S05E90 Exploring Surgical Philanthropy and Mission Work

In this episode of 'Three Plastic Surgeons and a Fourth', hosts Dr. Sam Jejurikar @samjejurikar, Dr. Salvatore Pacella @sandiegoplasticsurgeon, Dr. Lawrence Tong @yorkvilleplasticsurgery, and Dr. Sam Rhee @bergencosmetic delve into the topic of surgical philanthropy. They share their experiences from various mission trips and provide insights into the organizations they work with, such as Fresh Start Surgical Gifts and Smile Bangladesh. The discussion covers the impact of their charitable work, the importance of safety and logistics in these missions, and the personal fulfillment they gain from giving back. They also address the broader implications of philanthropy in their specialty and share anecdotal stories, including a remarkable tale about a boy named Luis who became a plastic surgery resident after receiving help as a child.

@3plasticsurgerypodcast #podcast #plasticsurgery #cosmeticsurgery #plasticsurgeon #beauty #boardcertified #aesthetic #3plasticsurgeonsandamicrophone ⁠#bergencosmetic ⁠#bestplasticsurgeon #beforeafter #aesthetics #realpatientrealresult #boardcertifiedplasticsurgeon #njplasticsurgeon #njplasticsurgery #nyplasticsurgeon #nyplasticsurgery

#VolunteerSurgeon #SurgicalPhilanthropy #CharityWork #MedicalMissions #GivingBack #FreshStartSurgicalGifts #SmileBangladesh #MedicalVolunteers #PlasticSurgeonsGiveBack #Philanthropy #MedicalJourney #SurgeryStories

S05E90 Exploring Surgical Philanthropy and Mission Work

TRANSCRIPT

[00:00:06] Dr. Salvatore Pacella: Greetings, everyone. Uh, good afternoon, good morning, good evening, wherever you're at right now. Um, I'm Dr. Sal Pacella and I'm tuning in to another podcast of Three Plastic Surgeons in a Fourth. Is that what we're calling it now? The whole nine yards? All right, sounds great. So, um, joined by my esteemed colleagues, Dr.

Sam Rhee in Paramus, New Jersey. He's, his Instagram handle is AtBergen. com. Cosmetic, right? Um, Dr. Sam Jejurikar in Dallas, Texas, of course, who you know, who's at Sam Jejurikar, or is it at Dr. Sam Jejurikar? At Sam

[00:00:42] Dr. Sam Jejurikar: That's Sam Jejurikar, no doctor.

[00:00:44] Dr. Salvatore Pacella: all right. And, of course, Dr., our friend from the North, um, Dr. Larry Tong, who's in practice in Toronto, and it's at Yorkville Plastic Surgery.

Gentlemen, we got a great episode today. We're going to be talking about surgical philanthropy or charity work or mission work that we do, um, and just give, uh, just give our experience and talk about, you know, I think giving back to the community. Um, before we do that, we're going to, uh, get into Disclosure here.

So I'm going to hand it over to Dr. Jejurikar.

[00:01:19] Dr. Sam Jejurikar: This show is not a substitute for professional medical advice, diagnosis, or treatment. This show is for informational purposes only. Treatment and results may vary based upon the circumstances, situation, and medical judgment after appropriate discussion. Always seek the advice of your surgeon or qualified health provider with any questions you may have regarding medical care.

And never disregard professional medical advice or delay seeking advice because of something in this show.

[00:01:43] Dr. Salvatore Pacella: Well, gents, I'm really excited to talk about this topic with you today. Um, those, uh, listeners who have heard our podcast before, a few years ago, we spoke about, um, a specific organization that I work with, Fresh Start Surgical Gifts, and we'll kind of dive into that in a little bit. Um, but first I just want to kind of open it up and, uh, Really, uh, you know, get your experiences on your thoughts on surgical philanthropy and charity work and mission work and things, uh, things that you do in the community.

So why don't we start with Dr. Jejurikar, um, who just came back from Bangladesh, I understand.

[00:02:17] Dr. Sam Jejurikar: Yes. Well, and I think that's an interesting distinction in terms of what you do versus what I do. Um, you know, Dr. Pacella has really made a meaningful impact in his own community. And I have struggled, I think, mainly because in our community, um, we actually have a, you know, a system. Parkland Hospital, which is very much geared towards the indigent with an excellent training program, and their plastic surgery services actually tend to get very well covered in this city.

