S04E76 A Tapestry of Care: The Human Side of Pediatric Surgery Leadership with Dr. Kathleen Van Leeuwen

Navigating the high seas of pediatric surgery and healthcare leadership, guest Dr. Kathleen Van Leeuwen, a pediatric surgeon shares a wealth of experience and contributions to the field of surgery. The discussion spans Dr. Van Leeuwen's career trajectory, starting from her medical training alongside the host Dr. Sam Rhee, through her notable achievements in pediatric surgery and her leadership roles at Phoenix Children's Hospital.

From the operating room's bright lights to the boardroom's strategic discussions, Dr. Van Leeuwen shares the delicate balance of managing hospital finances without losing the essence of patient-centered care. As a pediatric surgeon, she's not only skillful with a scalpel but also adept at crafting sustainable healthcare programs and touching the hearts of donors with compelling narratives. Her journey is a masterclass in cultivating a team's potential, making executive-level decisions, and advocating for patients with the same passion one reserves for family.

Dr. Van Leeuwen's candid stories illuminate the landscape of healthcare, offering a rare glimpse into the tenacity required to lead and transform a male-dominated field. Our reflections turn to the deep bonds formed during our surgical training, the resilience it takes to navigate a demanding profession, and the immeasurable satisfaction of mentorship. The dedication to her work and her family resonates profoundly, reminding us that success is not just about professional achievements but also the richness of personal fulfillment.

#PediatricSurgery #WomenInSurgery #HealthcareInnovation #MedicalMentorship #SurgeryEducation #botoxandburpeespodcast #GenderEqualityInMedicine #PatientCare #MedicalLeadership #SurgicalInnovation #CommunityHealth #podcast #plasticsurgery

00:00 Welcome to Botox and Burpees: Surgeons Series

00:38 Introducing Dr. Kathleen Van Leeuwen: A Pediatric Surgery Pioneer

04:05 The Journey from Medical School to Pediatric Surgery Excellence

13:16 Leadership, Mentorship, and Building a Positive OR Environment

20:23 Embracing Change and Focusing on What Matters in Surgery

28:12 Leadership Beyond the Operating Room: Building Teams and Programs

32:53 Launching New Programs and Leading Through Challenges

33:24 Navigating Gender Dynamics in Surgery and Leadership

35:09 Breaking Barriers: First Female Program Chair in Pediatric Surgery

39:39 Personal Growth and Embracing Gender Identity

45:25 Reflecting on Career Choices and Future Plans

47:59 Advocating for Health Equity and Sustainable Healthcare

59:31 The Power of Emotional Intelligence and Supportive Networks

Click on your podcast site to listen and subscribe!

S04E76 A Tapestry of Care: The Human Side of Pediatric Surgery Leadership with Dr. Kathleen Van Leeuwen

TRANSCRIPT

[00:00:00]

Hi, welcome to the start of a new series on Botox and Burpees, where we talk to surgeons. It's really a unique perspective. Surgeons bring a lot of different skill sets as well as perspectives to the table. And not all surgeons are the same.

There are certain things that are very unique to surgeons, but surgeons also have a lot of variety, not only in terms of their specialties, their procedures, but also just what makes them tick or why they operate. And so I couldn't think of a better person to start off the series than my friend, Dr. Kathleen Van Leeuwen, who is a pediatric surgeon out of Phoenix, Arizona. Our lives paralleled in many ways while we started training, we both went to Columbia medical school and we were both at University of [00:01:00] Michigan. She was a general surgery resident. I was a plastic surgery resident.

When you're in training and there are certain people that just really stand out, they're superstars. She was definitely one of those. And my first experience with Kathy, and we talk about it a little bit in this podcast episode, is when I started on the trauma burn service.

So I had a little bit of a atypical start to my residency. I did three years of general surgery at Columbia, and then I went and finished my plastic surgery residency at University of Michigan. Kathy had already been at University of Michigan as a general surgery resident for several years, and I spent two years in the lab before I went back and started my clinical training.

And taking two years off and then coming to a new institution and starting to work in a hospital again was a very rough transition and it would be for anybody. And I started with Kathy as well as another resident, Jonathan Haft, and they were probably the two best people I could have ever [00:02:00] imagined to have started working with, back in the hospital. The trauma burn unit is one of the busiest units at the hospital. It's a level one trauma center. They cover burns throughout the entire area. And Kathy was a superstar. She was a team builder. She was upbeat in a time when it was really a difficult and was really a hard place to work and they made my transition awesome.

They made me feel competent in a time when I felt like I was in over my head for sure. And Kathy has gone on to do great things, as the associate surgeon in chief, at Phoenix Children's in East Valley. And you can hear her when she talks in this episode about all of the team building that she's done over the years.

How she's leveraged her abilities as a surgeon and trust me, she is a superlative surgeon. I saw it firsthand. That's just a prerequisite for being a great surgeon. But it wasn't just her surgical skills that allowed her to become successful in [00:03:00] her career.

You can hear all of the other things that she built and the people that she worked with and the skill sets that she either intrinsically had or developed over time. And I think the way she has navigated being a woman in a very male dominated field, you can see where she's worked to overcome a lot of obstacles and I think she took a really practical approach to get things done.

And I think for anyone thinking about how do I become successful in whatever field? I would say the skill sets that Kathy has developed over time are intrinsic to whatever business you might be part of.

It really blew me away how successful she's become, how she's approached that success, and now as a senior surgeon, what her plans are now and in the future. And I really hope you enjoy this interview because I really enjoyed talking to her. So let's get right to [00:04:00] Dr. Kathleen Van Leeuwen, pediatric surgeon.

Thank you.

Dr. Sam Rhee: All right. Welcome. I have for my first guest, uh, on this, uh, surgical series, uh, an old, old colleague of mine, we go back way back since like medical school, even actually, Dr. Kathleen Van Leeuwen. She is a pediatric surgeon for over 20 years, which blows my mind how long we've been, uh, sort of in the business, I suppose.

Um, yeah. Um, so Dr. Van Leeuwen. Went to University of Southern California for her undergraduate training, where you actually got, um, a BA in English. I did not know that. That's great. Um, and then Kathleen and I were both at Columbia, uh, College of Physicians and Surgeons, now called Columbia University.

Vagelos College of, uh, Columbia University Vagelos College of Physicians and Surgeons, and we graduated from medical school there. And then we, um, [00:05:00] actually also crossed paths again. You were a general surgery resident at University of Michigan, uh, where you were also the chief resident. Um, and then after that you did your Pediatric Surgery Fellowship at, uh, Mott at the University of Michigan and you stayed.

Um, and then after that you joined, um, you went out to Phoenix, right? And you've been there for like 20 some years at this point.

Dr. Kathleen Van Leeuwen: yeah, it's close to 20 years, came out in 2005, and. I've really enjoyed being in Phoenix. I mean, first of all, it's great to talk to you, Sam. I'm so excited to, that you're, you know, looking at insights that surgeons have. We're a very unique population of doctors, right? Because surgeons are leaders. People look to us to lead, uh, people look to us for opinions, and so generally we have them, which is, I think, helpful when it comes to a podcast or comes to, you know, anything going on in the [00:06:00] community.

