May 13, 2025 • 44 mins
Dr. Maija Cheung is currently a surgeon at Yale University and the Chief Medical Officer for Kids Operating Room – the world’s leading children’s surgery charity. During her residency at Yale, she started working with group that would become Kids Operating Room (KidsOR). She became the Chief Medical Officer (CMO) for KidsOR in December 2023 as well as the CMO for the KidsOR commercial subsidiary Global Hospital which develops healthcare infrastructure and solar powered solutions in low-resource settings with all profit going to KidsOR to create capacity for children’s surgery around the world. Dr. Cheung has spearheaded numerous projects aimed at improving healthcare infrastructure, increasing training opportunities for the health workforce, and promoting access to care in underserved areas. She's currently working on two major projects as a part of her work to build operating rooms for children in Ukraine and a collaboration with NASA and American Oxygen to develop new technology for providing oxygen in low resource settings around the world. I hope you learn something new and enJOY!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This is me, Craig Ferguson. I'm inviting you to come
and see my brand new comedy hour. Well it's actually
it's about an hour and a half and I don't
have an opener because these guys cost money. But what
I'm saying is I'll be on stage for a while. Anyway,
come and see me live on the Pants on Fire
Tour in your region. Tickets are on sale now and
we'll be adding more as the tour continues throughout twenty
(00:23):
twenty five and beyond. For a full list of dates,
go to the Craig Ferguson show dot com. See you
on the road, my DearS. My name is Craig Ferguson.
The name of this podcast is Joy. I talk to
interesting people about what brings them happiness. Today, my friends,
(00:47):
my guest on the podcast is Dr Maya Chung, who
is a pediatric surgeon at Yale. That's pretty impressive in itself.
Speaker 2 (00:55):
She is also the chief medical officer of a group
called kits R, which provides pediatric surgical opportunities for you know, children.
Speaker 1 (01:07):
That need it in areas where it's kind of difficult
to get. So I'm going to let you talk to
her through me, and I'm going to talk to her.
I really like this one and she's very impressive. Enjoy. Hello, Maya,
(01:28):
how are you?
Speaker 3 (01:30):
I'm great. Craig, how are you?
Speaker 1 (01:31):
I'm good. Are you in Yale today? Are you in
new Haven today? I am.
Speaker 3 (01:35):
I'm just outside. Actually we're in Brandford.
Speaker 1 (01:39):
Now. Before we get into that, I just want to
talk to you a little bit about because you're you're
a surgeon at Yale, right.
Speaker 3 (01:45):
Yes, I've been for many years.
Speaker 1 (01:47):
Actually, now I want to talk to you a little
bit about Yale before we talk about you and we
talk about kids, oh are and we talk about surgery.
Because Yale. I've done stand up shows at Yale, and
I've stayed in New Haven. And the best description I
can give of Yale is it's Hogwarts in the middle
of downtown Detroit. Does that seem like a reasonable it does?
Speaker 3 (02:10):
It seems perfect, perfect description there. It's an interesting place.
It's an interesting campus, for sure.
Speaker 4 (02:17):
Yeah.
Speaker 1 (02:17):
The campus seems very lovely and collegiate and all sorts
of beautiful young people walking around with scarf sown and
stuff like that and performing magic. But then you go
outside and get things get a little crackier. In New Haven.
I noticed a little bit more, a little bit more,
but more lively. You know.
Speaker 3 (02:36):
It was one of the reasons I actually chose to
come here back in the day for residency, because I
wanted to take care of a lower resource population and
really be in a little more urban area, but not
be in New York City or Boston.
Speaker 1 (02:48):
Now that's interesting because two things I want to ask you,
Why you wouldn't want to be in New York City
and Boston. Let me ask you why you wouldn't want
to be in New York City or Boston.
Speaker 3 (02:59):
Well, I'm from Kansas originally.
Speaker 1 (03:03):
Not enough, Yeah, yeah, I get it. Yeah, it's a
little lively. So but what about why were you drawing?
Speaker 3 (03:11):
Uh?
Speaker 1 (03:11):
Well, I know this about you, but I'm kind of
leaning the witness a little bit. But why were you
interested in working with with lower income people? And does
not actually happen at Yale anyway? The people come in
and did they get out there?
Speaker 3 (03:25):
Yeah, I know absolutely. Yale and one of our sites
in Bridgeport are really high numbers in terms of people
who are on some type of assistance or who are
maybe migrant workers, unemployed, lower income socioeconomic backgrounds. So we
do have a lot more than certain areas. You know,
I had worked with kind of lower resource populations for
(03:48):
many years when I was in medical school, and before that,
I spent some time abroad in the Middle East and
Asia and was just really found a lot of fulfillment
in being able to provide care or help of any
kind to populations that maybe didn't have certain types of access.
Speaker 1 (04:06):
I mean, one would presume, and we'll get onto the
kids who are charity in a minute, which both you
and my wife are involved in, but the idea of
going into a lower resource population, I assume for a surgeon,
that would mean there's a lot of none of the
financy equipment that you get in Yale Hospital, right.
Speaker 3 (04:28):
I mean, there's a very big difference, yes, between what
I have access to at Yale versus when I'm operating
and let's say Kenya or Uganda. My main clinical practice
right now is actually at the Veterans Hospital in West Haven,
and the VA hospital is also an interesting place in
terms of minimized resources because obviously, as a government institution, right,
(04:52):
there's a lot of a lot of restrictions and things,
and that population especially is one that really seeks access
through the VA because they don't necessarily have a lot
of other options. So again a population of maybe more
homeless people than one would traditionally think about.
Speaker 1 (05:09):
And what kind of surgeries that you perform and on
people that are the trauma surgeries? Are they you know,
like appendect mees, what's going on?
Speaker 3 (05:17):
So I did training in minimally invasive surgery and bariatrics,
So I do a lot of belly surgery that's not cancer.
Is the easy way to put everything from gall letters, appendicitis,
different types of hernias, weightless surgery. I do a lot
of robotics. Actually, that was one of my specialized trainings.
Speaker 1 (05:35):
So yeah, do you use AI in your in the robotics?
Now do you use that for surgery?
Speaker 3 (05:42):
So we use AI in a couple of ways. More,
I think on the kind of academic side and looking
at metrics that AI can help us learn from what
we're doing in the operating room or what other people
are doing in terms of kind of maximizing our efficiency
with movement. Stuff like that.
Speaker 1 (05:58):
But thanks you so much, GP GPTC take that gold ladder.
Speaker 3 (06:05):
Yet, I'd be out of a job for sure.
Speaker 1 (06:07):
I don't. I don't think that's coming anytime soon. But
maybe it is. I don't know. I mean when you
when you go into a low resource population though, like say,
for example, I know about the charity obviously kids who
are and I know they have pediatric surgical sites in
Uganda in particular, and some of these places are in
(06:29):
rural Uganda. Is that right to say it's outside of Kampala? Yeah?
Speaker 3 (06:34):
Absolutely?
Speaker 1 (06:35):
So what what are you dealing with there? I mean,
are you able to get appropriate levels of sanitation, are
you able to get you know, you know, decent equipment.
What are you doing?
Speaker 3 (06:46):
It's really a spectrum. So some of the places I've
been you actually have minimally basive surgery laparoscopy. I was
teaching some of that in Kenya last year, which was
really phenomenal to work with the teams there. Other places
you might have a very minimal equipment, not the right equipment,
not a great opportunity to sterilize equipment for example. So
your reprehainst to a lot of challenges. But I'm sure
(07:09):
we'll get into this. But you know, a lot of
what we're doing at Kids Operating and is trying to
bridge that gap so that people in world Uganda don't
have to be doing without and can really provide the best,
safest care they can to kids around the world.
Speaker 1 (07:22):
And what kind of I mean, like the pediatric operating
rooms that you're working in Uganda or in other parts
of low resource areas, are they what kind of surgeries
are you see? Are the emergency things? Are they both?
Speaker 3 (07:40):
So there's a lot of emergency operations that are happening.
There's a lot of wait lists. You know, kids here
might get a hernia fixed in a couple of weeks
it might take years and a lot of other places,
and the impact on a child's life and a family's
life if that's the case, can be really devastating. We
also see a lot of complex surgery, so it's amazing
(08:00):
there's so much talent and all of these other places
they're able. I mean, you've gone as a perfect example
where they've been able to step right conjoined twins, and
you know, we think of that as something that's so
highly specialized, but the technique is there, the training is there.
It's really just the equipment and a little bit of
probably solar power, because that's another problem operating in these places.
(08:21):
Power outages that can really make a difference.
Speaker 1 (08:25):
I know. George Youngston, doctor George Youngston, who is a
friend of mine. George is one of the pioneers of
the work getting done out there. That George said that
when I first talked to him about kids who are
he said that cleft palate, for some reason was something
that a lot of people, they were dealing with a
lot of kids with with a cleft palate surgery they
(08:46):
were fixing. Is that true?
Speaker 3 (08:48):
Yeah, cleft palate, club feet, and you know those are
things that a quick, simple surgery can be a one
time fix, simple on the spectrum, right, but it's really life.
I mean, we have case studies out of Kenya. Is
one place, a refugee camp that we worked and there's
a child there who was born with cleft feet and
(09:08):
that would have been fixed within a matter of months
and some simple procedures in the US or the UK.
