August 14, 2024 • 17 mins
Join Holly Wayment in this episode of Pediatrics Now for Parents, as she interviews Dr. Ian Mitchell, Pediatric Surgeon-in-Chief at University Hospital. Dr. Mitchell shares exciting news about the new pediatric surgery center in partnership with Morgan's Wonderland, specifically designed to cater to children and adults with special needs.
Discover how this state-of-the-art facility, equipped with five surgical suites, aims to serve patients with neurodevelopmental issues, autism, and other behavioral or anxiety problems. Dr. Mitchell also discusses common pediatric surgeries, such as hernia repairs and treatments for pilonidal disease, providing invaluable insights for parents.
Learn about the importance of honesty and connection in pediatric care, and how being a father has influenced Dr. Mitchell's approach to surgery. Tune in for a heartwarming and informative conversation that highlights the resilience of children and the transformative power of compassionate medical care.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I'm Holly Wayment, and this is Pediatrics Now for Parents, health news in small
bites for the busy parent.
Today here in the podcast studio, I feel so honored because joining me here
is Pediatric Surgeon-in-Chief at University Hospital.
Also, he's a husband and busy dad. Dr. Ian Mitchell is joining us here in the podcast studio.
(00:24):
Thanks for being here, Ian. Thanks, Holly. It's great to be here. And Dr.
Mitchell, tell me about this amazing partnership with Morgan's Wonderland,
this new clinic for children with special needs.
So we have two things going on. We have our pediatric surgery clinic is expanding.
So down at Robert B. Green on Wednesdays, starting in October,
we'll have our next iteration of just general pediatric surgery clinic at our
(00:48):
UH facilities. And then you're right.
The big news is, is that University Health, in partnership with Morgan's,
the Umbrella Foundation and the Gordman Hartman Foundation, we're opening a
new surgery center. It's an outpatient surgery center.
It has five surgical suites in it. And it's inside the multi-assistance center,
which for families that drive up and down 35, if you're driving and you look
(01:11):
towards Toyota Field, you see a beautiful, bright purple building.
And that building is designed to have health care needs, social service needs,
even a hair salon for adults and children with special needs.
And we're fortunate and blessed to be able to open up a surgery center there,
both for that population and for any children and adults that go to providers
(01:33):
that work there. So we're really excited.
We're about a month away from opening and already we're signing patients actually
into the ORs already. What types of special needs is this center right for?
Do you want to mention a few? Sure.
So we'll cater to certainly the members of the MAC, people that are part of
there, but any patients with neurodevelopmental issues, things like autism.
(01:56):
Any other behavioral or anxiety problems that patients may have.
And that includes also our adults.
And so now that our adult patients with special needs are certainly living much
longer and have more healthcare needs than they used to. And so we think about things like dental.
We think of things about ophthalmology, about ENT, and ear tubes,
(02:17):
tonsils, all of these things.
And we're really looking forward to be able to taking care of this patient population
as well as, you know, if you're going to do eight operations in a day,
which is not that hard for our ENT colleagues,
and four or five of those might be special needs, and the rest might be kids
that just need some ear tubes.
So, is it for kids with special needs only in this center, or the kids without
(02:40):
special needs can come as well?
All the same. Adults as well. We're focused primarily on kids and adults with
special needs, but I would argue that depending on the specialty,
those numbers will change. So, for our dental colleagues, for example….
It's going to be all special needs folks because otherwise they'd be in a dental office.
Whereas for some of others like ENT or ophthalmology, it'll be a mix of special
(03:04):
needs patients and then those that we are operating rooms are really busy.
And so trying to get operating time is hard.
And also this is, if you see it, it's just a beautiful place.
You'd much rather do a straightforward outpatient operation there than doing
it at university if you can. Anne.
So let's talk about some of the surgeries that could be done there.
(03:27):
And just in general, an update for parents about pediatric surgery,
that it's important to know what's out there.
So I'm a general pediatric surgeon, which means I sort of, if you started about
the hyoid bone, so right about in the middle of your neck and go straight down
to the pelvis and people ask, what do I do?
And I say, go to the middle of your neck and go down. And I'll do most of the
(03:50):
stuff in there that's not a bone, not the heart and not a transplant.
And there are a few things in there that other people do do, but I'm really blessed.
