At Home in the O.R.
by Maryann Brinley
n his third year of medical school at the University of Chicago, Mitchell Price, MD, had an epiphany.
“I was always interested in sports and while I had briefly considered a career in
history, I really loved science so I thought I’d put medicine and sports together and do orthopedics,” says this college varsity basketball player and UMDNJ-Robert Wood Johnson Medical School (RWJMS) assistant professor.
Then, something intriguing happened to reorient his medical focus completely. He can still picture it easily in his mind after nearly two decades. He was rotating with Dr. Dennis Shermeta, a pediatric surgeon, and it was the first procedure Price observed on that service.
“Shermeta was this large, gentle man with big, beautiful hands,” Price recalls. An infant had been born with Hirschprung’s disease, a gastrointestinal nerve disorder which causes intestinal obstruction. “Here was a child with his whole life ahead of him except for one problem that needed to be fixed,” Price explains. Shermeta was able to do a complex repair on this little baby. “Then, he walked right out of the OR holding the child in his hands. He gave this baby back to his parents right there. The parents were crying and I thought, ‘Boy, to be able to do this. Well, this is something special.’ He could have become the next president of the United States as far as I was concerned.”
That one rotation made him aware that doctoring was not just taking care of bones or reading CT scans. “It was about interacting with people and fixing kids.” In pediatric surgery, Price would be able to find an intellectually stimulating, scientific area of medicine that would also allow him to care for different ages — from premies to
18-year-olds — and to deal with diverse areas of the body.
“In my work, I have to understand how the body fits together beginning with the embryology. I actually construct problems mentally in three dimensions to help figure them out. I don’t do cardiac, orthopedic, or neurosurgery, but I can operate on a baby who weighs less than a pound and a teenager who weighs 300 pounds. I can fix problems in the chest, the neck, the abdomen, extremities, anywhere a general surgeon operates.” On another day, Price might find himself, as he had the week before, rebuilding the concave chest wall of a frightened adolescent, utilizing an operation called the Nuss procedure, or minimally invasive repair of a condition called pectus excavatum. “We spent hours with him. Mentally, this child wasn’t ready for the procedure so we really had to help him through it. I have a couple of teenagers at home so I am beginning to understand the adolescent thing.” In fact, Price believes that the very personal touch is what separates his RWJMS team’s high quality care from similar surgical services.
“Think about this,” he suggests. “You come into my office with your child and in a half hour, I’ve got to convince you, a frightened parent, to let me take your baby, put him to sleep, cut him open, take parts of his body out or put things in, close everything up and make him look the same as before. How am I going to do that?” A good pediatric surgeon gains the confidence of parents as well as the children. For example, “White coats scare the heck out of kids.” So Price never wears one unless he’s in
surgical scrubs. He will try anything to put families at ease — from pretending that his arm is made of rubber, which makes children laugh, to discussing favorite ethnic foods with parents. “I’ll use sports, travel, school, food, anything, and make a concerted effort to connect with the family. In this way I can build their trust and enable them to let me help their child. At the same time, I give them facts and try to show them how I will fix the problem. This usually brings the parents to the point where they can think, ‘This will be okay.’”
The camaraderie and mutual support among the pediatric surgical subspecialty team members in the Bristol-Myers Squibb Children’s Hospital crosses departmental lines and extends into The Cancer Institute of New Jersey (CINJ). Everyone is on a first-name, call-anytime basis. “We are not doctors wearing white coats sitting in lofty offices who will see you for only five minutes.” The idea of office-only visits riles Price. He will go anywhere to treat a child and has been known to run to radiology or across the street to CINJ on a moment’s notice. “I’m always thinking, what can I do for this patient right now? I want to take care of people the same way I want to be taken care of.”
