DR. MANI MENON: MUSINGS
(On his role as Director of the Vattikuti Urology Institute)
October 10, 2015, a distinguished group of over 50 Urologists had gathered in Detroit to celebrate the Centennial of the Henry Ford Hospital/Health System Urology Department, which became known as the Vattikuti Urology Institute following a gift from Raj and Padma Vattikuti. Many of these surgeons had graduated after serving as Residents and Fellows, many going on to lead robotic programs in hospitals across the country. While Menon did not reflect much upon the upcoming 15th Anniversary of his first robotic prostatectomy, (11/29/2015) his leadership in the world of robotic surgery was quite present in the room. Here are some of his comments:
“I’ve been the chair here 18 years, and my legacy are the people who are in this room.
The longer you are a Chair, you realize your primary skill is to avoid getting fired. To negotiate the hot waters and the way you avoid getting fired- Jim, you’ll realize it- is uh, either by going to all the committee meetings or by learning to manipulate the numbers.
I don’t go to committee meetings, but I do know how to manipulate numbers. I did a quick calculation, and if we had 100 Residents here and, if each resident makes 400 thousand dollars a year, then- there are some outliers in Southwest Florida, but- (laughter).
We have from the Urology Department generated anywhere from one to two Billion dollars of value to the Alumni here. And so- that is a good and manipulated number. I don’t know any one of you thinks they are worth a million dollars, but- collectively, you are. And those of you who are in Residency training, you should realize, that this is worth- that you can look forward to. And- you would have touched millions of lives. Millions of people
Whether it is someone who comes in with perineal pain and anxiety, or whether it is someone who comes in with a renal cell carcinoma, or an atrial thrombus, you- or some of you, would train other people, and the legacy will go on. But without people training programs, there would be no medicine the way we see it. Patients clearly, would be worse off if this was just an apprenticeship and not a form of Residency.
There are 3 people who are involved with Residency training- one of whom is not here- Humphrey Atimo, the Residency Program Director, Jack Elder was the program Director for many, many years ago- for many, many years- for 7 years- and brought the program to accreditation with commendation. And Jim (Peabody) was the program director for 10 years before that.
My first week, I had a Russian patient who was an immigrant and, who didn’t speak much English. And he had two fairly attractive daughters. He had some renal cell carcinoma with nodes extending up into the atrium and I forget what, but he’s a big guy and a tough operation and it was not likely to succeed because he had palpable nodal disease, but he had just one request: "I want to spend the summer in Kroger, shopping for my family. If you can give me just 3 months of life- I can’t even move from the bed to the chair.
So, I said ‘We can do a palliative nephrectomy and remove the thrombus out.’
And, I booked the patient. The next thing I know is Bob- who’s Shetty’s running mate, has reported me to the Administration, saying ‘I’m doing unethical medicine, exceeding my capability.’
Now, I don’t know that it was unethical, but he might have been sharp at realizing that I had exceeded my capabilities, so- I didn’t understand why this would be- because I had been a chairman for 14 years, and- this is something that I had done, and we had written about it. I happened to have had one of the world’s greatest experiences with open surgery for atrial thrombuses at that point. So, I knew, certainly knew how to get into trouble- and most of the times- I knew how to get out of trouble.
So, I told Bob “If you feel ethically challenged by this, you shouldn’t scrub on this- I don’t want to involve your ethics.”
And I went to Dr. Cerney and Dr. Farah and I said, “Well, what should I do now? I mean, the Chief Resident, who’s under services, isn’t going to scrub on it.” Khurshid Guru, who is still roaming around there, so I didn’t know I could have called you (to Guru in the audience, who banters w/ Menon).
“You were under wraps.” (Laughter)
So Cerney said, “This is the best thing that has happened to you! Sugand Shetty will scrub on it and that patient will do fine!”
“And that’s exactly what happened. (To Shetty- in audience) Remember that? I mean, I’m abbreviating some of that, but Brad Bay, who some of you remember, went to that same Kroger and much to my surprise- he saw this gentleman for 2-years at the Kroger. So, I mean, you never know. I mean, maybe the smart thing would have been to have written him off. Certainly it was an expensive way to- allow someone.
But this is what we are about. Medicine is a profession- it’s not a business. You look after the patients. And very clearly, this is what he wanted. But there are all the nuances of ethics and I think I give a lot of credit for Bob Banzani- I was the new Chair and this was not something- according to Bob- that Urologists had done before I came. And he was strong enough that he voiced his complaints through the proper channels.
And so, I can only wonder what he would have done when I was doing robotic surgery! Which I really had no clue about.
So, Jim, I think, is an authentic ‘war hero,’ and a man of few words, um. The Robotic Program would not have existed without 3- people: Jim, Frank Holloway and Dirifat Dagger, these were the people who referred the first patients to us for- first laparoscopic surgery and then- robotic surgery.
Dr. (Mahendra) Bhandari had a distinguished career in India, where he started the department of Urology at my medical school, and then at Lucknow, A superspecialty hospital, which he then went on to lead- CEO of the medical center. Then, he went to King George’s Medical University, a university that is a couple hundred years old, and became the Vice Chancellor, completely re-vamped it… He has a dual appointment with the Vattikuti Foundation- he runs the Vattikuti Program round the world- the academics part of it, plus at VUI.
All of our residencies- I think I share what Khurshid Guru said so eloquently- the training was so important for us, and those years were critical, the people we worked with- the troubles we had anew. People pitched in and covered for us- these are parts of our- Mark, when you were saying earlier today. These are our true peers.
Jim had thought about creating a ‘Centennial Tie.’ There is a VUI tie, but some of you are ‘pre-VUI.’ I did not see a difference between VUI and pre-VUI, but that’s- perhaps that is shortsighted. VUI is not exclusionary, it just happens to be the re-naming of the department. So, we would like to create a centennial tie for this occasion. Craig Rogers and I and Jack Elder were at Johns-Hopkins Centennial, and that was one of the nice things they did. So, we’ll do it. We might have to defray… costs…
Dr. (Fred) Muhletale has agreed to defray all the expenses (laughter) and Dr. Shrivastava. Would you like to see Dr. Shrivastava’s house? Would you like to see Dr. Tewari’s son-in-law? Would you like to hear Dr. Ravi Barod? OK, Thank you.”
© 2015 Vattikuti Foundation