Some days I'm doing lung work and some days I'm doing some stuff in the neck.
And then most of the time I'm in the belly and doing other stuff there.
So lots of different places.
Here for what kind of operations might we do out there? And what are the most common things?
(04:12):
Little belly button hernia repairs. We call that an umbilical hernia repair.
If you see a groin bulge in a boy or a girl in young children,
even in babies, actually, they're the most common ones. That's an inguinal hernia. So I fix those.
And then I always laugh. I always throw some fuzzy butts in there.
And what I mean by that is that teenagers can often get a disease called pilonidal
(04:33):
disease, which is what it sounds like, pilo hair, neato nest,
and it's a nest of hairs inside the very bottom of their butt.
And so you might have a teenager who's suddenly complaining about pain or drainage
from just above their anus. And that is often pilonidal disease.
And I actually take care of that too.
And it may be a while before an adolescent tells anyone about this,
(04:56):
and they may be suffering with it and worried about it for a while.
Absolutely. It's an embarrassing condition. And, you know, it really sounds
like something that you'd think, well, if it's related to hair and their butt,
my only boys are going to get that.
And it turns out that's actually not the case. While I think globally or worldwide
that predominates, here in San Antonio, to me, just personally,
(05:17):
it seems a little more 50-50.
And I think certainly a lot of teenage girls, I can't imagine how embarrassing
it is to have this kind of problem in that location.
So I'm fortunate to be able to help take care of them and make things better
for them. Do we know, Dr. Mitchell, what causes this condition?
We know that people have some, I would say, people say a genetic predisposition,
(05:39):
but I don't think there's a single gene that says what it is,
but it's really having a little bit of hair down there in that area.
And then we do believe that it's the actions of getting up and sit down and
get up and sit down and get up, sit down. You do that a couple thousand times.
And if you have a little bit of these tiny pits in the skin there,
then that's what can cause them to to get infected or to bleed or get irritations.
(06:01):
And so the most important part about taking care of that disease is actually
cleaning your bottom really well, which you as a mom of teenagers,
mine are still a little young, might know that getting a teenage boy to clean
their bottom is sometimes not the easiest thing in the world.
Right. Absolutely. But good hygiene in that area and then also laser hair removal
(06:21):
can really help and often avoid needing to do surgeries.
Now, Sometimes if there's already a lot of inflammation or infection,
then we have to do some small surgeries, much, much smaller stuff than we used to do.
And so good for parents to know that if you have a teenager who's.
Something's going on, can't figure out, and may complain, or maybe even oftentimes
(06:44):
is walking a little funny, and you may wonder.
And unfortunately, you can't see that area yourself, so somebody's got to take a look.
But if you were to see a group of hairs or less of small pits in that area,
then time to visit the pediatrician and have them take a look.
For the other two, I think the most common things for parents to know about,
I do inguinal hernia repairs and umbilical hernia repairs.
(07:06):
And And hernia just means something bulging into somewhere that it's not supposed to.
And in the groin in boys, that's a sac that never closed.
That's always there, but it should close.
And the same in girls are the much more common in boys, probably about 90% boys.
And what you'll see most commonly in babies, but we see it certainly up until
(07:26):
about the ages six to seven.
And then it gets a little pretty uncommon again until you get into the late
teenagers and young adults.
And the mechanism is very different. People talk about a groin hernia in an
adult. That's from tissue that got weak.
In a child, it's from a hole that just never closed. And so that's why we see them in babies.
And so I repair them now almost 100% of the time with a camera in a small outpatient operation.
(07:52):
Obviously, if we have to do it in a newborn baby, we're doing it in the hospital.
But we put a camera in the belly button, take a look around,
make sure there isn't a hernia on the other side, and then just basically use
a needle and thread, tie the hole closed, and that's it. And people always ask
about activity restrictions.
I said, you don't need to worry about it. No three-year-old has ever restricted
their own activity in the history of three-year-olds.
(08:13):
And so once they're bouncing off the walls again, they're fine.
And then belly button hernias is another thing that's extremely common.
It is actually every single human has a belly button hernia when they're born.
Everyone does. And most of them close by a couple weeks, but there's still a
good number that will take months or even years to close.
(08:34):
And the thing I tell parents is that umbilical hernias in children don't hurt.
Children may be uncomfortable, especially if you're messing with it a lot.
