Vascular Alumni Spotlight
Nicholas Morrissey, '88, '92 (MD) '99 M (Res)
Associate Professor of Surgery at Columbia University Irving Medical Center, Division of Vascular Surgery
When Nicholas Morrissey, MD came to the University of Rochester to take part in the Rochester Plan program*, he wasn’t sure which area of medicine he wanted to pursue. In his third year of medical school, Morrissey started to lean toward surgery. “I realized I liked to get things done early in the day, and to use my hands to be creative. Surgery is such a creative outlet,” said Morrissey.
As a first year resident, a colleague of his—Roy Greenberg ʼ97M (Res), ʼ99M (Flw) who, Morrissey said, “went on to be one of the most creative, brilliant minds and innovators in vascular surgery”—took a career-changing vascular elective with Cynthia Shortell ʼ89M (Res), ʼ93M (Flw), now chief of vascular surgery at Duke University. As Morrissey had elective time at the end of that year, he spent a month with Shortell and Joseph Geary, MD, chief of vascular surgery at Rochester General Hospital. “It was before the advent of endovascular surgery. It was all open procedures. I loved all of it: the anatomy, the vascular anastomoses, the sewing,” said Morrissey.
In his second year on the vascular rotation, he had the privilege of working with Richard M. Green, ’70M (MD), ’76M (Res), who recently retired as associate chief, Division of Cardiac, Thoracic and Vascular Surgery at Columbia University, Kenneth Ouriel ʼ77, ʼ86M (Res), ʼ87M (Flw), the former chief of International Operations at New York-Presbyterian Hospital and current president and CEO of Syntactx, and James DeWeese ʼ49M (MD), ʼ56M (Res) who was then chair of Cardiovascular Surgery and Vascular Surgery and gave him a great deal of guidance. “I was hooked,” said Morrissey.
As a fourth year, he worked at Genesee Hospital with Thomas Penn ʼ77M (Res), one of his favorite attendings. “Tom, Ken Ouriel, Dick Green and Jim DeWeese were very supportive. It was an incredible time to train in the Department of Surgery. Its leaders—DeWeese, Schwartz, and Adams—were giants in the surgical field, and treated the residents wonderfully, like colleagues” noted Morrissey. Seymour ‘Sy’ Schwartz ʼ57M (Res) was then chair of the Department of Surgery, and James T. Adams, MD was professor of Surgery. “Every one of the surgeons taught the residents to be great doctors. They used to say they could teach anyone to use their hands to operate, but wanted to impart the concept of operating only when you have to and the importance of sound decision making. And in the tradition of Rochester’s biopsychosocial model, they also emphasized the importance of communication and respecting patients and their families.”
Morrissey recounted additional memories of Schwartz, Adams, and DeWeese. “My class was the last class under Sy Schwartz’s leadership as chair and it was the last year he operated on patients. He expected great things from us. Schwartz and Adams were best friends and would banter back and forth during conferences. We all got a kick out of it.”
When asked about Adams, he stated that “he scared everyone as he was blustery in the OR, but he was the kindest, greatest teacher to the residents. Adams was famous for saying, ‘It’s a long way from this side of the table to that side of the table,’ a saying my chair Dr Craig Smith and I use today at Columbia.” It was a sentiment that reflected the maturity required in order to be faculty, a maturity that went beyond technical prowess.
DeWeese and Adams were known for developing the DeWeese/Adams clip which, at the time, was a revolutionary, life-saving device that kept patients from dying in the hospital from pulmonary embolisms. “Today’s trainees might not know that when they sold the patent, according to a story Dr Adams related, they insisted that the clips never be sold for more than 50 cents apiece so that they would be used around the world to save lives,” said Morrissey. “When I was a fellow at Mt. Sinai, I remember seeing a DeWeese/Adams clip on a shelf. I wish I’d taken it! I’ll never find another one.”
By the time Morrissey became a resident, DeWeese was already semi-retired, but “he would go on rounds with us, ask questions.” He edited the book Band of Brothers: Creators of Modern Vascular Surgery in which one of his colleagues, Andrew Dale, interviewed the founding pioneers of American vascular surgery. “I still have my signed DeWeese copy which I show off to residents and fellows and brag about Rochester as a vascular powerhouse. The University of Rochester is responsible for developing a disproportionate number of the leaders in vascular surgery
When asked what Morrissey would say to future residents, he commented that they should, “treasure Rochester’s surgical legacy and take from it whatever you can. There is nothing quite like a Rochester-trained surgeon whether you stay at Rochester or go elsewhere. Its effect stays with you for life.”
