Dr. Palaez, same surgeon, new role

Attended the monthly thoracic surgery meeting this morning to discuss cases.

The rest of the morning was spent with Dr. Palaez, rounding and seeing patients.  It was an interesting contrast – at Cardioinfantil, we saw consults and patients in his role as Vascular Surgery fellow before proceeding to Clinica del Country to see patients in his role as the attending Thoracic Surgeon.  It was a different perspective for me and I asked Dr. Palaez about it.

He explained that while many of his colleagues thought it was interesting that he would return to training at this stage in his life (he is 49 and has been a practicing thoracic surgeon for many years), that he was really enjoying his training.  He believes strongly in lifelong learning but is very pleased to be close to the completion of his vascular surgery training.  He has enjoyed the experience but is looking forwards to being a practicing vascular surgeon.  (He is currently training with Dr. Jaime Camacho, who is himself, a hybrid surgeon with training in both vascular and cardiac surgery.

During rounds, we saw several post-operative patients as well as consultations in the emergency room with a wide variety of vascular disease.

Dr. Nelson Renteria, Thoracic and Vascular Surgeon

What a delightful afternoon with Dr. Renteria and Dr. Cecilia Villasante (Radiology)!  Dr. Renteria works at the Centro Vascular del Country, which led me to suspect that he may no longer practice thoracic surgery.. But, happily, I was wrong.

While I enjoy meeting all the wonderful and interesting people from all surgical specialties (like the orthopedic surgeons I met with today), I can never deny how much I enjoy talking to people from my home specialties.  Maybe it makes me a little less homesick for my patients because it’s all so familiar.. And it’s always thrilling to meet people who find empyemas,  VATS and all these other things thoracic as interesting and engrossing as I do, especially when you meet people like Dr. Renteria, who still loves what he does as much as I do.  He still enjoys discussing cases, and has a real enthusiasm for his patients.

And – He does esophagectomies!  (Not many thoracic surgeons in Colombia perform esophageal surgery which is kind of like the ‘open heart’ surgery of thoracics*.)  He completed his fellowship training in esophageal surgery at Toronto General Hospital with Dr. Pearson (Dr. F. Griffith Pearson of Pearson’s Thoracic and Esophageal Surgery) and currently does esophagectomies here in Bogota.  (This is much bigger news than it sounds – finding qualified thoracic surgeons that perform an adequate number of esophagectomies can be difficult even in large centers.  Currently, in my home state of Virginia  – University of Virginia is home to the largest esophageal surgery center with three dedicated thoracic surgeons.  Even my beloved Duke only does about 75-76 cases a year.)

So, I admit I lost a bit of my professional cool (if I ever had any).  I was like a kid in a candy store – talking about pre-operative optimization, Ivor -Lewis versus Transhiatal approaches, node dissection and other minutiae that I enjoy.

I must say – I am looking forward to following him to the operating room soon!

** Studies show a significant decrease in morbidity and mortality when esophagectomies are performed by thoracic surgeons (versus general surgeons).