Editor’s note: This is one of several feature stories in the Bulletin on families that include parent-child surgeons. If you are interested in sharing stories about your dual-surgeon family or know of colleagues who have two or more surgeons in the family, contact Diane Schneidman, Editor-in-Chief, at firstname.lastname@example.org.
Some surgeons have known the rigors and joys of the operating room (OR) since childhood. They grew up with a parent who was a surgeon, allowing them to see the profession up close. And although having a surgeon for a parent or for a child may not be essential to success in the OR, the respective fathers and sons featured in this article share an admiration for each other that complements their exceptional surgical abilities.
Constantine Mavroudis, MD, FACS, Peyton Manning Children’s Hospital at Ascension St. Vincent, Indianapolis, IN, and his son Constantine D. Mavroudis, MD, MSc, MTR, Children’s Hospital of Philadelphia, PA, are both pediatric congenital heart surgeons. From an early age, the younger Dr. Mavroudis had an intimate understanding of his father’s impact on patients’ lives.
“People would come up to us at dinner in a restaurant and say to my father, ‘Oh, you know, you operated on my daughter 12 years ago, and now she’s going to college,’ or ‘You know, you did this transplant, and now my child’s alive. It’s amazing,’” the younger Dr. Mavroudis recalled. “When you’re five or when you’re 10 years old, you’re out to dinner, and someone’s like, ‘Your dad’s amazing. Your dad saved this person’s life,’ that definitely has an effect.”
The younger Dr. Mavroudis also is proud of his father’s consistent enthusiasm for being a surgeon. “I sort of have the idea now how hard this job is, and how you have good days and bad days, and how some days you just want to crawl into a hole, and some days you’re on top of the world. But my dad was always happy—even in his 50s, 60s, and now he’s in his 70s, the guy still loves his job,” he said.
Although the elder Dr. Mavroudis has enjoyed his surgical career, he usually avoided talking about it with his children when they were growing up. “I think that the time that one has with one’s family is precious, singular, and it is almost an honor to have that,” he said. “I just wanted the kids to tell me about their lives, what they were doing, and how many goals my son scored when he was playing hockey or how he did in baseball.”
But now that his son is a surgeon, the elder Dr. Mavroudis welcomes the opportunity to discuss what happens in the OR with him. In fact, he recently consulted with the younger Dr. Mavroudis on how to operate on a young patient with an infected tube connecting his right ventricle and his pulmonary artery. “I called him before I did the case and asked him his opinion,” he said. “You know, when you get to this kind of education [nine years of postgraduate training], you can have important opinions. And I tend to listen, as does he.”
“For my dad to call me about a case like that was great. And we had a nice conversation about it. And it was something that even a couple of years ago, I wouldn’t have had much of an opinion on the matter,” said the younger Dr. Mavroudis. “After, I was amazed that I even had an opinion on an esoteric case. It’s a world that I’m still kind of new to, but, nonetheless, we had a great conversation.”
Given the esteem in which the elder Dr. Mavroudis holds his son, it makes sense that he sought his counsel. “It didn’t take much of an example set by me that someone with natural abilities can develop the way my son did,” he said. “I think that sometimes in life, some people have it. They’re born with it. They’ve developed it in some Aristotelian way. And God bless him, he did that.”
The elder Dr. Mavroudis also shared his opinion on what makes for a strong bond between a father and son who work together. “I think mutual respect is an important part of this,” he said. “I recognize that my son went through nine years of residency after four years of medical school and after college. If that doesn’t give you a modicum of respect, then nothing will.”
William C. Chapman, MD, FACS, is chief, section of transplant surgery, and chief, division of general surgery, Barnes-Jewish Hospital, Washington University, St. Louis, MO. His son William C. Chapman, Jr., MD, MPHS, is a fifth-year resident at the same institution. Working in the same hospital allows them to operate together on occasion and learn from each other’s surgical experience and expertise.
The elder Dr. Chapman generally didn’t discuss surgery with his children when they were growing up, but they knew that their father’s job was demanding. “Fifty percent of transplants occur in off hours, at least liver transplants,” he said. “So, frequently, the off times are interrupted.”
“Obviously, Dad would get called away for cases, and we would notice when he wasn’t there,” the younger Dr. Chapman said. “That was kind of a negative or downside of having a father who was in surgery and clinical medicine.”
Despite these absences, the younger Dr. Chapman’s formative exposure to his father’s work helped steer him toward medicine. “And maybe I’m just projecting, but I think a lot of kids grow up thinking they’re going to do what their parents did because that’s what they know, and that’s what they see,” he said. “I had grown up seeing Dad come home in his lab coat and would go to the office from time to time around the hospital. So, when I went off to college, I didn’t really anticipate doing anything other than medicine.”
But after graduating from college, the younger Dr. Chapman didn’t immediately apply to medical school. Instead, he decided to work on Capitol Hill in Washington, DC, because he had developed an interest in politics as a student at the University of North Carolina-Chapel Hill. Several years later, though, the congressman for whom he worked lost his reelection campaign, and the younger Dr. Chapman knew that politics wouldn’t provide him with the stability he wanted.
