Ingram's October 2022

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JOHN IRELAND Saint Luke’s Pulmonary Specialists/Saint Luke’s Health System Do you remember house calls? John Ireland does be cause his father—a small-town general practitioner in Rich mond, Mo.—used to make those visits, and his son would occasionally tag along. “I remember going into people’s homes, seeing how he interacted with patients in that kind of setting, and I thought it was really neat that he went in and went over their medication list, examined them, talked to them—and when he was done, he talked with them a little longer. It was almost like they were a part of the family in that setting. …I think I just wanted to do what he did ever since I can remember.” And that he’s done, following his D.O. degree from what is now Kansas City University. Rather than general practice, though, young Ireland gravitated to pulm

LINA O’BRIEN Mid-America Surgery Institute/HCA Midwest Health In the study of logic, they call it Occam’s Razor—separating the clutter around a given mystery to identify the most likely causes of unknown phenomena. In medical school, you might call it Occam’s Scalpel: The tool that separates surgeons from other health-care providers. It showed up the first time Lina O’Brien sat in on an operating room surgery with a med-school classmate. “I came out of there and said, ‘I love this! I want to be in

the operating room!” Her friend’s reaction? “I had it! I’m never do ing this again!” So he went on to radiology, O’Brien says, “and I went into surgery. I love it when you’re looking at a very concrete problem, fixing something.” Ex posure to the concepts of med icine and engineering during her youth may have had something to do with it, but with her parents from India steering her toward health care, surgery became a conflation of the two disciplines.

onology and critical-care med icine. “What really attracted me to it was the challenge of it, taking care of the sickest peo ple, the physiology of that. I’m still kind of fascinated with it today.” Kansas City turned out to be, in some ways, a scaled version of Richmond, making it the right fit for his practice. “I talk the language here, talk to people who come in from smaller towns and even go to smaller towns in outreach clin

The family immigrated to Canada when O’Brien was a child, and after 13 years, moved to Philadelphia, where she attended high school. After Penn State, she earned her medical degree at Jefferson College. The physicians’ group she works for is part of HCA Midwest Health, and there, she specializes in colorectal surgery. Many of those are cancer cases, but she does quite a bit of work with different diseases, she says. She’s also a spe cialist in robotic surgery, and the advances there have largely tracked with her own career. “It’s been an exciting time to prac tice,” O’Brien says. “When I finished my training, it was all big-in cision surgery. Then when I first started, we were just starting with minimally invasive procedures.” That evolved into hand-as sisted devices requiring smaller incisions, laparoscopy, and the ability to do more intricate procedures. “When robotics came about, it was even more exciting to see the improvements and see how patients benefited from it,” O’Brien says. “They don’t feel so much pain, and they bounce back better.” Modern tools are even more miniaturized, with smaller incisions and devices that rely on tactile senses rather than sweeping hand move ments. “It’s fun to be in that, always learning, always developing new things,” O’Brien says. Not every procedure she performs is purely elective, so she retained a semblance of normalcy when the pandemic began closing down many operating room pro cedures in 2020. “I feel like we’re getting back to things being more normal now,” she says, and in her space, that’s a good thing. Other medical disciplines have benefitted from telehealth advances in the past two years, “but surgery is a thing you can’t really do with telehealth,” she says. As a whole, the population isn’t doing a good job with its collective health; increasing cases of obesity and diabetes concern her. “I don’t know how to fix that, but better access to health care is something that would benefit society as a whole,” she says.

ics, where I can sit and talk to my kind of people,” Ireland says. “If you put me in a New York or Los Angeles, I’d be a fish out of water.” As a specialty, critical care gave Ireland a front-row seat in the waves of hospitalizations throughout the pandemic. “It was just exhausting at times, taking care of really sick people, seeing the amount of death that I saw over the past couple of years,” he says. “More than anything, what that experience did for me was give me a greater apprecia tion of the time that I spend with my family and loved ones. It probably made me more empathetic too, and that carried over to being a better physician, from that standpoint.” The nation’s health-care system, in some ways, is like a sick pa tient, and Ireland has a couple of prescriptions he’d like to write for it. “We want to deliver the best quality health care to patients, so if it came down to one thing—I can think of a couple of things—but lowering the cost of health care across the board,” he says. “That would allow us to deliver care to more people with better outcomes. Waving a wand and lowering costs would probably be the biggest benefit to all.” He’d also press to lower the debt burden on physicians from training. “I came out with a lot of debt, but now there are people $300,000 or $400,000 in debt, and I don’t know how sustainable that is,” he says. “You want your brightest people to go into health care and become physicians, but taking a decade of your life in training, medical school, and post-grad uate to come out that much in debt is not very appealing.”

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October 2022

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