Speaker spotlight: March 4

Inspirations, favorite quotes and more about speakers at SIR 2023—from well-known luminaries to first-time presenters! In this article: Timothy W.I. Clark, MD, FSIR; Jon C. Davidson, MD, FSIR; Abhishek Kumar, MD; Paula Novelli, MD, FSIR; Raj Pyne, MD, FSIR; Akhilesh Sista, MD, FSIR; Brian F. Stainken, MD, FSIR; and Hyeon Yu, MD, FSIR. Click the names below to find each one in the SIR 2023 program.

Timothy W.I. Clark, MD, FSIR

Why did you choose IR?

I came into IR through a less traditional background. I did medical school and residency in Canada, and after internship I did what was quite popular at the time—I practiced full time for 3 years as a GP before residency. Most of that time I worked as emergency room physician. Our busy ER was located right next to the radiology department. I would send patients to radiology for simple procedures like nephrostomy and appendiceal abscess drainage, and I began to shadow my patients over to radiology once my ER shifts ended. I was fascinated by these image-guided procedures and one day my radiology pal said to me, "Look, we're general radiologists who do minor procedures. If you want to see what interventional radiology is really like, then go visit the hospital where one of our former colleagues now works and check out a day in the life of an IR." I traveled 3 hours to a large tertiary hospital and met with the IR contact I had newly made. The first cases that morning were varicocele embolization, kissing iliac artery stents, double-J ureteral stent placement and a GI bleed embolization—all in the span of a few short hours. From that moment, I knew what I wanted to do for the rest of my career. I was also very fortunate during my radiology residency in Vancouver to have an aspirational mentor in IR—Lindsay Machan—who only further confirmed that I was entering an exciting, dynamic and impactful field of medicine.

How do you explain your work to non-IRs?

I say something like we fix conditions all over the body through therapies and devices that can be delivered to the site of disease through a tiny nick in the skin, all using image-guidance. 

What would you say drives your work or inspires you?

I like to say to our residents and fellows that IR makes patients' lives better in some way each and every day, and that several times a month, what we do as a team in the critical moments of a major emergency will save a patient's life.

What is your favorite or most meaningful memory/experience as an IR?

There have been so many that it's hard to pick one, but here goes. Early in my career, I was referred a young woman in the second trimester of her pregnancy with severe hypertension secondary to renal artery stenosis from fibromuscular dysplasia. Her systolic pressures were in the 160s, on five medications. She needed renal angioplasty, urgently. Her hypertension specialist and I recommended we proceed, while her maternal medicine physicians were quite skeptical that this would help. I ended up performing bilateral renal artery angioplasty from a brachial approach with lead shielding of her pelvis, and within a few days she was tapered off all of her antihypertensives. She gave birth to a healthy baby girl at term, and she and her husband were so grateful they named their daughter Emma after our daughter Emma.

What is your favorite quote (if you have one)?

Most of my favorite quotes are too salty for this publication. One quote I say often is "It's hard to make an asymptomatic patient feel better." I think this rings true in IR given the depth and breadth of therapies we can offer, in that we need to always be careful before performing procedures that may have little to no impact on improving a patient's health.

Jon C. Davidson, MD, FSIR

Why did you choose IR?

When I graduated from medical school, I matched into a general surgery residency. While I was doing my vascular surgery rotations, I was able to see first-hand the cutting-edge and transformational work that was being done in interventional radiology. This ignited my passion for IR, and why I chose IR as my career.

How do you explain your work to non-IRs?

We are clinical physicians who perform minimally invasive procedures using imaging guidance.  

What would you say drives your work or inspires you?

The constant innovation and evolution that comes from IR is always an inspiration to advance my career.

What is your favorite or most meaningful memory/experience as an IR?

My most memorable experience was being inducted as a Fellow of SIR in 2017.

What is your favorite quote (if you have one)?

"Yesterday is gone, tomorrow has not yet come. We have only today. Let us begin."—Mother Theresa

Abhishek Kumar, MD

Why did you choose IR?

I chose IR because it combined my desire to perform procedures and treat a wide array of diseases and organ systems. I loved that IR was at the forefront of innovation, transforming surgical care using minimally invasive techniques.

How do you explain your work to non-IRs?