So, what I have done, thanks to Dr. Rhee years ago, I got introduced to an organization called Small Bangladesh. Dr. Rhee actually went on their very first trip with their founder, Shahid Aziz, and I don't know, was it the third or the fourth trip that I went on with you, Sam? Um, And it was my, uh, it was, it was sort of my first introduction to going to Bangladesh.

And I think this trip I just went on now is my 10th trip to Bangladesh, um, after, you know, in the past 13 or 14 years. And it's, it's a huge, you know, I think we do, we have the impact as plastic surgeons, we have the ability to make a huge impact in, in places where people don't have access to our services.

But it makes just as big of an impact on me when I have the ability to go do that. I actually get to go to places in the world that I would never go to before. See people whose lives are just so different than And really get to know them on a very personal level in a very quick amount of time in a way that I just can't hear.

So, for me, I do it because I can help, but selfishly it does so much for me.

[00:03:45] Dr. Salvatore Pacella: Um, now, Sam, tell us a little bit about, Sam Rhee, uh, tell us a little bit about your experience with, uh, surgical philanthropy.

[00:03:53] Dr. Sam Rhee: You know, it's funny. We all trained at Michigan and I think for most of us, that's where we got our first exposure to surgical philanthropy. How many of us went with, um,

[00:04:05] Dr. Sam Jejurikar: Gilman?

[00:04:05] Dr. Salvatore Pacella: Bob

[00:04:06] Dr. Sam Rhee: yeah, with Dr. Gil, with Dr. Gilman overseas on a trip? Did you go, Larry? Were you able to go?

[00:04:11] Dr. Lawrence Tong: No, I did not.

[00:04:12] Dr. Sam Rhee: Yeah, yeah, but most, most,

[00:04:14] Dr. Lawrence Tong: I think that year there was like fears of a kidnapping or something like that in Columbia. They canceled it.

[00:04:20] Dr. Sam Rhee: yeah, there may have been some instability at that point, uh, politically, but yes, but most of us, many, many residents did go, and that was my, most of our first experience in terms of, of charity or, or helping others, um, with our surgical skills, and it was very eye opening. It was an amazing trip, um, really sort of opened my eyes to the possibilities of helping others using And ever since then, I've gone as Sam has gone to Bangladesh, and I've also gone to different countries as well.

I've gone to China. Um, we went to Colombia. Um, and then one of my highlights was going to North Korea about four years ago, which was pretty freaking mind blowing experience on a lot of levels. But, um, um, yeah. But every time I go, as Sam says, it's really selfish. I go because, you know, I do these things because I get so much out of it.

Um, and so, you know, we can sort of argue, and I have talked to people about, you know, should these resources be better served to help more people or have more of an impact or, or, in your case at least, Sal, um, help those around you that are closer. And, um, I'm very, very aware of the fact that, you know, Um, I'm doing this mostly for myself, but if I can also help others at the same time, that's, that's great.

[00:05:43] Dr. Salvatore Pacella: Well, so it's interesting, you know, um, the model of philanthropy that I work in is, uh, Eons different, I think, than what you two or three have experienced before. And not one is obviously better than the other, but, um, you know, what Fresh Start, the organization that was started about 30 years ago by a local surgeon here, used to, Dr.

Dennis Nigro, used to go down to Tijuana, just over the border and, and serve patients there. And then it evolved into a centralized location in San Diego that actually does exactly the opposite of a lot of these surgical missions. What we do as an organization is we treat international children as well as domestic children who may be underinsured for various procedures related to cosmetic appearance, craniofacial deformities, et cetera, burns.

We host all of the children to come to the United States to stay in San Diego. They stay at Ronald McDonald House. They have local donors that give them apartments. They can bring their families. We assist. We pay for their airfare. We pay if they need clothing or food. We pay for that. And the beautiful, wonderful thing about it is they are cared for.

At a top notch institution, Rady Children's Hospital in San Diego. Um, in fact, just this weekend, I was operating on a child from, um, From Tijuana, um, I took care of another child from deep into Baja, California. Um, and they stay in the United States as long as they need to until their sutures come out, until they're well on the road to healing.