They may be uncomfortable for some other reason.
They've got colic. They've got a viral illness.
They're constipated. They're just mad at the world. But really,
umbilical hernias should not be a reason for pain.
(08:54):
And the good news is, is the magic of the baby belly button,
that these hernias actually can still close all the way up to kids being four years old.
So if they haven't closed by four years old, then we'll do an operation to fix it.
But pretty rare for me to do a case, to do an operation for a baby,
a child under four years old. So it's not painful and wait until at least four
(09:16):
years old. Yeah. Do you want to talk about salt?
Oh, we have found a lot of parents out there may remember or may know children
that have had an umbilical granuloma.
And that's just a little piece of the belly button of that umbilical cord that
never quite fell off quite right.
And then it got sort of chronically irritated. And it's this red little fleshy
(09:38):
thing at the bottom. them now.
Obviously you want to check that out with your pediatrician,
but typically we have used something called silver nitrate, which kind of gives
it a little burn to really make that go away.
But what we have found a couple studies, including a really well done one out
of Malaysia has actually shown that you can actually just literally put salt
(09:58):
in that wound and it will shrivel up.
And their results were impressive, a 99% closure rate for that.
So while I would always advocate, please go see your pediatrician before pouring
salt into your newborn baby's belly button.
Don't be surprised if they either advocate doing that or touching it with silver
(10:19):
nitrate. Either one is going to work just fine.
Wow. Sometimes it can be so simple, the solution. Anything else you want parents to know?
Just that when you go and visit the pediatrician, a lot of times if parents,
if you are sent to see a surgeon, that can be a very concerning time.
It can be a really worrisome thing and be a really scary time and a great concern.
(10:44):
The good news is, is that the vast majority of children do very well with surgery.
You got to remember they may be small, but their physiology hasn't been stuffed
with cheeseburgers and all sorts of stuff for years and years.
They're incredibly resilient and they They generally do really well.
And just going to visit the surgeon doesn't mean you're destined to get a surgery,
(11:07):
but we're always happy to take care of kids.
This is all I do, and I love it.
And that's a great inspiration to have a healthy diet, what you just said.
But yes, you're extremely talented and working with you, it's obvious how much you love it.
And how has being a dad, has that changed your outlook on surgery,
(11:30):
inspired you more? Do you want to mention something about that?
I think what it has done is allowed me to recognize when, oh, that's normal.
Before I had children, my experience with children was every other night call
for two years, plus, you know, family members and things like that.
But after I became a father, you know, well, you see kids do all sorts of crazy
(11:54):
things and you think, well, that doesn't look right.
And then you realize, nope, the kid's fine. And so I think a lot of times we,
we as physicians actually have to remember,
even when we are taking care of children or operating on them,
that their physiology is some alien being that came down to earth because they
seem to be able to heal themselves out of do some of the craziest things and
(12:18):
come out on the other side.
And so I think one thing I learned from being a father is that most of the time
the kids will bounce and that a lot of the things that you see that could be
concerning, they end up okay in the end.
It's not everything, but it certainly teaches you a little more patience.
That's great. And did you know early on that you wanted to be a pediatric surgeon?
(12:38):
Oh, I had lung surgery in Toronto when I was 15.
I had been interested in doing trauma surgery before that, and I still have
some role in trauma, but I wanted to be a pediatric surgeon since then.
I was interested in different parts of pediatric surgery, but I'm where I'm supposed to be.
And when you were 15, it was because you were treated so well,
(13:01):
got such great care, if I'm remembering correctly, that that's what helped inspire
you? I got great care and I had one surgeon who I did not like.
And so it was a combination of this is really great. I want to be involved in
this. And also I can do it better than that guy.
And I know we've talked about how important it is to not be a jerk.
(13:23):
And when you're talking about hiring staff or doctors, if you're extremely talented
and also a jerk, we're not going to hire you.
I think that's the case. And even more so having taken care of a lot. You can't lie to a kid.
You just can't. And sometimes people want to protect kids and that's entirely understandable.
(13:48):
And certainly the way that you present the information may be slightly different.
But if something's going to hurt, you tell them it's going to hurt.
And I am always amazed by...
A lot of people say whenever you're taking care of a kid, you're really taking
care of the parents. And I think that's true.
