don't speak

really anymore, unfortunately, because, you know, if you don't use a language, you lose it. Um, and so

I've forgotten most of it since I learned it. Um, I never really used that much in the U S. Um,

I speak Hebrew fluently as well. Um, but that's not that much of a need for that in patient care

in the U S either. Okay. So what was more difficult for you being accepted into medical school or passing

it?

Oh, being accepted to medical school for sure. Once I was into medical school, it was, I mean,

it was hard, but, um, I would say it's much harder to get into medical school than it is to get through

medical school. Um, for me, medical school was an environment where I really felt like it kind of

played to my strengths a little bit. Like, you know, like you really medical school is just a lot

of reading, a lot of studying, um, a lot of like group studying and practice and stuff like that.

Um, and then patient interactions, which is like really what I was there for. Um, I loved my rotations

like third and fourth year. I just, I was in the hospital all the time. It was very easy for me back

then because I was not married and I didn't have kids. So I was just able to focus fully a hundred

percent on my education. And, um, it probably would have been a lot harder if, and I know a lot

of people who have done it with families and kids. It's very hard. There were people in my class who

had, um, you know, who were married and had kids. Uh, but yeah, I mean, I would say it's definitely

harder to get in for, for me, it was much harder to get in and to get through.

Looking back, is there anything you wish you had done differently during your pre-med years to help

your chances?

Um, probably I just didn't know what I didn't know, uh, to get into medical school. I didn't

really know like what medical schools were looking for. I didn't really have like a pre-med advisor.

I didn't have anyone that was like coaching me through what the process would be or what

medical schools were looking for. Um, if I'd had someone like that kind of earlier on, then

I think that definitely would have helped. Um, but I kind of just stumbled through it on my own

and thankfully it worked out. But I think having a little bit more, especially now, I mean, like my

understanding now of getting into medical schools, it's just like so cutthroat. Um, and you need like

a thousand extracurriculars and all this research. And like, it seems I probably, I don't know,

maybe I wouldn't get into medical school now if I applied, you know, in 2026. But, um, now I think

you just need like a lot, you know, like the competition is really fierce, but I think if I'd had a

little bit more mentorship, probably that, that would have helped. I think it helps to have that.

Okay. Well, thanks for sharing your experience and now moving on to your day-to-day life.

As a cardiothoracic surgeon, do you still practice on both the heart or the chest or do you specialize

in one area? I primarily operate on the heart. Um, I do all the kind of what we call bread and

butter cardiac surgeries. So coronary bypasses, valve replacements, aorta replacements. Um, I don't do

lung cancer surgery or esophageal cancer surgery, um, or any esophageal or really lung surgery at this

point. Um, for that matter, I just, I love the heart and I'm able to focus on the heart, the

position that I currently hold. I'm very fortunate that I'm able to do that. Um, and I do, that's what

I do. Did you study on both the heart and the chest? Yes, of course. And, and cardiothoracic

fellowship, everybody in order to graduate has to operate on both the heart and what we call like

thoracic structure. So long esophagus, medius dynum. So what's the reason most doctors either

like specialize in one area? Because it's easier to specialize in one thing than to do everything

at this point, you know, like 50, 60, 70, a hundred years ago, a lot of doctors did everything, but now

there's just so much specialization and there's just so much more knowledge and

things are a little bit more intricate now. So most surgeons will specialize, um, in one area or the

other. Most fellowships and training programs are tracked. So meaning where I was, there were four

fellows. It was a very big program. There were four fellows per year. And three of those spots were for

cardiac focused, um, trainees. So those who were already knew that they really wanted to focus on

the heart. Um, and one spot was for thoracic. Um, and so that's pretty typical. Um, it's not usually

that many per program. Most usually it's like one or two fellows in each program, but, um, that is

pretty standard. Okay. So what does a typical day in your life look like from arriving to the hospital and

going home? Oh man, there's not really a typical day. Um, but I would say, let's say if I, if I take a day

that I'm, um, that I'm operating, um, most days that you operate here, the case starts at 630. So meaning

the patient rolls back to the operating room at 630. And so I try to be in the hospital by six o'clock so

that I can go see the patient before they go to the OR, make sure everything is all good, make sure I can

answer any last minute questions. I try to say hello to the patient's family. Um, if they have family that

came to accompany them to the hospital, just reassure them, say I'm here. I, if you have any other questions

like last minute, I'm happy to answer them. You know, here's where I'll find you after the case. And just

kind of, um, I think that it's nice to like reassure patients that, you know, you're there and to give

them the opportunity to ask any last minute questions and to see you. Um, and then usually

when a patient rolls back at 630, it takes about an hour to get them set up for the procedure itself.