His parents carried him, you know, they physically carried him
for years everywhere he had to go, and finally he
was able to get care in one of our operating rooms.
And now he plays on his local soccer team and
runs around with them.
Speaker 1 (09:26):
Men U Jersey on Yeah, well, I'm not sure that
I'm completely a fan of his Startorial Troit team. Yeah,
but I mean that's an amazing thing to me. So
I mean hearing about the people who are walking, because
I did hear stories about this, about women who were
(09:46):
carrying their babies twenty thirty, forty miles and more and
physically walking through I don't know if it's jungle or
what kind of area is, but walking to get to
an op in room for the kids.
Speaker 3 (10:02):
Yeah, and I mean if you think about what that
does to a family, also the impact on them. Sure,
we did a lot of studies a while ago looking
at how much families had to sell, like sell cattle,
sell home goods, things like that to be able to
even make the trip. I mean that impact on a family,
And yeah, if it's only thirty miles, they're pretty lucky.
(10:23):
In a lot of these places, there might only be
one or two centers in the entire country that can,
you know, address their child's needs. So I think you're
a parent. I only have dogs, but you know the
impact and the devastation that must be felt. I know
i'd feel that for my puppies.
Speaker 1 (10:40):
Well, that's an interesting thing because I was going to
ask you about this anyway that you see some stories
by the nature of the work that you're drawn to.
I mean, look, pediatrics of any kind is going to
break your heart, and you know it's a calling which
I'm you know, is beyond me. I admire it, and
(11:02):
I don't know if I how are you emotionally equipped
to deal with with the bad news diagnosis involved around children?
It must be devastating, Yeah, it is.
Speaker 3 (11:13):
I think you know, as a surgeon that type a personality.
We like to help people. We like to see a
problem solve it feel like we had an impact that
keeps you going. The harder things in surgery and probably
medicine more broadly are when you can't help. So either
you know, the right equipment isn't there, the tools are broken,
(11:36):
the oxygen ran out, Maybe the patient gets there too
late because their tumor has grown too much, or maybe
because the mom had to walk, you know, for two
days and so the child has gotten so much sicker.
And I think that in those moments, it's that helplessness
and just standing by the family where you know, you
feel like if they'd just gotten there earlier, if you
(11:58):
just had to feel more, a little bit more oxygen
or a little bit more equipment, that maybe you'd be
able to have a different outcome, and it is that
helplessness that stays with you. But you know, ultimately that's
that's why we do the work we do and you know,
trying to fill that gap again so that no one
has to feel that way. But surgeons, we just we
(12:19):
have that need to see a problem, fix it. And
I think it's that desire to ultimately alleviate suffering and
make that impact that just keeps you going even when
you have one one bad thing or you you know,
it obviously changes you, it stays with you.
Speaker 1 (12:35):
Yeah, you learn from it. Yeah. I mean most surgeons
that I've met, and I've met quite a few, and
I know quite a few, most of them are quite
sporty people, which I wasn't surprised, a quite kind of
jocks a lot at the time. Do you are you?
First of all, are you a jock? Are you a
sporty person? Uh?
Speaker 3 (12:56):
Well, I'm the wife of a baseball coach, so I think, okay,
my definition, I'm probably pretty sporty. Yeah, But surgery is
shockingly physical. We stand for hours, we twist in different ways.
You know. I actually her needed my back moving a
patient a couple of years ago and had to have
surgery myself. So there's a definite you're dehydrated all day,
(13:20):
you're tired, you don't sleep that much, so there's a
definite physical toll. And you know, I think both kind
of mental health as well as physical health is really
important to extend longevity of one's career. And I think
we're now starting to acknowledge that, which we didn't do
for a long time.
Speaker 1 (13:38):
Yeah, I was going to say the idea of acknowledging
the mental health impact on surge is because even if
even if you approach, you know, a problem in a
sort of slightly more engineering frame of mind, like this
is a problem in the human body, I'm going to
I'm going to fix it or or approach it like
like this is a challenge for me. You know, there's
(14:01):
got to be a point where, you know, if there's
a like almost like a sporting mentality in the surgeon,
you're going to lose. Sometimes you're going to learn how
to lose.
Speaker 3 (14:11):
And it's a team, right, So yeah, like trusting in
my team, my nurses, my nsthesiologists, the patients trust in us,
the families trust in us, and sometimes you lose. You know,
in sports, they watch a lot of game tape and
learn from maybe mistakes are also successes with robotics, that's
(14:31):
one way for sure. We have the ability to record
our surgeries to watch them back if something, you know,
if there's a complication post operatively, we could actually review
that tape and see is there some mistake that we
made technically. And we spend a lot of time as
a community reviewing what we used to call morbidity and
mortality conferences, which we now call quality improvement, which are
(14:53):
you know, and things don't necessarily go according to plan,
but taking an opportunity to really holistically examine the pathway
of what happens so that we can all learn from it.
So I'm not just learning from, you know, my mistakes,
but I get to learn from my colleagues they can
learn from me. That way, hopefully we're not all making the.
Speaker 1 (15:09):
Same mistakes, right, you know, repeating the same thing. I mean,
I think it's a smart it's a smart thing. I mean,
you mentioned post operative care there as well, and I
thought that's quite interesting because I remember talking again, talking
to George Johnson years ago about why don't we just
fly a bunch of doctors in the g four down
in Uganda and fix all of these problems and then
(15:31):
they can all leave. And he said, well we can,
because we try that and it doesn't work because there's
you've got to do follow ups, right, You got to
you got to figure out what's going on. You have
to have surgeants who are there all.
Speaker 3 (15:42):
The time absolutely first of all, to select the patients
and figure out who are the patients that actually need
care urgently or maybe who maybe need more specialized care
from someone who's coming in the follow ups for sure.
But I think you know, in the world we live
in today, there's another reason why investing in the local
teams and supporting them to do the work is important.
(16:03):
And that's if you look at all of the conflicts.
So you know, kids operating room now we've installed one
hundred operating rooms thirty five countries from really challenging places
like the Kakuma refugee camp in Kenya, Congo, Afghanistan, Haiti
and Haiti is a perfect example where you know, all
the aid organizations left with the current conflict, a lot
(16:25):
of them don't have teams on the ground. So if
you were only sending in teams, you'd have a whole
cohort of children who wouldn't be able to get surgery.
But in fact, our operating rooms Imported Prince are two
of the only that are still working because they're stacked
by local teams because what we've done is support and
empower them. And so that means in all of these
(16:45):
places where global aid organizations can't go, the local teams
still have the capacity to care for those kids and ultimately,
you know, that strengthens the entire country and the country's GDP.
And so there's that component as well, which I think
you know in today's world is even more important to recognize.
Speaker 1 (17:05):
Hello, this is Greig Ferguson and I want to let
you know I have a brand new stand up comedy
special out now on YouTube. It's called I'm So Happy,
and I would be so happy if you checked it out.
To watch the special, just go to my YouTube channel
at the Craig Ferguson Show and is this right there?
Just click it and play it and it's free. I
(17:27):
can't look. I'm not going to come around your house
and show you how to do it. If you can't
do it, then you can't have it. But if you
can figure it out, it's yours. It's an interesting thing
because you talk about today's world, which is you know,
there are a lot of very intense and very opposing
political stances in all of the area, pretty much all
(17:49):
of the areas you're talking about. If you're going into
a war torne area, people are so mad at each
other that they're killing each other. So there's conflict going on.
How easy or difficult is it to navigate the political
fundraising side of things, like if you're if you're raising
money for kids who are which I don't think there's
anybody on any site of any debate would say, you know,
(18:12):
we don't want hospitals in there to look after children. Boo,
that's a bad thing. But everything is politicized. So how
do you how do you cope with it? How do
you deal with it?
Speaker 3 (18:25):
I mean it's a real challenge in certain places obviously,
you know, government agendas set a lot of the dictates.
We have always been in a political organization and try
to work wherever there's a need. Ukraine is a perfect
example of that. We're finishing up fund raising now for
(18:45):
six operating rooms in western Ukraine, and you know we
work with the local teams, the ministries of health there,
and we just try to focus on what you said,
which is taking care of kids. Ultimately, I hope most
people in the world are in favor of children and
supporting kids getting access to care, and so we just
try to maintain that real laser focus and explain that
(19:09):
what we're doing also is, you know, strengthening health systems
and creating security and empowering the economies and the families
and all of the downstream effects that one actually has
by being able to provide a child with surgery, they
can go back to school, their parents can work, you know,
there's a lot of things. So trying to focus on
the societal impact and focus away from the political one
(19:33):
is I think what we have to do right now.
But it's always a challenge.
Speaker 1 (19:36):
Do you ever you ever find yourself losing your temper
when you're there?
Speaker 3 (19:42):
I find myself losing my temper with well meaning but
poorly thought out plans.
Speaker 1 (19:50):
Oh my god, you hate me. Why don't we just
all fly down there? Are ticket? Yeah? Right?
Speaker 3 (20:00):
I mean, as a surgeon, you don't like surprises. When
I go into a belly, I want to know what
I'm going to find and what my plan is, and
I think my patients want that plan as well.
Speaker 1 (20:10):
Sure, but I mean well that you mentioned that if
you're going in like if you're in a lead low
resource area, you haven't presumably you're not getting the scans
that you would get and Yale, you're not looking at
all the you may or even get the blood work
that you want, So you might really begin a surprise.
