March 12, 2024
Becoming A Heart Transplant Surgeon with Dr. Brian Lima (Part 1)
Every heart has a story, and for Dr. Brian Lima, his heart was set on a mission from the moment he witnessed his father's heart attack. The esteemed heart transplant surgeon from Vanderbilt University Medical Center joins us to recount an odyssey that twists from academia's hallowed halls to the operating room's high-stress environment. Dr. Lima's story isn't just a tale of personal triumph and medical marvels; it's a reflection of the grit and grace required in the relentless pursuit of excellence in cardiac surgery. Join us as we explore Dr. Lima's journey, revealing the sacrifices and dedication that shape the 'Top Gun' surgeons who hold life in their hands.
Transitioning from the ivy-covered walls of Cornell to the esteemed corridors of Duke Medical School, this conversation with Dr. Lima sheds light on the relentless drive needed to thrive in the upper echelons of medical academia. As he shares the evolution of his study habits and the strategic moves that steered him toward his dreams, we're reminded that the journey to becoming a heart surgeon is laden with obstacles that extend beyond the books. It's a tightrope walk between personal growth and professional obligation, and Dr. Lima's experiences offer a roadmap for anyone navigating their own competitive career landscape.
Our final chapters with Dr. Lima illuminate the realities of surgical residency, the balance between ambition and well-being, and the resilience to confront burnout and career pivot points. We uncover the value of supportive work environments, mentorship, and the importance of not letting remuneration dictate one's professional journey. Dr. Lima's tale, interwoven with his Cuban immigrant heritage, teaches us that the path to success is fraught with challenges but rich with opportunity. By the end of our time together, you'll see that Dr. Lima's saga is more than a surgeon's chronicle—it's a beacon for anyone striving towards the seemingly unreachable, propelled by purpose and a heart dedicated to healing.
To discover more episodes or connect with us:
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Chapters
00:02 - Heart Surgeon's Inspirational Journey
12:34 - Transition From College to Medical School
18:28 - Duke Med School Admission Criteria
23:16 - The Journey to Heart Surgery
31:41 - Heart Surgeon Reflects on Career Evolution
39:57 - Navigating Career Transitions and Burnout
45:02 - Dr. Brian Lima's Remarkable Journey
Transcript
WEBVTT
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Hello and welcome to no Wrong Choices, the podcast that explores the career journeys of accomplished and fascinating people to shine a light on the many different ways we can achieve success.
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I'm Larry Samuels, soon to be joined by Tushar Saxena and Larry Shad.
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Please support our show by following no Wrong Choices on your favorite podcasting platform, connecting with us on LinkedIn, instagram, youtube, facebook X and Threads, or by visiting our website at nowrongchoices.
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knowwrongchoicescom.
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This episode is the premiere of season four of no Wrong Choices and features the cardiac surgeon, and, more specifically, heart transplant surgeon, dr Brian Lima, who practices medicine at the Vanderbilt University Medical Center.
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He's also the author of the book Heart to Beat.
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Larry Shea, why don't you lead us into this one?
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Yeah, this is the only professional capacity I would like to meet Dr Brian Lima, because if you're meeting him in his professional capacity, you've got issues, you've got problems.
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So I'm excited to share with everybody why he chose this journey.
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I mean, you know, when you think about the amount of work that goes into something like this, I mean it's overwhelming.
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I mean it's certainly not something that I would choose.
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I chose, you know, a relaxing profession radio.
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I mean what is that?
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But yeah, this guy is, you know, very impressive, and you're about to feel how impressive he is because this is a serious commitment and an amount of work that most normal people couldn't handle.
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He's Superman, let's face it, he's Superman.
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Yeah, that's a great thing you just said, because you use the word commitment and I think the more proper word is probably sacrifice, because that's what a lot of this is about.
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It's the notion of sacrificing your professional time and your personal time because you know you have to put a lot of hours into study.
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This is not a joke kind of profession.
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To be a heart transplant surgeon, to be a surgeon of any kind, takes a great deal of training, but then as you move up the ladder you know it's like being in top gun.
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He is in the top gun of his profession.
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He's the top 1% of 1% of that profession and this is not a joke.
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What the amount of schooling this man has gone through, the amount of sacrifice that he's had to do.
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It is not an easy profession to do.
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Not everyone's meant to do it.
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I'll tell you what Brian Lima is meant to do this.
