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“I was raised Polish and Catholic in a small Wisconsin town and learned early on the meaning of sin and the utility of cow shit.” This was the entirety of the requested 2000-word essay that I submitted to the American Student Medical Association, but it was enough to secure a summer internship in a medically underserved area of Appalachia. A philosophy major at the University of Wisconsin (1969), I also received my MD there (1973). I knew I was from a medical family (my father and 2 younger brothers are also MDs), but it took me by surprise that it was also a sexist family (my mother, a medical technologist, and my 3 sisters, RNs) (Author photo 1). I was basically absent during my 4th year of medical school, spending time in extensive rotations at the Alaska Native Medical Center; Tuskegee, Alabama; and rural Wisconsin.
My internship was a rotating one at Dalhousie University, Halifax, Nova Scotia, and my internal residency was at Good Samaritan Hospital in Phoenix, Arizona. I was destined to be a primary care doctor in a medically underserved area (Author photo 2; Video 1, available online at www.VideoGIE.org). However, during a GI rotation at the Phoenix Veterans Administration Medical Center, I met Bob Sanowski, whose senior GI fellow had taken an extended leave to shut down his family farm because of the death of his father (Author photo 3). On day 1, I had a 32-bed ward to run, and Bob, who became my mentor and lifelong friend, attempted to teach me endoscopy and colonoscopy. I was personally traumatized, believing at the time that it was the most demanding and hardest 2 months of my life. Nevertheless, when it came to additional training, I chose a GI fellowship, and not only that, but one that encompassed additional time with Bob and at the University of Arizona.
When I finished my fellowship, therapeutic endoscopy was in its infancy. I was unformed and spent 5 additional years as Assistant Chief of Gastroenterology, improving my ERCP skill set with the fellows that I was teaching, and learning and conveying therapies to treat GI bleeding, advanced polypectomy, and diagnostic laparoscopy, taught by Worth Boyce and George Berci during visits to the Medical Center. It was in Phoenix that I undertook transgastric and transduodenal pseudocyst drainage—not such a huge step when you understand that we also performed percutaneous transhepatic cholangiography and percutaneous transhepatic biliary drainage for the hospital.
My time spent in Arizona and 35 years spent at Virginia Mason Medical Center in Seattle convinced me of a number of things. (1) That gastroenterology is more than endoscopy. I was determined to be a well-rounded and caring physician, not simply someone with technical proficiency. (2) That I wanted to separate what I could do from what I should do. This led me to undertake multiple single-center and multicenter studies, technologic assessments, and publications. It also led me to publish my adverse events. It is frustrating to watch others repeatedly make the same mistakes that I did. (3) Finally, I was convinced that I wanted to give back to the specialty that had given so much to me. This has been in the form of societal interaction and ultimately leadership (American Society for Gastrointestinal Endoscopy [ASGE], World Gastroenterology Organisation [WGO], Society of Gastrointestinal Intervention [SGI]); training GI and advanced fellows (the latter range from James Grobe, Queens Medical Center, Honolulu, who trained in Phoenix, to our current Advanced Endoscopy fellow, Jennifer Higa); and influencing a variable number of younger endoscopists over the years, including the Co-Editors-in-Chief of VideoGIE, G. S. Raju and Todd Baron. They and others have been kind enough to call me a mentor even though we have lived at a distance (Author photos 4 and 5).
Who are my heroes, those who have influenced my career? Bob Sanowski, of course. Walter Hogan and David Fleischer, who got me involved with the ASGE. Jeff Ponsky and Bill Traverso, both surgeons. Guido Tytgat, Eamonn Quigley, and Henry Cohen from WGO. Ho-Young Song, an interventional radiologist from Seoul and the SGI. And the dozens of support staff, current and past colleagues, and those individuals who are elevating the discipline to new levels using skill sets and knowledge that I lack.
However, my career would not have been possible without the support and encouragement of my wife of 45 years, Linda, and my daughters, Katie and Ellie (Author photo 6, Author photo 7, Author photo 8, Author photo 9). By the way, Linda tells me I have passed my “shelf life” (Author photo 10).
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