But kids get their cues from their parents. If the parents are nervous or concerned
(14:12):
or frightened, which is understandable, then that gives cues to the kids.
And so from my standpoint, I think the main thing is being honest with kids
and also coming to their level.
If the kid is lying in bed, I sit in the bed with them. If the kid is in the
clinic sitting on the floor, I will sit on the floor with them.
And most kids don't have adults sit on a floor with them.
(14:34):
So a lot of them kind of find that amusing and interesting.
That's wonderful. And that eye level, eye contact, how crucial that is.
Absolutely. When that child all day has adults up higher and lights and things coming at them.
And now I remember one time my daughter, when she was younger,
saying, I started to tell her about something and it's going to be fine.
(14:56):
But, and then she pointed out to me, like, when it's something that could end
up not being fine, you always say it's going to be fine beforehand.
And it, And it just made me realize, like to your point, the kids can tell if
there's, and they appreciate the honesty and knowing about the risk, you know.
And then as a parent, we're trying to help them not to worry too.
(15:17):
And it did end up being fine.
And I always tell the kids, for example, because for an appendectomy,
you have to have good rapport for a kid and you have a very short window.
You might meet them in the pre-op holding area. you're about to go and do an
operation and they have to like you and trust you in a very short span of time.
And so I'll always tell them, look, it's not like I've done this a thousand times.
(15:39):
I've actually done it 3000 times. Love it. That's a great line.
And then I'll tell them, and almost every kid that I've ever done this on has
walked out the building.
And then they'll go, they'll look very scared for a minute.
And I go, well, the youngest patient was only 11 months old and hadn't learned
to walk. So that wasn't my fault.
And usually by that point, I've got him at least smiling, if not giggling. Oh, that's wonderful.
(16:02):
That's so great. And so you do surgery. Can you tell us again the places?
There's a building called the Robert B. Green Center downtown called RBG,
you might hear, for University Hospital.
So I'll have clinic there starting on October, in early October.
And then our division, I have a fantastic partner, Dr.
(16:22):
Katie Wiggins, as well as our nurse practitioner, Leanne Ricondo,
and our gastrostomy tube nurse, Corinne Parra. So we've got a little enterprise going.
They see patients here at University Hospital.
I will be seeing them at Robert B. Green. And then honestly,
as the UH system continues to grow, I anticipate we'll be seeing more patients
in different places coming soon.
(16:42):
And the ER that's in the new Women's and Children's Tower and all of it just
looks beautiful and amazing.
Yeah, the space is getting busy.
Busy dad and pediatric surgeon-in-chief, Dr. Ian Mitchell, thank you for taking
time out of your schedule to talk to us here on...
Music.
I'm Holly Wayment, and this is Pediatrics Now for Parents, health news in small
bites for the busy parent.
Today here in the podcast studio, I feel so honored because joining me here
is Pediatric Surgeon-in-Chief at University Hospital.
Also, he's a husband and busy dad. Dr. Ian Mitchell is joining us here in the podcast studio.
(00:24):
Thanks for being here, Ian. Thanks, Holly. It's great to be here. And Dr.
Mitchell, tell me about this amazing partnership with Morgan's Wonderland,
this new clinic for children with special needs.
So we have two things going on. We have our pediatric surgery clinic is expanding.
So down at Robert B. Green on Wednesdays, starting in October,
we'll have our next iteration of just general pediatric surgery clinic at our
(00:48):
UH facilities. And then you're right.
The big news is, is that University Health, in partnership with Morgan's,
the Umbrella Foundation and the Gordman Hartman Foundation, we're opening a
new surgery center. It's an outpatient surgery center.
It has five surgical suites in it. And it's inside the multi-assistance center,
which for families that drive up and down 35, if you're driving and you look
(01:11):
towards Toyota Field, you see a beautiful, bright purple building.
And that building is designed to have health care needs, social service needs,
even a hair salon for adults and children with special needs.
And we're fortunate and blessed to be able to open up a surgery center there,
both for that population and for any children and adults that go to providers
(01:33):
that work there. So we're really excited.
We're about a month away from opening and already we're signing patients actually
into the ORs already. What types of special needs is this center right for?
Do you want to mention a few? Sure.
So we'll cater to certainly the members of the MAC, people that are part of
there, but any patients with neurodevelopmental issues, things like autism.
(01:56):
Any other behavioral or anxiety problems that patients may have.