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Absolutely, and for me, you know, one of the most interesting aspects of the first part of our conversation was about his journey as a kid and overcoming some of the challenges that were in front of him from a familial standpoint, and some things were very surprising to me, which will dig into, and you know again, just a remarkable personal journey story that I think everybody's really going to enjoy.
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I should also point out that I've had a chance to spend some time with Dr Lima, brian Lima and he's a really good guy.
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He's a great storyteller and fortunately, the time that I spent with him was personal, not professional.
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So with that, here is Dr Brian Lima.
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Dr Lima, thank you so much for joining us.
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Oh, thank you so much for having me.
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All right.
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So before we move further, dr, can we call you Brian or do you want to go by Dr Lima to be, you know, very official?
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Oh, no, no, no, brian is totally fine, then we will call you Brian, all right.
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So, brian, who is Dr Brian Lima and what does he do?
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I guess that's the easiest question to ask.
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Sure, so I am a heart surgeon and within heart surgery, my area of kind of expertise and focus is the worst of the worst, you know, heart transplant, artificial heart pumps for folks with advanced heart failure.
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But that's a lot of what I am and what I do, I would say.
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And yeah go ahead T.
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No, so I was going to say so.
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You're out there quite literally, holding people's lives in your hands a lot of the time.
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Yes, yes, a lot of time, almost day in, day out.
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It took a long time to be able to do that, to finish all the schooling and training, but I love it.
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I wouldn't train places with anybody.
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So where did this begin?
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Talk about your childhood, because obviously we did our research, you know, knowing that we were going to talk to you today, and I know that family played a big part in why you chose this profession.
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So take us back to the beginning.
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What was the original dream?
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Why did you get into this and tell us a little bit about your upbringing?
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Sure, so, you know, the idea of becoming a doctor came.
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Really it sounded cool.
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You know, my dad had some heart trouble when I was young he was in his, I think, early 50s had a heart attack.
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I think I was like maybe 10 years old.
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That really scared us and it was a daunting thing to be in a hospital and I just remember feeling, you know, helpless.
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And thankfully at that time it was something that was handled, not needing surgery or anything.
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But it was kind of when, where that seed was planted of, hey, you know, it'd be great if I was a doctor, because that I wouldn't feel is helpless, I'd be able to help other people through situations like that.
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And it wasn't really until I got to scrub in on a case when I was shadowing a surgeon when I was in college at NYU I was doing a summer program and it was like one of those things that just click, you know it's.
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I felt really lucky that I had a situation like an epiphany, like that.
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I know a lot of folks don't get that.
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You know, that experience where you see something and it's just like whoa, I want to do that, like whatever it takes.
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And it was at that moment, you know at the age of what 17, 16, that I was like I want to do what that guy does.
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And then it was 16 or 17,.
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You know, you want to be a heart surgeon.
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Yeah, yeah, holy cow, yeah.
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Wow, and you know, and with that in mind, what role did your family play in terms of getting you there?
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You know you had the experience with your father when you were a kid.
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You know your background is unique from some others.
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Talk to us a little bit about your foundation and your upbringing.
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Sure.
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So my parents, my two older siblings, came over from Cuba in the late 60s and they had nothing except the clothes on their back.
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You know, my dad had to work in a pretty awful you know paint factory kind of pigment factory for paints, and inhaling a lot of fumes, working on a lot of overtime, shifts and not so great part of Newark, New Jersey, you know, and that's kind of where I grew up.
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We didn't speak English at home, Very, very, you know blue collar slash, lower class type of situation, apartment, that sort of stuff, and really the only thing that he kept preaching, you know, day in, day out, was hard work, hard work.
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You know that'll overcome talent.
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And as long as you can just, you know, put in the work, it doesn't matter how smart you are, it's all about effort.
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And that really kind of was ingrained in me and kind of gave me that chip on my shoulder that, you know, as long as I put in the work I could do it.
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And that really kind of recapitulated all throughout my schooling because I was, you know I can guarantee you, most of the time I was not the quote smartest person in the room in high school or college or med school I just outworked everybody.
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It's a pure work ethic.
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I mean it was.
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I almost kind of wish I could recapture that like sheer just work ethic where I could just sit down for 18 hours or 12 hours study and all of that.
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It's a different kind of learning.
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Now I guess you could say adult learning, but that's what I kind of owe to that upbringing and example that my dad set for me.
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Your story of the immigrant family growing up is very similar to mine.
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Obviously my name is Tushar Saksin, it's not John Smith.
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So my family same thing.
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My mother and father came from India and they preached hard work and they preached education as well.