It may be you know, cut and find out, right.
Speaker 3 (20:31):
You might, although hopefully you know you're working with a
local team who's used to working under those limitations, So
there are lessons we can learn from them about how
they work up or manage with very few resources without
a cat scan, for example, and implement that in a
safe way. I think that's really where the criticality of
(20:52):
having local partners comes in, because they know what they're
used to doing and what's worked in their own environment,
and there's a lot of innovation that comes out of
that as well. Right, Like, I've learned a lot of
lessons about what they've done that I've put into my
own practice, especially during the pandemic when we all had
to really think about what the resources were that we
(21:13):
were using.
Speaker 1 (21:13):
Here, did I have a major impact in what you
were doing? And Yale during the pandemic. Who you could
see and what you could do.
Speaker 3 (21:21):
Yeah, a bit. So, you know, new Haven not that
far from New York City, and there was a lot
of overflow. I was based in Bridgeport, Connecticut, which is
part way between New Haven and New York, and we
had a ton of overflow. We actually had a huge
medical tent set up in the courtyard of the hospital
and it sounded a lot like a big airplane hangar
(21:41):
because all of all the ventilation and you know, we
were really just trying to triage and save the lives
that we could save, and we didn't have a lot
of resources then. We also didn't know a lot about
COVID then, and so there was a lot of fear
and anxiety in general. But it definitely made us more
(22:02):
conscious about what resources are we using, everything from ppe
to blood. How should we think about prioritizing or triaging
resources as well. So there's a lot of things that
we that we all learned and were able to implement
into our own practices, for good and for worse.
Speaker 1 (22:21):
You know, you make mistakes, That's how you learn, I guess.
But when the stakes are that high where you're dealing
with the mortality of human beings. It's it's terrifying to me.
The idea of you've talked a lot about local using
local people when you're in a low resource area. If
there are local teams, the question I've got to ask
(22:42):
is what do they need from you? You know, when
you go in there, if there's a doctor who's a
pediatric surgeon in Uganda or is there is there a doctor,
I mean other doctors? Do you train them? Do you
do kids? Who are you know? Do you guys go
in and I think you mentioned earlier that you were
training people. There is that like a teaching hospital situation.
Speaker 3 (23:02):
So we do a variety of different things. We provide
scholarships to train more surgeons and as caesiologist. So you know,
when you and Megan first engaged with us back in
Uganda ten years ago, there was only one pediatric surgeon
in the country. Now there are nine. There are still
other countries that might have zero or one or two
for an entire population of like forty million children.
Speaker 1 (23:24):
So we do in for schotlarship is worth stopping for
a minute and saying there was one pediatric surgeon in
the whole country.
Speaker 3 (23:33):
Yeah, that's that's and no operating room for him, so
he was working after hours, he was working whenever he
could get space. And a lot of these countries, right,
we look at a population and in the US or
the UK, we're very used to kind of like a
very even curve. But in a lot of these places,
more than fifty percent of the population our children. So
(23:56):
we're not really talking about pediatric health. We're talking about
the nations health and the issues with that. But you know,
we also offer a lot of training courses. So I've
taught training courses myself in Uganda and Chad. We have
developed partnerships with nursing programs to teach nurses an incredibly
important part of the post operative care that you spoke about, right,
(24:19):
We all see what a critical role nurses play here,
especially for like family sure when the kids go home.
So we do a lot of hands on training. We
do a lot of We have an e learning program
that a lot of our collaborators work with, and ultimately
our goal is to just help maybe provide a little
bit of upskilling or some opportunities to learn about some
(24:41):
specialized things like laparoscopy or that minimally basive equipment. I
talked about But there are really great providers in all
of these countries, and each country's a little different, so
sometimes we need to provide more scholarships. Sometimes we don't.
Ukraine has a huge health workforce, but they don't have space.
They need their operating rooms to care for their children,
(25:02):
and so we you know, really direct our focus in
that country more on the infrastructure side.
Speaker 1 (25:09):
It's fascinating to me. I mean talking about you as
a doctor that you come from Kansas, right, yeah. And
do you come from a medical family? Do you come
from you know?
Speaker 3 (25:21):
Definitely not no, my, because you went you went a Deeca.
Speaker 1 (25:27):
I mean it's it's not just like, oh, I'd like
to be, you know, I know, a small town doctor.
I mean you're you're a surgeon at Yale, you know.
I mean you're the chief medical officer for kids who
are dangerous parts of the world. What draws you to that?
Speaker 3 (25:45):
A little bit of luck, a little bit of timing,
I think, you know, my definitely not a medical family.
My mom and dad were the first in their families
to go to college and get advanced degrees. I wasn't
sure what I wanted to do leaving high school. I
wanted the liberal arts education. So I went to Middlebury
in Vermont and wanted to explore a little bit of this,
a little bit of that. Was always kind of preferally
(26:08):
interested in medicine. But you know, the second day of
school for me as an undergrad was September eleventh, two
thousand and one, and I thought, gosh, I know nothing
at all about the Middle East, and a lot of
us really didn't. At the time, there was no such
thing as a Middle Eastern studies major. So I was
studying Italian in architecture, and then started studying Arabic and
(26:29):
Middle Eastern studies, a lot of political geography. And then
I was abroad in the Middle East after I graduated,
and I worked at a women's and children's health clinic
there and started to see some of the issues of
healthcare in little resource settings. And I had spent some
time in China also as a kid. My dad's from
Hong Kong, so I traveled a lot and seeing kind
of healthcare in different countries. And then, you know, after
(26:52):
I came back from the Middle East, I thought, oh,
I want to be involved in like human rights and
I want to work with people. So I decided I
would be a Paralleague at a law firm doing international
law for a year and realized that actually that is
just paperwork and bureaucracy and so not the kind of
like hands on helping I wanted to do. So I
(27:14):
ended up going back to do a post back and
then to med school, and the luck that comes into
it was just kind of the opportunities that I found.
I think I always tell people, the worst thing anyone's
going to do is just say no to you. So
Tony Fauci gave a talk when I was doing a
post back, and I didn't really know who he was,
and he wasn't that famous then, but I managed to
(27:35):
go up to him afterwards, and I did an internship
for the year and then spent some time abroad and
had some great opportunities that just kind of all connected
in a way that I started to see this path forward,
and even connecting with you know, what became Kids' Operating
Room was really just luck. I was working in Uganda
doing some work and teaching a trauma course, and that
(27:55):
was back in the day when that first operating room
was being installed that you and Meghan were involved with.
So things just kind of it happens, you know.
Speaker 1 (28:05):
It's a funny thing. Though. The idea of being drawn
into medicine from liberal arts is kind of a reach.
It's like, I don't know how a person makes that jump.
I mean, were you squeamish when you I mean, like
the first time you go into an operating room, do
you like, like just to operate? I mean I could
(28:27):
handle it. I just could.
Speaker 3 (28:29):
Some people can't take blood. No, I've always liked breaking
my hands, and I played the violin. I was always
interested in the intricacies of like when we did anatomy
in high school, dissecting frogs and things like that, so
that never really bothered me. And I think I just
really liked the idea that I could help solve a
(28:51):
problem directly in front of me, and that for me
was really appealing.
Speaker 1 (28:57):
It's an interesting thing. Were you you graduated where Dotford
Dartford Medical schools? Yeah, Darts Yeah, that's right. Yeah, which
is uh, that's pretty swanky school.
Speaker 3 (29:07):
It's a bit swinky. I think your wife knows the
area gotta yeah.
Speaker 1 (29:11):
Yeah. But it's kind of like it's an interesting thing
for me because I would have thought that the trajectory
of someone going through that level of ivy league, education
and stuff would have been actually in New York or
(29:32):
Los Angeles. You know that these kind of leg but
clearly there is another side that pushes you to it.
It's not just problem solve when it can't be, or
you wouldn't be putting yourself in these situations because presumably
some of the places you go to are there's personal
jeopardy involved as well.
Speaker 3 (29:54):
Yeah, there is. I mean we try to minimize that.
Obviously for women, there's probably more. You know, I was
lucky my parents had spent a lot of time traveling
in the nature of their own work and were incredibly supportive,
sometimes shockingly so I'm not sure how many parents would
have allowed their you know, freshly graduated daughter to go
(30:14):
to the Middle East and kind of have a one
week hotel reservation and then not really know what she
was going to do after that. But i'd you know,
my family was always really involved in different types of
initiatives and nonprofits. When I was in high school, my
mom started a nonprofit with a colleague that looked at
solar powered cookers in Tibet. So they were produced in
(30:36):
Tibet and they allowed children to not have to gather
yak dung, which is what was the traditional source of fuel,
and then the kids could actually go to school and
they got an education. So again the kind of like
downstream effects of what some other nonprofits we've been involved
in were able to do. And I think that I
was just really lucky to be exposed to a lot
(30:58):
of those things globally and feel like there was a
place to be able to and also I think a
responsibility to contribute if I can.
Speaker 1 (31:08):
You are you a religious person or it's your family religious?
Is that is that now? Is the impose that from there?
Speaker 3 (31:16):
No, not at all.
Speaker 4 (31:18):
It's interesting to me the said desire to be what
what do you mention that your parents that traveled, the
love for the work they were and what did they
do if you unless they were spies, in which case
you probably shouldn't tell me.
