September 14, 2020

Pioneers of Hope

Irving J. Zamora, MD, MPH, Pediatric Surgery. Photo by Erin O. Smith.

At Monroe Carell Jr. Children’s Hospital at Vanderbilt, our work extends beyond patient exam rooms. We are also searching for discoveries to offer better treatments, provide quality care and train the next generation of clinicians. The profiles here represent only a sampling of the tireless work performed daily to make Children’s Hospital a place of unwavering hope. In each issue, we also include a profile to highlight our longstanding partnership with our community pediatricians who help ensure all children receive the best care each and every day.

 

Molly Hood, MD, FAAP, Community Pediatrician. Photo by Donn Jones.

Molly Hood, MD, FAAP, had every intention of practicing internal medicine and caring for adults until a pediatrics rotation near the end of her third year of medical school at the University of Tennessee. She quickly changed her career track.

Hood’s father was a general surgeon who later completed a second residency and became a radiologist practicing at Southern Hills Medical Center in Nashville. Her mother was a nurse who taught nursing students at Morehead State University in Kentucky. Between the two, she was constantly surrounded by medicine growing up. But becoming a doctor, and especially a pediatrician, was not something she was drawn to early on. Now, she can’t imagine any other career.

“I did my peds rotation and absolutely loved it,” she said. “Then I decided to do a combined internal medicine/pediatrics residency. By the end of my residency, I realized I enjoyed pediatrics much more. You have such an ability to make a real impact in lifelong health during the early years of life as opposed to taking care of problems that already exist in internal medicine in adults.”

Hood served as pediatric chief resident at LeBonheur Children’s Hospital and practiced pediatrics in Memphis,

Tennessee, before joining Pediatric Associates of Franklin in 2005. The Williamson County practice has cared for families for more than 40 years and has been voted “Best Pediatric Practice” for 20 years by readers of Williamson Parent Magazine.

As a graduate of Brentwood High School, Hood was returning to familiar surroundings, but she credits her mentors at the practice, Ray McNeeley, MD, and Scott Brooks, MD, for helping her find secure footing in private medical practice.

“I had a lot to learn,” Hood said. “Back then, most of your residency training was inpatient, where you learned how to care for hospitalized patients. You have some clinic exposure, but it’s not the day-to-day life of a private practice by any means. They were big influences for me here, in everything from how to actually manage a practice to how to best care for both patients and their families.”

Another huge support has been her practice’s close connection with specialists at Monroe Carell Jr. Children’s Hospital at Vanderbilt who are always available to answer her questions or help manage patients’ more complex care. And the resources of the Cumberland Pediatric Foundation, a nonprofit company that supports scientific, charitable and educational needs of

pediatric practice members, have been especially invaluable, she added. Today, Hood serves as vice president of the foundation.

“The Cumberland Pediatric Foundation is a way to make great personal connections with both specialists at Vanderbilt and with other area pediatricians,” she said. “It really helps provide a great sense of community.”

Hood credits a patient’s family with connecting her to a specialty close to her heart, caring for children with Down

syndrome. Hood became friends with the family as she provided care for their first child who has Down syndrome. She soon joined the mother’s efforts to bring a Gigi’s Playhouse to Middle Tennessee. Gigi’s Playhouse, which originated in Chicago, provides free educational and therapeutic programs to individuals with Down syndrome from birth through adulthood. In 2013, Gigi’s Playhouse opened in the Cool Springs area of Williamson County, less than a mile from Pediatrics Associates of Franklin.

“I served on the board there for several years,” Hood said. “Now, our Gigi’s Playhouse is thriving and is just a wonderful place.”

When she’s not caring for patients, Hood is busy planning her next hiking excursion. She’s enjoyed the winding trails of the Grand Canyon and been awestruck by the vivid, quaking aspens of Rocky Mountain National Park in autumn. But she’s just as content at nearby treasures such as Radnor Lake and Percy Warner Park.

“I’d go hiking every single day if I could,” she said. “I still have a lot of places on my list I want to go.”

– by Jill Clendening

 

Frank Fish, MD, Interventional Cardiology. Photo by Susan Urmy.

Frank Fish, MD, is a highly sought interventional cardiologist at Monroe Carell Jr. Children’s Hospital at Vanderbilt who specializes in correcting abnormal heart rhythms, using a procedure called cardiac ablation.

