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AUDIO: Dr. Lishan Aklog - Why Did You Become A Cardiologist?

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Hi, and thank you for joining us at EmpowHER – the home of women’s health online. I am joined right now by Dr. Lishan Aklog; he is the Chairman of EmpowHER’s Medical Advisory Board. He is the Director and Chief of Cardiovascular Surgery at the Heart and Lung Institute of St. Joseph's Hospital and Medical Center in Phoenix, Arizona and, you know, Dr. Aklog has one of the most amazing stories and so, I wanted to find an opportunity where we just introduced him. He is a major player here on the site. Hey, Dr. Aklog!

Dr. Lishan Aklog:
Hi Todd.

Todd Hartley:
You know, I have gone over your bio so many times and I just find you just fascinating. Let’s see, born in Ethiopia, one of the world’s poorest nations, came to the U.S. at, what 13?

Dr. Lishan Aklog:
I came at, actually I was 13, although I had lived here earlier, when my, for a few years when my father was doing his residency, and just as a point, actually as interesting as my life and my sister’s lives have been, my parents actually had much more fascinating lives in terms of what they were able to overcome to get our family positioned to where we are now.

Todd Hartley:
Yeah, I have read in your bio that your father was the first cardiologist to practice in Ethiopia and your mother was the country’s first woman to receive a graduate university education, which she did it from Harvard where you also went.

Dr. Lishan Aklog:
Right, I look back up my mother in say, you know, 1956, you can imagine what some of the issues in this country were to have this petite little African woman from the small poor country land in Boston and at Harvard to get a graduate eduction. I think about that and I am just absolutely amazed at what she has accomplished over the years, going back home and being again, the first woman to have her graduate education and to be one of the first professors at the university. She really became an international figure in child development and so on and so forth. It’s an amazing inspiration for us.

Todd Hartley:
Well you really had some huge shoes to fill.

Dr. Lishan Aklog:
And you know my father came from a very humble background. Earned his way through the western school so the British had Ethiopians able to exult regardless of their economic background could get through and he just got through on just sheer work and brains and ended up getting a medical degree of the American University Bariatric, which is affiliate of Columbia, and then he did his residency in the U.S. and then went back and became one of the leading physicians for, you know, 40 years.

Todd Hartley:
Dr. Aklog, how old were you when you enrolled at Harvard?

Dr. Lishan Aklog:
I was 15, going on 16.

Todd Hartley:
And how long did it take? I know how long it took me to get through the University of Arizona. I sure hope it didn’t take as long as it took me. How old were you when you graduated from Harvard?

Dr. Lishan Aklog:
Let’s see, I guess I was, well I mean I did my undergraduate I was 19, I guess and then went on to medical school for four more years. So, I had a lot of years ahead of me to become a heart surgeon, so it was a good thing I got an early start.

Todd Hartley:
Wait a second. My notes say that you are the youngest heart surgeon ever to join the Harvard faculty. Is that true?

Dr. Lishan Aklog:
Someone had told me that. I don’t know if it’s ever been really, if it’s ever been confirmed but I suspect it’s probably true.

Todd Hartley:
Well that’s really impressive, I mean considering where your families come from and, you know, nobody in my family has gone on to be a cardiologist or a cardiothoracic surgeon so, you guys are really putting us to shame.

Dr. Lishan Aklog:
No, I don’t know. I mean, again, I think it goes back, as with anybody, and I tell my kids this, and others, really, at the end of the day, what it comes down to is, you know, your parents, your family, your, people who have mentored you through your life and who have established, you know, instilled some confidence and some desire to excel and that’s where, really, it all comes, that’s what it comes down to, being given the opportunities along the way.

Todd Hartley:
Dr. Aklog, you spent a lot of time at Brigham Women’s, Boston Children’s Hospital, at Harvard, what is it about that institution of Harvard Medical that just makes it one of the leading facilities in the world?

Dr. Lishan Aklog:
I think it must be something in the water.

Todd Hartley:
Really?

Dr. Lishan Aklog:
Yes, because when you, I mean, I am obviously joking, you know, but the, I think one of the things that struck me and I think people may be have a misconception about Harvard in general, is that it’s actually a very anti-elitist institution. People have this image and views of wealthy prep schools kids all showing up together and what I found striking, what I found most gratifying about my experience, particularly as an undergraduate, was the exact opposite that, as important as the curriculum is and the professors and all the facilities and so forth, what made that experience so rewarding is that it attracts really incredibly bright, energetic kids from literally all over the world.

