Physician Profile

Each month, the home page of the Resident’s Corner will feature a physician who is making great strides in his or her field both as an example and as a resource for residents If there is a physician that you would like to see on this web page, please feel free to send us a line at residents@anesthesiaweb.com.

A Bright Light in Wisconsin
By Gerard Graham, M.D.

Have you ever worked with an attending who seems to know literally everything? I mean a person who knows everything about anesthesia and about most other stuff in the world? We see these types in medicine not uncommonly, but what is uncommon is to see an equal measure of humility in the person. There is just such a person at the University of Wisconsin. He is a pediatric anesthesiologist whose breadth of knowledge is equal to his depth of knowledge. What’s more, he’s not dull! He is a very good teacher and makes learning fun. In our lives, there are mentors, great and small, who mark our life course like signposts in the night directing, guiding us toward enlightenment. Most times we recognize these people easily in hindsight, but rarely, there are those whose light is bright enough that we can recognize their impact on our lives while looking forward. Dr. Lester T. Proctor is one of those.

Dr. Proctor graduated from the Medical College of Wisconsin in 1982 followed by an internship at Mt. Sinai Medical Center in Milwaukee. Next he spent four years as a general medical officer in the Indian Health Service on the Wind River Indian Reservation in Wyoming. He then returned to the Medical College of Wisconsin for his residency in anesthesiology in 1987, and followed this up with his pediatric anesthesia and research fellowship beginning in 1990 at the Children's Hospital of Wisconsin. He began practice in the Department of Anesthesia at the Milton S. Hershey Medical Center / Pennsylvania State College of Medicine in 1991, was subsequently appointed as the Director of Pediatric Anesthesia and later the Director of Education.

The following are excerpts from my interview with Dr. Proctor:

Why did you do a fellowship ?

I was certain that I wanted to stay in an academic practice and I love to take care of children.

Why pediatrics?

No one can deny that caring for children can be the most stressful of the subspecialties in anesthesiology. The 500 gm neonate, the hypoplastic left heart. The list goes on. It seems that the stakes are the highest in children because children are never supposed to die. On the other hand, children are the most resilient of the people we care for: Often only a single illness, little if any, self-inflicted disease, seldom seeking secondary gain, a generally positive and simple attitude toward life, easily understood psychodynamics. I chose pediatric anesthesia for three reasons: First, the challenge of doing the most difficult cases. Second, I can care for every type of patient; cardiac, neuro, airway, etc. Lastly, the joy of making a child's passage through the perioperative period as pleasant as possible. The face of God is not seen in a painting by Rembrandt, but in the laugh of a child.

Why academics ?

Why would anyone give up a lucrative private practice for academics? Grant deadlines, late afternoon meetings, slow surgeons, residents who consistently need help and teaching to do things that you could do perfectly well on your own? I think that I am in academics because it is exciting. I like passing along a little of my joy at being able to be a doctor. My curiosity at learning new things and understanding why things work is satiated in this setting. Being in an institution filled with people who are trying to be at the cutting edge of medical science is important to me. Yes, and having residents who challenge me to explain the reasons for what I do or at least force me to pay attention to what they are doing motivates me. I hope I try to bring a sense of adventure to being an anesthesiologist. The drudgery of doing the same thing day after day would eventually drain my enthusiasm for getting out of bed and going to work. Anesthesiology is not just my job and I don't want it to become that. I believe that if you can take pride in seeing young physicians become better than you are, if you want to stay current in your profession and if you are a little bit of an adrenaline addict, academics is for you.

Are there any unique aspects about the way you do pediatric anesthesia ?

Good pediatric anesthesia is really just taking care of the basic principals - airway, breathing and so on - applied to poorly understood organisms - children. The old aphorisms always apply; "if you ain't got an airway, you ain't got much", "it's hard to kill a spontaneously breathing patient" "if you think everything is OK, you don't understand the situation" and so on. A reflective anesthesiologist can incorporate basic developmental anatomy, physiology, pathology and pharmacology into pediatric anesthesia. Beyond that, I hope I spend more time thinking about and dealing with the psychological aspects of the child's experience. Dumb jokes, fractured fairy tales, balloon animals, etc. are an intentional means of reducing the trauma, just as midazolam is. I believe understanding the developmental changes in child psychology is as important as knowing the correct dose of propofol.

A good sense of humor goes a long way too. Dr. Proctor is quick to laugh or tell a joke. His teaching style is inclusive, never intimidating or condescending, and he makes you want to learn. I was once taught that the great teachers don’t teach, they motivate their pupils to learn. Dr. Proctor is indeed a great teacher.