We're definitely community members, community driven, surgeons tend to be very, you know, Uh, mission driven, like whatever the mission is of their hospital or their, what they're trying to do could be a private, you know, organization. But, um, I think that is something that Columbia taught us too. I think at Columbia, um, most of the physicians that trained us were very unique and very driven in a way that was not just their personal success, but they really wanted to teach us that.

We should be taking care of the community. And, um, coming from this West coast, there wasn't as much of that at USC. I loved going to USC, but you know, I was not very, I would say visible to the, the community there. And then in New York, you just felt more of a part of something. And in Michigan, um, that was the case too.

I think you'll agree. Like it just was sort of more hometown, smaller, you know, You know, understanding what we're trying to do. [00:07:00] So then when I hit Phoenix, I thought, okay, I don't know what kind of impact I'll have here, but Um, it turns out that it's, you can really have a very big impact because it's a very small, it's a, it's a very young town, which is weird, but like you're in New Jersey.

I'm in Arizona where we've only been a state since 1912. So and Phoenix Children's has only been an organization for 40 years. We just had our 40th anniversary. Um, Columbia is like 250 years old, right? And so we, I think that's what I was used to, just this like steep, steep, you know, tradition, like a deep, steep tradition.

And in Phoenix, there isn't that. So you can build whatever you want. And if the, if the mission is to really take care of the community, it can be starting from scratch. That's what we do. Um,

Dr. Sam Rhee: I would, I want to get into that for sure because your, your growth, I mean, obviously Phoenix is a place where the growth has been explosive and you're now [00:08:00] associate, um, surgeon in chief for Phoenix Children's East Valley.

And so I want to get into that and see what it's like to be in a place that's so crazy. New, like you said, and also growing though, like expanding, like, so you're basically creating a lot of, um, traditions that maybe we had always had, both at Columbia and in Michigan. But what is it that you took away, say, like, remember something for me either from Michigan or Columbia that Really sort of that formed your or guided you as a surgeon or as a young surgeon or someone thinking about surgery at the time that you were like, okay, this really kind of put me on that path.

Dr. Kathleen Van Leeuwen: Yeah, I would say there, I was always looking for something that was, um, Supportive. And so there were a couple experiences that were huge for me. I did a sub-I you remember the sub-I at Columbia, they were like, you could just be a subi with one [00:09:00] person. And so for a month I was with Roman Noe grad,

Dr. Sam Rhee: Oh, no way. The vascular guy.

Dr. Kathleen Van Leeuwen: the vascular surgeon.

That guy, like for a month I was like his like gal. Friday, I will kind of call it that because. It didn't seem like you were his student. He treated his subbis with so much respect. He would let you do all kinds of cool things and then really got you, I mean, you were with him every second of his day. So all of clinic, all of OR and watching him interact with the chief residents and just showing everybody a ton of respect.

And I talked to him about it. He had, he had daughters. He only had daughters. And he, he mentioned, because I said something to him about, you know, while your interactions with people are so great, especially it just feels so supportive. You're supporting women surgeons, female surgeons. And he talked about his daughters a lot.

And I remember very [00:10:00] clearly, like they're the people that train me that have daughters treat me differently than the people who train me who don't. And that I remember it really, really clearly in medical school. And then I remember it very clearly in my head. At Mich, at Michigan, it was the same way. If somebody had daughters, if one of the surgeons had daughters, they really got it.

They understood not only who you are and how they could train you differently, um, and they did. I think they trained women and men surgeons, you know, differently. Just, they kind of lean into whatever your particular skills are. And just like help you develop those. And I felt it there. I remember talking to them about it.

Um, Dr. Koren, Dr. Arne Koren, who is a pediatric, like a famous pediatric surgeon who trained me. His daughter was probably a couple weeks difference in age of me. And you could feel that he was training me. As if I was his trainee and like a daughter. And he [00:11:00] mentioned it many times to all of the trainees.

He treated us like they, we were his own kids. And that sounds kind of weird because like you're not a kid by the time you hit residency, you're in your twenties, but, but you could feel how important it was to them to treat you with that kind of respect, that real true sense of, I want this person to succeed just as if they were my kid, I want.

Everything for them. I want them to be bigger than me. And that's how we are, right? With our kids, like, we want them to succeed, like, more than us, but also learn from anything, mistakes we made. And these surgeons were like that. And I took that away, both those experiences, for sure.

Dr. Sam Rhee: Roman Noigrad was a legend at Columbia and, and there are so many anecdotes, so many people who, who remember him so well. And I think you're right. He, the one thing I remember about him was he spent every waking moment in the hospital. If you needed a vascular consult, he was there. You could pretty much always get him.

[00:12:00] Um, he kind of had a bum leg from a motorcycle accident, but he was always walking everywhere. Like he was like kind of gimping around and doing any case, any case that anyone had, like, you know, wanted to tee up, no matter it was a, you know, what it was, he would take that case on and, uh, He, he was legendary for it.

And I think, um, Dr. Coren is a legend in the pediatric surgery community, for sure. Um, and I think that a lot of these mentors kept us as family members, like we were family to them. I mean, these are people who spent Immense amount of time in the hospital, in the operating room. And like you said, we, it was kind of an apprenticeship, mentorship, family.

Like we got to know them so well because that's really what their life was about. They were dedicated to. Their career, their, their, you know, to teaching, you know, they were, these were all highly [00:13:00] academic surgeons. Like they didn't want to just do surgery. They wanted to pass on that craft and what they knew and, and more importantly, how they did things properly to, to us as mentors.

And I think, I mean, you know, as mentees, and I think that was really, really important. And so do you take that now when you have younger surgeons, when you have other people around you, like, what do you do to sort of. Pass that along or, you know, keep that in mind.

Dr. Kathleen Van Leeuwen: I mean, I let them in. I, I let them into the details of my life, how it works. Like, how do I handle, you know, raising kids? I have, um, three kids, two, um, daughters and one non binary daughter. And it is a very interesting, I'm also single. I was, ended up being divorced like now 12 years ago. And I have a significant other, Jason, who lives up the street from me.

We're eight houses apart. So he has a boy house and I have a girl house. Which is like, really unique. When people [00:14:00] find out that, they're like, Wow, that seems like that would work. I'm like, yeah, it does. Um, you know, um, I think people need to know how you manage your home life too. How you raise strong daughters.

Again, you know, learning from not other people. I don't necessarily learn from other women how they raise their daughters, but I learn from other men how they raise their daughters, which I think is kind of a unique thing. So I'm kind of like a mom and a dad in a way. Um, but I do let people in when I'm training people.

Now, I think the reason why I succeed here in Arizona. And why people seek me out is they see me as a surrogate parent in the OR for that, for their child. So I think of everything they need to know. I'm listening to their brains and all their questions that they don't know they have, right? So if I'm telling someone about surgery, I make sure I'm telling them everything that I think they would need to know if I was the parent, including how much time off they're going to need, like how [00:15:00] they're going to have to arrange that.

You know, recovery and they know when their kid is asleep that I am serving as the surrogate parent and I'm making sure that in the OR we're all showing this great respect to this sleeping child while we're operating on them and that we all have a lot of respect for each other, um, which we do in our OR.