Doran Mix '13 (MD), '19 (Res)
Assistant Professor of Surgery at University of Rochester, Division of Vascular Surgery
When Doran Mix, MD, reflects on what makes his support for education in vascular surgery at University of Rochester meaningful, he stresses the connection between research and education that was so important to him in his own personal experience. Mix completed two years in a vascular surgical research lab, one as a student, and the second year as a resident. At the time, he shares that there was no mechanism for resident research support. That meant he had to moonlight in order to dedicate time to the lab. His desire now is that resident research be a priority for the division. “If we are going to produce future surgeon scientists,” Mix says, “It is necessary to set the foundation for that early on. You cannot go into your first job and say you want to be a surgeon scientist, without any evidence that you can do the work. It’s critical that we support those residents through this process with dedicated time away from the rigors of clinical care.”
Mix himself never expected to become a doctor when he began his career. He started as a computer engineer at Rochester Institute of Technology (RIT), but he did have an interest in medical equipment. He was inspired by a mentor who set him up for his first co-op program, as he was going through his engineering curriculum. It was in an office outside of Syracuse, owned by a vascular surgeon. They designed visual x-ray equipment. Mix went on to work at Welch Allyn.
After that, Mix shares, “My dad got sick, and I didn’t know what to do next. I realized I wanted to be more engaged directly with patient care. I was interested in emergency medicine.” Mix had been a member of the student-run ambulance service at RIT, and had later become a paramedic in Syracuse, working nights and weekends. So he entered into the post baccalaureate program at Bryn Mawr College. He remembers, “At that point I was 100% convinced I was going into emergency medicine. So I set up a summer internship. That’s when I met Dr. Karl Illig who did a brief presentation on peripheral vascular disease (PVD). He was a former engineer and compared PVD to an electrical circuit. That’s how I got sucked into vascular surgery.” Mix completed a year-out program in the cardiovascular engineering lab. He shares, “In my experience it all came down to mentorship and the opportunity to do a year or two of research in a 1 to 1 research model. That’s why I feel it’s so important to support resident research.”
For Mix, mentorship has meant everything to him during his career. “It’s how I got on this track,” he says, “Vascular surgery was never something I contemplated before meeting Dr. Illig as a mentor. The fact that he gave me time as a medical student was not something you would expect. His energy and excitement about vascular surgery was inspiring.”
Now, Mix holds the position of Director of the University of Rochester Cardiovascular Engineering Lab (CVEL), which works towards solving cardiovascular problems using engineering principles. They are researching novel ultrasound imaging and 3D printing techniques to examine patient-specific aortic tissue properties and treatment strategies for aortic aneurysmal disease.
Mix describes that their original intention was to create novel imaging tools to predict outcomes of cardiovascular disease that would specifically improve metrics of patient outcomes. “The tools we had were ultrasound and electrography. My mentor at RIT, Dr. Dan Phillips was doing pressure wave velocity (PWV) at Dr. Karl Schwartz’s lab. I also worked with Dr. Kevin Parker in biomedical engineering, who basically invented ultrasound electrography, which is a methodology to determine how stiff tissue is,” Mix says.
There was a need to find an objective measure. “Vascular surgeons have always put their hand on a patient’s belly to feel pulsing,” Mix explains, “So the question was, can a machine make a prediction of the chance of rupture based on the feel?” Ultimately, material properties of the tissue dictate the likelihood of the tissue to rupture or degenerate. Aneurisms that are stiff remain stable.
Xzabia A. Caliste '16M (Res)
Albany Medical Center, Albany, New York
Xzabia Caliste, MD, RPVI, FACS always knew she wanted to become a doctor. Later it was the variety of cases and hands-on opportunities that attracted her to vascular surgery, and ultimately her residency at the University of Rochester Medical Center. “I was six years old when I decided I wanted to be a doctor, but I never had any idea I would be a surgeon,” she recalls. “I thought I would be a pediatrician, and then when I was preparing to go to medical school and doing my premed classes, I started thinking I might pursue OBGYN. I did think of other careers. I considered business school and law school, but none of those paths had any real appeal.”
While attending Georgetown University School of Medicine, Caliste got more perspective on the options for specialization, “I was thinking medicine vs surgery, and surgery won out because I wanted to physically do things that would have an immediate tangible effect. In other areas of medicine it can take a longer time to see results. What attracted me to vascular was that I loved the diversity of cases. Now, in a week I might spend a day doing procedures in the endovascular suite, then do a two vein spliced bypass the next day, followed by a day doing a carotid and HD access cases. It’s stimulating to experience so much variety in your work.”
