Best Doctors for Women 2011
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Some deliver newborns. Others reattach severed limbs. And still others outline grim prognoses as tenderly as possible. But the 418 Twin Cities physicians named in Minnesota Monthly’s Best Doctors for Women poll were chosen by their peers not just for professional expertise. We also asked respondents to nominate professionals who were “attuned to the specific needs of female patients.” We wanted to know who put the care in healthcare. Here are the results.
Dr. Virginia Lupo, Maternal-Fetal Medicine
What It Feels Like to Deliver a Baby
It doesn’t get old or trite. I finished residency 28 years ago, and today even the simplest, most complication-free delivery is a total rush. For a lot of my med students, their first delivery is their most moving, meaningful experience.
Obstare. That’s the Latin behind the word “obstetrics.” It means “to stand before.” And it’s apt: sometimes the baby just shoots out and we literally catch it. A lot of deliveries can and do happen on their own.
Sometimes, though, we need to help it out. A 10-pounder is not going to slide out on its own. I always tell med students, babies are much heavier and much more slippery than you think. Most of us are not used to holding 10 slippery pounds in front of an audience.
One of the scariest things is when the head comes out and the rest of the body gets stuck. So what you do is, you turn the head sideways, and you pull it down toward the floor—always with your hand over the ears. That’ll get the anterior shoulder out. Then you pull back up to the ceiling, to get the other shoulder out. And with your other hand, you guide out the torso and legs. Ideally, you end up with the baby’s head in the palm of one of your hands, the body along the forearm, and the little feet touching your inner elbow. So he’s like a football. And then you have the other hand free to clamp the umbilical cord, wipe the face, and wave to the video recorder.
If someone’s available, we let him or her cut the cord. They won’t know where to cut, so you have to show them. An umbilical cord, it’s pretty tough—about three quarters of an inch around, with three blood vessels in there. And you gotta be sure the baby doesn’t fling his hand up to help, because you can slice fingers off in a heartbeat.
We’re the first person to cradle every baby. Even if we put him right up on Mom’s tummy, we still have the privilege of being the first to hold him.
I’m a good Catholic girl. And since I started seeing and understanding labor, I’ve always listened to the Christmas story in the Bible differently. It’s very humbling to be in the presence of these lives starting. You deliver these little people, and you think, “Where were you before this?” It’s quite moving.
Dr. Scott Anseth, Orthopedics
How to Replace a Patient’s Hip
It doesn’t require a ton of horsepower to dislocate a hip. If you’ve ever done it to yourself, accidentally, you know. That’s nice for us surgeons, because we have to get that old hip out before we can put in the replacement. When you do it, though, it does make this gruesome sound. I flex the hip just a bit—at this point I’ve already cut in deep and split the joint—and the top of the femur pops right up through the incision. To me, it always looks like a baseball, round and white. We isolate it, then I take a saw and buzz through the tip of the thighbone. That’s really what we’re replacing, that top ball part.
The thighbone is a tube. And the metal stem that we put in isn’t that thin. It’s thicker than a pen. With a little bit of pressure, I work it inside, pushing it down through the spongy material inside the bone. Then you use a mallet to tap it home. You have to listen. There’s a certain pitch you want. When it fits, it makes a certain “tink, tink—thunk.”
The procedure is very mechanical. It allows us to imagine the body as a machine that can be easily fixed, which is comforting. Of course, that isn’t true, but with other surgeries—removing an appendix, transplanting an organ—the patient may not get obviously, visibly better. With this, they go back almost immediately to normal. You replace the hip, and two or three days later, they have substantially less pain. After six months, they have their lives back. They can play with their kids again. They can walk around the lake with their spouse. As a surgeon, there’s a lot of immediate gratification. Who you are is defined a lot by what you do physically, and nothing makes you feel more alive than movement. People weren’t meant to sit around.
It’s probably the best, most perfect surgery in medicine. I love doing it. Patients’ lives get much better instantly. It’s mind-blowing.
Dr. Dana Carlson, General Surgery/Breast Cancer Specialist
What It Feels Like to Tell a Woman She Has Breast Cancer
We had a young woman who had just delivered a baby the day before. She was up in the post-partum ward and was having trouble nursing. That’s when she noticed a large mass in her breast.
So I go see her, and she’s holding this beautiful little girl. She’s in that blissful post-partum state—totally unprepared for what I’m about to drop on her.
I knew immediately it was cancer. It felt like she had golf balls in her armpit. With lumps that big, you wonder why the patient never noticed them. But she’s 30. Totally healthy. No risk factors. The last thing on her mind is, “Huh, maybe I have cancer.” She thought her breasts were swelling because her milk was coming in. But your milk doesn’t come in until after you deliver.
I just say, “We’d like to look at something with a mammogram ultrasound.” I’m 90 percent sure she’s got cancer, but I’m potentially about to take a woman from the best day of her life to the worst day of her life. I don’t want to be wrong.
It’s not just me. Everyone is hesitant to jump to the cancer diagnosis. The radiologist wants to do a biopsy. I say, “I’m pretty sure it’s cancer.” And she says, “Well, I am, too, but I really don’t want to tell her that.” So we’re all kind of stalling. With post-partum women, it’s an emotional roller coaster. Your hormones are crazy. And we’re about to add cancer to the mix? We get the biopsy: it’s cancer.
Her whole family is there in the exam room—her parents, her husband. I’m the one who tells her. I walk up to the patient, grab her hand, and just say, “You have breast cancer.” She falls into a chair and starts sobbing. She asked me the question “Why?” probably 20 times. I’m tearing up.
But I always tell them, “You’re going to be okay. We’re going to work through this together.” Now, the vast majority of the time, this is true. Breast cancer is not a death sentence. The survival rate is high. But it can always come back. So a little bit of that “You’re going to be okay” is positive thinking, and some of it is really truth. That’s the big benefit of working with breast cancer: it’s treatable.
I called her the other day to check in. She had just had chemo and was out for a long walk. It was a hot, disgusting day. I said, “Oh my god, in this weather? I wouldn’t go for a walk in this!” And she said, “You know, other than losing my hair from the chemo, I haven’t had any real physical side effects.” She’s got good energy, her baby’s sleeping through the night, she’s got a wonderful attitude—her odds are quite good. And if it does come back, we’re still here to support her.