It's just. It's fun and it's respectful and, um, we just never, there's no snapping, shouting, you know, nothing like that. Um, and so that kind of environment leads to really good outcomes. You're just kind of making sure that everything is smooth. That's what I've been told. Like, all my moves are, you know, intentional and smooth.

There's not, they're efficient, there's not extra stuff. Um, like one of the, one of the things that, that I know that you think about too is like, what other distractions do you have in the OR? And we do play music in the OR. I feel like music does, um, kind of speed you up sometimes. Like it keeps the rhythm going instead of just [00:16:00] like silence.

Um, but it still has to be, I would say pretty respectful music, right? I know some people might choose things that are a little, you know, off color or whatever, that's not going to happen in a pediatric OR usually. Um, but also I have kicked people out of my OR when they come in and they're kind of negative.

And, um, sometimes I don't kick them out in a mean way, but I'll say, you know, why don't you go grab a cup of coffee in the doctor's lounge or I'll tell somebody, why don't you, why don't you go see if there's anybody you can round on because we have a super positive, um, attitude in here and I'll say something like that.

It does. It's not very often that I have to do that, but I think when I'm training people, I do, I do let them in everybody, right? So like you said, it's family, everybody in the OR knows they'll ask you like, how are the girls? Like. They'll ask you if you're going on vacation or you're going somewhere. And we all are kind of learning from each other because maybe if you had like a more [00:17:00] normal life, You would have friends and you would like all my friends are kind of the people at work, right?

So if I'm gonna go on vacation, for example, and it's somewhere I've never been, I'm gonna ask anyone in the OR who's been there for recommendations. We're kind of talking about, oh, where did you stay? What did you do?

Dr. Sam Rhee: school.

Dr. Kathleen Van Leeuwen: Also schools, like, you know, applying to colleges, like what kind of cars for your kids, like vehicles.

It's all done at work. It's kind of interesting, right? Like probably other industries, there's not as much of that. Maybe there is, I don't know, but everything we do is so intimate. And so like everybody's wearing the same clothes. We're all in scrubs. We're, you know, taking care of someone's body. It's just all really kind of interesting.

I think how different it is. But yeah, I think the main thing I learned from my mentors is just how to be real person to my mentees. So that, you know, you're not just like up on a shelf. So I like that part.

Dr. Sam Rhee: It [00:18:00] really resonates with me that the things you talk about, first of all, the group that you are with, you are trusting that there's an immense amount of trust and responsibility in the operating room for everybody. Right? And like you said, it's a team and everyone is very close.

And so it's natural that you would share your family life. You know, where are you going on vacation? What, you know, all those, you know, what's going on with your kids with them, because these are the people that you are around all the time. And that was always the way it was. When we were training too, we knew everyone in the operating room.

We, we, uh, different surgeons had different cultures or environments, but we certainly, I knew everyone really well. Um, I mean, we were residents, we basically lived there. So that was sort of, that was sort of a natural extension of where, where you are now with it. Um, I also think it resonates with me a lot about no wasted motion, efficiency.

I think the best surgeons make it look easy, because there, because there are no wasted movements [00:19:00] with anything. Everything is very, it looks simple, but to get to that simplicity takes a lot of practice, experience, a lot of work. Um, it's when you start and everything you do it at first. And it's very unsimple at that point that you have to learn how to, how to, how to keep it simple.

Like you said, set everything up. So everything just works for you.

Dr. Kathleen Van Leeuwen: I think you can teach that for sure. So the, the fellows, so we were pediatric surgery fellows, right. And we have also general surgery residents. But teaching them this extra moves that they don't need, the way I'll say it is, okay, that extra thing you just did, whatever it was, sometimes it's part of the prep, right?

So like, they'll give us these little Ioban strips to put the towels down. I'm like, well, you also have stickers on the drapes. So you don't really need the Ioban. And, and some, I don't want to say never say never, but like. In general, I tell you, like that amount of time you just took to put the Ioban on, multiply that by, you know, 500, 800 cases a [00:20:00] year.

How many years are you going to be in practice? First of all, the cost of it, you can just forget, like you don't need that. So, but the time of your, like you're getting back all this time, let's do the math, of your life. So just don't do stuff you don't need to do, because you're going to save. All this time, like it's really, I think it's important to learn, but they can take it or leave it.

Dr. Sam Rhee: what is one of your favorite surgical procedures, procedures now that you really love to do?

Dr. Kathleen Van Leeuwen: So I do reconstructive surgery mostly now. And it is cause I run the differences of sex development program here at Phoenix Children's, which is, that's also my areas of research is like, um, you know, kids born with a mix up between their chromosomes and their anatomy. So you might have a girl with XX chromosomes and she's, Born with more, you know, male appearing parts or, you know, might have something the opposite of that.

And we do a lot less procedures on infants now, as you probably know, there's like, you don't want to [00:21:00] maybe fix things as an infant. And so we do just a lot of, um, medically necessary procedures when they're babies. But then later. These kids will want reconstructions or need reconstructions, so I do a lot of teenage reconstructions, so, and, you know, throughout their lives, but those are big cases, and they're combo cases, so they're with urology and the fellows, and there's always a bunch of people in the room when we're reconstructing somebody.

We like those cases because you're making a big difference for someone. making their lives better because they can, you know, pee and poop better, which is the basics that we all want to be able to do. Um, so those are probably my favorite cases. Some of the ones that I initially did here in Arizona were a lot of scope cases.

So like thoracoscopic repair of a diaphragmatic hernia, thoracoscopic lung lesions, taking out pieces of lung with cameras. And on babies, that is no easy surgery. And so I did a lot of those initially [00:22:00] here. And then at some point I was like, you know, the ju the younger people can do some of these more, like, stressful cases.

I'm going to do, not that reconstructing someone's bottom isn't stressful, but it's, there's something to be said about kind of limiting the life threatening surgeries that you do. So at this point, I do very much less trauma, less cancer. Uh, cancer in kids just Just is heartbreaking to me. I don't, I just can barely handle it.

Um, families still will seek me out, some of the cancer families, because they think I'm like a good luck charm or that I have like some sort of like pixie dust. That's kind of, I'm kind of known for like pixie dust. So you can kind of like sprinkle something on a kid. And it just is this extra added level of like improving their outcome.

And that's kind of weird, but like we started the ovarian preservation program here with the cancer, [00:23:00] um, folks. So girls who are going to go undergo like gonadotoxic therapy, we'll take their ovary out and store it. Right. And I of course was one of the people that helped start that, but that to them, like These families, you know, you're just taking it over.

It's like not that big of a deal. But to them, the fact that I do it, it makes it somehow more hopeful because I'm hopeful. They can tell. They're like, I see that kid's future and they know I see it and they want their doctor to see their kid's future. And so that's probably what I provide. Is different, but yeah, it's a weird job.

I have a weird job compared to some surgeons, I think all these things come into play.

Dr. Sam Rhee: It sounds funny because I think when we're younger, we are kind of adrenaline junkies. We want to do all the cases. We want to do everything, the most complex stuff, the most challenging stuff, the most difficult stuff. And then I don't know what it is as we get older, but we get a little pickier and choosier about exactly Is [00:24:00] it, do you think it's, um, yeah, what do you think that is?