Speaker 3 (31:30):
Wouldn't that be fun? My mom was an archaeologist, so
she was on a dig over in Europe when I
was born. I was born in Switzerland, but she spent
a lot of time in the former USSR and in Europe.
And my father was born and raised in Hong Kong.
Came to the US for college, and he worked for
(31:52):
the National Animal Disease Center. He was a scientist, but
he spent a lot of time again after the breakup
of the USSR, working and mentoring former Soviet scientists and
creating a lot of mentorship opportunities and working on different projects.
So they traveled a lot for both conferences as well
as work, and really I think, you know, wanted to
(32:13):
expose us to other parts of the world. When I
was in my mom was on a dig in China
when I was in second grade, so we actually lived
in Beijing for a year when she was doing archaeological
work there. So, you know, experience is that not everyone gets.
Speaker 1 (32:29):
Yeah, no, it's a fabulously glamorous, almost like Wes Anderson
type childhood. But there seems to be an altruistic impulse
that in you, like your father's doing, you know, help
mentoring people coming out of the fall of the Soviet
Union then and what you ended up doing, and it
(32:53):
seems like there is a I mean, I don't want
to push you to it, but is there a spirit
all need for it? Is there is? Is there a
need for it that goes beyond because I find it
hard to accept that it's just about the mechanics of
solving a problem in front of you.
Speaker 3 (33:09):
Yeah, I mean, there's not a spiritual impulse we are.
I think my dad's family is kind of Buddhist, you know.
My mom was raised some type of Christianity that she
never practiced, not Catholic, right, some type of Protestantism. And
(33:32):
I think if anything, it was that like spirituality that
was probably just instilled by them, and then probably their
upbringing in terms of like both coming from incredibly you know,
poor backgrounds, really having to make everything that they did
for themselves, and then believing that because they succeeded, they
needed to give back, and if we succeeded, we needed
(33:54):
to give back as well. My dad was one of
like ten or eleven kids, and he used to sleep
under the table in Hong Kong. That's where he slept.
My mom, her mom pass away when she was young,
and she ran the whole farm, and the farm was
for to survive, you know, it wasn't a wasn't it
like a high producing dairy farm or something, right, So
(34:15):
I think it was really that.
Speaker 1 (34:23):
Where does it leave you? When you see You're going
to see some pretty heartbreaking things and some pretty unpleasant things.
You're going to see some wonderful things too, things that
you know people would say it's a miracle and stuff.
So does it Where does it leave you personally with
the idea of where we are the universe? Is there
a are you an atheist that you are? You a theist?
(34:45):
That you do you not think about it? Do you
just completely steer your mind away from it and stay
engineering focused? What do you do?
Speaker 3 (34:54):
I think I like to believe that there are maybe
spirits out there, whether they be ancestral or or whatnot,
who are looking over us or guiding us in some way.
You know, there are definitely times in my life where
I've prayed to a higher being, maybe in times of
like extreme sadness or anxiety or something like that. So
(35:19):
it's not that I don't acknowledge it. And I and
I would also say that I think sometimes it's really
important for my patience and to acknowledge a belief that
they have in some presence or being out there that's
looking over them and providing safety. But it doesn't really,
you know, come into my mind on a daily basis.
Speaker 1 (35:43):
No, You've never, like, have you ever in a last
resort case with a problem you could solve ask for
some kind of divine intervention.
Speaker 3 (35:52):
Well, I think that I probably have, But I think
that sometimes that divine intervention might come in the way
of either you know, asking that question to a mentor
or someone calling you, or somehow that answer is given
to you in the universe, and whether it's come to
me because I asked for it. You know that kind
(36:12):
of story about the flood and the guy on the
roof who's asking for help and asking God to help him,
and guy keep sending him boats until finally he drowns.
Speaker 1 (36:25):
There's a great old joke I love about a priest
and a rabbi going to see a boxing match together
and before the fight, one of the boxes crosses himself
and the rabbi says to the priest, what does that
mean when he crosses himself? And the priest says, if
he can't fight, not a fucking thing, which I kind
(36:46):
of love. But it would seem to me though, that
not only your own belief system, but you're going to
places maybe delivering children or performing procedures which you're going
to run into other people's belief systems that might be
a problem. Like you know, have you run into that
(37:12):
where there is a local religion or a belief system
or tradition that will not allow you to do the
work you need to do to help someone we have.
Speaker 3 (37:24):
You know, there are plenty of kind of faith healers
in different parts of the world, and there's definitely been
instances where maybe a child shows up with let's say,
a very big belly, and they're very sick, and they
might have cuts on their belly. There are some faith
healers who believe that, you know, that is a treatment.
And I think ultimately the experience that I've had is
(37:46):
that when they've come to me or the people that
I'm working with, or at our kids' operating rooms, they've
actually shown up to a health center. They've shown up
for care. So the parents have gotten to the point
where they have either overtly or not overtly, said to themselves,
we are willing to set aside our own belief system
(38:07):
and the hopes that this other intervention, modern medicine could
actually save our child. I think that we don't experience
it as much on the initial standpoint, right because we're
only seeing the kids who are brought to us where
that decision has already been made. But there's definitely those instances.
There's also I would say, the challenge of kind of gender,
(38:31):
and in some parts of the world, for example, you
really need a female provider, a female doctor for a
female patient, otherwise they might not get care. So there
are those things and they can be really challenging, and
you do the best you can to apply logic to
the situation, make that connection with the patient or the family,
(38:53):
try to explain to them, meet them halfway, understand where
they're coming from, Explain to them where you're coming from,
and ultimately hope in the end that you've been still
the enough trust in them to be able to trust
in you for what needs to happen. Doesn't always work out,
and that can.
Speaker 1 (39:13):
I was going to say, have you ever had you know,
have you ever had that denied to you. Have you
ever had someone say you're a woman, you can't treat me,
you can you can't help me, you can't help my son.
Speaker 3 (39:27):
Yeah, but I've even had that at the in the US,
like at the VAAL. Yeah, sure, a lot of those biases.
They exist in the US as well and in the UK. Right.
And then I've had patients who have said they don't
want one of my residents treating them perhaps because of
their their gender or because of their ethnicity. And again
(39:48):
we try to use those as teaching moments and explain
to the patient why they need care, why this person
can provide excellent care. But you don't win every argument,
and and I think sometimes those are just ones you
at some point have to let go. And the same
with you know, preferences for blood transfusions or avoiding blood transfusions.
(40:11):
I mean there's a lot of.
Speaker 1 (40:14):
Right, yeah, the idea that you can wasn't there a
core order done? Recently someone didn't want their kid to
have a blood transfusion which would save the life, and
the court was like, Okay, fuck it, we're doing it
and you'll just have to deal. I mean, it does
seem yeah, I mean, you want to respect people's belief systems,
(40:36):
but you.
Speaker 3 (40:38):
Do you also want to believe that like logic and
data went out at the end, but that is.
Speaker 1 (40:44):
Not the for everyone, for everyone I know. And also compassion.
I feel that seems so odd to me that because
everything is is so on fire politically or or socially,
the genuine compassion will be treated with suspicions like what
(41:05):
do you want? What do you want? And people are
so beat up by I don't know their life or
the world or what's happened to them that they can't
accept the hand when it's reached out to them. Does
that happen much?
Speaker 3 (41:20):
I think maybe initially. But what I've found is that
you know when you're I'm One of the things about
being a surgeon, right, especially if it's something that's emergent,
is that you have to build that trust with the family,
with the patient in a matter of minutes, because you're
asking them literally to put a life in your hands,
and so being able to meet them on a human level,
(41:43):
being able to just listen answer their questions, usually I
can get people to the ultimate outcome of like agreeing
to let me do surgery. I think, like anyone, if
you just push back and are immediately stand offish and
patriarchal and demanding, no one responds well to that. I
(42:04):
don't think anyone automatically changes their mind, whether you're trying
to get them to eat a hamburger or get them
to have an emergent surgery. And so that human element
becomes really important, and as you said, the humanity aspect
of listening to them and understanding where they're coming from
and asking questions like why is this the case? And
sometimes you have to compromise. Sometimes I have to agree
(42:26):
that I'm not going to give the blood transfusion in
the case of an emergency, but at least being able
to attempt understanding where they're coming from and have them
understand where I'm coming from and ultimately making a decision
that is hopefully best for the patient.
Speaker 1 (42:44):
Yeah, I mean, I guess because the legalities of it
as well. You'll be dealing with minors a lot of
the time, who the permission has to come from a
parent or guardian, and that might gosh. I feel like
I don't know how well I would do in that situation.
No one as me, but I mean the idea of,
you know, trying to help a kid and you've got
(43:07):
someone in the way, I think must be very frustrating.
Speaker 3 (43:11):
And I think even when everyone agrees, you know, I
always try to make sure, especially teenagers, they should have
a voice and I want them to be in agreement
with what we're planning on doing, even if they're not
the one signing the forum. I think if you lose
trust in your surgeon or in your physician, you're starting
(43:32):
from a really bad place, and the possibility of everything
going wrong from that point on is just huge. It
really needs to be based on trust. So even when
everyone's in agreement, I will always ask the kid as well,
do you understand what we're doing? Do you want to
do this? Is it's okay with you? You know you
want to have that that trust and rapport.