He treats children and adolescents, as well as adults who acquire arrhythmias as a delayed consequence of surgical correction for congenital heart defects, performed in their childhood.

“My three things are running, music and my job,” said Fish, professor of Pediatrics and Medicine at Vanderbilt University Medical Center, whose main instrument these days is bass guitar. He also plays upright bass, bassoon, saxophone, a bit of piano and some guitar.

Growing up on the south side of Indianapolis, school sports and marching bands meant everything. Fish played bassoon and ran cross country for his high school.

“I knew they needed a bassoon player in the school orchestra, so I made a deal with the band director. I told him ‘I’ll play the bassoon, and I promise I’ll play it well, if you let me out of marching band so I can run cross country.’” His bassoon playing attracted college scholarship offers but Fish also had longstanding interests in math and science and chose to study chemical engineering and biology.

He wound up in medical school by accident, he says. “A friend suggested, ‘Hey, maybe you should take the MCAT [Medical College Admission Test] and just see how you do’ … somehow I found myself sitting in first-year medical school.”

He questioned the choice for years, but that changed in the 1990s with the rise of cardiac ablation.

Through a blood vessel in the groin or neck the cardiologist threads an electrode into the heart, precisely positioning the tip at the interior heart wall and using radio frequency energy to selectively scar or destroy small bits of troublesome tissue and thereby restore normal heart rhythms. At VUMC, Fish was part of the team that performed the first cardiac ablation in Tennessee, on Jan. 6, 1992. As the clinical program took off for adults and later for children, he found his profession.

“It seemed to be something well-suited to the way my brain works, something that came fairly easily and naturally to me,” said Fish, who sees parallels between music performance and the ablation procedure. “I decided, well, this is something that makes good use of my nature, if you will.”

Fish keeps a bass guitar in his office in the Doctors’ Office Tower at Children’s Hospital. He continues to play jazz, blues and rock in various local ensembles. And he’s still a runner. He and his wife, retired neonatologist (and oboist) Wendy Fish, MD, have two children — Hannah, a physician who this summer embarks on cardiology training at VUMC, and Emily, who teaches seventh grade in Rutherford County, Tennessee.

– by  Paul Govern

 

Sarah Tolan, BSN, RN, Pediatric Cardiology. Photo by Susan Urmy.

Sarah Tolan, BSN, RN, has a devotion to her young patients that is all-encompassing. As a nurse in the Pediatric Cardiovascular Intensive Care Unit (PCICU), she cares for the families of children who undergo multiple surgeries to repair congenital heart defects.

In one such case, 4-year-old Toby Williams’ expected 2-week stay in the hospital for open heart surgery stretched into 338 days, characterized by one complication after another. Every day Tolan worked, she was at his bedside, learning about and caring for him as complications mounted. Her work was recently recognized with a DAISY Award, which recognizes nurses for exceptionally compassionate care.

Tolan was “the face he looked forward to seeing, the smile and voice he knew he could count on, even when he couldn’t smile or talk in return,” Toby’s mom, Amanda Williams, wrote in nominating Sarah for the award. “She changed thousands of diapers, gave hundreds of Lovanox shots, got him up and out of bed no matter the extra time or effort it took. She took him on wagon rides, washed his hair, played Play-Doh, and held his hand while he endured yet another wound vac change. She sang songs and wore silly hats and told him he was strong and brave.”

For Tolan, it’s just another day on the job. “I just like helping people, being on my feet and always thinking. I have a pretty sunny disposition in general, which I think sometimes helps. You have to be really creative to be a nurse. I think you use every skill you’ve acquired throughout your life as a bedside nurse.”

Tolan is passionate about her specialty, the PCICU, but she came into it almost by accident. During high school in her hometown of Gulf Breeze, Florida, she decided she wanted to be a nurse, but had no idea of the area in which she would specialize. In her junior year of nursing school at the University of Mississippi, she applied for an externship that — to her surprise — placed her in a PCICU.

“At the time I didn’t know much about congenital heart defects and the surgeries required, so I initially thought, ‘that’s  going to be so boring,’” she said. “I was in there for not even a week and I thought, this is fascinating.”