And that includes also our adults.
And so now that our adult patients with special needs are certainly living much
longer and have more healthcare needs than they used to. And so we think about things like dental.
We think of things about ophthalmology, about ENT, and ear tubes,
(02:17):
tonsils, all of these things.
And we're really looking forward to be able to taking care of this patient population
as well as, you know, if you're going to do eight operations in a day,
which is not that hard for our ENT colleagues,
and four or five of those might be special needs, and the rest might be kids
that just need some ear tubes.
So, is it for kids with special needs only in this center, or the kids without
(02:40):
special needs can come as well?
All the same. Adults as well. We're focused primarily on kids and adults with
special needs, but I would argue that depending on the specialty,
those numbers will change. So, for our dental colleagues, for example….
It's going to be all special needs folks because otherwise they'd be in a dental office.
Whereas for some of others like ENT or ophthalmology, it'll be a mix of special
(03:04):
needs patients and then those that we are operating rooms are really busy.
And so trying to get operating time is hard.
And also this is, if you see it, it's just a beautiful place.
You'd much rather do a straightforward outpatient operation there than doing
it at university if you can. Anne.
So let's talk about some of the surgeries that could be done there.
(03:27):
And just in general, an update for parents about pediatric surgery,
that it's important to know what's out there.
So I'm a general pediatric surgeon, which means I sort of, if you started about
the hyoid bone, so right about in the middle of your neck and go straight down
to the pelvis and people ask, what do I do?
And I say, go to the middle of your neck and go down. And I'll do most of the
(03:50):
stuff in there that's not a bone, not the heart and not a transplant.
And there are a few things in there that other people do do, but I'm really blessed.
Some days I'm doing lung work and some days I'm doing some stuff in the neck.
And then most of the time I'm in the belly and doing other stuff there.
So lots of different places.
Here for what kind of operations might we do out there? And what are the most common things?
(04:12):
Little belly button hernia repairs. We call that an umbilical hernia repair.
If you see a groin bulge in a boy or a girl in young children,
even in babies, actually, they're the most common ones. That's an inguinal hernia. So I fix those.
And then I always laugh. I always throw some fuzzy butts in there.
And what I mean by that is that teenagers can often get a disease called pilonidal
(04:33):
disease, which is what it sounds like, pilo hair, neato nest,
and it's a nest of hairs inside the very bottom of their butt.
And so you might have a teenager who's suddenly complaining about pain or drainage
from just above their anus. And that is often pilonidal disease.
And I actually take care of that too.
And it may be a while before an adolescent tells anyone about this,
(04:56):
and they may be suffering with it and worried about it for a while.
Absolutely. It's an embarrassing condition. And, you know, it really sounds
like something that you'd think, well, if it's related to hair and their butt,
my only boys are going to get that.
And it turns out that's actually not the case. While I think globally or worldwide
that predominates, here in San Antonio, to me, just personally,
(05:17):
it seems a little more 50-50.
And I think certainly a lot of teenage girls, I can't imagine how embarrassing
it is to have this kind of problem in that location.
So I'm fortunate to be able to help take care of them and make things better
for them. Do we know, Dr. Mitchell, what causes this condition?
We know that people have some, I would say, people say a genetic predisposition,
(05:39):
but I don't think there's a single gene that says what it is,
but it's really having a little bit of hair down there in that area.
And then we do believe that it's the actions of getting up and sit down and
get up and sit down and get up, sit down. You do that a couple thousand times.
And if you have a little bit of these tiny pits in the skin there,
then that's what can cause them to to get infected or to bleed or get irritations.
(06:01):
And so the most important part about taking care of that disease is actually
cleaning your bottom really well, which you as a mom of teenagers,
mine are still a little young, might know that getting a teenage boy to clean
their bottom is sometimes not the easiest thing in the world.
Right. Absolutely. But good hygiene in that area and then also laser hair removal
(06:21):
can really help and often avoid needing to do surgeries.
Now, Sometimes if there's already a lot of inflammation or infection,
then we have to do some small surgeries, much, much smaller stuff than we used to do.
And so good for parents to know that if you have a teenager who's.
Something's going on, can't figure out, and may complain, or maybe even oftentimes
(06:44):
is walking a little funny, and you may wonder.
And unfortunately, you can't see that area yourself, so somebody's got to take a look.