I use imaging and tiny pinholes to perform intricate procedures inside the body to treat diseases in every organ system.

What would you say drives your work or inspires you?

Taking care of sick patients who need us. Being in the moment in the IR suite. Teaching the next generation of physicians.

What is your favorite quote (if you have one)?

“Everything negative—pressure, challenges—is all an opportunity for me to rise.”—Kobe Bryant

Paula Novelli, MD, FSIR

I originally matched in neurosurgery then rematched into diagnostic radiology. I was initially drawn toward neuro endovascular procedures. I had a neuro IR rotation sandwiched between 2 IR months and was not comfortable with some of the outcomes in the early days of neuro IR. I often felt that the complexity of the procedure itself generated more excitement than did the expectation of favorable patient outcomes. Again, this was early in the field of neuro IR.

I was lucky enough to be a resident at a major liver transplant center under the supervision of two of the early pioneers in liver transplant intervention, Albert Zajko and Philip Orons. With their mentoring, I was immediately drawn toward the liver, the cleverness and complexity of the procedures, and the good patient outcomes; and after spending time as a surgical resident, I had also found myself a little frustrated by diagnostic radiology, where there is not much close patient contact. IR was a way to be directly involved in patient care and I was enamored with portal hypertension and hepatobiliary interventions.

The “innovation” that was important to my mentors is still very much what drives IR . That is what makes our careers continuously evolve for better treatment outcomes and offerings. We called the service “special procedures” at that time and the liver interventions were “special procedures” to me back then as they are to me today. I still think we are a perfect match! Every day, every case allows us to pause and consider how patients can benefit from IR and that keeps me going every day. The patient is always the focus of our work.

IR is often in the background fixing something that has gone awry, and we don’t often get a shout out in the charts as other clinical services do but as Maya Angelou, once said, “They may forget your name, but they will never forget how you made them feel.” This is IR and I still have a hard time explaining what I do to my parents. My husband “gets it” because he is an IR too.

Raj Pyne, MD, FSIR

Why did you choose IR?

I went into medicine as I loved the surgical paradigm of "fixing" a medical disease definitively, hoping to be like the surgeon who saved my father's life when I was a child. But once I got to medical school, I quickly realized that I didn't love all the baggage that came with it: long operations, disrupting natural anatomy, difficult postoperative recovery, expected risks and complications, the OR culture, etc. I quickly fell in love with radiology and its ability to use anatomy and physiology to diagnose nearly any pathology in a way that has almost replaced the physical exam. Discovering that I could marry expertise in imaging to "fix" patients in quick procedures with minimal recovery, all using ingenious techniques from a tiny nick somewhere else in the body? Game, set, match. IR is truly the most fascinating and elegant field in medicine.

What is your favorite or most meaningful memory/experience as an IR?

As a teacher and educator, I realize that most trainees are drawn to IR for the cool procedures, creative techniques and cool devices we get to master. But patients are human, and we often interact with them at their lowest and most vulnerable point. I once treated a patient numerous times with Y-90 and kept her quality of life very high for multiple years until the mets recurred. I was most surprised to get a call as she was on her deathbed, and she had requested me to be at her side as she died along with her closest family. I  felt so undeserving of this gesture as I thought that I had let her down in some way, but to realize that she was grateful and thought I belonged at her side was truly humbling.

What is your favorite quote (if you have one)?

"IR is often a patient's best first option and their best last resort." (I made this one up myself)

Akhilesh Sista, MD, FSIR

Why did you choose IR?

I enjoyed coming home every day after my IR residency rotation with a story to tell. Something inspiring, crazy or eye-opening happened on a daily basis. I honestly couldn't believe I was going into IR, but could not see a better way to spend my career.

How do you explain your work to non-IRs?

That I am a body plumber! (below the neck). I use fancy toys and futuristic technology, but at the end of the day, I open up blockages and plug up leaks. 

What would you say drives your work or inspires you?

How much medicine means to this world—our patients, us, society. We have the opportunity to problem-solve on an individual and grand scale; this is deeply satisfying. 

What is your favorite or most meaningful memory/experience as an IR?

Like every other IR, saving a life. My first massive PE save comes to mind—the teamwork around bringing that 30+-year-old from the precipice of death is unforgettable. And parlaying that into a research career culminating in PE-TRACT getting funded is a dream. 