Speaker 1 (43:53):
Well, you've got my vote, doctor, and I wish you
continued success with kids who are well. Put up a
link for everybody year as well if they want to
know more about it or maybe help out where they
can go to do that. Keep doing what you're doing,
and it's a pleasure as always to talk to you.
Speaker 3 (44:11):
Thank you, thanks so much Craig for your time. I
really appreciate it very by catch it
This is me, Craig Ferguson. I'm inviting you to come
and see my brand new comedy hour. Well it's actually
it's about an hour and a half and I don't
have an opener because these guys cost money. But what
I'm saying is I'll be on stage for a while. Anyway,
come and see me live on the Pants on Fire
Tour in your region. Tickets are on sale now and
we'll be adding more as the tour continues throughout twenty
(00:23):
twenty five and beyond. For a full list of dates,
go to the Craig Ferguson show dot com. See you
on the road, my DearS. My name is Craig Ferguson.
The name of this podcast is Joy. I talk to
interesting people about what brings them happiness. Today, my friends,
(00:47):
my guest on the podcast is Dr Maya Chung, who
is a pediatric surgeon at Yale. That's pretty impressive in itself.
Speaker 2 (00:55):
She is also the chief medical officer of a group
called kits R, which provides pediatric surgical opportunities for you know, children.
Speaker 1 (01:07):
That need it in areas where it's kind of difficult
to get. So I'm going to let you talk to
her through me, and I'm going to talk to her.
I really like this one and she's very impressive. Enjoy. Hello, Maya,
(01:28):
how are you?
Speaker 3 (01:30):
I'm great. Craig, how are you?
Speaker 1 (01:31):
I'm good. Are you in Yale today? Are you in
new Haven today? I am.
Speaker 3 (01:35):
I'm just outside. Actually we're in Brandford.
Speaker 1 (01:39):
Now. Before we get into that, I just want to
talk to you a little bit about because you're you're
a surgeon at Yale, right.
Speaker 3 (01:45):
Yes, I've been for many years.
Speaker 1 (01:47):
Actually, now I want to talk to you a little
bit about Yale before we talk about you and we
talk about kids, oh are and we talk about surgery.
Because Yale. I've done stand up shows at Yale, and
I've stayed in New Haven. And the best description I
can give of Yale is it's Hogwarts in the middle
of downtown Detroit. Does that seem like a reasonable it does?
Speaker 3 (02:10):
It seems perfect, perfect description there. It's an interesting place.
It's an interesting campus, for sure.
Speaker 4 (02:17):
Yeah.
Speaker 1 (02:17):
The campus seems very lovely and collegiate and all sorts
of beautiful young people walking around with scarf sown and
stuff like that and performing magic. But then you go
outside and get things get a little crackier. In New Haven.
I noticed a little bit more, a little bit more,
but more lively. You know.
Speaker 3 (02:36):
It was one of the reasons I actually chose to
come here back in the day for residency, because I
wanted to take care of a lower resource population and
really be in a little more urban area, but not
be in New York City or Boston.
Speaker 1 (02:48):
Now that's interesting because two things I want to ask you,
Why you wouldn't want to be in New York City
and Boston. Let me ask you why you wouldn't want
to be in New York City or Boston.
Speaker 3 (02:59):
Well, I'm from Kansas originally.
Speaker 1 (03:03):
Not enough, Yeah, yeah, I get it. Yeah, it's a
little lively. So but what about why were you drawing?
Speaker 3 (03:11):
Uh?
Speaker 1 (03:11):
Well, I know this about you, but I'm kind of
leaning the witness a little bit. But why were you
interested in working with with lower income people? And does
not actually happen at Yale anyway? The people come in
and did they get out there?
Speaker 3 (03:25):
Yeah, I know absolutely. Yale and one of our sites
in Bridgeport are really high numbers in terms of people
who are on some type of assistance or who are
maybe migrant workers, unemployed, lower income socioeconomic backgrounds. So we
do have a lot more than certain areas. You know,
I had worked with kind of lower resource populations for
(03:48):
many years when I was in medical school, and before that,
I spent some time abroad in the Middle East and
Asia and was just really found a lot of fulfillment
in being able to provide care or help of any
kind to populations that maybe didn't have certain types of access.
Speaker 1 (04:06):
I mean, one would presume, and we'll get onto the
kids who are charity in a minute, which both you
and my wife are involved in, but the idea of
going into a lower resource population, I assume for a surgeon,
that would mean there's a lot of none of the
financy equipment that you get in Yale Hospital, right.
Speaker 3 (04:28):
I mean, there's a very big difference, yes, between what
I have access to at Yale versus when I'm operating
and let's say Kenya or Uganda. My main clinical practice
right now is actually at the Veterans Hospital in West Haven,
and the VA hospital is also an interesting place in
terms of minimized resources because obviously, as a government institution, right,
(04:52):
there's a lot of a lot of restrictions and things,
and that population especially is one that really seeks access
through the VA because they don't necessarily have a lot
of other options. So again a population of maybe more
homeless people than one would traditionally think about.
Speaker 1 (05:09):
And what kind of surgeries that you perform and on
people that are the trauma surgeries? Are they you know,
like appendect mees, what's going on?
Speaker 3 (05:17):
So I did training in minimally invasive surgery and bariatrics,
So I do a lot of belly surgery that's not cancer.
Is the easy way to put everything from gall letters, appendicitis,
different types of hernias, weightless surgery. I do a lot
of robotics. Actually, that was one of my specialized trainings.
Speaker 1 (05:35):
So yeah, do you use AI in your in the robotics?
Now do you use that for surgery?
Speaker 3 (05:42):
So we use AI in a couple of ways. More,
I think on the kind of academic side and looking
at metrics that AI can help us learn from what
we're doing in the operating room or what other people
are doing in terms of kind of maximizing our efficiency
with movement. Stuff like that.
Speaker 1 (05:58):
But thanks you so much, GP GPTC take that gold ladder.
Speaker 3 (06:05):
Yet, I'd be out of a job for sure.
Speaker 1 (06:07):
I don't. I don't think that's coming anytime soon. But
maybe it is. I don't know. I mean when you
when you go into a low resource population though, like say,
for example, I know about the charity obviously kids who
are and I know they have pediatric surgical sites in
Uganda in particular, and some of these places are in
(06:29):
rural Uganda. Is that right to say it's outside of Kampala? Yeah?
Speaker 3 (06:34):
Absolutely?
Speaker 1 (06:35):
So what what are you dealing with there? I mean,
are you able to get appropriate levels of sanitation, are
you able to get you know, you know, decent equipment.
What are you doing?
Speaker 3 (06:46):
It's really a spectrum. So some of the places I've
been you actually have minimally basive surgery laparoscopy. I was
teaching some of that in Kenya last year, which was
really phenomenal to work with the teams there. Other places
you might have a very minimal equipment, not the right equipment,
not a great opportunity to sterilize equipment for example. So
your reprehainst to a lot of challenges. But I'm sure
(07:09):
we'll get into this. But you know, a lot of
what we're doing at Kids Operating and is trying to
bridge that gap so that people in world Uganda don't
have to be doing without and can really provide the best,
safest care they can to kids around the world.
Speaker 1 (07:22):
And what kind of I mean, like the pediatric operating
rooms that you're working in Uganda or in other parts
of low resource areas, are they what kind of surgeries
are you see? Are the emergency things? Are they both?
Speaker 3 (07:40):
So there's a lot of emergency operations that are happening.
There's a lot of wait lists. You know, kids here
might get a hernia fixed in a couple of weeks
it might take years and a lot of other places,
and the impact on a child's life and a family's
life if that's the case, can be really devastating. We
also see a lot of complex surgery, so it's amazing
(08:00):
there's so much talent and all of these other places
they're able. I mean, you've gone as a perfect example
where they've been able to step right conjoined twins, and
you know, we think of that as something that's so
highly specialized, but the technique is there, the training is there.
It's really just the equipment and a little bit of
probably solar power, because that's another problem operating in these places.
(08:21):
Power outages that can really make a difference.
Speaker 1 (08:25):
I know. George Youngston, doctor George Youngston, who is a
friend of mine. George is one of the pioneers of
the work getting done out there. That George said that
when I first talked to him about kids who are
he said that cleft palate, for some reason was something
that a lot of people, they were dealing with a
lot of kids with with a cleft palate surgery they
(08:46):
were fixing. Is that true?
Speaker 3 (08:48):
Yeah, cleft palate, club feet, and you know those are
things that a quick, simple surgery can be a one
time fix, simple on the spectrum, right, but it's really life.
I mean, we have case studies out of Kenya. Is
one place, a refugee camp that we worked and there's
a child there who was born with cleft feet and
(09:08):
that would have been fixed within a matter of months
and some simple procedures in the US or the UK.
His parents carried him, you know, they physically carried him
for years everywhere he had to go, and finally he
was able to get care in one of our operating rooms.
And now he plays on his local soccer team and
runs around with them.
Speaker 1 (09:26):
Men U Jersey on Yeah, well, I'm not sure that
I'm completely a fan of his Startorial Troit team. Yeah,
but I mean that's an amazing thing to me. So
I mean hearing about the people who are walking, because
I did hear stories about this, about women who were
(09:46):
carrying their babies twenty thirty, forty miles and more and
physically walking through I don't know if it's jungle or
what kind of area is, but walking to get to
an op in room for the kids.