But if you were to see a group of hairs or less of small pits in that area,
then time to visit the pediatrician and have them take a look.
For the other two, I think the most common things for parents to know about,
I do inguinal hernia repairs and umbilical hernia repairs.
(07:06):
And And hernia just means something bulging into somewhere that it's not supposed to.
And in the groin in boys, that's a sac that never closed.
That's always there, but it should close.
And the same in girls are the much more common in boys, probably about 90% boys.
And what you'll see most commonly in babies, but we see it certainly up until
(07:26):
about the ages six to seven.
And then it gets a little pretty uncommon again until you get into the late
teenagers and young adults.
And the mechanism is very different. People talk about a groin hernia in an
adult. That's from tissue that got weak.
In a child, it's from a hole that just never closed. And so that's why we see them in babies.
And so I repair them now almost 100% of the time with a camera in a small outpatient operation.
(07:52):
Obviously, if we have to do it in a newborn baby, we're doing it in the hospital.
But we put a camera in the belly button, take a look around,
make sure there isn't a hernia on the other side, and then just basically use
a needle and thread, tie the hole closed, and that's it. And people always ask
about activity restrictions.
I said, you don't need to worry about it. No three-year-old has ever restricted
their own activity in the history of three-year-olds.
(08:13):
And so once they're bouncing off the walls again, they're fine.
And then belly button hernias is another thing that's extremely common.
It is actually every single human has a belly button hernia when they're born.
Everyone does. And most of them close by a couple weeks, but there's still a
good number that will take months or even years to close.
(08:34):
And the thing I tell parents is that umbilical hernias in children don't hurt.
Children may be uncomfortable, especially if you're messing with it a lot.
They may be uncomfortable for some other reason.
They've got colic. They've got a viral illness.
They're constipated. They're just mad at the world. But really,
umbilical hernias should not be a reason for pain.
(08:54):
And the good news is, is the magic of the baby belly button,
that these hernias actually can still close all the way up to kids being four years old.
So if they haven't closed by four years old, then we'll do an operation to fix it.
But pretty rare for me to do a case, to do an operation for a baby,
a child under four years old. So it's not painful and wait until at least four
(09:16):
years old. Yeah. Do you want to talk about salt?
Oh, we have found a lot of parents out there may remember or may know children
that have had an umbilical granuloma.
And that's just a little piece of the belly button of that umbilical cord that
never quite fell off quite right.
And then it got sort of chronically irritated. And it's this red little fleshy
(09:38):
thing at the bottom. them now.
Obviously you want to check that out with your pediatrician,
but typically we have used something called silver nitrate, which kind of gives
it a little burn to really make that go away.
But what we have found a couple studies, including a really well done one out
of Malaysia has actually shown that you can actually just literally put salt
(09:58):
in that wound and it will shrivel up.
And their results were impressive, a 99% closure rate for that.
So while I would always advocate, please go see your pediatrician before pouring
salt into your newborn baby's belly button.
Don't be surprised if they either advocate doing that or touching it with silver
(10:19):
nitrate. Either one is going to work just fine.
Wow. Sometimes it can be so simple, the solution. Anything else you want parents to know?
Just that when you go and visit the pediatrician, a lot of times if parents,
if you are sent to see a surgeon, that can be a very concerning time.
It can be a really worrisome thing and be a really scary time and a great concern.
(10:44):
The good news is, is that the vast majority of children do very well with surgery.
You got to remember they may be small, but their physiology hasn't been stuffed
with cheeseburgers and all sorts of stuff for years and years.
They're incredibly resilient and they They generally do really well.
And just going to visit the surgeon doesn't mean you're destined to get a surgery,
(11:07):
but we're always happy to take care of kids.
This is all I do, and I love it.
And that's a great inspiration to have a healthy diet, what you just said.
But yes, you're extremely talented and working with you, it's obvious how much you love it.
And how has being a dad, has that changed your outlook on surgery,
(11:30):
inspired you more? Do you want to mention something about that?
I think what it has done is allowed me to recognize when, oh, that's normal.
Before I had children, my experience with children was every other night call
for two years, plus, you know, family members and things like that.
But after I became a father, you know, well, you see kids do all sorts of crazy
(11:54):
things and you think, well, that doesn't look right.