Why do you think that is?

Dr. Kathleen Van Leeuwen: Well, you know, that when you have any kind of outcome, even if it's like minimally bad, like it's just not, you know, not that someone passed away or anything, but you really perseverate over it. And we all learn to do that in residency because it's in our hands. Like all of that, that service that we're taking care of for those attendings, it's in our hands to have a good outcome.

And we. We feel it and every little detail you, if it doesn't go right, you can perseverate. And so I think as you get older, there's just so many other things competing for your time. When your kids are little, there's something easy about just like every little kid. It's easy to take care of them. You know, it, as they get older, these kids are very unique.

Each of your kids needs your time in different ways. I feel like I had to buy some time back from my job to give to my, my kids. And doing really stressful surgery, it, it's a, it's a big part of your brain, you know, while [00:25:00] that kid is recovering, even if it's so on the reconstructions, while they're recovering, um, you know, making sure they're coming back to see me a lot, making sure they're healing.

Okay. It's just very time consuming. So I think we have to buy back our, that little part of our brain that's like storing all that stress so that there's room for other people. Plus, like, think about the people you met when you were first out of your, your early attending and you meet people who are much older than you.

Like maybe they're your partners, maybe they're at the hospital and they're 20, 25 years older than you. And they either seemed really great. Or they seem super stressed and burnt out. And right. And I met some of them and I was like doing the math. I'm like, okay, this person is so stressed out and they are 20 years older than me.

So that means I need to retire in 20 years. Like I'm going to have to retire in 20 years because like, I won't be able to, I don't want to be like that. And. Instead of retiring, [00:26:00] because now it's 20 years, um, instead of retiring, I just think you have to anticipate, like, how am I not going to be burnt out, right?

I don't want to be like that. And one of the ways was reducing the stressful surgeries for me. And the other was reducing time in general and just starting to build Programs that let me be out of the OR, to be honest.

Dr. Sam Rhee: Now, as you get more senior, do you still, well, first of all, do you still take call? Like at any of the places that you're at?

Dr. Kathleen Van Leeuwen: I do, yeah. So I don't take overnight trauma call at Phoenix Children's, which is like a very, very busy hospital. Um, I take the call that is servicing all of our neonatal ICUs in town. And then when our new hospitals, Phoenix Children's is opening two hospitals this year, like full hospitals with 24 7 ERs.

And that's going to be important. So, uh, we're in central Phoenix, um, Phoenix children's is, and there'll be a new hospital in the East Valley and a new hospital in the West Valley. And I'm in charge of like both of them, uh, just like organizing all the [00:27:00] clinical services. So I'll take call there as well.

Those hospitals won't have, um, as many high acuity things. And so it's a little bit more of a bread and butter call. Uh, but yeah, being on call is fun because, you know, like, I think I trained my brain a long time ago. Any consult is just a cry for help. I wouldn't call it a cry for help, you know what I mean?

Any consult, someone is just asking for your help, no matter what it is. So you can't, you, you have to provide that help. You can't be annoyed. Like if you're annoyed, like it's not helpful. So we teach the residents too, like you shouldn't ever ask, like, is this a consult or is, you know, is it a curbside or is it a consult?

Well, they called you, so it's a consult and they want your help. So go help them, you know? So at the outside hospitals, that's a lot easier. At the main hospital, when. Everything's going crazy, you know, it's a little harder. So I, um, I [00:28:00] changed the call I took and that helps my brain too.

Dr. Sam Rhee: That's a really good advice. I probably should have listened to something like that more when I first started taking call a long time ago. It would have helped me probably. Um, so you now, um, have picked up a lot of administrative, uh, responsibilities, leadership responsibilities. As a surgeon, they don't really teach you in training how to be a leader.

You kind of watch people managing people sort of, but no one actually says, Hey, this, these are leadership principles. This is what you're supposed to do. And now you're doing a. So how did you learn those skills as just a surgeon? Because, you know, we're just expected to operate most of the time.

Dr. Kathleen Van Leeuwen: Yeah, that's a great question. So, I mean, you can learn them. A little bit of it is just innate to you and your background, right? So one of my things in my background is, is producing. I did [00:29:00] a lot in high school, college, medical school and residency, like producing. Events, um, as if I was like, you know, Kathleen Kennedy and George Lucas, like, I think in another life I would've been a movie producer.

But the idea is that you have a team of people, you are assembling that team. You're almost like casting them, right? This is like a, a Columbia. I was in charge of the drama club , and so I, we. Produced shows. Um, we had a musical we did, Kiss Me Kate, where I cast some of the most unlikely people. I remember Sean Biddick and Glenn

Dr. Sam Rhee: Oh, yeah. Yes.

Dr. Kathleen Van Leeuwen: right?

In these awesome roles where they stole a show in Kiss Me Kate. And it was just like, they both said, we've never acted before. I said, no, it doesn't matter. Like you guys are gonna just literally, you're gonna kill it. It's gonna be amazing.

Dr. Sam Rhee: Well, they were huge, like, rugby players. So that's awesome that you got them involved in something like that.

Dr. Kathleen Van Leeuwen: Right. And they had so much fun and they thanked me and [00:30:00] they said it was one of the most fun things they did in medical school. But this idea that you're just casting the right people, so it's just an idea of inclusivity. So first of all, making sure that the right people, the right stakeholders are included in something as you build it.

Um, and then not micromanaging everything, letting people really shine and letting, like understanding what their skills are and letting them help you do it. And those things I think were just innate to my background, but then I did do an entire year of coaching that I sought out. Um, and that was really helpful to understand what's it.

What's an executive level move? Like you're, as a surgeon, you, you're willing to, like you said, be working constantly, you'll do all of it. You'll do every step of building something because you're just so ready to like meet that deadline and, and do more and more and more work. And so more executive level.

You know, activities are like letting [00:31:00] other people do it and also expecting that they'll do it, like that you won't, you know, come to the rescue if they don't get it done. So I think learning those things, someone just sent me a, a great compliment, which was a book that they read that they said reminded.

Um, this person of me and it's called the multipliers and it's about some leaders are really trying to make everyone around them smarter and literally allowing them to do things to show their full potential and other leaders are more reducing people so that they can retain power and he said, you have always been a multiplier and you are for so many people, so thank you.

And I started listening to the book and it's just such a compliment because

Dr. Sam Rhee: I apologize, I

Dr. Kathleen Van Leeuwen: I love that. I love it. I even study teams. I study multidisciplinary teams, um, that we created here for spina bifida, for diaphragmatic hernia. Just the idea of like, let's actually study a team and how it works, um, because then [00:32:00] we can make it even better.

But I think the key to all of, like, executive work is Inclusivity. You've got to bring everybody in to the table and making sure that they are heard. And then the thing takes off because it's not you building it. It's like the team builds it and then it literally just takes off. Um, one thing that I think is a key for all leaders is look around for the gaps, like what is not being provided.

And when you build something to provide that service, That's a full value add, right? Like it was not being provided at all. And you created something, you're going to get all of the business. So we created something here for the babies as they come out of the NICUs. They're supposed to have a neonatal follow up clinic.

And it's like required in a way by, you know, national guidelines.