Speaker 3 (10:02):
Yeah, and I mean if you think about what that
does to a family, also the impact on them. Sure,
we did a lot of studies a while ago looking
at how much families had to sell, like sell cattle,
sell home goods, things like that to be able to
even make the trip. I mean that impact on a family,
And yeah, if it's only thirty miles, they're pretty lucky.
(10:23):
In a lot of these places, there might only be
one or two centers in the entire country that can,
you know, address their child's needs. So I think you're
a parent. I only have dogs, but you know the
impact and the devastation that must be felt. I know
i'd feel that for my puppies.
Speaker 1 (10:40):
Well, that's an interesting thing because I was going to
ask you about this anyway that you see some stories
by the nature of the work that you're drawn to.
I mean, look, pediatrics of any kind is going to
break your heart, and you know it's a calling which
I'm you know, is beyond me. I admire it, and
(11:02):
I don't know if I how are you emotionally equipped
to deal with with the bad news diagnosis involved around children?
It must be devastating, Yeah, it is.
Speaker 3 (11:13):
I think you know, as a surgeon that type a personality.
We like to help people. We like to see a
problem solve it feel like we had an impact that
keeps you going. The harder things in surgery and probably
medicine more broadly are when you can't help. So either
you know, the right equipment isn't there, the tools are broken,
(11:36):
the oxygen ran out, Maybe the patient gets there too
late because their tumor has grown too much, or maybe
because the mom had to walk, you know, for two
days and so the child has gotten so much sicker.
And I think that in those moments, it's that helplessness
and just standing by the family where you know, you
feel like if they'd just gotten there earlier, if you
(11:58):
just had to feel more, a little bit more oxygen
or a little bit more equipment, that maybe you'd be
able to have a different outcome, and it is that
helplessness that stays with you. But you know, ultimately that's
that's why we do the work we do and you know,
trying to fill that gap again so that no one
has to feel that way. But surgeons, we just we
(12:19):
have that need to see a problem, fix it. And
I think it's that desire to ultimately alleviate suffering and
make that impact that just keeps you going even when
you have one one bad thing or you you know,
it obviously changes you, it stays with you.
Speaker 1 (12:35):
Yeah, you learn from it. Yeah. I mean most surgeons
that I've met, and I've met quite a few, and
I know quite a few, most of them are quite
sporty people, which I wasn't surprised, a quite kind of
jocks a lot at the time. Do you are you?
First of all, are you a jock? Are you a
sporty person? Uh?
Speaker 3 (12:56):
Well, I'm the wife of a baseball coach, so I think, okay,
my definition, I'm probably pretty sporty. Yeah, But surgery is
shockingly physical. We stand for hours, we twist in different ways.
You know. I actually her needed my back moving a
patient a couple of years ago and had to have
surgery myself. So there's a definite you're dehydrated all day,
(13:20):
you're tired, you don't sleep that much, so there's a
definite physical toll. And you know, I think both kind
of mental health as well as physical health is really
important to extend longevity of one's career. And I think
we're now starting to acknowledge that, which we didn't do
for a long time.
Speaker 1 (13:38):
Yeah, I was going to say the idea of acknowledging
the mental health impact on surge is because even if
even if you approach, you know, a problem in a
sort of slightly more engineering frame of mind, like this
is a problem in the human body, I'm going to
I'm going to fix it or or approach it like
like this is a challenge for me. You know, there's
(14:01):
got to be a point where, you know, if there's
a like almost like a sporting mentality in the surgeon,
you're going to lose. Sometimes you're going to learn how
to lose.
Speaker 3 (14:11):
And it's a team, right, So yeah, like trusting in
my team, my nurses, my nsthesiologists, the patients trust in us,
the families trust in us, and sometimes you lose. You know,
in sports, they watch a lot of game tape and
learn from maybe mistakes are also successes with robotics, that's
(14:31):
one way for sure. We have the ability to record
our surgeries to watch them back if something, you know,
if there's a complication post operatively, we could actually review
that tape and see is there some mistake that we
made technically. And we spend a lot of time as
a community reviewing what we used to call morbidity and
mortality conferences, which we now call quality improvement, which are
(14:53):
you know, and things don't necessarily go according to plan,
but taking an opportunity to really holistically examine the pathway
of what happens so that we can all learn from it.
So I'm not just learning from, you know, my mistakes,
but I get to learn from my colleagues they can
learn from me. That way, hopefully we're not all making the.
Speaker 1 (15:09):
Same mistakes, right, you know, repeating the same thing. I mean,
I think it's a smart it's a smart thing. I mean,
you mentioned post operative care there as well, and I
thought that's quite interesting because I remember talking again, talking
to George Johnson years ago about why don't we just
fly a bunch of doctors in the g four down
in Uganda and fix all of these problems and then
(15:31):
they can all leave. And he said, well we can,
because we try that and it doesn't work because there's
you've got to do follow ups, right, You got to
you got to figure out what's going on. You have
to have surgeants who are there all.
Speaker 3 (15:42):
The time absolutely first of all, to select the patients
and figure out who are the patients that actually need
care urgently or maybe who maybe need more specialized care
from someone who's coming in the follow ups for sure.
But I think you know, in the world we live
in today, there's another reason why investing in the local
teams and supporting them to do the work is important.
(16:03):
And that's if you look at all of the conflicts.
So you know, kids operating room now we've installed one
hundred operating rooms thirty five countries from really challenging places
like the Kakuma refugee camp in Kenya, Congo, Afghanistan, Haiti
and Haiti is a perfect example where you know, all
the aid organizations left with the current conflict, a lot
(16:25):
of them don't have teams on the ground. So if
you were only sending in teams, you'd have a whole
cohort of children who wouldn't be able to get surgery.
But in fact, our operating rooms Imported Prince are two
of the only that are still working because they're stacked
by local teams because what we've done is support and
empower them. And so that means in all of these
(16:45):
places where global aid organizations can't go, the local teams
still have the capacity to care for those kids and ultimately,
you know, that strengthens the entire country and the country's GDP.
And so there's that component as well, which I think
you know in today's world is even more important to recognize.
Speaker 1 (17:05):
Hello, this is Greig Ferguson and I want to let
you know I have a brand new stand up comedy
special out now on YouTube. It's called I'm So Happy,
and I would be so happy if you checked it out.
To watch the special, just go to my YouTube channel
at the Craig Ferguson Show and is this right there?
Just click it and play it and it's free. I
(17:27):
can't look. I'm not going to come around your house
and show you how to do it. If you can't
do it, then you can't have it. But if you
can figure it out, it's yours. It's an interesting thing
because you talk about today's world, which is you know,
there are a lot of very intense and very opposing
political stances in all of the area, pretty much all
(17:49):
of the areas you're talking about. If you're going into
a war torne area, people are so mad at each
other that they're killing each other. So there's conflict going on.
How easy or difficult is it to navigate the political
fundraising side of things, like if you're if you're raising
money for kids who are which I don't think there's
anybody on any site of any debate would say, you know,
(18:12):
we don't want hospitals in there to look after children. Boo,
that's a bad thing. But everything is politicized. So how
do you how do you cope with it? How do
you deal with it?
Speaker 3 (18:25):
I mean it's a real challenge in certain places obviously,
you know, government agendas set a lot of the dictates.
We have always been in a political organization and try
to work wherever there's a need. Ukraine is a perfect
example of that. We're finishing up fund raising now for
(18:45):
six operating rooms in western Ukraine, and you know we
work with the local teams, the ministries of health there,
and we just try to focus on what you said,
which is taking care of kids. Ultimately, I hope most
people in the world are in favor of children and
supporting kids getting access to care, and so we just
try to maintain that real laser focus and explain that
(19:09):
what we're doing also is, you know, strengthening health systems
and creating security and empowering the economies and the families
and all of the downstream effects that one actually has
by being able to provide a child with surgery, they
can go back to school, their parents can work, you know,
there's a lot of things. So trying to focus on
the societal impact and focus away from the political one
(19:33):
is I think what we have to do right now.
But it's always a challenge.
Speaker 1 (19:36):
Do you ever you ever find yourself losing your temper
when you're there?
Speaker 3 (19:42):
I find myself losing my temper with well meaning but
poorly thought out plans.
Speaker 1 (19:50):
Oh my god, you hate me. Why don't we just
all fly down there? Are ticket? Yeah? Right?
Speaker 3 (20:00):
I mean, as a surgeon, you don't like surprises. When
I go into a belly, I want to know what
I'm going to find and what my plan is, and
I think my patients want that plan as well.
Speaker 1 (20:10):
Sure, but I mean well that you mentioned that if
you're going in like if you're in a lead low
resource area, you haven't presumably you're not getting the scans
that you would get and Yale, you're not looking at
all the you may or even get the blood work
that you want, So you might really begin a surprise.
It may be you know, cut and find out, right.
Speaker 3 (20:31):
You might, although hopefully you know you're working with a
local team who's used to working under those limitations, So
there are lessons we can learn from them about how
they work up or manage with very few resources without
a cat scan, for example, and implement that in a
safe way. I think that's really where the criticality of
(20:52):
having local partners comes in, because they know what they're
used to doing and what's worked in their own environment,
and there's a lot of innovation that comes out of
that as well. Right, Like, I've learned a lot of
lessons about what they've done that I've put into my
own practice, especially during the pandemic when we all had
to really think about what the resources were that we
(21:13):
were using.