“I wanted to develop a skill set that was marketable and needed and still would allow a lot of personal interaction,” he said. And so, he applied to medical school.
The elder Dr. Chapman was pleased when his son eventually decided to go into surgery, even though he was careful not to encourage him to go in that direction. “To me, surgery’s the right place in medicine,” he said. “I think my son pretty much picked that out on his own. And after he did, I thought that was the right choice. I was glad he did it, but I didn’t want to be the one pushing him into it in case later he might regret it.”
But the younger Dr. Chapman has not regretted going into surgery or doing his residency at the same hospital where his father is chief of the division of general surgery. “It’s been a pretty unique experience, and I think that obviously you learn a lot from your parents in general, but it’s been very unique to also learn some technical skills and patient management from a parent as well,” the younger Dr. Chapman said. “I’m very inexperienced, and a lot of my knowledge has come from reading about something rather than seeing somebody else do it and rather than doing it myself. And so, certainly I’m very lucky to have a resource to sit down with and chat things over.”
Sometimes, they discuss their respective cases over lunch in the hospital cafeteria, and the elder Dr. Chapman sees the advantages of having his son as a resident at his hospital. “He will say, ‘This is what we did in this case,’ and I might say, ‘I don’t know if I would’ve done that. I might’ve thought about x, y, and z,’” the elder Dr. Chapman said. “I think that’s been a good learning experience for both of us.”
When Lyle Joyce, MD, PhD, FACS, helped implant the first permanent total artificial heart in Barney Clark in 1982, David Joyce (who was seven years old at the time) and his siblings felt the impact of that historic operation. “I remember going to school and seeing the press coverage of that event. To us, it was probably like what the moon landing was for a lot of people,” David Joyce, MD, MBA, FACS, said. “Whether we realized it or not, I think for all four of the kids in my family that event really kind of set us on sort of a quest to do something important and meaningful in our lives.”
With some assistance from his father, Dr. David’s quest eventually led him into the OR. “My dad somehow always managed to get me into the OR, even to scrub with him early, early, early in my medical education. I come from a family of what I would call extreme rule followers,” Dr. David said. “But when it came to trying to figure out what I could do in the OR, he looked at that rulebook and figured out every loophole we could come up with to get me in there at a very young age.”
For Dr. Lyle, scrubbing in with his children was his opportunity to pass on the fulfillment that was instilled in him when he was a child on his family’s farm. “I was out doing chores on the farm just as soon as I was big enough to pick up a one-gallon paint can full of chicken feed. And then as time went on, I could do more and more. Eventually, my father made me feel like a full partner in everything,” he said. “That gave me a sense of ownership, a part of the operation, whatever the job was. He had a way of including me to the point that he became my colleague and best friend. I don’t know that I necessarily intentionally tried to copy what he did. I think it was just something that came naturally.”
In addition to welcoming his son into the OR, Dr. Lyle also kept Dr. David on his toes in medical school. “I remember one time, I scrubbed with my dad on a thoracic case,” Dr. David recalls. “He pointed at some structure and asked me what it was. And I was so focused on what I had been studying in the abdomen that I mistakenly identified it as something that wasn’t even in the chest. And I remember immediately after I said that being absolutely mortified, thinking, ‘My poor father’s thinking after spending all this money on tuition for Harvard Medical School, what has the world come to here?’”
Despite this slip-up, Dr. David made it through 10 years of surgical training and one day found himself in the OR not just with his father but also with two of his siblings. Dr. Lyle recalls, “I have a fond memory of one day at the Mayo Clinic [Rochester, MN] when my youngest son, Daniel Joyce, MD, who’s now a urologist, was in medical school and was on my service. David, who was a faculty member as well, scrubbed in to help out, so there all three of us were operating together. My oldest daughter is a pediatric intensivist at the Mayo Clinic, and she came in to talk to us over the ether screen. So, I had the chance to sort of relive my early years on the farm—the family working together in a common profession.”
David P. Winchester, MD, FACS, is former Medical Director, American College of Surgeons Cancer Programs, and retired clinical professor of surgery at the University of Chicago, Pritzker School of Medicine, and past-chairman, department of surgery, Evanston NorthShore University HealthSystem. His son David J. Winchester, MD, FACS, is a general surgeon in Evanston, IL, and is affiliated with NorthShore University HealthSystem-Metro Chicago. The elder and younger Drs. Winchester share a passion and proclivity for surgery that has brought them into the OR despite some of the profession’s more challenging aspects.
The elder Dr. Winchester had an inkling that his son would make a successful surgeon before he expressed any interest in it. “I do believe that there are certain traits in my son’s growing-up life that gave me a hint that he would do well in surgery. He was athletic. He had good hands. He was very thoughtful and smart. And I thought he had the stuff to make a very good surgeon. I didn’t tell him that at the time, but he had all those things.”