And, um, you know, I, I have not had the opportunity to travel overseas for surgical care. Uh, it doesn't necessarily fit into my life right now, just with COVID. With two small kids and a busy practice, certainly I would be willing to do that in the future. Um, but I've always sort of had a little bit of a reservation, um, because, you know, I just don't simply know what's going to happen to the patients after I leave them, you know, and, and if they have a complication or if there are some issues that needed to be followed up on, um, Um, you know, I, I think it limits a little bit about the, the intensity of what you can do for a lot of these kids.

Maybe, maybe you two can comment on that a little bit, what your, your comfort level and, and types of surgeries that you do.

[00:08:05] Dr. Sam Jejurikar: Yeah, so, you know, I'm fortunate enough at this point to actually be on the board of directors for Smile Bangladesh. So, I know a fair amount about how, um, How we operate. And, you know, before we go, we typically do two trips a year. It's all cleft lip and palate surgery. And it's actually a team that's run by oral surgeons.

Sam and I are two of a total of three plastic surgeons that actually have a large involvement with the organization. And there's close integration with medical facilities in Bangladesh. At this point, there's four or five cities that we go to regularly, and a few hospitals that we have developed trust with over the years.

So when we go, there's going to be a pediatrician and a medical director who's heavily integrated. There's going to be, um, they're going to be advertising throughout the country, letting them know that there are going to be these camps for indigent children who have cleft deformity. Kids show up before, well before we've actually gotten there.

They've been screened by the local medical team. They've gotten basic blood work. So every patient already has a CBC and electrolytes. We have this day where we see just a mass of patients, like, you know, 50, a hundred patients, which is sort of chaotic. You know, they're, they're in there for three or four minutes.

And we see them, we evaluate their deformities, the complexity of their deformities. If they need additional screening, like if this, on this last trip, there were a couple of kids that we thought needed echocardiograms, uh, before we, before we operated on them, we were able to get those ahead of time. Um, and then we prioritize them.

So after that first day, we have typically three or four very, very busy operative days where we are operating from 830 or nine in the morning till late at night, 1030, 11 o'clock at night, doing a crazy number of cases. Um, and we do that, uh, for three or four days. a large number of patients short amount of time.

The if they're very complex, for a large amount of blo do that because we don't that come in and harm the Basic cleft lip deformity or cleft palate deformity or cleft revisions that need to be done, even basic cleft rhinoplasty. We can do that on these trips, and we can do them safely on these trips.

And we have the ability, you know, the problem is, is you just can't get 50 patients over to the U. S. every few months. That's not feasible. But if we go there, For about the cost of about 300 per patient, we can treat every patient and we can make a really big difference.

[00:10:39] Dr. Salvatore Pacella: That's fantastic. Um, you know, it kind of, uh, kind of begs the question, you know, you guys sort of mentioned at the beginning of the podcast here why you do it and, and, and you said it was, you know, sometimes that's a little bit of a, of a selfish thing. You do it for your experience and for your, your feel, you know, the feel good component of it.

I mean, I think, oh, we lost Dr. Todd here. I think he's got a. Some recording issue, but I think it should be signed back in. Um, and I agree with that. Um, I, I think, um, You know, the way I sort of see it in, in the context of my life is, You know, we've, we've been very blessed and very fortunate to be, To succeed academically, to succeed personally, Um, and the discipline of plastic surgery, we've invested our lives into it, But we have reaped, Incredible rewards from it, both intellectually, personally, and financially.

I mean, we, we make a great living at what we do. We help people. And, and to me, You know, I, I think we have a bit of stewardship that needs to occur in our specialty. And unfortunately, when you, when you look at the whole Hollywood, Beverly Hills kind of world, you know, it doesn't really come to mind. I think we, we sort of need to, To say, Hey, we've, we've, we need to pay it forward, um, to society because we've been blessed with this ability to care for people the way we have.

I don't know your thoughts on it.

[00:12:12] Dr. Sam Rhee: I mean, yes and no. So, I mean, one of the arguments I have had made to me is, if you wanted to help more people, why not spend the money you're spending on that one child to have clean water filtration for an entire village somewhere? And you could help 500 kids. Or something, you know, uh, of that nature where, you know, we should be spending our money on, you know, vaccines for malaria for kids so that they, you know, or vitamins so that they don't have nutritional deficiencies as opposed to helping ten kids.