So my, I lived on the first floor dorm in Harvard Yard as a freshman in 1981, and there were 12 of us, 12 guys on the first floor and it literally read like a United Nation’s there. We had a working class kid from Boston whose father was a train operator. We had upper class Atlanta; we had a brewery worker’s son from Milwaukee. I was the last one to show up and they couldn’t quite figure it out. They had seen my name, Lishan Aklog, they weren’t really sure what it was, but given Harvard’s history of taking in exotic people, the bed was that I was an Eskimo, but they found soon otherwise that I was not.

Todd Hartley:
Dr. Aklog, besides just being born in a family of cardiologists, what is it about the heart that inspires your work?

Dr. Lishan Aklog:
Well, you know, I think it’s really, for me it’s a combination of the heart and the heart system and then surgery, and the intersection of the two, but you know, the heart is really the central organ in the body, and people talk about the brain, but, you know, without the heart pumping blood to the brain, we wouldn’t be alive and I think that was very attractive.

Also, my background is really in physics and I’m always, sort of, a quantitative nerdy student and the mechanics of the heart on the cardiovascular system is really, it really, some of that can be quantified and understood in a quantitative way and it certainly was a good match for the way I, my academic background.

The other, and then you add the compound of the surgery to it and, you know, what’s really very attractive, was very attractive to me and, you know, adds to the job satisfaction as well as to the job stress is that, when you are operating on the heart, every operation is a so-called, think case. So there are very few things that we do day-to-day where the stakes are not sky high, and as I said, that adds to the stress because these are human beings and we never forget that that the patient is somebody’s mother, grandmother, father and so forth, and so that does add to the burden of what we do, but also, we have a big impact on patient’s lives and if we do what we do right and we are successful, we can take patients who are often quite debilitated or their quality of life has suffered in the recent past and get them to be very active and have an excellent quality of life and really, nothing could be more gratifying than having a patient like that and having them come back for their three-week or their three-month follow-up visit and see that they are really back to enjoying the full quality of life.

Todd Hartley:
Well, what makes a great doctor, in the interest of full disclosure I am grateful that you are my doctor and that I have been fortunate enough to come and see you a few times and I would consider you to be a great, great doctor. What is it that makes a doctor so exceptional and how can women look for that when they are in the doctor’s office?

Dr. Lishan Aklog:
Well, I mean I am not including myself in this, but I have worked with many great doctors in all sorts of specialists, and I think at the end of the day, it really, the qualities are very basic and are the same independent, whether you are a rural general practitioner or whether you are some high-power sub-specialist in a big medical center, the basic qualities are the same because at the end of the day no matter what our specific skills or what we are doing, we are still at the end of the day taking, as I said, a human being and they are entrusting us with themselves and with, you know, in many ways with their life.

And one of the things that we take a lot of pride in and we will always do, no matter what the economics of health care dictate, is that we talk to our patients and we spend a lot of time with them. You know, the way I see it, when I meet a patient, it’s a very, you know, we may do heart surgery every day, but for that particular patient that’s an event, for their family it’s a very dramatic event of a lifetime and we try not to forget that, and so what may seem routine and common place for us because that’s what we do everyday, is far from that for other patient and their families.

So what I try to do is I try to really make sure that after we have discussed their condition and what the options are, you know, sometimes that will take an hour and a half to do that, that we are really on the same page and I really believe that there’s nothing so complicated in medicine that cannot be explained ultimately to a patient or their family if the doctor is patient and, you know, takes the time to explain things in terms that people can understand and so I think that’s extremely important.

So really, the specific answer to your question is, is to find somebody who will spend the time with you, who will talk to you, who will explain your condition, explain the options, be honest about risks that are involved. You know, the last thing is you want that someone say, “Oh this is routine. We do this everyday. Everything is going to be just fine.” That should be red flag, you know, I think that’s a great starting point. If they spend time with you and you feel comfortable at the end, then your gut instinct is probably right.

Now, you know, obviously looking up, asking direct questions about how experienced and how many cases and so forth, all that’s important and I think patients are entitled to do that and we encourage people to do that, but the gut feeling about, “This person is really looking out for me and has my interest in my heart,” that could only come from sense that they are committed to your care.

Todd Hartley:
Yeah, I really got that sense from being in your office that you were invested in me as I was invested in you and that was rare and a profound experience for me as a patient, and I know that I wouldn’t have taken that approach had I not followed Michelle King Robson, EmpowHER’s founder’s guidance in showing up to my doctor’s appointment with you with questions and being prepared to ask questions and look for answers that were going to help me make the right decisions.

Dr. Lishan Aklog:
I think that philosophy, as you sort of hinted at through Michelle, is really what EmpowHER is all about, right?

Todd Hartley:
Yeah.

Dr. Lishan Aklog:
I mean it’s about having patients be fully informed. Doctors should not fear, and I don’t think most doctors do, but doctors should not fear fully informed patients. I love patients that come to me with a stack of articles from the Internet or whatever and some of them need to be debunked, but some of them are very valid and I think having patients who are fully informed and with sites like EmpowHER, where, you know, I think we can really empower women and patients to really come to their physicians, you know, really well informed and really understanding this to the full.