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I would say, did your family ever say you should go into the big four professions, being medicine, business, engineering or I forget what the fourth law, because you already decided four of them?
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So I mean, when you said to your family at a young age 16, 17 that I am not only going to be a doctor but I'm going to be a surgeon, heart surgeon what was their reaction to that?
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One of the things that I was really lucky to, because it sounds a bit crazy, but the initial part of that dream, I guess, was hey, I'm going to, instead of staying locally, and go to college, I want to go to Cornell.
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I want to go to Ivy League school.
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And they had no idea what the hell Cornell was, what Ivy League meant.
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In a classic, traditional Latin home, kids don't leave home until they're going to get married and moving into a start, a family of their own.
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This idea of me going to some college away, for hundreds of miles away, was crazy, but my parents backed me all the way, with the caveat being hey, we can't afford it.
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I mean, we probably won't be able to pay anything.
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So if you can, hey, you have our blessing.
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If you can somehow get a scholarship, we have your back.
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I mean, they actually took a lot of heat.
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My dad had a bunch of brothers and sisters and a few of them were here in the States and they all, including my cousins, thought I was the black sheep, believe it or not.
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How could you do this?
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How could you abandon the family?
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Where are you going?
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Oh my God, what a crazy reaction is that?
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My parents totally were with it, but they and I had to deal with that.
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I had to contend with that sort of chirping in the background of other family members for years and years because, as well, I'm sure we'll talk about it took what two decades.
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And they are always like, what is he doing?
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Like, is he even talking?
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What is this?
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like when is the payoff?
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Yeah, yeah.
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And I don't know.
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It's a funny way it all panned out.
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It's not what you would have thought, it's counterintuitive.
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My parents backed me all the way, had my back, just said, hey look, you know you could do it and somehow get funds for it.
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Scholarships, you have our, you know we got you.
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But and they kind of just said, you know, just quiet down to the rest of the family, he knows what he's doing.
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I'm glad you talked about the you know the education stuff there that you weren't.
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You didn't feel like you were the smartest kid in the room, right, that you had to out work everybody.
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I imagine that's the kind of drive that brings somebody to this level of success, because you know, if things are given to you, if things come easy, what you know, you may not have that drive.
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So talk to me about the age of 10 and when you have this scary moment with your dad and then through 16 and 17, and then you see that surgery for the first time and you're like oh my god, this is my life's calling right here.
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Was there ever a moment of trepidation, of like you know what I don't know like along that path?
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Was there ever a moment we're like because you have to wake up every day ready to kill it the grades?
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Get the scholarship.
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Yeah yeah.
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Kill it Kill it Kill life.
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It was.
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It's intimidating, you know, seeing when I kind of decided, yeah, that's what I want to do, and then kind of realize what it takes to do it.
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And I really had to kind of embrace this One day at a time, one class at a time, one exam at a time type of mentality.
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And what my dad was masterful at was not only the first lesson of the hard work thing.
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The second lesson of the two was complacency.
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He, you know he would, he would totally help celebrate with me and the wins along the way.
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But he also was super quick to be like all right, well, don't you know, don't rest on your laurels now, kind of this, that little.
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It was like this gentle, you know, hey, great, big win, awesome, but you know it's time to reload next right.
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Right, it was it was a.
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I think it's a two prong thing.
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It's the work ethic aspect of it and the complacency, sort of lack there of aspect of it that you kind of have to.
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That I learned along the way.
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So what does that look like in college?
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You go to Cornell, you're pre-med and I had a very good friend who was pre-med and in college and we never saw him.
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So I'm kind of curious.
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You know what that life is like and what that routine is like.
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Super intimidating.
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I went to some you know run of the mill local high school in New Jersey.
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You know my hometown.
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I didn't have any AP credits or anything like that.
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So I showed up to Cornell with a bunch of kids that had gone to prep school and had 20.
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You know I placed out of all these classes and and we're just, I mean it, so intimidating and going to use intro pre-med classes like chemistry or biology to be in the a range of anything, you have to be to standard deviations above the mean.
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So these exams would be impossible intentionally to sort of weed out quote, weed out people.
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So I had to completely revamp.
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You know I kind of had high school figured out.
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It's basically just wrote memorization, you, you regurgitate on the exam and it's a pattern recognition, right?
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College was that's not enough.
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College was you know, forget the.
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You know laws of chemistry as you know them here's a new set of rules and apply them.
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You know that was one exam where I really like to learn stuff.
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Yeah, you had to.
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You know an example always uses e equals empty, squared right.