You could help a thousand. And all of that is valid. But, know, you're trying to choose values on people's lives. I mean, I have seen the difference that Sam has made in a child's life. I've seen, you've seen the differences on the children that you've made, the impact. And so weighing that, how does one weigh that?

Like, what value can be placed on that kind of impact? Especially if the, if those children are truly making, uh, impacts in their own communities after they've gotten the corrective surgeries that we've performed. Um, I think the one thing, uh, the difference you were talking about going overseas or, or staying, um, closer is that you can do fairly complicated surgeries. Sal, like, very complicated surgeries. Um,

[00:13:51] Dr. Salvatore Pacella: Yeah. Just for, for example, uh, you know, we've had a, I've had a gent, a young gentleman, and, uh, he's 15 who I've been caring for the last year. I think I've operated with him probably at least three or four times now, uh, with, uh, ophthalmologists. We, we essentially rebuilt him an eye socket. Um, From, from nothing.

Um, uh, and, you know, we, we could never do something like that out of country. Uh, he lives in Columbia, he comes here, um, states for a couple weeks, recovers from surgery, comes, goes back, comes back for another stage. Um, so, you know, I, I think, um. You know, we've, obviously the charity has spent thousands and thousands of dollars on him and, but is that going to make an impact?

I mean, it makes, certainly makes an impact for him and his family. I, I think, you know, you, you have to, when you think about philanthropy, Philanthropy. You have to, we're not all Bill Gates or Bezos, right? So we, we have to do what, if we choose to give, we have to do it within the sphere of our own orbit. If I was a, if I was a, um, a water engineer, I certainly wouldn't be doing plastic surgery.

I would be out there trying to treat the most people with clean water, right? Um, we do surgical philanthropy, Um, because we, we know it, you know, and we, we don't necessarily put a price tag on it. And, you know, I don't, I don't know what the cost of bringing somebody in here specifically is. I, I do know the cost to me, you know, the, the amount of hours I spend or the, the time I take away from my life or my practice or my family.

And, and, and that's, uh, that pays dividends, I think, in the future for, for everyone involved. And, and, you know, Let's just say even I'm spending on a Saturday afternoon or Saturday morning, I'm spending time away from my children. Okay. Well, what's important? Is it me spending the time with my children or is it that my children say, well, where's dad?

He's helping out somebody else. And maybe that will make them, um, you know, go towards philanthropy as a, as a, you know, as a strategy in their life.

[00:16:01] Dr. Sam Jejurikar: I think you both have said it very well. The bottom line is we are plastic surgeons. I think we have a skill set that many people, that most people do not have. And so, um, I feel like if we can make an impact doing what we know best, that's what we should do. And, um, I think Pacella makes a huge impact in his local community.

Rhee, you make a huge impact every time you go somewhere. Larry, I'm sure you make an impact somewhere. HAHAHAHAHAHA But your internet went out, so you have no idea what we're talking about right now. So, exactly, some technical difficulties. But, but, uh, but the bottom line is, you know, um, I remember the first trip I took to Bangladesh.

Again, I went there because Sam invited me to, to go along with him on that trip. And we went to actually to the same site that I went to on this most recent trip. And on that trip, Sam and I actually met water engineers from Dallas, Texas, who were working, you know, that location is right on the border with Myanmar or Burma, where there's this displaced population of people called the Rohingyans who live in the, uh, Largest refugee camp in the world, like a million people.

And the, you know, these water engineers from Dallas, we're very much there to help them come up with water filtration for this refugee camp. So the bottom line is if we all do our part in the world, we can make it a better place. As plastic surgeons, I feel like plastic surgery is what comes naturally to us.

And so, however, we're doing it, I think is, is wonderful. Larry, I don't know what your thoughts are on this.

[00:17:37] Dr. Lawrence Tong: Sam, I just had a question for you. You had mentioned earlier before my internet went out that you see, you screen patients prior to choosing who you're going to operate on. Um, I was just curious, is there a way that you guys rank, uh, which ones you're going to do? Or do you just accept and then once you get to your sort of capacity, then you, you stop?

[00:18:03] Dr. Sam Jejurikar: No, we rank them. We definitely rank them. We have a ranking system one through three, you know, ones are, are the, you know, the, and it takes into account how safely we can do the operation and how big of an impact we can actually make, um, typically, um, Typically we operate on everybody that we can, that shows up, that we think we can safely do.