Dr. Sam Rhee: NASA. But,

Dr. Kathleen Van Leeuwen: We didn't have one. And we opened it mid COVID, by the way. And now we service like 2000 families a year. So it's just [00:33:00] like the value add to the organization when you build something that didn't even exist and letting my team fully run it.

Like I, all I did was basically launch it. So that kind of stuff has been really cool. And like you said, learning to be a surgeon leader is,

Dr. Sam Rhee: be a

Dr. Kathleen Van Leeuwen: is a challenge because you're, you're willing to really just be the lead and you've got to just be a team member. The other problem is a gender problem. There is a gender problem still in surgery and there is still in leadership.

So this idea that not a hundred percent of the people I work with are going to listen to me. There's a small percentage that are just like, Hmm, I'd rather, I rather she look different. You know, like I would want her to look like more gray hair, more authoritative, more, you know, cut and dry, not as cheerleader y.

I'm very, I'm very like the cheerleader. Um, so I, I think that, you know, What I've learned there is I just partner [00:34:00] with men in my teams that sometimes I have to say, why don't you go try to get this part done? And I know that sounds almost defeatist, but it is the way that I learned to handle it. So I can still get the programs, you know, launched.

Um, but Arizona still has a little bit of that. Maybe there are some places it's not as common, but I think we do have.

Dr. Sam Rhee: New Jersey's got it too. Like, it's still everywhere. I, I think, uh, and, uh, that's such interesting, that's an interesting approach and I really, um, it's, it's a very practical approach about getting things done. And, uh, I wonder in 10 or 15 years whether that, uh, will be the way our kids kids get things done.

Um, I feel

Dr. Kathleen Van Leeuwen: Or if it'll change like the numbers will change. Yeah, I think so. So the applicants to pediatric surgery this year, 75 percent of the applicants were female.

Dr. Sam Rhee: [00:35:00] Wow. That's so different than when we applied. It was like, how many women applied your year? Like very few. It was so

Dr. Kathleen Van Leeuwen: Very few. Yeah. And so. It was in the pediatric surgery, the main pediatric surgery association is called APSA, American Pediatric Surgery Association. And APSA has only had, um, five female presidents out of 55. And the first program chair to be female was me. Um, like two years ago, I was the first program chair ever that was female.

So the program chair is in charge of like what we're thinking about in the national meeting. Like it's a big deal. It's a big job. And I wanted to be on the committee. And so I applied to be on the committee and then I get this email, congratulations, you're on the committee. In fact, you're the vice chair.

I'm like, how did I get to be the vice chair? Like I wasn't even on the committee yet. And then one of my colleagues was like, you understand that if you're vice chair, that means you're going to be the chair. Later. And I was like, Oh, that seems cool. And then when I found out what [00:36:00] the job was, I was like, wow, I understand why I got this job because it's a lot of work and I'm going to get it all done. Um, but the person who gave me that job was Ron Herschel, who

Dr. Sam Rhee: Oh yeah.

Dr. Kathleen Van Leeuwen: pediatric surgeon, um, at Michigan, who was the president of the organization at that time. And I've talked to Ron about it. I was like, Ron, that was such a big deal that you basically accelerated my path to be the program chair. And like, We should tell people that you did that or that, you know, you noticed that there were no females that had ever taken that role or had ever been given the chance.

And he said, Kathy, it's partly that, but it's mostly because you're a closer. Like I needed a closer. Okay. I understand. And I can get stuff done.

Dr. Sam Rhee: I mean, I remember at Michigan when you were there, like we were co residents on Trauma Burn and you, you had those leadership qualities, the things you mentioned that have sort of driven what you're doing now. You were a [00:37:00] cheerleader. You brought everyone together. You were super positive. I remember we were third year residents and the twos and the interns loved you.

It was like a really close knit team and you brought a lot of positivity to a place that was very, Depressing and had a, it was a tremendous amount of work and, and yet you were able to bring people together. They worked so well as a team and it wasn't, um, and you were a cheerleader, but a cheerleader in the best sense.

Like you brought the best out of every, everyone at every level. So whatever they could contribute as a, As a first year, as a second year, you know, even just sort of attacking every issue, every problem, everything that came in, like, you were indefatigable. Like, you couldn't, you couldn't be stopped.

Everything always was super positive for you. And, and

Dr. Kathleen Van Leeuwen: Yeah.

Dr. Sam Rhee: that was, that's unique. So I think a lot of your [00:38:00] success, uh, Yes, there is a lot that other people can learn, but some of it is, is very, very intrinsic to who you've always been, I think.

Dr. Kathleen Van Leeuwen: I think so. It pays off now. I mean, I still know those trainees. They, when they come through, there might be applying for a job here or, um, division chief jobs. I mean, I want them all to succeed just as much as I did when they were, um, Um, the other thing about a team approach though is then it's less lonely for you.

Like, you, you know, your own, like, isolation, uh, taking care of a patient or making something succeed. It is less hard when it's a team. And so some of the hardest stuff I do here is really like these, these tough, um, cases, these babies born with differences of sex development or cloacas, baby born with cloacas where every, you know, all their holes are mashed up into one hole. Those are hard cases over time. They're hard surgeries. [00:39:00] They're hard to take care of the families. So as a team, it's way easier. Like I remember taking care of these patients by myself when I first got here. It was like, Oh, we're going to need a cloaca team. We're going to need a DSD team because, It's just, it's so much easier.

Not everybody is a good team player, right?

Dr. Sam Rhee: Right? I mean, and I think you, I think you've identified how you work and, and try to overcome those issues, which I think is also important that you realize it's not always sunshine and rainbows for, for everything that you do, and, and that, and that's, that's really important. But you still haven't lost that intrinsic sort of positivity in terms of building and growing.

Let me ask you this. You're sort of at the forefront of what is a pretty political or politicized part of medicine these days. Um, gender. Right? So, how do you deal with that sort of stuff?

Dr. Kathleen Van Leeuwen: Um,

Dr. Sam Rhee: you, at all, do you avoid it? Is that something that you want to deal with? Because, like, you know, [00:40:00] gender care,

Dr. Kathleen Van Leeuwen: yeah, in general, it can be avoided, um, because the kids who are born with a congenital problem, they're protected under most state laws, even in the, in the, in the states that are a lot more conservative, um, I'll give you an example, I want to say it's Ohio. Just, you know, pass some.

legislation that was not supportive of gender related care, but within that legislation, kids with congenital differences are protected in that they can still get whatever they need, which the hospital systems went, they do work with the legislatures in many cases, and they're, the legislature, when they're doing something regarding children's care, children's health care, will check with, The legal systems around them in these, in these, um, in hospitals.

And so they had to do that because you can't, you can't ban things that especially are medically necessary. It's not going to make any sense, right? Um, if a, if a [00:41:00] kid is, has a risk of having a cancer in one of their gonads, you're probably going to need to deal with that. You can't ban it. And so that part has been okay to kind of avoid it.

I think what we do instead of worrying about what the legislature says or what, you know, states or federal people say is we just make sure that when kids are in front of us, they understand we're taking care of them and that it doesn't, it doesn't matter. We're, we're legally taking care of them, what they need.