It takes a lot of prep work to get a patient ready for a cardiac operation. So usually after about an hour,

they're ready, um, for incision. So I usually start the case at around 730. Um, and then it just depends

on what I'm doing. So, you know, if I'm doing like a three vessel bypass, um, that takes a little bit

longer than just an aortic, like a simple aortic valve replacement, for example. So, you know, then

you're operating for the next few hours and then, um, you know, maybe I'm done with the case anywhere

between like 1230, 1 PM, 3 PM. It just depends on what's going on. Um, you know, finish up with the

operation. Usually I go straight from the OR to the waiting room to talk to the family and tell them

how things went. Um, and then I go to my office and usually, you know, chart the op report, check up on

other patients, things that are going on. Um, and then I go to make sure the patient gets settled

nicely in the ICU. Um, check on my other patients, usually in that hour between 630 and 730, I go

around that my other patients also, if I have other patients in the ICU. Um, and then, yeah, if I'm on

call, you know, deal with any other stuff that comes up. If I'm not on call, then usually I'll just make

sure everyone's settled and then go home. Just, and what time I go home just really depends on what's

going on in the hospital. Um, that can be anywhere from 430, five o'clock, six o'clock, seven o'clock.

It just really depends. Um, if I'm not operating, then I can come in, you know, see my patients.

Usually I have some clinic patients to see if it's a clinic day or, um, some days I have patients added

on if it's not a clinic day. Um, and then I'm just available. We're all, you know, all of us in the

group are available to help each other for, for cases or to cover each other as needed. So, um,

you just kind of have to go with the flow. And then when I go home, you know, then I'm,

then I'm the mom and the wife and I help my husband out with the kids and, you know, get everyone fed

and put them to sleep and, and all that. And then I, you know, spend some time, try to spend some time

with my husband. So could you walk me through like a common surgical procedure that you do

in language that I could understand? Sure. Um, so I would say coronary bypass is one of the

operations I probably do the most and I really enjoy doing it. Um, essentially what that involves is

the first part of the operation is actually, uh, harvesting conduit, um, for the bypass itself.

So what a bypass is, is when a patient's heart, which has arteries that supply the heart muscle

itself, um, sometimes those little arteries get blocked. And so the heart muscle is not able to

receive the nutrients and oxygen it needs. And so the heart can become weak and that, you know,

patients can get heart attacks from that. Um, and so what I do is I don't remove the blockages,

the blockages stay where they are. So, um, what I do is actually create a new pathway around the

blockage. Um, and in order to do that, you need some sort of tube, right? That can bring blood from

a source of blood, which is usually the aorta, um, or, uh, a vein, sorry, the source of blood,

which is the aorta. So you need some kind of like either an artery or a vein. Um, and so we most

typically use veins from the patient's leg. Um, and then an artery from, uh, underneath the sternum

or the breastbone called the internal thoracic artery or the internal mammary artery. Um, and so

usually I have a physician's assistant that will be harvesting the vein from the leg while I am

harvesting the artery from underneath the breastbone. So the first part of the operation is just obtaining

that conduit. Um, and then once that's all done, um, the patient's ready to actually be put on bypass.

So most cardiac operations are done what we call on pump. Um, and what the pump is, is it's a machine

that takes over the function of the heart and lungs. Um, and why do we need that? Well, a lot of times

during a cardiac operation, the heart has to be stopped in order to be able to work on it. Um,

and so we need to be able to keep the patient alive while the heart is not pumping blood.