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Everyone can, you know the average person can say, yeah, that's an equation and it looks so simple.
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But to derive that equation right, it is, amongst you know, the most complicated math and science ever, right?
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Few people on the planet could Understand it.
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But it then ends up being this little simple equation.
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So I had to then think of things from that perspective, like how did this stuff get into the textbook, understanding how it evolved to be able to teach it in a way and that was really the only way I had to in Master the information to such an extent that I could apply it and then perform at that higher level.
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How were you accepted by some of your other other classmates at the time?
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And I don't mean like, where you did you ever experience racism?
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But you know there must have been a lot of like.
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You know there must have been a lot of like side eyes towards you because, as you said, you didn't have this, you didn't in your own opinion, you didn't have the schooling to match up to theirs.
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But that is the.
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That's an elite, cutthroat type of environment.
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So I'm gonna I'm gonna assume that a lot of folks probably looked at you kind of side.
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I was like you know what's this guy doing here?
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Absolutely actually.
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You know, once I got higher up in the chemistry classes in my major in college, you know no one wanted to be my lab partner.
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Like who's this this?
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Like you know, I'm kind of like a jock to like who's this kind of knuckle dragging guy from New Jersey.
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I don't get it.
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You know like well, you're a chemistry major, really okay, and so I had to do a little bit of that too.
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But yeah, I mean, it's just looks are deceiving, right, and People really didn't take me seriously as far as classmates that I just didn't fit the bill of the usual.
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You know what a pre-med, you know nerdy student looks like, background wise and you know that stuff.
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Yeah, it's funny.
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We sometimes interview people on the show and they talk about their college learning experience like that, I didn't use any of that.
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I mean I'm thinking you like had to apply all of this, like do you still use stuff that you, you, you studied for 20 years?
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You know?
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Essentially, trying to get to where you are now, I mean you must go back to.
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Oh my god, I learned that my second year or my third year, like, what's the application of of what you learned back then?
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well, it's funny you ask that because I think you know in the UK and other countries they kind of condensed a lot of that time that I really need to major in chemistry and do all this other stuff for four years In college and then go to four years in med school and all that could have that probably could have been condensed into like five years or something or six years.
00:16:53.250 --> 00:16:56.883
And so you know I was a chem major through and through.
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I can't remember half of that stuff, man, if I was right, right, right, like I had.
00:17:01.677 --> 00:17:19.912
It's like I think of it as I have a limited amount of space in my brain and so the new material like the bio you know, the anatomy and the surgery stuff and knowing how that kind of you know Put all that other chemistry and equate and molecules to the back, I Can't even.
00:17:19.912 --> 00:17:21.155
I mean, it's crazy.
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I think about that sometimes I'm like, wow, you know I was an organic chemistry whiz.
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I was a teaching assistant.
00:17:27.994 --> 00:17:30.622
I can't remember almost any organic chemistry.
00:17:31.311 --> 00:17:41.319
Now has it come to the point now where, like every new fact that comes in something, hey, it's like yeah, it is it's?
00:17:41.942 --> 00:17:46.278
it's like spring cleaning, you know it's like all right, come on, we got to get one of these days, you'll forget how to make a sandwich.
00:17:46.278 --> 00:17:51.978
Also really, man seriously it's crazy.
00:17:52.378 --> 00:18:03.872
So I want to talk now, obviously, obviously, you excelled at Cornell, so your next stop after that is, I guess, what residency, or no, it would have been Medical.
00:18:04.153 --> 00:18:05.058
Yeah, Duke Medical School.
00:18:05.058 --> 00:18:06.305
Yeah, that was insane.
00:18:06.305 --> 00:18:07.130
Yeah, that was crazy.
00:18:07.571 --> 00:18:11.210
What was that transition like from pre-med Cornell to Duke Medical School?
00:18:11.210 --> 00:18:14.142
And I'm and let's be honest, this is no slouch, right.
00:18:14.142 --> 00:18:15.849
I mean, we're not talking about dumb schools here.
00:18:15.849 --> 00:18:16.551
He's going from.
00:18:16.551 --> 00:18:19.318
Cornell to Duke from Ivy to Ivy.
00:18:19.500 --> 00:18:28.332
Yeah, so the numbers start to get very I Hate the reuse the same term again intimidating, but you know so.
00:18:28.332 --> 00:18:32.382
Duke med schools the top three med school they take a hundred people a year.
00:18:32.382 --> 00:18:34.317
So there's a hundred people in the class, right?
