Monday’s meetings with the congenital heart surgery team at Medical City Children’s Hospital are not like a typical office. Of course, some of them may sound familiar: over a dozen doctors, surgeons, clinic directors, and other staff meet around 7:30 a.m. to discuss the week ahead. Part of the team calls virtually; others sit around a conference table. But that’s where the similarities end.
When I was there in July, several people jumped out to leave the room halfway through the meeting. They weren’t filling their coffee or using the restroom. One of their patients required immediate resuscitation. (The team succeeded and the patient survived). When the doctors returned, they sat back in their seats as if they were just walking away for a snack. Typical, this is not the case.
During the reunion, what looks like an indecipherable mass of bloody flesh is shown on screen, but it says a lot about the team. They report deformities and the results of past procedures and create a plan for each of the children upstairs in the team’s intensive care unit. As I walk past the patient rooms, I am struck by the small size of the children in the full size hospital beds. Machines loom on either side, pumping out fluids and antibiotics, beeping as parents huddle nearby. Lying on their backs, many have spots on their eyes, their breasts rise and fall almost imperceptibly.
Meanwhile, downstairs in the meeting, Dr Kristine Guleserian is leading the discussion from the head of the table. She is the first and only woman to lead a congenital cardiology team in the country, and her in-depth knowledge of patients, their families and the condition of their hearts is brought to the fore as the group discusses each case.
She and the team work effectively with contributions from all directions. Guleserian is the head of the program, but it’s not a one-woman show. Pediatric cardiologists, general surgeons and clinic directors step in to add their perspective, weighing in on imaging, family, mental health and medical history. It is no coincidence that the group works so well; Guleserian built the team with moments like this in mind.
Bring the group together
After more than a decade at UT Southwestern and a stint in Miami, Guleserian was hungry to lead and was more than capable. Although she is not much more than five feet tall, she holds an important place in the world of congenital heart surgery, serving on the leadership of many organizations and is a coveted speaker at conferences. While at UT Southwestern, she made headlines when she performed a heart transplant on what was at the time the world’s smallest patient, a five-pound newborn baby.
When she arrived in Medical City in September 2019, the hospital invested in building its ideal team, a collection of cardiologists who balanced all the qualities she sought in her colleagues – and they all happened to be women.
âIt’s like fantasy football. You choose whoever you would dream of working with and you change the whole atmosphere, âsays Guleserian. “You get rid of the toxic work environment so many of us have been subjected to, and you build a team with all the best people, the most talented and those with the best attitude and personality at the bedside. . “
Finding a doctor who is technically gifted, good with patients, and devoid of a disruptive ego is no easy task. But Guleserian is convinced she has found a team that checks all of its boxes. Over the years, she has made a mental note of who she would want to work with if given the resources to build her own team and bring in her favorite talent.
Over the past year, Guleserian has recruited four doctors to join her at Medical City Children’s. All were from UT Southwestern, although they are all at different stages of their careers. Usually, it would take years for resources to open up for such a massive talent acquisition, but Medical City has succeeded.
Guleserian’s fantastic line-up includes Dr. Vivian Dimas, Medical Director of Adult Congenital Heart Disease at Medical City Children’s Hospital, specializing in minimally invasive treatments for complex heart disease. She is joined by Dr. Carrie Herbert, a pediatric interventional cardiologist who also focuses on minimally invasive procedures.
Dr Poonam Thankavel is a pediatric cardiologist and medical director of pediatric cardiac imaging, specializing in imaging and diagnostics. Dr. Ilana Zeltser is a pediatric cardiologist and medical director of pediatric electrophysiology, specializing in diagnostics.
It’s rare to have so many female leaders in a cardiology program, but Guleserian didn’t leave with that intention.
âI chose them for their talent,â she says. “They just happen to have two X chromosomes.”
Guleserian also brought in his surgical partner, Dr Javier Brenes, from Costa Rica, and the team’s intensive care unit director, Dr Mark Clay.