They are not being their own doctors; they are just informed patients, so those are two different things, but I think, you know, we see it as a team. You know, I mean, I am the surgeon and generally the lead person on the team, but I have a large team. I have got other practitioners, other clinical people, as well as the patient and their family. We try and look at everybody as one big team because, you know, things don’t always go perfectly and when things deviate from that path, we need to all be in it together and we need to all understand how we got there and how we are going to come out of that, come out of that situation. So I think that’s important, sort of, philosophically.

Todd Hartley:
Dr. Aklog, I noticed that you are one of the first surgeons in the United States to use surgical robots in patients undergoing heart surgery. How many years ago was this?

Dr. Lishan Aklog:
That was some while ago actually, so that was about, coming on over ten years ago. I was at Brigham Woman’s. I was one of the junior faculty surgeons there and this Da Vinci robot sort of showed up and we were, I think the fourth hospital in the country to get it, and at that point it was this amazing piece of technology but we weren’t really sure what to do with it or how to use it or how to have it enhance heart surgery and what’s been interesting over the past ten years is that the role of the robot, the robot is a little bit of a misnomer but when I have time to go over that, but we’ll call it the robot, the role of the robot is much, much clear now in other specialties such as urology and gynecology and so forth, and it’s still a little bit unclear what its role should be in heart surgery and we are still trying to figure that out.

Todd Hartley:
Dr. Aklog, I noticed from dealing with you over the years that your personality seems to be a little bit different from other heart doctors. Are you the typical prototype of a heart doctor?

Dr. Lishan Aklog:
I think you are trying to get me into trouble Todd, so I am going to be careful with that. I think not so much the case of the heart doctors but, you know, there’s a sort of classic surgical mentality, surgical personality that’s in Hollywood and television and, you know, I think there’s some truth to that.

I think all surgeons, to some degree, including myself, and my partners, have that surgical bravado underneath. I think you have to be, to some degree. It’s a pretty gutsy, crazy thing to be opening people up and fixing them. And so I think that comes with a territory, but in the days of, sort of extreme personalities that have dominated surgery over the years, I think those days are gone. Most of us these days have a little bit more humility than the classic iron-God surgeon from Hollywood.

Todd Hartley:
Well, you know, I have never asked this question, I have probably interviewed a couple of hundred doctors all of the United States and, do you ever get scared?

Dr. Lishan Aklog:
Oh absolutely, absolutely. I think that just comes with being, with being humble and I think maybe scared is not the right term, although it may be more of a deep concern but, you know, what we do is complex and small errors, small deviations can lead to big, big problems and so, there are absolutely times during an operation where things are going well and then there’s sudden little red flag that might indicate a problem and that we have to look into further or address and there’s a period of time where there’s, you know, some serious concern.

You know, I think one thing that’s, we talked about surgical personalities, I think one thing that is important to balance I think is that, you know, at that time, in the heat of the moment while you are doing surgery you have to be a little bit emotionally detached to be able to understand and address that issue. So I think, you know, some of the humility and some of the other social characteristics that we talked about earlier, those kind of get put on the back burner while we are actually operating because they can interfere with some of that decision making but, deep concern and bordering fear, that does happen, and hopefully, you know, with a level head and with a good team around you, we, most of the time are able to overcome that.

Todd Hartley:
Well he is Dr. Lishan Aklog. He is the Director and Chief of Cardiovascular Surgery at the Heart and Lung Institute of St. Joseph’s Hospital and Medical Center in Phoenix, Arizona and, he just so happens to be the Chairman of EmpowHER’s Medical Advisory Board. Dr. Aklog, thank you so much for taking a few moments and allowing us to just dig into who you are and incidentally, your role here at EmpowHER, you are the Chairman of the Medical Advisory Board, can you explain a little bit to the audience what that entails?

Dr. Lishan Aklog:
Well yeah, I mean I think at the end of the day, you know one of the goals of EmpowHER is to assure that, you know, the information that’s available to the people who come to our site is really accurate and is really based on facts and so forth and we see the role of the Medical Advisory Board to help balance what is always and should be a very lively debate and exchange of ideas and information about various medical conditions, to balance that with the science and facts with underlying medicine and so, we spend a lot of time really reviewing material and reviewing some of that dialogue to make sure that we are not allowing this information to be spread to the participants on our site. I think that’s our primary mission.

Todd Hartley:
Yeah, that’s well said. Dr. Aklog, I am honored to be a patient of yours. I enjoy working with you and I am grateful you took the time to help us find out a little bit more about you.

Dr. Lishan Aklog:
Thank you Todd. My pleasure.

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