Knowing VUMC’s reputation for excellence, Tolan applied for the competitive nurse residency program, fully expecting not to be accepted. She had enjoyed visiting Nashville with her family when Ole Miss football played Vanderbilt University. If she was accepted, she specified the CVICU was where she wanted to be.

Tolan was accepted in the yearlong program and started in the PCICU; the nurse residency cohort that she started with is still at VUMC, nearly four years later.

When she’s not treating patients, Tolan loves traveling, tennis, indoor cycling and, most of all, going to the beach. But her patients are never far from her mind.

“Every patient shapes me in some way as a nurse and as a human being,” she said. “It’s really easy to make this job, these patients, these families, your whole life. It’s a whole lot more difficult for it to just be part of your life. Because they just grab at your heart and they fight so much. These kids, they beat the odds.”

– by Matt Batcheldor

 

Irving J. Zamora, MD, MPH, Pediatric Surgery. Photo by Erin O. Smith.

Irving J. Zamora, MD, MPH, says his earliest memories of wanting to be a doctor come from middle school, but his parents say that dream started much earlier.

One year before Zamora was born, his parents were involved in a car accident, breaking the majority of his mother’s lower spine and leaving her in a full-body cast. She remained in that cast through Zamora’s birth.

“My mom says that as early as she can remember, I would always say I wanted to be a doctor because I wanted to ‘fix’ her,” said Zamora, now a pediatric surgeon specializing in minimally invasive surgeries at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

He attributes his successes to an “aligning of the stars,” acknowledging his road to pediatric medicine was anything but traditional.

A native of Nicaragua, Zamora moved with his family to the United States when he was 5 seeking political asylum from a civil war. With dreams of becoming a paramedic, he attended a vocational technical high school in inner city Miami, Florida, to complete first responder training as an EMT and volunteer firefighter.

“With all the time I spent on ambulances, that’s when I remember becoming more excited about being on the other side of the health care delivery tree. When we dropped patients off at the emergency room, I always wanted to figure out what else was going on with them,” said Zamora.

Zamora was valedictorian of his class and became the first person from his high school to head off to an Ivy League college — Cornell University — thanks to the help of scholarships and the timely receipt of his green card. He continued his work as a volunteer firefighter and became a resident assistant at Cornell to help supplement his college housing.

Rotations in global health led him to practice in Spain, Africa and China, but it wasn’t until an eight-week preceptorship at Texas Children’s Hospital during the summer between his junior and senior year that he discovered his dream of becoming a pediatric surgeon.

“Pediatric surgeons have a huge breadth of practice. We take care of congenital diseases, cancer, trauma, acute surgical problems and benign conditions requiring elective operations. We see everything from fetal patients before they’re born to the youngest of neonates when they’re only 24 weeks and weigh less than 1,000 grams. I also operated on a 28-year-old patient the other day. We span the early lifetime,” said Zamora.

“We like to say, ‘We don’t save lives, we save lifetimes.’ That’s one thing I love about pediatric surgery — you’re able to affect someone’s life so early.”

Zamora was recruited to Children’s Hospital in October 2019 to help build a minimally invasive surgery program, allowing major surgical operations to be performed through tiny incisions. He believes that’s where the future of pediatric surgery is headed, and research spearheaded through the new program will examine the approach’s outcomes and ways to improve surgical techniques. Recently, he was named as director of Advanced Minimally Invasive Surgery at Children’s Hospital.

In addition to bringing surgical diversity and training to Children’s Hospital, Zamora is proud to bring his cultural background, which helps him connect with Nashville’s growing Spanish-speaking population.

“As our country continues to attract people from all over the world, having surgeons and doctors who look a little more like you is a big deal. I take that responsibility with pride, knowing I represent not just myself and my family, but a community of Latin Americans in the United States and lots of children who want to become doctors and surgeons,” said Zamora. “Other young people are seeing me, and I hope it makes them think, ‘If he can do it, maybe I can too.’”

Outside of work, Zamora enjoys spending time outdoors with his wife, Lindsey, an assistant professor of Clinical Obstetrics and Gynecology at Vanderbilt, and their two daughters, ages 1 and 3. His hobbies span from salsa dancing and playing percussion to water sports and soccer.

– by Kelsey Herbers

Hope – Summer/Fall 2020