And they understand that. Um, I think nationally though, I don't talk a ton. Like you don't see me on a lot of, you know, um, national shows kind of talking about what we do. What we do is extremely reasonable. Like Phoenix Children's has an amazing approach of just like, if you need something that's medically necessary, you get it.

If you don't, we make sure that you understand everything using shared decision making tools, which we've studied, like, you know, so I'm kind of considered Switzerland in a way, like the [00:42:00] people who are political or the. The advocacy organizations that are stressed about surgery, um, they see me as like a neutral party, which is, which is great.

So you can kind of be everything to everyone. You just kind of, we put the patient first. Their, their body self image, their, how they feel about themselves, their family connections are super important. Like identifying that your parents, if your parents love you and want the best for you, your outcome will be great.

That it's just, it doesn't matter what we do to you. The surgery doesn't matter. What matters is how much does your family support and love you? And if they don't, which some families don't, then those kids, unfortunately, they have to grow up and they take care of themselves. And that's when, you know, they can, they can change who they are or how they feel.

The other thing I'll say about gender is that we both know it is, it's just something of who you are, right? You cannot tell somebody what gender to [00:43:00] be. So, since I have three daughters, but my oldest is non binary, I've learned, and that's my oldest, so I've learned a ton from River as River's grown up. You know, River's now 22 years old, but this is a child that did not want to wear, um, girly bathing suits from day one.

I mean, I wouldn't necessarily put them in like bikinis as babies, right? Cause that's so silly, but I did at least pick out, you would pick out bathing suits that were, you know, from the girls section until River got old enough to let me know that they, that's not what they really wanted. So now we go to Target, you know, this was when they were little.

We'd go to Target and we'd pick out girl bathing suits for Zoe and sort of boy bathing suits for River. And I would just let them pick out what made them feel comfortable. And it, it's a real lesson in your own house that then you kind of take to work with you. It's like kids just are who they are, but they really can't shine until you just let them act [00:44:00] like who they are.

And once they do, they just don't make a big deal about it either. Like they're just. You know, when it was time for River to go to prom, they wanted to take their girlfriend and we went into Nordstrom and we bought a suit and the suit is gorgeous. Like this gorgeous, like navy blue, you know, Ted Baker suit that, um, we went into the men's section and had it altered and it was just a great experience.

So sometimes it's just, Understanding, you know, just letting somebody be who they are, like you and me, like we get to be who we are. I get to shine because of who I am, like how great that is, right? Like you said, it's just my personality lends itself to some of the success I've had. So you would obviously want that for, again, your own kids and your own patients.

And if you see your patients like your kids, which in Pete's surgery is so easy to do, um, it's just about thriving, right? What does it take to thrive? And I mean, we have to think about that for ourselves, right? Just like the two of us and all the people [00:45:00] our age. What does it take to thrive in our next 10 years?

Our last 10 years?

Dr. Sam Rhee: Well, that's what I was going to ask you about was, uh, so we've seen our mentors and some of them have sort of finished off their careers, maybe gracefully. And then some were like draft horses, which they just kept going until they literally, uh. Couldn't do what they did anymore and drop dead in their, like, harness or whatever.

Uh, so, what is your plan in terms of, like, what you're going to be doing in the future, eventually? Because we all have to stop working eventually.

Dr. Kathleen Van Leeuwen: We do. I think you gotta just take care of your family. So I'm kind of an orphan, which is weird. So my parents died pretty, I would say pretty young. I was. 30 and 43 when my parents died. And I don't, um, my oldest brother also passed away and my middle brother is kind of estranged. And so, and my dad was from Holland.

So I don't like there's [00:46:00] nobody in the U S so I kind of am, you know, obsessed with my daughters, as you've heard, and also plan on. Taking, helping them take care of their families when they start to grow their own families, like I will be across the street, like, what do you need? And so that's how my mom was before she passed away.

She helped me with my kids. And so I really want to be this awesome grandma. I mean, my vibe right now, I call it like cool mom vibe. So it's going to have to go to like cool grandma vibe. And then that's probably my future. I also, I think there is a role for continuing to support women surgeons like in pediatric surgery because I'm, I'm kind of known in those circles too when the fellows come through, they're like, Oh, you're famous, like, you know, you're famous, right?

And I say, well, that's very flattering, but like, I don't know what I'm famous for other than these things, like, right. Being super supportive. So I feel like that will be a future too. I think what you [00:47:00] should do is you should see what you're really good at and what the hospital is like, so needing you to continue to do, and you need to identify somebody else who can do it and train them and get them to where it's sustainable.

So. The sustainability of the cool programs I built here, fetal care, DSD, spina Bifida, CDH, the new hospitals. It just, it's easy if you can find somebody as passionate as you and as Mi mission driven as you, to like take it over, mentor them, and then hand it over. And then I think you just say it's, it's still, all the babies are still thriving, all the, you know, the, all the programs are growing up just like your own kids.

And then you retire and you say, thank you everybody for. Continuing my work, but it's such a blessing to have that in Arizona, to be at such a young hospital where I got to build something that I can continue, you know, same thing with, um, my work in DSD and just like it's sustainable. It's [00:48:00] the last part for me here is, is equity.

So health equity for people in Arizona who are Hispanic and Native American. And making sure that whatever I'm providing for all the other families, that those families are getting the same thing. So we, we're studying that really hard right now, and just making sure that we're figuring out how to provide it.

So, there's one Native American community south of Phoenix that, we're just going to go provide the services there for this baby follow up program. Because they just, for a variety of reasons, have a hard time coming up to Phoenix to get the services. To be in those clinics. So we're taking the clinics to them because that's what they asked us to do.

And I think like my last part of my career will be like kind of stamping that, um, that we're, we're not kidding around about health equity, but that's hard,

Dr. Sam Rhee: I was about to say, every time I've worked with hospitals, it's always been about the money. It's about funding. How do you manage that [00:49:00] where you are in terms of dealing with providing health care? Like these, these are not, I mean, I would say a hospital administrator would be like, that's great, but we're going to just lose a ton of money if we do this.

Dr. Kathleen Van Leeuwen: so it's downstream revenue, which once you figure out like how to work with the finance people on like, what does that clinic bring in? It just either has to pay for itself. Or be profitable. We're at a nonprofit hospital, so we don't have to make a ton of money on something, but. Um, it's, uh, pay for yourself would be profitable.

If there's a slight loss to something, you just have to see if you can kind of recoup it in another way or if it's just the right thing to do. The hospital has a mission, and so they'll understand, like, sometimes we gotta provide something that's just the right thing to do, as long as we can kind of sustain it.

Dr. Sam Rhee: um,

Dr. Kathleen Van Leeuwen: going forward nationally with these DSD, um, programs is to teach people how to do it. So how much does it cost to hire an RN? What does an RN coordinator [00:50:00] cost and how much is that over five years? And how many patients do you need to see in order to to make that profitable? Um, and then The hospital administrators here have let me in on those secrets.

And I think teaching other people about that, um, reporting, you've got to tell people when you're doing a job. What the impact was. If someone's going to give you money, like a foundation donor is going to give you money for a program, you can tell them how many families they've touched, you know, because of that donation.