Caliste found that the breadth and scope of procedures and surgeries at URMC was useful in shaping her career, as was her experience learning from her mentors. “The diversity of operations and supportive environment that Dr. Michael Stoner created was impactful,” she says. “Seeing how Dr. Stoner shaped the program and his leadership style, all that influenced my decision to stay in academia. I knew I wanted to mirror that relationship between attending and trainees. That was the kind of leader I wanted to be.” As she considered her own potential future as a professor, Caliste studied the different approaches of her attending physicians. “I learned from the leadership style of my mentors,” she says. For example, Dr. Roan Glocker. His methodology of teaching was relaxed and friendly. As a trainee you make mistakes, you’re learning, so to have someone take the time to explain and to guide you is so meaningful. Every person has a different way of learning, and that applies to teaching too. It was valuable to see the approaches of Dr. Stoner and Dr. Glocker, and I valued both of their perspectives.
As a woman of color, studying surgery, Caliste made a path for herself in a field where she did not have access to many mentors who looked like her. She is honest about that experience. “Let’s be real, it’s challenging. This is a white male dominated industry. I am seeing more women and more people of color, but they are still few and far between. We need diversity in gender and culture. This is an area for major improvement in all areas of medicine, particularly the vascular surgery sub-specialty.”
Now, Caliste looks for opportunities to reach women and people of color who are just starting out in their careers. “Representation matters,” she says. “Prospective students and trainees might see me and connect with me. I endeavor to foster those relationships.”
In her current position as an Assistant Professor of Surgery at Albany Medical Center, Caliste has become the mentor she always wanted to be, having learned from her valued relationships with her advisors at Rochester, but also being an important representative for women of color in vascular surgery. “Our walk is going to be different from other people’s walk,” she says, “I try to show that I am open to having trainees talk to me about anything they want to talk about.”
Looking back at her time at URMC, Caliste says she would very much encourage students to consider Rochester for their residency, “It was a great place to train, an excellent group of faculty who will train you well. There is also a great diversity of cases, overall a lot of opportunity to learn.”
She hopes the future will bring even more opportunities for alumni like herself to build connections with trainees and gladly makes herself available to speak with current residents and share her experience.
Georgina Pappas, '22M (Res)
WellSpan Health, York, Pennsylvania
As an undergraduate at George Washington University, Georgina Pappas, MD, dreamed of going to medical school, but she wasn’t encouraged to do so. A Hemingway class she took changed everything. After learning about her aspirations, the professor put Pappas in touch with someone at the Walter Reed Army Institute of Research/Naval Medical Research Center. A summer internship there turned into a full-time job as a research and surgical assistant in the NeuroTrauma Department. She spent two years researching the pre-hospital management of traumatic brain injury and hemorrhagic shock based on the models emerging from the wars in Iraq and Afghanistan. “It was then that I decided to go to medical school and pursue surgery,” said Pappas. “We were accessing blood vessels and looking at hemodynamic changes and hemostasis using different products that they used on the battlefield. I loved working with my hands and seeing the direct result.”
After medical school at Quinnipiac University, she thought she would complete a sub-internship to see if vascular surgery was her career path. Her mentor at Quinnipiac put her in touch with Michael C. Stoner, MD, the chief of the Division of Vascular Surgery at the University of Rochester School of Medicine and Dentistry. “I knew within my first two weeks that I wanted to do a five-year residency in vascular surgery at Rochester,” said Pappas. “I loved the combination of perfecting operating skills and becoming patients’ physician for life, helping them maintain good vascular health. I also immediately saw the commitment of Dr. Stoner, Jennifer Ellis, MD, and Doran Mix ʼ13M (MD), ʼ19M (Res) to their patients, their exceptional technical skills in the operating room, and their passion for what they do. They demonstrated the qualities I now want to emulate in my practice.” Pappas noted, for example, that Ellis is “technically brilliant. She can simplify complex processes that are taking place simultaneously and do the right thing for the patient in the OR and in the clinic. It has been an honor to work with her and have her as a mentor.”
When asked about the legacy of Rochester’s program, Pappas said, “Because of Rochester’s reputation for excellence, it’s expected when you arrive here that you know how to operate. But you gain a level of technical and clinical skills here that set you apart from other residency programs. And you learn how to be a surgeon leader. I also had the opportunity to focus on, and publish, clinical outcomes research helping to build the physician-modified endograph aortic program. I couldn’t have done that anywhere else. I am now very confident in the OR and with how I take care of my patients. That’s a direct result of having been in this program.”
So CVEL uses novel imagine modalities, MRI and ultrasound to determine which aneurisms are at risk. This goes against the original theory of aneurism which thought that pressure on something stiff was greater cause for rupture.
To those who are thinking about doing their residencies at URMC in vascular surgery, Mix says, “My advice to future residents is no matter what you do, do it emphatically and passionately. If research is your thing, pour your all into it. If clinical care is, then similarly, put all of yourself into it. Our program trains future leaders. Support for resident education specifically provides for those future surgeon scientists.”