So what we do is, is we hook the patient up to this heart-lung bypass machine, which does the

job of the heart and the lungs. And it allows the heart and the lungs essentially to be turned off.

We turn the heart and lungs off. The patient's heart and lungs are not functioning while I do the

operation. Um, and the machine is pumping the blood through their body. So we hook the patient up to

that machine. Once we put the patient up to that machine, um, we stopped the heart. Um, and then I

make all the little connections I make, I sew, um, the connections between that vein or the artery that

I harvested in the heart. Um, and then once all the connections are, are done, then I restart the heart,

heart starts beating again. Um, you know, I'm working very, very closely with the anesthesiologist.

We have specialized cardiac anesthesiologists, um, who are, uh, specialized in working with patients

who are undergoing cardiac surgery. They can do other things, but we only work with anesthesiologists who

specifically do cardiac operations because they need to be experienced in, uh, working with patients

who have heart disease and whose hearts are stopped. And while the hearts are stopped, we work, you know,

and while they're on bypass, we work very closely with the perfusionist. And the perfusionist is the

specialist that runs that heart-lung bypass machine. Um, so there are a lot of people in a cardiac

surgery operating room. It's not just you and the anesthesiologist. It's the surgeon, anesthesiologist.

Usually there's a, uh, like a CRNA, which is a nurse anesthetist. Um, that's there for most of the

case and the perfusionist. Um, of course the scrub tech is the one that hands me the instruments

during the case. And they're really, I was going to say instrumental and I didn't want that to be a

pun, but they are instrumental. Um, and then there's usually a nurse or two, what we call the circulator,

um, whose job it is to basically keep the room running because, you know, everyone that's scrubbed in

is sterile and we can't go and like grab an instrument or grab a suture or grab a, um, any other kind of,

um, material that we need during the procedure. So their job is to be able to keep us is to allow

us to be able to stay sterile during the operation. So the nurses are really, um, really, really

important part, um, of any cardiac or any operating room in general. Um, but I think one of the new

things about cardiac surgery is just really how closely the whole team works together. It's really,

really important to, for everyone to be able to communicate clearly. Um, and the surgeon is kind

of like the conductor of that whole orchestra. So, um, but to go back to what I was saying,

so, you know, we restart the heart, the heart starts beating again. I'm talking to the anesthesiologist,

making sure everything looks good. I'm talking to the perfusionist, making sure on their end,

things look good. Um, and then once I feel the patient's ready to be disconnected from the bypass

machine, you know, the heart's beating, the lungs are turned back on again. So the patient's lungs are

being ventilated through the ventilator machine. Um, then I disconnect the patient from the heart

lung bypass machine. Um, and as long as everything looks good, then you close the patient up. We use

typically wires, stainless steel wires to close the patient's bone to put it back together. Um,

and then, you know, suture the skin back up and that's it. And we get them off the operating table

and taking them back to the ICU where they recover. So after the surgery is done, there's like two

outcomes, either the, either it's successful or unsuccessful. How do you handle the emotional

side of medicine that includes complications and difficult outcomes? Well, I think first of all,

you have to kind of, uh, maybe clarify what you mean by unsuccessful. Um, I guess maybe that term

applies differently in different situations, but you know, if I'm doing a heart-lung bypass,

sorry, doing a coronary bypass procedure. Um, I guess success is measured by how well those bypasses

stay open. Um, and how well the patient is able to avoid heart attacks in the future and heart failure.

Um, and so by that measure, the vast majority of coronary bypass procedures are successful. It's very,

very, very, very rare, um, for none of the bypasses to be open or for the patient to get a heart attack

right after the procedure or very soon after the procedure. It's very uncommon. It does happen.

It's very uncommon. Um, but there are other complications that can happen. Um, and I tell

patients that before every surgery, because every surgery has risks and you, I only operate when I feel

that the benefits outweigh the risks. Um, so every surgery involves complications such as infection,

bleeding. Um, if someone has enough bleeding, sometimes they have to go back to the operating

room for another operation to stop the bleeding and to wash, wash them out. Um, you can have

lung complications. Patients can get pneumonia. Um, patients can require oxygen for an extended period

of time after surgery. Patients can have kidney complications, um, meaning they might have some

degree of kidney failure afterwards to have that be a very serious thing is very rare, but it does happen.