So these are all the things that my part time job is like raising money for the hospital. I am told by the foundation people that if I wanted to quit my job and just work as a fundraiser that I would do really well. But

Dr. Sam Rhee: sounds, that, I think that's one of the biggest parts of your success, is that that hat that you wear, you're probably really, really good at, which is what hospitals need, especially from surgeons who don't necessarily have that skill set. I would say most of them actually, actually don't.

Dr. Kathleen Van Leeuwen: to be able to tell a story [00:51:00] to someone and then show them the impact of their dollars. It's inspiring.

Dr. Sam Rhee: I think that that's something that as a young anyone, like knowing that those hats are hats that are really important for you to wear, no matter what your job is, be it a surgeon, be it in any other industry, like you have to know that you're going to need all these skills to really sort of go where you want to go, because these are places you wanted to go, things you wanted to do.

But if you didn't have these skills, it would have been a lot, a lot harder to do. But I would

Dr. Kathleen Van Leeuwen: it's a personality, right?

Dr. Sam Rhee: It

Dr. Kathleen Van Leeuwen: your personality.

Dr. Sam Rhee: It is. And some people just have to maybe build up that part of their personality more than, than others. I think it's a learned skill to a certain degree, some of it, not all of it, but some of it.

Um, what, so you're operating less now. Um, you see yourself not operating sooner, later, and when you do that, will you regret it? Is that something that you're like, okay with, like stepping back from [00:52:00] the OR?

Dr. Kathleen Van Leeuwen: Yeah. I mean, even when I did, I will tell you one of my partners, um, who I respect a lot, his name is Dave Notrika, he said this biggest tragedy ever was when Kathy Van Leeuwen stopped operating as much because you were the best surgeon here and you, you know, um, it, it's just a tragedy. And I'm like, well, I mean, the thing is I can take better care of patients cause I'm not as exhausted as I was.

So I was operating my fingers up when I got here. And the problem with complex patients is that they need an answer when something's going wrong. The team that I told you about, all these teams we built, sometimes they have to ask you for your expertise. You can't just be unavailable and tired and sleeping and, you know, the same thing for your family.

You can't just be exhausted the next day. So I think I take better care of patients because I have more time and so it's different. It's not operating as much, but it's operating on a higher level. Like these complex [00:53:00] reconstructions, just trying to teach people how to do it. I mean, you know from like moving tissue around, You have to kind of get a sense of what can and cannot be done.

You have to do a lot of something in order to understand it. So when I'm teaching somebody how to do urogenital reconstruction, we can draw it on the whiteboard as many times as you want, but they're not gonna get it until they see it. And that's what they say is like, Oh man, I didn't even understand at all what you're talking about.

Until I saw you, you know, make that incision or move that tissue around. So all of that, I couldn't have done, you know, 10 years ago when I was just operating like crazy. I didn't have time. You can't go, there was one day I did 17 cases in a row. I had been, yeah, I had been up all night and, and still operating the next day, which a lot of times that, you know, it just happens if you're doing emergencies at night, but those 17 cases, you kind of think they have to Pretty simple stuff.

Otherwise, with the amount of [00:54:00] tiredness you have, you just can't do it. So now, going into a case that's very complicated, but fully rested, which is what the families expect from us, right? They don't want you post call and tired. They want you on your game. And I, I provide it. I just say, I'm going to do that.

And, um, I'm careful about the schedule to make sure that I'm not tired. That I'm, you're not flying in that day and you got a case that day. You're not flying out that night to go somewhere. So, um, In case there's a complication, right? So it's a lot of work to be the kind of surgeon that you think you should be.

But, but I'm, I'm, I'm spending that time to do it. I still do very well financially and it has to do with all the other work I do too, right? So one thing you can do Tired is you can evaluate your program where you can gather the numbers from your clinic. You know, you don't have to. There's things you can do that aren't it that aren't somebody's life in your hands when [00:55:00] you're tired, but when you're Operating on somebody you should be rested.

So I'm not gonna regret operating less I think it's a really nice way to wrap up the career is not be like you said This like workhorse that's going till they're till they drop over

Dr. Sam Rhee: all correct. And we

Dr. Kathleen Van Leeuwen: And we both know of like, you know people who've done that or you know We've all been around long enough to see people who who lost their lives early.

You know, Dr. Teitelbaum at Michigan who had the brain tumor. You know, I, I went to visit him and I helped him write letters to his daughters because that's what my mom had done. She had written letters to my daughters. I'd ask him, do you want to dictate letters to your daughters while I'm here? And you know, he did.

And I, you know, it's so emotional, but it's so like listening to somebody talk about the people they love the most. And just this idea that he died, he was 56 years old, you know, I'm 55. So you, you can't, you [00:56:00] cannot just be in the operating room all the time later. You need to be enjoying your family. And enjoying, like, your life.

You need to be traveling. We went to Yosemite in, last fall, my youngest and I. And of course I'm completely blown away. I think I've been waiting my whole life to go to Yosemite.

Dr. Sam Rhee: It's literally like in your backyard.

Dr. Kathleen Van Leeuwen: I don't know, like, why does it take you this long? So, you know, we went hiking and we, I watched Free Solo while I was there about Alex Honnold, the guy, like, I was terrified.

I was like, what is this guy doing? I mean, I know by the end of Free Solo, you know, he's alive because it's about him and it's like how he did it. This idea of just like, you have to get outside. You know, you have to lead your life and travel and enjoy things. And it just can't, there are people who will argue, well.

But you're at your best. You've operated so much. Like, you're so good at that [00:57:00] age, 55 to 60, for example, that you should just be operating. Okay. But like, I also want to go to Sweden. Like, where we want to, you know, I want to, I want to do things, you know, that are work related. We're going to Sweden on a meeting, but still, like, I want to go do things.

So, that's how I'm going to do it.

Dr. Sam Rhee: That's, I think every surgeon, uh, that is the dilemma and you're, you're right. You are at the peak of your experience, your game, your, your skillset, your knowledge, you know, and yet. When we've seen our mentors, um, everyone approaches it differently in terms of what, what is meaningful for them in life, what matters.

Uh, I think, um, some of my mentors that I've seen would have felt exactly the way, you The other surgeons around you said, like, we need you in the operating room [00:58:00] doing as many cases as you possibly can while you are at your peak. And I don't think, I mean, personally, I don't think that that's the healthiest way to approach it, but it really depends on what fulfills you.

What fills your cup? Like for some people, and I know that only being in the operating room is. What makes them happy, like just being in flow state, sitting there and operating over and over and over and over again. Like that is what they need for fulfillment, maybe to the exclusion of others or, or a balanced life or what have you.

Um, I have to look at your life and say that's a pretty good blueprint actually for, for a lot of people. I would say if you're a young surgeon, um, sort of following along with sort of what you did would be a great way to look back at your career and say, you know, this was a very, very impactful way because, um, like you said, you're impacting a lot of lives, um, by setting up Um, at a, at a relatively young [00:59:00] city, institutions, care, care network, and hopefully making an impact for years and decades or longer, hopefully, uh, once those things have been set up.

And we've seen that at other places like at Michigan, at Columbia, once they, they have traditions, once they set up, you know, sort of traditions of excellence, um, that, that, You know, hopefully that that impact will be made, especially like you said, with younger people that you're training, others around you, um, starting out on your career.

