Mentor Spotlight: An Interview with Dr. Lori Pounds
Wednesday, April 8, 2020
Dr. Lori Pounds is a vascular surgeon at the South Texas Veterans Health Care System, University Health System, and Methodist Hospital, in San Antonio, Texas. She graduated from Temple University Lewis Katz School of Medicine in Philadelphia, Pennsylvania and completed her residency at the University of Texas Medical Branch Hospital in Galveston, Texas. She completed her fellowship training in vascular surgery at Temple University Hospital in Philadelphia. She is the Chief of Vascular Surgery at Audie L. Murphy VA Hospital and she is the Program Director for the Vascular Fellowship at the UT Health San Antonio Long School of Medicine. Dr. Pounds also serves as the Faculty Advisor for multiple Long School of Medicine student interest groups, including the Association of Women Surgeons and Vascular Surgery Interest Group.
Dr. Pounds dedicates herself to her patients as well as her peers and mentees. She has served as a role model for many aspiring female surgeons, and we are so thankful to have her as a mentor.
Could you tell us how you discovered your interest in surgery, specifically, vascular surgery?
Although neither of my parents were in the medical field, I knew at age 5 that I wanted to be a surgeon. I would watch Marcus Welby, M.D. and flip through the pages of my grandmother’s nursing book. I knew what I wanted to do with my life. In spite of being told that I could not do that because I was a girl and not from a physician family, I never listened. I thought, ‘that doesn’t apply to me.’ I was determined to be a surgeon.
I was a member of the Boy Scouts Medical Explorers group. In high school, we did excursions to the University of Pittsburgh. They had old school amphitheaters with big glass enclosures, and we’d sit up there and watch transplants. In college, I volunteered in hospitals at the University of Pittsburgh and Presbyterian, and I did research so I could go into the OR and watch surgeries.
I wanted to be a transplant surgeon; it was all you heard about in Pittsburgh in the mid-80s. Thomas Starzl was in the news every night, and I wanted to be a transplant surgeon like him.
I went to medical school in Temple, but they didn’t have a transplant program at that hospital. Vascular surgery was the closest thing. Then, I met a dynamic vascular surgeon and he became a mentor. He got me involved in projects, and I did multiple rotations besides the regular 4-week rotation including a sub-Internship and a Vascular Surgery research month. I met another dynamic vascular surgeon in my residency program. He told me I was going to be an academic vascular surgeon, and he supported me throughout my career. He said I should choose what I enjoy doing and that I did a good job at vascular surgery. He never really talked about the fact that I was a woman or that it was different for women. It just never came up. I did not see any difference or barriers - he never pointed them out.
What obstacles did you encounter in your surgical training and how did you overcome them?
As a woman, I was expected to go into breast surgery or pediatric surgery. Those were both standard, accepted surgical specialties for women. Choosing anything outside of that was unorthodox; if you chose something else, people would question you. I had to break that mold and fight expectations. I was constantly facing questioning and doubt, and had to say ‘yep, that’s what I’m going to do’ and ‘yep, I’m actually doing vascular.’ I ended up having to work twice as hard and prove myself, constantly. But when I was training, my chief residents and co-residents at UTMB never made me feel different or treated me differently because I was a woman. It was people outside of the program who questioned my position and abilities. Once I was a part of the training program, I was very accepted by my peers.
What would you say are the biggest changes you’ve seen in surgical culture in the past few decades?
It was a different culture when I started out. It’s morphed over the last 20 years. Surgeons had more of a reputation for being gruff. Now there’s more of an emphasis on getting along.
In a Leadership class I took a test called a DISC score that measures your patterns of behavior. (DISC: Dominant, Inspiring, Supportive, and Cautious). I have a 95% supportive personality. I was surprised, because as a surgeon, I thought I would be more dominant. Being supportive is actually a great quality for a surgeon, since surgeons need to be good team leaders as they function as captain of the ship. Great leaders are able to get support and buy-in by supporting their teammates, not through domineering methods. You want to accomplish goals together, as part of a team. There are some situations, especially life-threatening ones, where you need to get things done and you have to be more direct, but for other situations, you want team buy-in to accomplish goals as a group.
As you progressed through your training, how did your perception of surgery change?