And then you realize, nope, the kid's fine. And so I think a lot of times we,
we as physicians actually have to remember,
even when we are taking care of children or operating on them,
that their physiology is some alien being that came down to earth because they
seem to be able to heal themselves out of do some of the craziest things and
(12:18):
come out on the other side.
And so I think one thing I learned from being a father is that most of the time
the kids will bounce and that a lot of the things that you see that could be
concerning, they end up okay in the end.
It's not everything, but it certainly teaches you a little more patience.
That's great. And did you know early on that you wanted to be a pediatric surgeon?
(12:38):
Oh, I had lung surgery in Toronto when I was 15.
I had been interested in doing trauma surgery before that, and I still have
some role in trauma, but I wanted to be a pediatric surgeon since then.
I was interested in different parts of pediatric surgery, but I'm where I'm supposed to be.
And when you were 15, it was because you were treated so well,
(13:01):
got such great care, if I'm remembering correctly, that that's what helped inspire
you? I got great care and I had one surgeon who I did not like.
And so it was a combination of this is really great. I want to be involved in
this. And also I can do it better than that guy.
And I know we've talked about how important it is to not be a jerk.
(13:23):
And when you're talking about hiring staff or doctors, if you're extremely talented
and also a jerk, we're not going to hire you.
I think that's the case. And even more so having taken care of a lot. You can't lie to a kid.
You just can't. And sometimes people want to protect kids and that's entirely understandable.
(13:48):
And certainly the way that you present the information may be slightly different.
But if something's going to hurt, you tell them it's going to hurt.
And I am always amazed by...
A lot of people say whenever you're taking care of a kid, you're really taking
care of the parents. And I think that's true.
But kids get their cues from their parents. If the parents are nervous or concerned
(14:12):
or frightened, which is understandable, then that gives cues to the kids.
And so from my standpoint, I think the main thing is being honest with kids
and also coming to their level.
If the kid is lying in bed, I sit in the bed with them. If the kid is in the
clinic sitting on the floor, I will sit on the floor with them.
And most kids don't have adults sit on a floor with them.
(14:34):
So a lot of them kind of find that amusing and interesting.
That's wonderful. And that eye level, eye contact, how crucial that is.
Absolutely. When that child all day has adults up higher and lights and things coming at them.
And now I remember one time my daughter, when she was younger,
saying, I started to tell her about something and it's going to be fine.
(14:56):
But, and then she pointed out to me, like, when it's something that could end
up not being fine, you always say it's going to be fine beforehand.
And it, And it just made me realize, like to your point, the kids can tell if
there's, and they appreciate the honesty and knowing about the risk, you know.
And then as a parent, we're trying to help them not to worry too.
(15:17):
And it did end up being fine.
And I always tell the kids, for example, because for an appendectomy,
you have to have good rapport for a kid and you have a very short window.
You might meet them in the pre-op holding area. you're about to go and do an
operation and they have to like you and trust you in a very short span of time.
And so I'll always tell them, look, it's not like I've done this a thousand times.
(15:39):
I've actually done it 3000 times. Love it. That's a great line.
And then I'll tell them, and almost every kid that I've ever done this on has
walked out the building.
And then they'll go, they'll look very scared for a minute.
And I go, well, the youngest patient was only 11 months old and hadn't learned
to walk. So that wasn't my fault.
And usually by that point, I've got him at least smiling, if not giggling. Oh, that's wonderful.
(16:02):
That's so great. And so you do surgery. Can you tell us again the places?
There's a building called the Robert B. Green Center downtown called RBG,
you might hear, for University Hospital.
So I'll have clinic there starting on October, in early October.
And then our division, I have a fantastic partner, Dr.
(16:22):
Katie Wiggins, as well as our nurse practitioner, Leanne Ricondo,
and our gastrostomy tube nurse, Corinne Parra. So we've got a little enterprise going.
They see patients here at University Hospital.
I will be seeing them at Robert B. Green. And then honestly,
as the UH system continues to grow, I anticipate we'll be seeing more patients
in different places coming soon.
(16:42):
And the ER that's in the new Women's and Children's Tower and all of it just
looks beautiful and amazing.
Yeah, the space is getting busy.
Busy dad and pediatric surgeon-in-chief, Dr. Ian Mitchell, thank you for taking
time out of your schedule to talk to us here on...
Music.
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