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Brody grad briefs ECU docs on Clinton surgery

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Joshua R. Sonett, MD, spoke with East Carolina Brody School of Medicine students in the department of Cardiovascular Sciences, as he gave a lecture on Thymectomy in Myasthenia Gravis: Surgical Evolution and Proof in Benign and Malignant Disease inside of the East Carolina Heart Institute auditorium, Wednesday morning. Sonett led the team that performed a chest surgery on Bill Clinton in 2005, where they removed build up of scar tissue following his quadruple bypass.


By Michael Abramowitz
The Daily Reflector

Thursday, April 26, 2018

A 1988 honors graduate of the Brody School of Medicine at East Carolina University returned to the school on Wednesday as a lecturer at the school’s cardiovascular sciences grand rounds with the distinction of having served a patient more well known to the university — and world — than him.

Dr. Joshua Sonett, 55, is chief of general thoracic surgery at New York-Presbyterian Hospital/Columbia University Medical Center, professor of surgical oncology at CUMC and director of The Price Family Center for Comprehensive Chest Care and the Lung and Esophageal Center.

In 2005, Sonett and his colleague, Dr. Kenneth Steinglass, performed four hours of surgery on former President Bill Clinton to remove a thick band of scar tissue that had built up as a complication following Clinton’s quadruple bypass operation earlier that year.

Sonett walked his ECU colleagues through the case and surgical procedure during the grand rounds, a weekly topic- and case-based presentation by members of the faculty and their invited guests to provide the latest information about timely issues in medicine.

A collection of bloody fluid had caused scar tissue to form and squeeze the lower lobe of Clinton’s left lung, impeding his breathing capacity by more than 25 percent, Sonett told the New York Times afterwards in an interview.

“It was like peeling an orange,” he said during a follow-up news conference. At the end of the procedure, Clinton’s lung “was very healthy and looked excellent.”

Sonett said these many years later that he would be lying if he said operating on a U.S. president was not stressful.

“I remember walking in at 4 a.m. that day and seeing 30-40 trucks with satellite dishes outside the hospital, knowing they were waiting to see how I did,” Sonett said. “I focused on doing what I do and what’s the right thing for someone who happened to be the president. In the end, it was the same operation but with more of a sense of gravity, of course.”

Sonett said he started the surgery as usual with the minimally invasive video technique, but ultimately switched to the old-fashioned open chest approach.

“I was pretty sure from the beginning we wouldn’t be able to do it with the video, but we looked in with it and determined that the right thing for that patient was to do it the old-fashioned way for the proper operation, even though I knew there would be some second-guessing as to why I didn’t do it with the video. But again, it was the right thing to do.”

Sonett did not personally view the president any differently with his chest open before him, he said. He relied a great deal on what he learned in his formative years as a Brody student.

“You can fall into the trap of treating a celebrity differently than you would another patient, but (ultimately) you can end up giving him worse care by trying to avoid doing something ‘out of the realm’ because its a special person,” he said. 

“You have to do what you think is the right thing for that patient knowing they will get better in the long run,” Sonett said. “I learned that at ECU from Dr. Walter Pories and Dr. Ranny Chitwood (the first heart surgeon to perform robot-assisted heart valve surgery in the U.S.). Those formative lessons stick with you; the apple doesn’t fall far from the cart.

”I received four years of imprinting on how you’re going to treat your patients and colleagues when you’re out,” he said. “I don’t know whether other medical schools are like this one because I didn’t train at those. All I can say is I did train here and I’m happy that I did. It was fantastic.

“At Columbia (Hospital), we focus on patients in the humanistic way, with the ‘down-home’ feeling I was taught at East Carolina,” Sonett said. “I spend a lot of time with my patients and see them year after year as we grow old together. That’s important for understanding the impact you have on their disease and each of them as a person.”

Sonett said that alongside the opportunity he has to heal their sickness, the investment he makes in getting to know his patients and the joy it brings him are the most important aspects of his professional career — his antidote to the problem of physician burnout.

“You can get caught up in the volume of medical records and paperwork and detach yourself from what originally drove you to practice medicine,” he said. “We doctors are privileged to be able to walk into a room with another person and talk about very intimate things that you would never discuss outside. We have cursory friendships with people we don’t really know, but then we walk into a room with someone from any walk of life who is, at first, a complete stranger, and can instantly get to know that person on a very personal level. It’s what keeps me going.”

Time spent away from his family is the toughest part of being a surgeon, Sonett said. He makes the most of each opportunity to be a regular guy, he said.

“You have to grasp those moments; put down your cellphone, be there in the moment and try to appreciate that,” he said.

Contact Michael Abramowitz at mabramowitz@reflector.com or 252-329-9507.