âEver since I was a medical student, I always dreamed of building a team of all the people I loved working with. That’s the vision here: to bring the best of the best that you love to work with, âsays Guleserian. âThey are more than just clinical experts. They have a great bedside attitude, outside personalities and interests that make them multidimensional.
Many of us have experienced this special team or group of colleagues where it all clicked. Together you did a great job, get along well and care about each other. Time, money, families, partners and other opportunities end up getting in the way. But you keep in touch in case there is a way to work together again. That’s what Guleserian made happen.
âIt’s hard to believe how well we’ve done, but it’s about bringing the group together with a group of people who respect each other, love each other and work well together,â Dimas said.
Those who were on the pediatric cardiology team before Guleserian’s arrival say they noticed a marked difference in the ambition of the program and the innovation it encompasses.
âDr. G thinks outside the box and is a perfectionist, which is absolutely vital to what we do,â says Dr. Jane Kao, a pediatric cardiologist who has worked at Medical City since 1995. âShe never says that can. t be done. She asks, “Why not?”
Bringing in so many new leaders in a short period of time is not easy in any business setting, but in just six months the team is already operating at a high level. It is essential to focus on the patient.
âEveryone who is on this team comes together for the good of the patient,â Kao says. âWe always put the patient first. Guleserian believes she has her cardiology cake and is eating it too. âPeople sometimes ask, ‘If you had to have a technically excellent surgeon or a surgeon with good bedside manners, which one would you choose? And I always said, “Why can’t I have both? “
Operate in a man’s world
Several of the doctors I spoke with shared a similar story. It looks like this: As women at the top of their field, who present and speak often at conferences, they tend to see the same audience while looking over the podium. Before them, there could be 100 doctors from all over the world, but only eight of them would be women.
Interventional cardiology remains a stronghold for male physicians. Even though gender parity has improved over the past generation, women still experience a persistent disparity. At the last in-person lecture Dimas attended, before the pandemic, she approached the faculty check-in table. A woman seated behind the table said to him:
âSupplier registration is done there. Dimas said, “I told him, ‘I’m registering for the faculty.’ This [kind of] there’s always stuff out there.
âI chose them for their talent. They happen to have two X chromosomes.
Dr Kristine Guleserian
Double standards don’t stop at international conferences. Women surgeons and cardiologists are always subject to assumptions that affect women in multiple professions.
âThere is this feeling that as women they will never be as dedicated as men because they are dedicated to their family and cannot give their all to their job,â says Dimas.
But around the conference table at the Medical City Children’s Hospital, on the lower floors with the incredibly small infants preparing for or recovering from heart surgery, Guleserian is working to change the paradigm.
âWe’ve all been the victims of some form of workplace harassment,â she says. “What we are trying to do is lead by example and have a zero tolerance policy.”
In addition to building her dream team, breaking down barriers to medical leadership, and performing some of the most complex and delicate surgeries on the planet, Guleserian seeks mentorship opportunities with young women at all stages of their medical education. . She embraces her role and looks at the opportunity. A few years ago, before moving to Miami, she invited medical students to dinner. As they finished their meal, the students pleaded with her to continue to empower women, build teams and fearlessly share her story. âI said, ‘You know what? From there, I’ll take a stand. Because if we can make things better for the next generation, then that’s what we need to do. “
Dr Kristine Guleserian became the first woman to lead a congenital heart surgery program in the United States when she was appointed medical director of the Medical City Children’s Hospital Heart Center last year. She has since built a âdream teamâ in cardiac surgery whose members include:
Dr. Kristine Guleserian
Medical Director of the Heart Center of the Medical City Children’s Hospital
Dr Vivian Dimas
Adult Congenital Heart Disease Medical Director
Dr Carrie Herbert
Pediatric interventional cardiologist
Dr Jane Kao
Dr Poonam Mercievel
Medical Director of Pediatric Cardiac Imaging
Dr Ilana Zeltser
Medical Director of Pediatric Electrophysiology
Contact Will Maddox at [emailÂ protected]