Speaker 1 (21:13):
Here, did I have a major impact in what you
were doing? And Yale during the pandemic. Who you could
see and what you could do.
Speaker 3 (21:21):
Yeah, a bit. So, you know, new Haven not that
far from New York City, and there was a lot
of overflow. I was based in Bridgeport, Connecticut, which is
part way between New Haven and New York, and we
had a ton of overflow. We actually had a huge
medical tent set up in the courtyard of the hospital
and it sounded a lot like a big airplane hangar
(21:41):
because all of all the ventilation and you know, we
were really just trying to triage and save the lives
that we could save, and we didn't have a lot
of resources then. We also didn't know a lot about
COVID then, and so there was a lot of fear
and anxiety in general. But it definitely made us more
(22:02):
conscious about what resources are we using, everything from ppe
to blood. How should we think about prioritizing or triaging
resources as well. So there's a lot of things that
we that we all learned and were able to implement
into our own practices, for good and for worse.
Speaker 1 (22:21):
You know, you make mistakes, That's how you learn, I guess.
But when the stakes are that high where you're dealing
with the mortality of human beings. It's it's terrifying to me.
The idea of you've talked a lot about local using
local people when you're in a low resource area. If
there are local teams, the question I've got to ask
(22:42):
is what do they need from you? You know, when
you go in there, if there's a doctor who's a
pediatric surgeon in Uganda or is there is there a doctor,
I mean other doctors? Do you train them? Do you
do kids? Who are you know? Do you guys go
in and I think you mentioned earlier that you were
training people. There is that like a teaching hospital situation.
Speaker 3 (23:02):
So we do a variety of different things. We provide
scholarships to train more surgeons and as caesiologist. So you know,
when you and Megan first engaged with us back in
Uganda ten years ago, there was only one pediatric surgeon
in the country. Now there are nine. There are still
other countries that might have zero or one or two
for an entire population of like forty million children.
Speaker 1 (23:24):
So we do in for schotlarship is worth stopping for
a minute and saying there was one pediatric surgeon in
the whole country.
Speaker 3 (23:33):
Yeah, that's that's and no operating room for him, so
he was working after hours, he was working whenever he
could get space. And a lot of these countries, right,
we look at a population and in the US or
the UK, we're very used to kind of like a
very even curve. But in a lot of these places,
more than fifty percent of the population our children. So
(23:56):
we're not really talking about pediatric health. We're talking about
the nations health and the issues with that. But you know,
we also offer a lot of training courses. So I've
taught training courses myself in Uganda and Chad. We have
developed partnerships with nursing programs to teach nurses an incredibly
important part of the post operative care that you spoke about, right,
(24:19):
We all see what a critical role nurses play here,
especially for like family sure when the kids go home.
So we do a lot of hands on training. We
do a lot of We have an e learning program
that a lot of our collaborators work with, and ultimately
our goal is to just help maybe provide a little
bit of upskilling or some opportunities to learn about some
(24:41):
specialized things like laparoscopy or that minimally basive equipment. I
talked about But there are really great providers in all
of these countries, and each country's a little different, so
sometimes we need to provide more scholarships. Sometimes we don't.
Ukraine has a huge health workforce, but they don't have space.
They need their operating rooms to care for their children,
(25:02):
and so we you know, really direct our focus in
that country more on the infrastructure side.
Speaker 1 (25:09):
It's fascinating to me. I mean talking about you as
a doctor that you come from Kansas, right, yeah. And
do you come from a medical family? Do you come
from you know?
Speaker 3 (25:21):
Definitely not no, my, because you went you went a Deeca.
Speaker 1 (25:27):
I mean it's it's not just like, oh, I'd like
to be, you know, I know, a small town doctor.
I mean you're you're a surgeon at Yale, you know.
I mean you're the chief medical officer for kids who
are dangerous parts of the world. What draws you to that?
Speaker 3 (25:45):
A little bit of luck, a little bit of timing,
I think, you know, my definitely not a medical family.
My mom and dad were the first in their families
to go to college and get advanced degrees. I wasn't
sure what I wanted to do leaving high school. I
wanted the liberal arts education. So I went to Middlebury
in Vermont and wanted to explore a little bit of this,
a little bit of that. Was always kind of preferally
(26:08):
interested in medicine. But you know, the second day of
school for me as an undergrad was September eleventh, two
thousand and one, and I thought, gosh, I know nothing
at all about the Middle East, and a lot of
us really didn't. At the time, there was no such
thing as a Middle Eastern studies major. So I was
studying Italian in architecture, and then started studying Arabic and
(26:29):
Middle Eastern studies, a lot of political geography. And then
I was abroad in the Middle East after I graduated,
and I worked at a women's and children's health clinic
there and started to see some of the issues of
healthcare in little resource settings. And I had spent some
time in China also as a kid. My dad's from
Hong Kong, so I traveled a lot and seeing kind
of healthcare in different countries. And then, you know, after
(26:52):
I came back from the Middle East, I thought, oh,
I want to be involved in like human rights and
I want to work with people. So I decided I
would be a Paralleague at a law firm doing international
law for a year and realized that actually that is
just paperwork and bureaucracy and so not the kind of
like hands on helping I wanted to do. So I
(27:14):
ended up going back to do a post back and
then to med school, and the luck that comes into
it was just kind of the opportunities that I found.
I think I always tell people, the worst thing anyone's
going to do is just say no to you. So
Tony Fauci gave a talk when I was doing a
post back, and I didn't really know who he was,
and he wasn't that famous then, but I managed to
(27:35):
go up to him afterwards, and I did an internship
for the year and then spent some time abroad and
had some great opportunities that just kind of all connected
in a way that I started to see this path forward,
and even connecting with you know, what became Kids' Operating
Room was really just luck. I was working in Uganda
doing some work and teaching a trauma course, and that
(27:55):
was back in the day when that first operating room
was being installed that you and Meghan were involved with.
So things just kind of it happens, you know.
Speaker 1 (28:05):
It's a funny thing. Though. The idea of being drawn
into medicine from liberal arts is kind of a reach.
It's like, I don't know how a person makes that jump.
I mean, were you squeamish when you I mean, like
the first time you go into an operating room, do
you like, like just to operate? I mean I could
(28:27):
handle it. I just could.
Speaker 3 (28:29):
Some people can't take blood. No, I've always liked breaking
my hands, and I played the violin. I was always
interested in the intricacies of like when we did anatomy
in high school, dissecting frogs and things like that, so
that never really bothered me. And I think I just
really liked the idea that I could help solve a
(28:51):
problem directly in front of me, and that for me
was really appealing.
Speaker 1 (28:57):
It's an interesting thing. Were you you graduated where Dotford
Dartford Medical schools? Yeah, Darts Yeah, that's right. Yeah, which
is uh, that's pretty swanky school.
Speaker 3 (29:07):
It's a bit swinky. I think your wife knows the
area gotta yeah.
Speaker 1 (29:11):
Yeah. But it's kind of like it's an interesting thing
for me because I would have thought that the trajectory
of someone going through that level of ivy league, education
and stuff would have been actually in New York or
(29:32):
Los Angeles. You know that these kind of leg but
clearly there is another side that pushes you to it.
It's not just problem solve when it can't be, or
you wouldn't be putting yourself in these situations because presumably
some of the places you go to are there's personal
jeopardy involved as well.
Speaker 3 (29:54):
Yeah, there is. I mean we try to minimize that.
Obviously for women, there's probably more. You know, I was
lucky my parents had spent a lot of time traveling
in the nature of their own work and were incredibly supportive,
sometimes shockingly so I'm not sure how many parents would
have allowed their you know, freshly graduated daughter to go
(30:14):
to the Middle East and kind of have a one
week hotel reservation and then not really know what she
was going to do after that. But i'd you know,
my family was always really involved in different types of
initiatives and nonprofits. When I was in high school, my
mom started a nonprofit with a colleague that looked at
solar powered cookers in Tibet. So they were produced in
(30:36):
Tibet and they allowed children to not have to gather
yak dung, which is what was the traditional source of fuel,
and then the kids could actually go to school and
they got an education. So again the kind of like
downstream effects of what some other nonprofits we've been involved
in were able to do. And I think that I
was just really lucky to be exposed to a lot
(30:58):
of those things globally and feel like there was a
place to be able to and also I think a
responsibility to contribute if I can.
Speaker 1 (31:08):
You are you a religious person or it's your family religious?
Is that is that now? Is the impose that from there?
Speaker 3 (31:16):
No, not at all.
Speaker 4 (31:18):
It's interesting to me the said desire to be what
what do you mention that your parents that traveled, the
love for the work they were and what did they
do if you unless they were spies, in which case
you probably shouldn't tell me.
Speaker 3 (31:30):
Wouldn't that be fun? My mom was an archaeologist, so
she was on a dig over in Europe when I
was born. I was born in Switzerland, but she spent
a lot of time in the former USSR and in Europe.
And my father was born and raised in Hong Kong.