00:18:35.330 --> 00:18:36.253
How many apply to get in?
00:18:36.253 --> 00:18:41.515
I don't mean to cut you off, but like oh, I think Maybe a thousand or a few.
00:18:41.535 --> 00:18:42.396
You know several.
00:18:42.576 --> 00:18:45.604
It's insane yeah so it's like the top gun of med school.
00:18:45.604 --> 00:18:47.478
Yeah, so out of that hundred.
00:18:47.739 --> 00:18:53.375
I think I was one of four or five from Cornell, they were 15 from Harvard, 15 from Yale, 10 from Duke.
00:18:53.375 --> 00:19:02.804
I mean we're talking mutants on steroids, you know, just like there was one guy who was 16 years old, a child prodigy, harvard.
00:19:02.824 --> 00:19:09.061
You know we're talking the elite of the elite, yeah and so it was graded on an honors pass fail.
00:19:09.551 --> 00:19:22.589
So basically, to get honors on a given class, like, let's say, gross anatomy, which it's like you've got to have, you got to have an honors, you know that means you had to be in the top 10 or 20 out of that hundred for that given class.
00:19:22.589 --> 00:19:35.653
So I think, put it in perspective, the cutoff for I'll never forget this as long as I live for gross anatomy, because everyone was gunning really hard for gross anatomy, it's like how can you become a surgeon if you didn't get honors in Gross anatomy?
00:19:35.653 --> 00:19:40.710
I think was like 96% Meaning like are you kidding?
00:19:41.090 --> 00:19:46.721
No, so you had to like be at that or above to get honors for that course.
00:19:47.163 --> 00:19:47.923
Oh my god.
00:19:48.557 --> 00:19:49.230
So this gives you night.
00:19:49.230 --> 00:20:02.702
I mean, I thought I had a good study, you know method and all this other stuff, and I had to step it up even more Higher intensity, because there's even more information, like huge amounts of information.
00:20:03.490 --> 00:20:04.232
What does that mean?
00:20:04.273 --> 00:20:24.910
that you had to step up your studying even more so at Cornell and and somewhat in high school, what I, what I, the method I evolved to, was kind of imagine if you were told by the Professors like, hey, you can bring in a cheat sheet, you know, whatever you could fit on that cheat sheet, fair game, do that.
00:20:24.910 --> 00:20:33.946
So I kind of adapted that to like this micro scribe where I would you know, and in the process of doing that, I think I saw this on an episode of Growing Pains.
00:20:34.861 --> 00:20:35.564
Of all shows.
00:20:36.085 --> 00:20:51.988
Mike Seeders yeah, yeah, he had, like he was trying to cheat or something on the test and he ended up writing all this stuff and then in the process of he like learned the material and he like aced the exam, but he got still got in trouble because he had all these notes on his cast.
00:20:52.079 --> 00:20:54.788
Actually I did that once in a physics class myself.
00:20:55.221 --> 00:20:56.297
I did that once in a physics class.
00:20:56.579 --> 00:21:00.623
I ended up cheat cheating stuff and then realized I just knew it all Right, so I was like I saw that card.
00:21:01.000 --> 00:21:04.324
So I was like this, so that was my method and it was handwritten.
00:21:04.324 --> 00:21:07.424
But in in med school they gave us laptops.
00:21:07.424 --> 00:21:11.528
I didn't have enough money to get a laptop and it was like I think laptops were still relatively new.
00:21:11.528 --> 00:21:38.884
So they gave us laptops and I basically then converted to a digital upgrade of my micro scribe and would do like eight font or smaller, two columns on on each page and this whole like shorthand that I just created over time and I remember I condensed like a whole neurobiology textbook I think it was like 300 to 500 pages into like 20 pages, wow.
00:21:38.903 --> 00:21:39.265
Oh, my God.
00:21:39.980 --> 00:21:41.967
And so I would do that and it was it worked.
00:21:41.967 --> 00:21:48.366
I mean, I would, just once I finished doing that, we read it a few times and that was it.
00:21:48.599 --> 00:22:01.765
It was like locked in and you had to get into the top few percentage points of these classes, against that kind of competition, in order to pursue your ultimate dream of becoming a cardiac surgeon.
00:22:02.839 --> 00:22:14.147
Yeah, I mean, I think to to get in the top residencies, you know, because then it keeps, it's a funnel that keeps narrowing right, and to get into a top surgical program.
00:22:14.147 --> 00:22:18.830
They take, you know, six people, five people.
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