Brian F. Stainken, MD, FSIR

Why did you choose IR? 

Whipple procedures. I was a surgery intern and took care of too many patients post op. The pain, the complications, the long hospitalizations ... I understood the indications for the operation, which remains a mainstay for resectable disease, but I could not get past the reality that I was not the right person to convince a patient to undergo the surgery. To succeed, you need to believe in what you do. That's what I found in IR.

How do you explain your work to non-IRs?

I am a cross between a surgeon and a radiologist. Rather than making an incision, I use radiology/imaging tools to get to the target. These same tools allow me to see disease in ways the human eye can not, so I can operate on the diseased area with precision. The IR approach does not work for everything but, where it works, it  eliminates the incision, the dissection and injury to normal tissues. These techniques can dramatically decrease risk, suffering, and recovery time. 

What would you say drives your work or inspires you?

I feel fortunate to have found IR during its early years, and without a doubt, I'm a believer. Looking back, I think it is a mixture of the unending challenge, the knowledge and pride that your peers in the hospital see you as a valued "problem solver," and the patients. The relationships that you form with many, the ones who compliment as you review their imaging with a radiologist's eye by saying "You are the first one to really explain things to me." We talk about how people don't know who we are but the truth may be that we are largely unaware of our own value to health care, and how impactful our interactions with patients are.

What is your favorite or most meaningful memory/experience as an IR?

Hard question ... There's the time my scrub bottoms fell off under my gown, or the time I slipped and fell in the suite. A few hours later, the techs had set it up like a TV crime scene, tape and all. There are the relationships with the techs and nurses and peers. And of course the many many patients, some tragic, some fantastic. I don't know why, but I'm suddenly recollecting a time when we were caring for a patient with portal thrombosis caused by eating a toxic mushroom in his back yard. He was awake and conversant and upset. His brother came to visit and brought him ... a mushroom pizza. The techs were mercilessly ribbing him, which set him at ease more than any drugs, and I remember thinking, how incredible is this. We are doing something that no one else can do, the patient is chatting away and comfortable, and will be fine—as long as he stays away from the backyard veggies.  

What is your favorite quote (if you have one)?

"Do what you can with what you've got, where you are."—Theodore Roosevelt

Hyeon Yu, MD, FSIR

Why did you choose IR?

Since I was young, even before entering elementary school, I have considered myself a craftsman, assembling and disassembling toys and plastic models repeatedly without being bored until I could not put them back to their original shapes anymore. That feeling and excitement rejuvenated from deep inside me the first time I participated in biliary drainage with lithotripsy in a patient with oriental cholangiohepatitis as a second-year resident. It was only natural for me to choose IR as my lifelong career. I have never regretted my choice, even in the darkest moment after my first complication case during my fellowship. Those experiences, memories and constant interactions with others make me a more robust, resilient and careful physician. 

How do you explain your work to non-IRs?

I always draw illustrations on paper, simplified but precise, using markers or thick gel pens, including basic anatomy, my access routes, one or two devices, and final actions, such as balloon angioplasty, stenting or embolization. I do this in my clinic encounter, in a reading room during a discussion with other specialists, at home with my family and sometimes at the dinner table. Then, I try to add some colorings as a joke. Almost everyone understands quickly and loves my drawings. They are amazed at how those complex, risky and exciting things can happen without opening the patient's belly.

What would you say drives your work or inspires you?

There is no better moment than seeing my mentees and trainees surpass my knowledge and skills. At that moment, they are my teachers and inspirers, encouraging me to be awake, work harder and be a better educator.   

What is your favorite or most meaningful memory/experience as an IR?

A while ago, I had a gastrostomy tube placement case for a young male with visual and speaking difficulties. He was extremely nervous before the procedure. Although we could not communicate, I took time to explain each step so he could be prepared for pain from the Lidocaine injection and later for pressure. After the procedure, he wrote a letter on the back of the wrinkled and partially stained nursing paper, thanking our team's work. It was illegible and skewed. But it was the most priceless gift I have ever received. It is still on the wall of my office, warming my heart every day.  

What is your favorite quote (if you have one)?

"If you only read the books everyone else is reading, you can only think what everyone else is thinking."—Haruki Murakami