The younger Dr. Winchester, however, had reservations about becoming a surgeon like his father. “I thought about medicine, and it became kind of like, I should probably do this,” he said. “You know, it was hard to be always waiting for my father to come home to see him, to have dinner, to be waiting for the family dinner at 8:00 pm because he was working late. So, it was hard for me to commit to that, honestly. And then in medical school, it became the best option. I liked it the most. I was always fighting to explore my options because I recognized it was such a huge commitment to do what he had done.”
Once the younger Dr. Winchester became a resident at Northwestern Feinberg School of Medicine, Chicago, IL, where his father was a senior faculty member, he was ready to prove his surgical acumen even outside of the OR. “We have a fairly large family and our family dinners differed after that because David and I actually unknowingly became isolated at the dinner table at one end and talked business,” the elder Dr. Winchester recalled. “I drilled him with questions about general surgery and what he should do, and he answered them. And we sort of were isolated from the rest of the family, but not in a negative way. It just was the way it happened.”
But they didn’t remain isolated. On one occasion, the younger Dr. Winchester and his father operated together on a patient along with a scrub nurse named Diane Winchester, RN. “So, my son rotated through my service. And he was the first assistant resident, and I was a surgeon. And interestingly, the scrub nurse was my daughter, Diane,” the elder Dr. Winchester recalled. “So, we had an all-Winchester team taking care of this patient. And it was quite a memorable event. He did a very good job. And, of course, Diane did as well.”
Although the elder Dr. Winchester is now retired, he and his son still bond over their work and the patients for whom they have provided care. “My father will ask me what I’m doing every day and what I did the week before. And we talk about it. I asked him yesterday if he remembered a patient whom I saw on Friday,” the younger Dr. Winchester said. “And he had a very clear recollection of what he did for her. So, he loves it. He loved that part of his practice in his life and that connection with patients.”
Jeremy E. Leidenfrost, MD, FACS, is a thoracic surgeon in Chesterfield, MO, and is affiliated with St. Luke’s Hospital-Chesterfield, where his father, Ronald D. Leidenfrost, MD, FACS, is a cardiac surgeon and chairman of the Heart and Vascular Institute. Although they may not always see eye-to-eye on certain cases, their mutual respect and willingness to collaborate are qualities that lend themselves to safeguarding the Leidenfrost legacy.
Even from an early age, Dr. Jeremy Leidenfrost was comfortable around surgeons. “I remember the first time he ever made rounds with me here at St. Luke’s Hospital. He was six years old,” Dr. Ronald Leidenfrost recalled. “And we ran across this older internist. And we met him in the hall, and Jeremy was a little on the hyperactive side. I had just started getting cases from this gentleman, and Jeremy, being six, was very friendly and everything. And he started climbing all over him and stepping on his shoes. And I was thinking to myself, ‘Well, I’m never going to get a case from this guy again.’”
Despite that memorable visit, Dr. Ronald Leidenfrost didn’t try to deter his son from returning to St. Luke’s. “My wife and I never really said to any of our kids, ‘You know, this is what you should do,’” Dr. Ronald Leidenfrost said. “We pretty much left it open to let them find and follow that dream and do what they thought would be best for them.” And joining his father in the OR has helped Dr. Jeremy Leidenfrost realize his ambition of being a cardiothoracic surgeon.
“I know a lot of heart surgeons who finished training and got their first job and didn’t last a year, and for whatever reason, you can take a bad job out of training, and if you’re not well-protected from things, and you have some bad outcomes, that could be the end of your career,” Dr. Jeremy Leidenfrost said, reflecting on his decision to work with his father as a cardiothoracic surgeon at St. Luke’s Hospital. “So, it was nice to have somebody who had my best interests at heart. But obviously, it’s not easy working with your parents probably in any field because you work with them all day, and then you also see them on the weekends. So, I think it’s been good overall, but it’s not easy.”
“The biggest challenge is dealing with change because Jeremy trained 30 years after I did. His methods are more sophisticated. I guess it also has to do with the difference in our ages,” Dr. Ronald Leidenfrost said, reflecting on the challenges of working with his son. “His thinking is more, perhaps, forward-thinking. Mine is more experience thinking. I think that there’s a certain amount of daily tension with sometimes common things.”
Drs. Ronald and Jeremy Leidenfrost work past their different approaches to surgical care, though, and uphold the respect and trust associated with their name. “St. Luke’s is going to have the opportunity to have 60, maybe 70 years of Leidenfrost heart surgery here, which has been very, very good. It’s got a brand. Just the name has a brand in the St. Louis area. And it’s not just St. Luke’s. Our name is a brand,” Dr. Ronald Leidenfrost said. “Even though I’m not ready to hang up the guns yet, and I still enjoy doing a couple of cases a week, I don’t try, or never have tried, to hold onto anything that didn’t want to be with me. But it’s a good feeling to know that my son has the same sense of value for a lot of the things that I value.”
The respective fathers and sons featured in this article value each other’s accomplishments and support both inside and outside of the OR. While working with a family member poses unique challenges, they share a commitment to surgery that keeps them grateful for and supportive of each other.