Plastic Surgeon With a Mission

In 2016 a formidable gaggle of close to 50 multidisciplinary medics gathered in a theatre at Kenyatta National Hospital to separate conjoined twin girls, Flavour and Blessing.

In the theatre – led by old hands Dr Chris Musau (UoN) and Dr Fred Kambuni (KNH) – were paediatric surgeons, neurosurgeons, plastic and reconstructive surgeons, anaesthetists and nurses.

Also present were lead consultants Prof Nimrod Mwang’ombe, a neurosurgeon and Prof. Julius Kyambo a paediatric surgeon. And so these best brains and the steadiest of hands got to work and 23 uninterrupted hours later, made history as the first successful surgery of its kind in Kenya.

Also in that theatre, standing at the periphery of the room, was a brilliant 30-year-old doctor, John Paul Ogalo, a senior resident plastic reconstructive and aesthetic surgeon who, together with his partner, Dr Gray Mukuzi, had created a 3D printed surgical model (used for the first time in the country) that added to the success of the surgery.

JACKSON BIKO checked up on him over tea as the twins turn five this year.

What does a young surgeon like you struggle with?

My finances, for one. [Chuckles]. But the training is growing and so time wise, you’re pretty much stretched. This of course affects social aspects of my life again. Again, as younger surgeons there is immense expectations of us to come with fresh ideas but also some of these ideas face resistance because the medical field doesn’t bend as easily.

It’s not easy to get your ideas through because in the medical field, you have to prove not just yourself but your science. Your science has to be solid before people can take it on because the environment belongs to old dogs who know all the old tricks. Currently we’re in a space of innovation and how to have these accepted.

That 3-D model that was used for the historic surgery, is it in glass casing in some museum of sorts?

It was supposed to go in the museum of medicine but I have it in my house, somewhere in my closet.

Oh goodness, amongst your old shoes?!

[Laughs] Yeah. It’s a piece of history, we hadn’t just figured out where to place it at the moment right now.

As a young, driven surgeon, one with great innovative ideas, how do you get the old surgeons who have decades of experience under their belts, give your ideas a chance? Or are you guys surgeons-in-waiting just biding your time until they retire or die?

[Laughs]We are sitting pretty by learning but you have to put yourself out there be confident when you are putting your message across. People need to believe you to buy what you’re selling. When you’re not confident about the idea yourself, nobody is going to believe you. Most importantly is research and you need to publish.

What do you want to be known for?

Changing the thinking or breaking the ceilings. I want to be a pioneer in healthcare for the Fourth Industrial Revolution. There are aspects within the healthcare that we haven’t researched sufficiently.

For instance, I’m also involved in some work related to stem cell and stem cell health. So, I want to be known as the person who opened those doors and broke a few of those barriers.

I also want to be known as the person who perfected the business side of medicine or who reinvented the business side of medicine. More often we tend to be stuck on science and fail to see how that translates into a sustainable business.

We have great ideas, great research but ends in the lab and in theatre. How do we take it to the next step where we are helping people commercialize their ideas in the industry and opening new doors training, employment for policy?

There must be a lot of young surgeons who want to be given a chance to prove themselves and think they are not being given that chance by the older doctors who have done their time. But do you younger surgeons feel like you have to just make your bones first before you get a seat at the high table?

[Laughs] Well, I have never felt that I have to wait for my turn. I think I’m ready. I’m not one to be passive, to make excuses. I’d rather try and fail. Like I told you everything about the 3-D printing technology was a series of failures before we got it right, so failure is something I have always brushed off.

But in your case failure could cost a life, no? I mean, I imagine that this is not a case of using the wrong paint colour on some canvas….

[Laughs] Any surgeon will tell you this, failure is something that you have to accept. You get complications, things will not always go your way, sometimes people die and it’s difficult and painful. What I meant in with failure is the sense of breaking out, getting out of your shell. Most of the surgeons ahead of us are really quite encouraging rather than discouraging.

At this formative point of your career have you started getting used to losing a patient?

(Pause) The patients I have lost have been in very critical conditions. As a surgeon and as a doctor, you have a very good appreciation of the limits of life, where it starts and where it ends and everything in between.

We understand a new life being made has as much as we understand somebody dying. So, we accept death, we understand it, we know you can find it at any corner, sometimes when you’re ready for it, and sometimes when you’re not ready for it.

So, we don’t like losing but even when we do, we don’t have that much time to sit and wail. We have to pick ourselves up and remember that somebody else using this door needs our help just as the one we just lost.

So I take it that you don’t linger around trying to process death as somebody like me, for instance, would. You are much numb to the feeling of grief and loss. Does that also numb your feelings of empathy, love and compassion at the same time?

No. I mean, we love, we fear, we cry, we mourn just as much as the next person but with surgery in medicine, sometimes in my own personal opinion, it’s important to compartmentalize, to box all the emotions that come with it because at the end of the day we are charged with the duty of taking care of the patient who is alive. I have to be up professional at that point in time.

I think death gives you different perspectives on life, and this might sound cliché, but the meaning of life. It helps you understand what’s important and what’s not.

And what is the meaning of life, incidentally?

(Long Pause) I have absolutely no idea. [Laughs]. But does life have to have a meaning? I don’t think so. It is just what it is. We are here, then we are not.