Um, and stroke, um, is one of the other things that can happen after a cardiac surgery as well.

All of these complications on an individual level are very rare. Um, all of them together also are not as

common, but they are things that definitely happen. Um, and it can definitely be frustrating when they

happen because you only want the best for your patient and you're operating on them because you

want them to have a longer and or better quality of life than they had before. Um, and so you don't

want that to be complicated by having to deal with, you know, prolonged ICU stay, infections,

um, you know, stroke complications, things like that, but it does happen. And the main

way that I tried to deal with complications like that is just by treating the patient,

you know, you can't get frustrated about something that happens with the patient, you know, that starts

to become evident that the patient is having, um, you know, a need for dialysis or something like

that. You can't just be like annoyed about it. You have to be like, okay, we got to treat the patient.

We're going to get nephrology on board. We're going to get them access. We're going to do what we need

to do in order to get them treated and get them better. And the vast majority of time, the patients

recover from these complications as well, which is great. Um, but you know, even small things,

for example, like let's say a patient comes back to clinic and it's, I can see on their x-ray,

their kind of post-op, their two-week post-op x-ray that they have, um, a fluid collection around

their lungs, which happens, doesn't happen all the time, but it happens. It's frustrating. Like,

I don't want them to have another little procedure to have that fluid removed, but like, you just

have to treat the patient, you know, just be like, okay, we're going to get this drained.

You're going to get better. And it's going to be done. Like, we can't just be like upset about it.

You know, there's no use crying about it. You just got to treat the patient and get them better.

You know, that's why you're their doctor. So that's how I try to try to think about it.

So during surgery, do you use AI and robotics to help you?

Not during the operation. During the operation, things are still relatively old school. You know,

it's just you and your hands and the instruments and your brain, um, you know, doing things the way

that we've been doing them more or less for the last, I don't know, 20, 30 something years. I mean,

with updates, you know, obviously there's like new techniques and new instruments and new materials.

Um, but right now in the open heart space, we don't use a lot of, um, like AI or some people do

robotics. I mean, where I trained in fellowship, we did robotic heart surgery. Um, I don't do that

here, but, um, there are places that do it. That's still like a little bit more niche. Um, one way that

I do use AI sometimes is just in, um, doing research, prepping for a case. You know, if I have a patient

that, excuse me, I encounter in consult, um, who, you know, every patient is different. So sometimes

you'll have a patient who, um, presents a challenge in terms of trying to figure out like what's the

best option for them, surgical or non-surgical, or what's the best surgical in terms of a few

different types of operations. And so I do use AI, um, to help me gather data. Um, and then I can make

a better decision by, you know, being up to date on guidelines and things like that, because things

are changing a lot. And sometimes I'm like, you know, I don't really know. I don't remember exactly

like what was the guideline on this particular issue or, um, have there been other instances

or other cases of this and where it used to be that I would do like a PubMed search on that. And

it would take a long time because you're sifting yourself through all these different papers. Um, but

now there's different AI models that will help you gather and synthesize that data. So that can help a lot.

Heart surgery is often viewed as one of the most technically difficult careers in medicine.

How much of succeeding in the profession depends on academic ability and how much depends on

communication?

Um, well, I think you mentioned three different things because you mentioned, uh, technically

challenging or technically demanding, um, academics and communication. I think those are three very

different things. Um, because, uh, academics, meaning like how well you can answer a question

on a test, um, that can be taught. Um, and some patients—some people are not very

inherently good at that. Um, and it doesn't mean that they're not smart. It just means that their

brain is just not wired as well for multiple choice tests. Um, and those same people can be very,

very good at interacting with patients, have excellent bedside manner, have a lot of common

sense, have excellent clinical judgment. Um, and with that also goes like really good communication.

Um, and then there's the skill aspect, which just has to do with like how dexterous you are and how

well you are able to like execute all the fine movements that are needed in order to do a cardiac

operation, which, yeah, I would say, I would agree that cardiac surgery is probably one of the more

technically demanding surgical specialties. Um, and I think that skill can be improved upon.