Price, who is also a regional representative of the national Children’s Oncology Group, believes that families and referring pediatricians need to know that there is no reason for New Jersey children to be traveling to Philadelphia or New York for quality treatment. “Myself, my partners — Thomas Whalen, MD, and Randall Burd, MD, as well as the other members of our pediatric subspecialty group —are nationally known and deliver a very high level of care in our respective fields and collaboratively.” Trained in minimally invasive laparoscopic surgery, he brought this diagnostic tool and expertise to RWJMS when he arrived in 1996 after completing a pediatric surgical fellowship at the University of Colorado, Denver Children’s Hospital. “We’ve been so highly successful with our advanced laparoscopic program that our complication rate is almost zero.”
Born in Brooklyn, he grew up for a time living across from the Prospect Park Zoo and near the Brooklyn Botanical Gardens. “I took a subway to first grade,” he says, and he still sees himself as a city person — someone who treasures hole-in-the-wall restaurants and the ethnic vibrancy of street life. “We lived outside. What I remember most about New York City is that you could walk down the street and be in Asia, Europe, South America, the Caribbean or anywhere in the world. I learned how to grab life and to experience the wonders of diversity through other people’s eyes. I didn’t need a lot of money to fly on airplanes. I just had to travel down the block.” One of two children, Price says that his father was a pharmacist and his mother was a teacher. His wife, Christine Perney, was a Russian studies major and varsity swimmer at the University of Chicago, who went on to do graduate work at the Harriman Institute/Columbia University in New York. After first teaching college and then taking time off for her family, she now teaches high school while juggling the busy lives of Joshua, 18, Zachary, 15, Sarah, 11, Jacob, 8 and Ilana, 6. “She was one of five growing up and had a lot more fun than I did,” Price laughs, adding that his household is “controlled chaos but it’s worked out great. My kids hang out together and are best friends. They are terrific.”
The Price children have followed their parents’ athleticism into soccer, basketball, tennis, baseball and swimming. “There is a real goal orientation they’ve all learned, both for sports and academics.” Joshua, who just started his freshman year at Haverford College, was an all-state soccer player who won the top athlete/scholar distinction for his school and was honored by the state athletic association of New Jersey last year. Zach “played varsity high school tennis as a ninth grader and both he and Josh can shoot the lights out in basketball. I can’t beat them anymore though I still play every Wednesday night. Sarah is a competitive swimmer and is excellent. Jacob is one of the better soccer and baseball players in his grade and Ilana does all sports including swimming and ballet. We’ve always told them, ‘We’ll support you.’” Shaking his head about the inability to stretch a 24 hour day any further, Price recalls that when he was a resident at New York University School of Medicine and later during his fellowship, he missed a lot of the everyday childcare. “Now I can say to them, if you make the effort, I’ll be there. I’ll even coach. My family is the single most important thing in my life; it makes me a better person, a better doctor, and allows me to better understand my patients.”
Price is fond of telling his children that they have to work hard to reach their goals and that if anyone ever tells them it can’t be done, that should be their impetus to go ahead and try. It’s a mantra that he himself has lived. Back when he was a sophomore in college at the State University of New York- Binghamton, a counselor once warned Price to scale down his expectations. “I had signed up for architecture, history, and liberal arts courses but I also wanted to take science.” Being told that he would not succeed if he stretched himself too far and that he wouldn’t be recommended for medical school unless he narrowed his academic focus was frustrating. “I wanted to try to be a kind of Renaissance man, to have a life that was full of all kinds of things, to have varied interests and to dabble in everything and still be a great doctor.”
Meanwhile, Price had seen an article in the news about how some medical schools were offering programs that combined undergraduate and graduate training and also allowed room for liberal arts. Creating well-rounded, humanistic doctors was the ultimate goal. The University of Chicago’s Arts and Sciences Basic to Human Biology and Medicine Program was one of them and accepted students for a special curriculum beginning their junior year in college while granting them entrance into medical school. “I applied and was the only transfer accepted that year. Someone must have smiled on me,” Price says. But perhaps this surgeon solved that academic dilemma by applying the same straightforward approach to his education that he uses to solve congenital birth defects and pediatric anomalies now.