Um, what's hard though is sometimes we have converse and, and people will, will straggle in once they, once the community hears that these operations are going on, there are people that start showing up on day two or day three and we figure out a way to get them done too. The hard conversation is when there are people who we will screen and you hear a giant murmur, you know, when you think, oh God, this kid may have a, Atrial septal defect or a ventricular septal defect.

And I can't safely do this here. Or this child looks like they're syndromic and it may be unsafe to do their palate. Cause I may get into bleeding. It's hard to explain that to the families that we can't safely do your operation. But, you know, taking, taking that into account is obviously very important.

We don't want to be an organization that comes in. It hurts people, um, and, and our, you know, in our, in our overly heroic. But so yes, we have a ranking system, but we still pretty much do everyone, but we can safely.

[00:19:18] Dr. Sam Rhee: I've, I've seen different organizations where, um, that have traveled and not all of the, and I think for, for any kind of philanthropic effort, safety has to be even more of a priority than. Thank you. I mean, it is obviously a priority when you're operating in your own, uh, operating room at home, but it, in some ways it has to be even more stringent sometimes because the resources are limited as when you travel or sometimes because, um, yeah, these children are that, that are traveling, like, for example, in Sal's case to your institution, um, you know, they might have other issues or, as Sam said, or, or very, a lot of complications.

And so. The last thing you want is to try to help someone and end up inadvertently seriously harming them. And so, uh, I think You know, you cannot understate the importance of the people and the teams that we work with. I'm sure the anesthesiologists, the pediatricians, all of the other staff that, um, you know, uh, prepare and get these children ready, uh, If that isn't in place, we really can't do what we do.

So, uh, that screening, you know, the decision that you, uh, and your team makes, uh, Sam or Sal, when, when you bring patients in, it's a significant investment in time and effort for every child. And so you have to, you have to make sure that you are doing it safely.

[00:20:51] Dr. Salvatore Pacella: know, the, uh, the other thing, uh, you know, I want to mention here too is, you know, so we, we have in Fresh Start, we have, um, these, what we call surgery weekends every six weeks or so. And we usually do some intense surgery on a Saturday and see the patients again or screening on the Sunday morning, uh, after the, uh, event.

And, you know, it's, it's certainly just not surgeons that are volunteering. It's a tremendous support staff. I mean, the logistics of putting one of these weekends on is, is tremendous. From, from porters to people doing laundry to people bringing food for the volunteers, uh, people driving, you know, it's, it's a tremendous, uh, Um, tremendous undertaking.

And you know, you, you guys mentioned, you know, plastic surgery is in our sphere and so we, we do what we can and, and that's where our talents allow us to take it. But, you know, anyone can be involved with any charity, just if you have the, if you have the, the wherewithal.

[00:21:56] Dr. Sam Jejurikar: Yeah,

[00:21:59] Dr. Salvatore Pacella: Well, um, you know, we're, we're getting towards the end here, and I, I just wanted to share a little story. Uh, this is kind of a legendary s story in the, uh, in the annals of, uh, fresh start that, uh, always comes up for every couple years. It's, uh, it's about the, the founder of the organization, Dr. Nigro. Um, so one of the first years he was down in Tijuana, um, he was doing cleft lip and pallets and there was a, like the screening process that you described, Sam, um, in Bangladesh, it was very similar.

There were, you know, 50, 100 kids lined up around the corner waiting to be screened. Okay. And this, uh, this sweet Mexican woman ran to the front of the line with her infant child named Luis. And he had a cleft lip and one, one of the volunteers noticed that she was trying to get in and she brought her, she brought her and her son to the, to the front of the line.

And Dr. Nigro took on Luis as a, as a patient and had cared for him throughout the first few years of his life. Um, Dr. Nigro unfortunately passed away, uh, when the child was about, uh, I think 15 or 16, um, and the organization obviously took over. Luis is now a physician that went to medical school in Mexico and is a plastic surgery resident.

in Mexico, about to treat patients on his own. And, you know, if that isn't the definition of paying it forward, you know, I don't, I don't know what is. It's just a wonderful, wonderful story. So.

[00:23:40] Dr. Sam Jejurikar: that's wonderful.

[00:23:42] Dr. Sam Rhee: Yeah.

[00:23:42] Dr. Salvatore Pacella: Well, gents, um, thanks again. And, um, until next time we'll sign off.