I think it definitely helps to have some innate ability and some innate dexterity. Um, and,

but having common sense, compassion, um, good clinical judgment, I think all of those things are really

hard to teach. And those are some of the things that are actually the most important in being a good

cardiac surgeon, because I have worked with surgeons in the past who are technically very good. They can

do a very technically beautiful operation, but they have very poor clinical judgment, meaning that they will

operate on people who really should not have surgery and they can do a lot of harm in that way.

Um, and so I think a really important part of being a heart surgeon, a really important part of being

any type of surgeon or any type of doctor is knowing when to do something and when not to do something

and allowing yourself to execute that, uh, sort of judgment. Um, and communication of course is always

like a huge part of it. I would say in CT surgery, probably even more than in other specialties, because

we work so closely with other specialties as, uh, a general surgeon, perhaps I would say

we work a lot less with medicine specialties. Um, and it's, it doesn't make as much of a difference

to have like a really close relationship with the anesthesiology, but, um, CT surgeons work very

closely with cardiology, work very closely with anesthesia, um, very closely with critical care. Um,

and so I think that being able to communicate and be part of that bigger multidisciplinary team is

really, really, really important. It makes a huge difference for your patients. So, um, I think

recognizing that you're part of a bigger team is, is really important. Okay. So are there any

sacrifices of this career that students do not hear about often enough?

Um, there are huge sacrifices. Uh, I don't know if students hear about them or not. I would say that I,

I probably did not understand the magnitude of the sacrifices that I would have to make in order to

do this job. You know, like I made the decision to be a heart surgeon when I was very young and I just

kind of pursued that very persistently, um, without really understanding what exactly it involved.

Um, I think that there are really big sacrifices in terms of your personal life, your social life,

your family life, um, that have to be made. I think as a woman in surgery, there's no avoiding

the fact that you're going to make really big sacrifices in terms of family. Um, I think that

I don't feel that I've ever been discriminated against, um, as a woman surgeon. I never felt that

I was ever discriminated against as a resident or as a fellow. I feel, again, this is my personal

experience that I was always treated with a lot of respect, um, and was treated by my attendings and

my co-residents, um, no differently because I was a woman. However, um, I think that people don't

appreciate or understand really like, it's just very, it's very, very difficult if you want to have

a family, if you want to have kids being pregnant, doing this job, having a newborn doing this job is

extremely difficult. Um, and I'm doing it. I'm, I'm currently, I have two young children

and I'm expecting a third in about five weeks. Um, and it's very hard, but it's definitely doable.

Um, if you, it's helps to have a very supportive and involved partner. Um, my husband's amazing.

Um, but it's very, very, very, very, very hard. And I am not, I would encourage anyone that wants to

go into the specialty to, you know, pursue it and talk to as many people as possible. Um,

but you know, so that you can get a sense of if this is really something that you want to do.

Um, but you know, I love my job. I'm very, very fortunate that I get to help people in this way

every day. And I really value being able to be part of the people's lives that I helped in the way that I

am. Um, and it can be extremely gratifying. Um, but yeah, it's very hard. You make a lot of

sacrifices. I spent the entirety of my twenties, you know, studying and in the library, I was probably

not at all as good at having like more of a social life as I could have been. There's definitely people

who are in med school who are not studying all the time. Like people are in med school and have

lives outside of med school and you can 100% do that. Um, I just like, didn't really know how to do

that. I didn't know that that was like an option. So I sacrificed like, you know, a decade or more.

I mean that, you know, my entire twenties I spent like in school, you know, so, and as a resident. So,

um, you know, but I don't have any regrets and I just, I think that it's good for people to know

what the options are and like what they're getting themselves into.

Well, first, congratulations. And, uh,

Thank you.

Second, you mentioned you had a family and you need to support that. So for you personally,

what percent of being a doctor is about the money versus helping people?

