January 19, 2023

Pediatric surgeon’s medical career began with a lucky catch

While he was in medical school, pediatric surgeon Joseph Fusco, MD, learned in an unusual way that he had thyroid cancer.

Joseph Fusco, MD

Not being able to hit David Price’s curveball may have saved Joseph Fusco’s life.

Fusco, MD, is an assistant professor of Pediatric Surgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt, and he was a really good ball player — but was persuaded that medicine might be a better career when, as an undergraduate member of the baseball team at Georgetown, he faced Price, who became a Vanderbilt and Los Angeles Dodgers star.

“I feel like every baseball player who went into medicine became an orthopaedic surgeon,” laughs Fusco. “I figured that would be my route, but then I fell in love with pediatric surgery.”

The change of plans, both in careers and specialties, was a lifesaver — literally.

Just as Fusco was planning his second to last clinical rotation in medical school at Mount Sinai School of Medicine, he decided to switch from orthopaedic surgery to general surgery as his clerkship specialty, which led to a location and month change. It meant he landed at the Bronx VA with Terry Davies, MD, the president of the American Thyroid Association, as his lead attending.

One day — it is so burned into his memory that Fusco is very specific that it was a Tuesday — the regularly scheduled noon learning conference was canceled. The attending, not wanting to waste a learning opportunity on the assembled students, decided to demonstrate how to perform thyroid ultrasounds.

“I remember it so clearly,” recalled Fusco. “I was the last person in the room and so he selected me as the ‘volunteer.’

“He put the probe to my neck and found a pretty large nodule. He started describing these somewhat alarming features. It wasn’t concrete at that time for me. Other residents practiced operating the ultrasound on me after the session.”

At the end of the class and as most students had filtered out of the room, Davies instructed Fusco to make an appointment with him.

“That’s when it hit me,” said Fusco. “Something was definitely awry.”

By Thursday, just two days later, Fusco was seen by Davies, and biopsies were taken. On Monday, six days after the classroom ultrasound, Fusco received an email that no one wants to get from a doctor: “Dear Joseph, call me ASAP. Terry Davies.”

Fusco still has the email.

After speaking with Davies about his thyroid cancer diagnosis, Fusco called his parents and tried to explain to them what was going on. He realized that, in the stress of the moment, despite his medical training, he had completely blocked out the conversation he had with Davies.

He wanted to tell his mom and dad the specifics of his condition and couldn’t recall any of it — just that the biopsy was positive. He had to call Davies back and ask him to go over it all again.

“That was the moment that really changed how I practice medicine in respects of taking that extra time with patients, allowing them to digest information, circling back to them and making sure they understand,” Fusco said. “I take it a few steps further and ask them to make a list of questions and meet with them again later in the day and in the days after to ensure all of their questions are answered.

“I felt like it showed me it’s not just about taking care of a patient, but the whole patient, which includes family.”

Fusco said his patients appreciate his attention to how they process information.

“As my training progressed and I settled into my post here, I see a difference in my ability to empathize as well as sympathize, as someone who experienced cancer.”

While he does not always share his story with patients or families, he has come to realize when it would be most helpful or impactful saying, “It’s a level of understanding that I think is hard for anyone else to have, if they haven’t been through it.”

Fusco, who always wanted to work with children, is glad he shifted his medical concentration to general surgery because it reiterated his focus and commitment to helping patients with cancer, specifically solid tumors like Wilms’ tumor, the most common type of kidney cancer in children and neuroblastoma, a cancer that develops from immature nerve cells found in several areas of the body.

“My own experience confirmed my interest,” Fusco said. “It gave me perspective.”

On Mar. 1, 2012, Fusco had his thyroid removed, followed by radioactive iodine treatment six weeks later.

After his surgery, he had two rotations left to complete his medical school requirements. He was able to complete one rotation and nearly finish his last before the iodine therapy.

“I finished my last rotation on the last possible day I could before graduation,” Fusco said. “I was cutting it close, but my entire experience is what pushed me forward.”

This year he celebrated 10 years being cancer free.

Fusco graduated magna cum laude from Georgetown University in 2008 and Mount Sinai School of Medicine in 2012. He later completed his postgraduate training at Barnes Jewish Hospital of Washington University in St. Louis and his research and clinical fellowships at Children’s Hospital of Pittsburgh of UPMC.

He has been at Monroe Carell one year.

While medicine and research take up most of Fusco’s time, he falls back on a favorite pastime for stress relief and fun.

“I play in three different softball leagues,” he said, smiling. “I really enjoy it, and it helps to continue some of that competitive edge I had when I played in college. It’s a great outlet for me.”