The act of performing surgery is still thrilling. It’s beautiful, it’s a gift you get to do. Over the years, it has become more laborious as the business of medicine has become a greater part of practice. How I treat the patient matters, not coding for billing purposes. The emphasis on business is contributing to burnout. Physicians feel isolated and interchangeable, less an integral member of a team. But each surgeon is different. Surgery is an art, not an algorithm. People need to respect the human aspect of medicine. I’m trying to bring more old school values and etiquette into my practice.
You spend a significant amount of time mentoring medical students and creating opportunities for medical students to get involved in vascular surgery research projects and shadow vascular surgeons (all types of surgeons, really). What motivates you to provide this mentorship?
I want to keep the next generation engaged. I think it’s important to pay it forward. Not a lot of people were available to mentor me, but I am indebted to those that were. My mentors weren’t necessarily vascular surgeons, but they were people who helped me out and I look up to them. When I was a medical student there was a Trauma Surgery resident who had a baby. I thought ‘wow, people can actually be married and have children as a female surgeon.’ There was a Transplant Surgeon at UTMB who had a baby as a faculty member. She had a picture of her daughter in her locker. Every day I saw that picture and thought ‘one day, I’ll have that.’ It was a big thing for me to see that picture in her locker, something as small as that baby picture meant a lot.
The women who meant a lot to me didn’t necessarily sit me down and say, ‘you can do it,’ but I saw them doing so many different things and I thought ‘I can do that,’ and it was enough. Even being around for me to see, I could see that it’s possible to accomplish my goals.
What advice would you give aspiring female surgeons?
It’s a wonderful career. There is a bit more of an adjustment than some of the other medical careers but if you really like it, you like it. It’s a bit like the Harry Potter sorting hat, you just need to find your people. You need a good posse of people around you to support you, in and out of the hospital.
If you could go back and start over, would you still pursue a career in surgery? Is there anything you would change?
I would absolutely still pursue a career in surgery, and I wouldn’t change anything. Even though I know they have kidney and liver pumps so you don’t have to be up in the middle of the night, I would still choose vascular surgery.
What has been the accomplishment you’ve been most proud of?
Just being here, being a surgeon is the accomplishment I’ve been the most proud of. I’m proud to have this opportunity.
How do you maintain a balance between being a wife, mom, and surgeon?
It’s a challenge. I gave up a long time ago on the house being perfect or being able to go to every after-school event. I thought I could have a dual career and everything would be perfect, but I had a realization that that wasn’t plausible. I had to reset my thinking and stop beating myself up for not being perfect and doing everything.
I’m toward the end of my mid-career, but I’m only now getting into national organizations. Most people get involved in national things at the beginning of their mid-career. I purposely didn’t do a lot of things because I didn’t want to travel or take on extra responsibilities, I wanted to be at home. You look at some people, maybe 6-7 years into their career, and they’re already in the national spotlight running a million different things. You have to be comfortable with who you are and what you do. Do your best where you can.
What are your future career goals? Where do you want to go from here?
I’m feeling a little nomadic at this point. I’m one level higher than I ever imagined I would be. There were so many barriers to get here and be a surgeon. Becoming a surgeon was my goal, but now I am a surgeon, and I still have another 12-15 years of practice. I’m not sure what I want to do now. I’ve been taking leadership courses and courses on graduate medical education to better understand the formality of how to teach. It’s an interesting mindset of how to incorporate giving constructive feedback rather than the gruffer feedback I got as a trainee. But surgery is a life or death thing, you have to be able to incorporate legitimate criticism into your feedback. There are things trainees need to know; you can’t ‘bless your heart’ out of certain situations. Overall, I’m happy to be in an academic setting where you meet people from all over the world. I enjoy the diversity.
Katherine Jensen and Alyssa Langley are second-year medical students at the University of Texas Health Science Center San Antonio Long School of Medicine. Katherine served as the President and Alyssa served as the Vice President of the UTHSCSA Medical School Chapter of AWS in 2019. They were honored to host the first Southwest Regional Association of Women Surgeons Conference during their tenure as AWS Officers. Katherine is interested in orthopedic and vascular surgery and Alyssa is interested in trauma, plastic and vascular surgery.