I mean, I would say like, don't go into the, don't go into this if money is your only motivation,

because it's going to be very disappointing. I would say, I'm not going to lie and say,

as a CT surgeon, I don't make good money. I make good money. CT surgeons are some of the most

highly paid physicians. Um, so I think that I'm very fortunate in that aspect. Um, but

a lot of other specialties are not as well paid at all. Um, and it doesn't mean that they don't work

as hard. Um, it doesn't mean that they don't help people as much or more than I do. Um, it's just the

way the system works, unfortunately, and the way that, uh, healthcare reimbursement in this country

goes. Um, so I would say that a very, I would say it's more helping people versus the money,

because if it was just the money, then I would do something else. You know, like there's a lot of

other ways to make a lot more money than to be a heart surgeon. I mean, like for the money alone,

it is not worth the stress and the time. I mean, like being a heart surgeon is unbelievably stressful.

Um, your patients are very, very, very, very sick. Um, and being on call as a heart surgeon,

I mean, you have to be ready to just drop everything you're doing at the, you know,

at a moment's notice. Um, and that is very stressful. So yeah, I would say if you want to do this,

you have to be very strongly motivated to help people. Um, and only minimally motivated by the

money because the money alone is not going to get you there. So if a student has the passion,

do you believe medicine is still a good career if they need to borrow money to complete their education?

Yeah, of course. I mean, I had to borrow money to complete my education. I'm still paying off my

student loans and, you know, that's just a part of my life. But, um, if someone has the passion and the drive

and the, um, the willingness to do the work that it takes, then I 100% think that medicine being a physician

is, is a good path to take. Um, but I think it's the, the landscape of healthcare is changing a lot.

So I'm not sure how, you know, where it's going to go over the next, you know, 10, 15, 20 years. Um,

but I, you know, there's already a shortage of physicians in this country and that shortage is

only going to get worse. So I think it's, it's still a very worthy field to pursue.

So do you see AI and robotic surgery as threats to medical careers or tools that will change

for the future of medicine?

I don't think it's a threat. I think it's a tool that will change medicine and in a lot of ways can

make, make it, make our ability to help patients. It'll expand our ability to help patients. So it'll

make it better. Um, and I think as with all technological advances, like it's not worth fighting

because it's going to happen whether you like it or not. And so you might as well get on board and

figure out how it can benefit your ability to help patients, um, rather than just, you know,

taking a stand and refusing to allow yourself to be, you know, um,

helped because it's just not the way technology goes, you know, people who are, people who refuse to,

you know, use technology or just, it just, it doesn't help you.

So if your children someday told you that they want to be a cardiothoracic surgeon,

would you encourage them, warn them about the sacrifices or do a bit of both?

Well, I have two girls, um, and the baby I'm currently pregnant with as a boy. Um, I do think

that makes a difference to be honest. Um, but regardless of who it is, if the boy or the girls

told me they wanted to be a heart surgeon, I would 100% just, I would, I think they would see

the sacrifices already growing up with me as their mother, but I would, yeah, I would tell them about

the sacrifices I would tell them about. I would make sure that they understood like how difficult

it is. Um, I wouldn't discourage them from it. Um, I think that I would try to help them make the best

decision possible. Um, and I would make sure that they understood that you don't have to be

only a heart surgeon to be able to help people. I think it's a wonderful thing to do.

Um, and I think that women make incredible surgeons and I wish that we were a little bit better

supported in this country. Um, from like a family standpoint, um, because I think that fewer women

would leave, um, the workforce or, um, be discouraged from going into certain specialties if we had

better support, um, as mothers essentially, because most, most women still want to be mothers. I mean,

a lot of people don't, but most women still do. Um, but in certain specialties, that number is a lot lower.

Um, and I'm not saying that everyone has to have kids at all. Like that's a very personal decision,

but for the people that do, I think they need better support because those same people can still

be really, really, really good doctors and surgeons. But, um, you know, when they're fighting against

a system that doesn't support them, it becomes very, um, counterproductive.

What made you feel that St. Clair would support, would support you as both a surgeon and mother?

