Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, January 22, 2016

Superlatively Good At What He Does

"If this guy can't help you -- nobody can. He does the stuff that other doctors are too scared to do. I knew I couldn't possibly be in any better hands anywhere in Canada. But the downfall of that was that I was in those hands because I needed to be."
"I wouldn't be around today if not for him. the only way you can thank somebody for that is to live your life as well as you can, and to somehow show him that he didn't waste his effort."
Brian Voykin, former surgical patient with cancerous tumour of the heart

"We want the ball to start rolling so that when a doctor finds a mass in your heart they are not thinking you're dead, but that there is a guy in Toronto or Houston or Oslo doing this surgery."
"I am still amazed to touch someone's heart. If you look at a person's lung, you don't really see it moving. But you look at the heart -- it beats -- it moves."
"You do the operation but you don't determine the outcome [belief in a higher power]. I believe there is something more than my expertise."
Toronto heart cancer specialist R.J. Cusimano

"The most interesting thing about him [Dr.Cusimano] is his compassion. He takes on higher-risk, difficult surgeries, and he accepts patients that other doctors refuse and why he does this, I think, is because he thinks about the patient."
"He thinks about what giving them and their family a chance means -- and he lives this compassion. It is at the base of his work. When you see these patients and they survive, it is a beautiful thing."
Juglans Alvarez, Brazilian physician on Canadian fellowship
Laura Pedersen/National Post
Laura Pedersen/National Post  Dr. RJ Cusimano has become the go-to-surgeon for removing heart cancer in Canada

Dr. Robert James Cusimano, 56,  comes from an accomplished family. His father Salvatore is of Italian immigrant stock. And the furthest he reached in achieving a formal education was Grade 8, forced by circumstances to go out to work to help his family survive the Depression. Nonetheless, Dr. Cusimano gives his father the credit due him: "Education was my father's big thing. He put eight kids through university", of which number R.J. was third.

Of the Cusimano offspring of that generation there is himself, a brain surgeon, another is a family physician, another an architect, another an accountant, and the remainder are teachers. All, it is safe to say, excel in their professions. Dr. Cusimano and his wife, another doctor, have two children. Presumably, with this background they will have been stimulated to do exceedingly well in the professions of their choice, as well.

Sometimes, the genetic inheritance of an entire family is well shared and extraordinary.

Surgeon brothers Michael Cusimano, left, a neurosurgeon at St. Michael's Hospital, and R.J. Cusimano, a cardiovascular surgeon at the University Health Network, are both leaders in their fields.
David Cooper / Toronto Star 
Surgeon brothers Michael Cusimano, left, a neurosurgeon at St. Michael's Hospital, and R.J. Cusimano, a cardiovascular surgeon at the University Health Network, are both leaders in their fields.

Not that Dr. Cusimano hasn't experienced episodes throughout his career when surgeries were not successful, when even his expert and caring capability failed to save a life. The "first one" of any catastrophic event is no doubt always the hardest to come to terms with, an event that helps shape one's philosophical outlook and to teach just the right amount of humbleness. Believing, as a man of religious faith, that it is a higher power that directs the outcome and he is but an intervenor, it seems evident that Dr. Cusimano needs no lessons in humility, in any event.

"It wasn't a surprise that he [the first patient he lost] died; it was a risky thing", he noted in an interview*. "But what was a surprise was the family -- how grateful they were. I am not saying everybody is thankful when someone dies. People are angry -- and they should be. But I have been taken by how people react to a bad outcome, where they are almost consoling to me. And it's because I think they see how much a bad outcome affects me. My patients have taken care of me as much as I have taken care of them."

One of whom was Brian Voykin who had suffered the strange phenomenon of an indefinable itch which doctors were unable to diagnose. For years he felt that the malady that was affecting him was related to an anxiety disorder. Until after years of feeling his heart racing with strange force, and his body breaking into heavy perspiration, he was diagnosed with a rare and potentially lethal, heart-sized tumour. That tumour the size of his heart was in fact  bound to and wrapped around his heart, causing it to struggle to perform its mission in Mr. Voykin's chest.

His life was preserved when he moved from Western Canada to Toronto and was given a new lease on life when Dr. Cusimano agreed to conduct the kind of surgery that would make most cardiac surgeons blanch. This was a rare condition; no more than 30 to 40 such cases are seen in a typical year in the country. Dr. Cusimano is a specialist extraordinaire, one committed to addressing a life-threatening condition that few others would commit their expertise to.
 
*Dr. Cusimano's interview was with Joe O'Connor, National Post

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