Came to the US for college, and he worked for
(31:52):
the National Animal Disease Center. He was a scientist, but
he spent a lot of time again after the breakup
of the USSR, working and mentoring former Soviet scientists and
creating a lot of mentorship opportunities and working on different projects.
So they traveled a lot for both conferences as well
as work, and really I think, you know, wanted to
(32:13):
expose us to other parts of the world. When I
was in my mom was on a dig in China
when I was in second grade, so we actually lived
in Beijing for a year when she was doing archaeological
work there. So, you know, experience is that not everyone gets.
Speaker 1 (32:29):
Yeah, no, it's a fabulously glamorous, almost like Wes Anderson
type childhood. But there seems to be an altruistic impulse
that in you, like your father's doing, you know, help
mentoring people coming out of the fall of the Soviet
Union then and what you ended up doing, and it
(32:53):
seems like there is a I mean, I don't want
to push you to it, but is there a spirit
all need for it? Is there is? Is there a
need for it that goes beyond because I find it
hard to accept that it's just about the mechanics of
solving a problem in front of you.
Speaker 3 (33:09):
Yeah, I mean, there's not a spiritual impulse we are.
I think my dad's family is kind of Buddhist, you know.
My mom was raised some type of Christianity that she
never practiced, not Catholic, right, some type of Protestantism. And
(33:32):
I think if anything, it was that like spirituality that
was probably just instilled by them, and then probably their
upbringing in terms of like both coming from incredibly you know,
poor backgrounds, really having to make everything that they did
for themselves, and then believing that because they succeeded, they
needed to give back, and if we succeeded, we needed
(33:54):
to give back as well. My dad was one of
like ten or eleven kids, and he used to sleep
under the table in Hong Kong. That's where he slept.
My mom, her mom pass away when she was young,
and she ran the whole farm, and the farm was
for to survive, you know, it wasn't a wasn't it
like a high producing dairy farm or something, right, So
(34:15):
I think it was really that.
Speaker 1 (34:23):
Where does it leave you? When you see You're going
to see some pretty heartbreaking things and some pretty unpleasant things.
You're going to see some wonderful things too, things that
you know people would say it's a miracle and stuff.
So does it Where does it leave you personally with
the idea of where we are the universe? Is there
a are you an atheist that you are? You a theist?
(34:45):
That you do you not think about it? Do you
just completely steer your mind away from it and stay
engineering focused? What do you do?
Speaker 3 (34:54):
I think I like to believe that there are maybe
spirits out there, whether they be ancestral or or whatnot,
who are looking over us or guiding us in some way.
You know, there are definitely times in my life where
I've prayed to a higher being, maybe in times of
like extreme sadness or anxiety or something like that. So
(35:19):
it's not that I don't acknowledge it. And I and
I would also say that I think sometimes it's really
important for my patience and to acknowledge a belief that
they have in some presence or being out there that's
looking over them and providing safety. But it doesn't really,
you know, come into my mind on a daily basis.
Speaker 1 (35:43):
No, You've never, like, have you ever in a last
resort case with a problem you could solve ask for
some kind of divine intervention.
Speaker 3 (35:52):
Well, I think that I probably have, But I think
that sometimes that divine intervention might come in the way
of either you know, asking that question to a mentor
or someone calling you, or somehow that answer is given
to you in the universe, and whether it's come to
me because I asked for it. You know that kind
(36:12):
of story about the flood and the guy on the
roof who's asking for help and asking God to help him,
and guy keep sending him boats until finally he drowns.
Speaker 1 (36:25):
There's a great old joke I love about a priest
and a rabbi going to see a boxing match together
and before the fight, one of the boxes crosses himself
and the rabbi says to the priest, what does that
mean when he crosses himself? And the priest says, if
he can't fight, not a fucking thing, which I kind
(36:46):
of love. But it would seem to me though, that
not only your own belief system, but you're going to
places maybe delivering children or performing procedures which you're going
to run into other people's belief systems that might be
a problem. Like you know, have you run into that
(37:12):
where there is a local religion or a belief system
or tradition that will not allow you to do the
work you need to do to help someone we have.
Speaker 3 (37:24):
You know, there are plenty of kind of faith healers
in different parts of the world, and there's definitely been
instances where maybe a child shows up with let's say,
a very big belly, and they're very sick, and they
might have cuts on their belly. There are some faith
healers who believe that, you know, that is a treatment.
And I think ultimately the experience that I've had is
(37:46):
that when they've come to me or the people that
I'm working with, or at our kids' operating rooms, they've
actually shown up to a health center. They've shown up
for care. So the parents have gotten to the point
where they have either overtly or not overtly, said to themselves,
we are willing to set aside our own belief system
(38:07):
and the hopes that this other intervention, modern medicine could
actually save our child. I think that we don't experience
it as much on the initial standpoint, right because we're
only seeing the kids who are brought to us where
that decision has already been made. But there's definitely those instances.
There's also I would say, the challenge of kind of gender,
(38:31):
and in some parts of the world, for example, you
really need a female provider, a female doctor for a
female patient, otherwise they might not get care. So there
are those things and they can be really challenging, and
you do the best you can to apply logic to
the situation, make that connection with the patient or the family,
(38:53):
try to explain to them, meet them halfway, understand where
they're coming from, Explain to them where you're coming from,
and ultimately hope in the end that you've been still
the enough trust in them to be able to trust
in you for what needs to happen. Doesn't always work out,
and that can.
Speaker 1 (39:13):
I was going to say, have you ever had you know,
have you ever had that denied to you. Have you
ever had someone say you're a woman, you can't treat me,
you can you can't help me, you can't help my son.
Speaker 3 (39:27):
Yeah, but I've even had that at the in the US,
like at the VAAL. Yeah, sure, a lot of those biases.
They exist in the US as well and in the UK. Right.
And then I've had patients who have said they don't
want one of my residents treating them perhaps because of
their their gender or because of their ethnicity. And again
(39:48):
we try to use those as teaching moments and explain
to the patient why they need care, why this person
can provide excellent care. But you don't win every argument,
and and I think sometimes those are just ones you
at some point have to let go. And the same
with you know, preferences for blood transfusions or avoiding blood transfusions.
(40:11):
I mean there's a lot of.
Speaker 1 (40:14):
Right, yeah, the idea that you can wasn't there a
core order done? Recently someone didn't want their kid to
have a blood transfusion which would save the life, and
the court was like, Okay, fuck it, we're doing it
and you'll just have to deal. I mean, it does
seem yeah, I mean, you want to respect people's belief systems,
(40:36):
but you.
Speaker 3 (40:38):
Do you also want to believe that like logic and
data went out at the end, but that is.
Speaker 1 (40:44):
Not the for everyone, for everyone I know. And also compassion.
I feel that seems so odd to me that because
everything is is so on fire politically or or socially,
the genuine compassion will be treated with suspicions like what
(41:05):
do you want? What do you want? And people are
so beat up by I don't know their life or
the world or what's happened to them that they can't
accept the hand when it's reached out to them. Does
that happen much?
Speaker 3 (41:20):
I think maybe initially. But what I've found is that
you know when you're I'm One of the things about
being a surgeon, right, especially if it's something that's emergent,
is that you have to build that trust with the family,
with the patient in a matter of minutes, because you're
asking them literally to put a life in your hands,
and so being able to meet them on a human level,
(41:43):
being able to just listen answer their questions, usually I
can get people to the ultimate outcome of like agreeing
to let me do surgery. I think, like anyone, if
you just push back and are immediately stand offish and
patriarchal and demanding, no one responds well to that. I
(42:04):
don't think anyone automatically changes their mind, whether you're trying
to get them to eat a hamburger or get them
to have an emergent surgery. And so that human element
becomes really important, and as you said, the humanity aspect
of listening to them and understanding where they're coming from
and asking questions like why is this the case? And
sometimes you have to compromise. Sometimes I have to agree
(42:26):
that I'm not going to give the blood transfusion in
the case of an emergency, but at least being able
to attempt understanding where they're coming from and have them
understand where I'm coming from and ultimately making a decision
that is hopefully best for the patient.
Speaker 1 (42:44):
Yeah, I mean, I guess because the legalities of it
as well. You'll be dealing with minors a lot of
the time, who the permission has to come from a
parent or guardian, and that might gosh. I feel like
I don't know how well I would do in that situation.
No one as me, but I mean the idea of,
you know, trying to help a kid and you've got
(43:07):
someone in the way, I think must be very frustrating.
Speaker 3 (43:11):
And I think even when everyone agrees, you know, I
always try to make sure, especially teenagers, they should have
a voice and I want them to be in agreement
with what we're planning on doing, even if they're not
the one signing the forum. I think if you lose
trust in your surgeon or in your physician, you're starting
(43:32):
from a really bad place, and the possibility of everything
going wrong from that point on is just huge. It
really needs to be based on trust. So even when
everyone's in agreement, I will always ask the kid as well,
do you understand what we're doing? Do you want to
do this? Is it's okay with you? You know you
want to have that that trust and rapport.
Speaker 1 (43:53):
Well, you've got my vote, doctor, and I wish you
continued success with kids who are well. Put up a
link for everybody year as well if they want to
know more about it or maybe help out where they
can go to do that. Keep doing what you're doing,
and it's a pleasure as always to talk to you.
Speaker 3 (44:11):
Thank you, thanks so much Craig for your time. I
really appreciate it very by catch it
Host
Craig Ferguson
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