What made me feel that way? Well, from the very first interview I had with, um, Dr. Andy Kiser,

I knew that he would do that because one of the very first questions he asked me was,

tell me about your family, tell me about your personal life, tell me about your husband,

tell me about your kids. Um, and I knew that he cared not just about me as a surgeon, but he cared

about me as a person and supporting me, um, as someone who's not just part of his team, but part of his

community, you know, and so he wanted to make sure that I was supported, um, on all those fronts.

And so that is a huge part of why I took this position because that support is very rare to find.

So how do you physically remain present for your husband and children

when you might need to be at the hospital at unpredictable hours?

Well, when I'm at the hospital, I'm not physically present with them at all. So, I mean, you know,

you just have to make sure that your partner is aware of the fact that you're on call, that you have

to leave at any moment, um, try to have backup childcare available if possible. We are definitely

struggling with that because we don't have any family here in Pittsburgh, but, um, you know,

so you kind of have to get, you know, your village and neighbors and babysitters and nannies and stuff

like that. Um, but yeah, it's, I mean, when I'm on call and I'm at home, I try to be at home as much

as possible. I, when I'm not on call, I leave my phone in a different room. I don't look at my phone.

Um, when I'm on call, I have to have my phone, you know, nearby so that I can hear if someone

calls or something like that. But, um, you know, I try to be as present with them as possible when I'm

there. And then if I have to leave, I have to leave and that's it. And my husband understands and he

supports me and, you know, you just, you figure it out. Um, and you just take, take it one day at a

time, a lot of coordination, a lot of planning, a lot of organization. I mean, when I say one day

at a time, I mean, like mentally you take it one day at a time, but, um, you know, my husband is

very, very organized and on top of things. So we plan things out well in advance.

Well, the final question, what piece of advice do you wish you had heard when you're an early teen like me?

Um, I would say, I don't know if I would have followed this advice, but I would probably say,

um, when you're in college, try to not just sit in the library all day, every day, you know, try to

get out there, enjoy your life, spend time with friends. If you're in college in a city that you

haven't lived in before, go explore the city, go meet new people, try to get out there. Um,

and don't just have this mentality of like, I'm a pre-med student. The only thing I can do

is study and be a pre-med, you know, student. I think it's really important to get out there.

And that's also part of why, like, I went to Panama, I went to learn Arabic, I got to do these

different things. But, um, I definitely was a little more single-minded than I should,

but that I could have been, you know, like I could have probably gotten out there a lot more, but

I just didn't know. I was, I didn't know like what, what the world was like. So, um, yeah, I mean,

like, well, the main piece of advice I would say is like, spend as much time as possible outside,

I guess, like do sports, move your body, um, be outdoors, throw your phone in the garbage.

Like, don't be on your phone. Like, I can't stress that enough. Like, don't be on your phone, I guess.

That wasn't so much of an issue when I was younger. And like, now I'm like,

it's, uh, yeah, just be, be present in the real world. You know, I think you'll learn a lot more,

um, from that than, you know, from a lot of stuff that you see on the internet.

Okay. Well, thank you so much for agreeing to be interviewed. I am currently weighing my options

on what type of doctor slash surgeon to become. So I really appreciate all the information you've

given me. Of course. Can I just say you, what grade are you in? I'm in eighth grade. I'm in the

summer transition, transitioning to ninth. Okay. I would say don't make any decisions right

now. That's maybe one other piece of advice I would give. Like, I didn't make a decision to be

a heart surgeon until I was halfway through residency. You know, like, it's very difficult.

You can't make that decision right now. Um, I would say like, allow yourself to be open to

different specialties. Um, you're so young and so inexperienced. And I don't say that to like,

insult you. I'm saying that to allow you to understand that your options are limitless.

Like you have so much potential and so much ability to do whatever you want. So don't

pigeonhole yourself too quickly. Um, no one's forcing you to make that decision right now.

There's no need for you to feel like you have to decide right now what kind of doctor you want to

be, or if you even want to be a doctor. So I would say just try to keep your, try to keep your mind open.

Um, and I think you'll be really pleasantly surprised about like how much that opens you to new experiences.

Okay. I won't decide.

Thank you. All right. You're welcome. Take care. Enjoy the rest of your summer.

Yep. Good luck with everything.