Um, let me finish with this. Is there anything else that you feel is really important if you were to look back or if, or, I don't know, our situation is different, but someone now, like if you, if you had to give them something to take away, uh, what, what would that be at this point?

Dr. Kathleen Van Leeuwen: Um, I think probably just leaning into your emotional intelligence, like, like we've talked about a little bit on this [01:00:00] podcast, but the idea that being you're being true and, um, really exposing yourself to people, like allowing people to understand who you are and what motivates you. Is a part of the game that is, makes you super successful, but also super vulnerable.

Like people who, There's still people who are kind of, I wouldn't say they're out to get me, but they are not pleased, I would say, with my success and sometimes try to find, you know, um, issues. Oh, she's too, she's too busy. She's, you know, she's too busy with her kids or something like that. I've had people say that, or like, she's too into, you know, her own, taking care of her own kids.

It's like, well, that should be a huge feather in your cap, but it's for whatever reason, sometimes a detractor. So I would say that's the main thing. If I had to do surgery again, I would want to do it now. So I would want, if I had to do surgery again, I don't want to do it. From [01:01:00] 20 years ago when I had, I was the first, um, the first resident at University of Michigan to have a baby during their clinical years.

So that's weird. Like to me, I want to do that now. I want to go back to Michigan and I want to be there now when there is a baby. a whole policy on allowing the residents to have babies and making sure that they're not doing a combined liver kidney transplant at 38 weeks pregnant, which was like, you

Dr. Sam Rhee: you do that?

Dr. Kathleen Van Leeuwen: McGee.

Yes, 38 weeks pregnant, combined liver kidney with John McGee on a Sunday. And I told John, we are not having this baby today. And he said, no, no, Kathy, no, absolutely not. We are not having this baby today. I 100 percent agree. And so he was on his best behavior and we got through that case, but it is, you know, that's dangerous.

I now know that like the complications that women surgeons have, we've, we've studied this and written on it, is it's just impossible. Like the fact that we can get [01:02:00] through these pregnancies with the kind of work we do, And in a lot of cases it does work out. So for me, it was fine, but, but still, is it fine?

Like sometimes you kind of wonder what were the epigenetics of growing those babies, you know, during my training and in my first year, um, out. But I, I think if I had to do it again, I want to go back and I want to do it now when there's more protection for. Families as they're growing their families and it seems like there's more Tolerance of just being yourself and that 20 years ago.

I had to I had to scrunch a lot of that down that I don't have to now. So, but I thank you so much for inviting me to do this. And, and Sam, I think it's such a blessing that I've been able to stay in touch with you all this time. And I was thinking about Haft and

Dr. Sam Rhee: Yes.

Dr. Kathleen Van Leeuwen: of us, John Haft, like, um, you know, I'm very close with John still, and I think that we were in the battle together, which is [01:03:00] why we all became so close.

It was hard,

Dr. Sam Rhee: It was really, it was so hard, and I just remember how kind both you and, and John were. I was the, like, out of the tripod, I was the weak leg of the chair, because I was the plastics guy. I came from another institution. I, I, I wasn't, uh, I, I was, and I just remember how positive, uplifting, kind. Um, it was for such a difficult time, um, you remember the people who are lights, who shine, who, you know, you, you know, who are the superstars, you know, who's going to be there and just do amazing things.

And I always felt like, Watching you and Haft, like, you guys, like, and Haft too, is just such a, he was always positive, he always had so much enthusiasm, like, way more positive than a cardiothoracic, a future cardiothoracic guy should have, because everyone else always seems so dour and, and, and, and down, and he, [01:04:00] and, and you guys just, uh, brought a lot, a lot

Dr. Kathleen Van Leeuwen: So he has, he has emotional intelligence even as crazy as Jon is. He, when my dad passed away and I came back, it was kind of sudden and I came back, he just hugged me and he was just sobbing. And you know, he'd only met my dad like once, but he, he just understand, he understood like, How hard that was for me.

And so what I'm saying is like, we felt like with you and John and me, like we felt the same way about you, that if this was a great team that took good care of patients, because we also took good care of each other and, and I think, you know, making sure people could sleep, making sure people could eat, these are the basics.

And, um, I don't know, I remember it fondly, even though, I guess it takes 25 years to get over scarring events like that.

Dr. Sam Rhee: That's that's why it resonates with me when you said, I wish I could do my training now because there was so much back then that was so [01:05:00] difficult and especially women. It was like 10 times more difficult. Um, I remember just so many incidents that would blow people away now. Really? Like that's what they said to you?

Or this is what happened? Or, and, and so I think the best thing we could say is that it was people like you who were able to get through and, and affect change and then become people in positions where you could actually start changing the culture and making things different because, um, It was, there was, you're right, there's a lot of psychic scars that it took a while for us to sort of get over and, um, and we can look back at it now and, and, and laugh a little bit, but boy, um, it, it was really pot, it was the, it was the, The, the superstars that I saw then, and that's why I do this now is because I want to go back and, which [01:06:00] reminds me, Haft has told me he would do it, but then he hasn't gotten back to me about it.

So, so bug him and make sure you get

Dr. Kathleen Van Leeuwen: him. Yeah, I'll tell him. Yeah.

Dr. Sam Rhee: And, and, uh, And just to highlight the people that, you know, have a lot to bring to the table. Like, I think not just for, you know, young surgeons or other people, but like, I want my kids to hear stuff like this. I want other people who are just thinking about what is it that is important in life?

What, you know, what is it that, you know, How do other people of quality do things? And maybe it's not exactly the way they'll do things, but it's a, it's a great different perspective for them to, to hear. And especially someone who, as we said, been through the trenches, seen a lot of really tough stuff and has, and you've come out on the other end stellar, like you've, you, it didn't break you, it didn't beat you down.

And even now when you have people that are not, you know, who are the naysayers or, you know, who aren't super positive, like. You're still managing to, [01:07:00] um, to do your best and, and to keep a really awesome attitude about that, which is really, that's inspiring.

Dr. Kathleen Van Leeuwen: one thing I'll say to close is that, um, some of what we get to do on a daily basis is life changing. Like, you will have an experience. in training, but since then, that is actually life changing. That is so shocking and so dramatic that it's like watching a television show. That you, you know, it's like watching Grey's Anatomy.

It's just like, it really is truly life changing. Some of these kids and how they handle these diagnoses, um, they inspire me. And I, I never, I, I am, I never get over it. Like it's never, um, I'm never jaded. I'm always a better person for having met the right people. Some of these families and some of these kids and you know, I come home and I share that with my own kids So I'm super grateful and I would say yeah [01:08:00] the gratitude of meeting people like you and remain, you know Just remaining friends and then having these families affect me It's I'm grateful and I just feel like I mean my mom who is again passed away, but up in heaven For sure, she thinks everything that I do was, is just because it was supposed to happen, that families put themselves in my path and that I am like, Oh, I got to take care of you.

Here you are. And there's a reason. And you know, whether you believe in faith or fate, it's, there's, they're the same, which is you should be doing, you know, impactful things. So, but thanks so much, Sam. This has been fun. It's been fun to think about it.

Dr. Sam Rhee: Thank you so much for spending the time and I really appreciate it, Kathy.