VUMC Reporter Profile: Full commitment — From Africa to Nashville, Sandler found success by giving his all

VUMC Reporter Profile: Full commitment — From Africa to Nashville, Sandler found success by giving his all

Starting a new job is never easy, but for Martin Sandler, M.D., the first day as chairman of Vanderbilt University Medical Center's Department of Radiology and Radiological Sciences presented some unusual challenges.

First, a faculty member came in and said he was quitting. Then, a resident came in and said that the residents were unhappy with the program and were starting to look at other programs to complete their training. After convincing them both to stay, if just for a few months, Sandler left the office with a heavy heart.

“I went home and sat on my porch for about three hours. Then I went upstairs and told my wife, 'That's it. I'm going to tell Dr. Jacobson tomorrow that he needs to find someone else.’”

His wife, Glynis Sacks, M.D., quickly reminded Sandler of what he would tell their daughter when she got down on herself during a tennis match.

“You always say that it doesn't matter if you win or lose, but you're going to stay for the whole tournament,” Sacks told him. “You're now going to have to eat your own words.”

“So five years later, here I am,” Sandler said.

Life's Early Lessons

As the Carol D. and Henry P. Pendergrass Professor and chair of the Department of Radiology and Radiological Sciences, Sandler has helped the department go from 43rd in National Institutes of Health funding to 11th over the past five years. The clinical faculty now staff four out-patient imaging centers, in addition to the adult and children's hospitals. Radiology residents have been ranked first out of 190 residency programs nationwide for the last four years, and the department’s financial reserves have increased by more than 1,000 percent.

But when you ask Sandler what he's most proud of, it's not the money generated, the new facilities or the department's growth in stature — it's the people in the department.

“I'm very proud of the fact that of all the people that have joined the department, not a single faculty member has left in the last five years,” he said. “I think everybody has an enormous amount of talent if they just dig deep enough. It's amazing what people can achieve if they commit themselves to doing the best that they can.”

Sandler's belief in the power of commitment and hard work stems from his own experience as a teenager in Zimbabwe, former Rhodesia.

“I wasn't a high achiever as a child — I was a cruiser,” Sandler said. He enjoyed playing rugby and cricket, and was very comfortable being in the middle of his class.

But when Sandler was 16, his father died from pneumonia, and he began to think about what he was going to do with his life.

“My father's death made a huge impact on me — I was just a young kid, but it gave me time to reflect on the fragility of life, and what it all means. I was in the last year of school, and thought — this is not the best I can do. It was time to see what I really could do. I remember starting that last year very clearly and testing myself,” Sandler said.

He graduated at the top of his class.

“Since then, whatever I've done, I've given a full commitment and I've tried to spread that commitment to those around me. I think if you don't commit to doing what you can, the only person you're cheating is yourself,” he said.

“I'm sure there are many very successful people, in all walks of life, who never thought they could achieve what they've achieved. And it's not for recognition; it's for getting the most out of what you can do. I don't think you know what you're capable of until you try.”

Although Sandler had a new perspective on life, he never planned out his life — instead he sought to have as wide a horizon as possible. After finishing high school, he set his sights on college and was looking to earn a business degree. But at the last minute, Sandler changed his focus to medicine. He garnered a full scholarship and earned his medical degree at the University of Cape Town in South Africa.

“At that time we were in the era of clinical medicine, and the challenge was to sit down at the bedside, take a history, do a physical exam and make a diagnosis.

“You had the luxury of being able to follow the course of a disease and see if you were right or wrong. I was fascinated by what people call the art of medicine and became an internist,” Sandler said.

During his residency in South Africa, Sandler set his sights on a different type of challenge — a pretty, blonde medical student in the hospital cafeteria.

“I was a chief resident and Glynis was a medical student, so I probably couldn't take her out today — I'd have to get permission from Dr. Kirchner,” Sandler said. “Back then the only complication was that her phone number was unlisted, but I found a way to meet her.”

Sandler made another full commitment, asking Sacks to be his wife.

“We've been married 26 years and have two beautiful daughters — it's been a wonderful relationship,” he said.

From South Africa to 'the South'

Sandler never predicted he'd go from an internist in Africa to an academic researcher in Nashville, Tenn. And he certainly never predicted he'd go from an endocrinologist to a radiologist. But then again, Sandler tried not to predict where his life would take him.

“It was really by accident that I met one of the co-chiefs of the endocrine department, who was an ex-South African visiting his mother in Johannesburg. He invited me to come over to the U.S. and do a post doc,” Sandler said. The move suited his interests in academics, as well as his conscience.

“Zimbabwe was very unstable — the colonization of Africa was not a good thing. During the period I grew up in there was an attempt to decolonize — a terrorist war from 1966 to 1980, which bled down into South Africa. Rhodesia became independent Zimbabwe, but that meant a minority of people were abused by the majority, versus a minority abusing a majority. Both were equally unacceptable,” Sandler explained. “This was my primary reason for leaving Africa. Look at the U.S., we have choices here — a freedom of choices that should never be taken for granted.

“So I left with nothing but a medical degree, but I left with a knowledge that had I stayed, I would have belonged to something I didn't agree with. I never wanted to look back and question my actions.”

For Sandler, getting a start in a new country wasn't easy. Although he had a fellowship, and his wife soon garnered a residency, making ends meet was difficult.

“Martin was working five jobs, moonlighting and basically working all the time,” said Sacks, associate professor of Radiology and Radiological Sciences. “It was difficult, but Martin is an extremely hard worker, and we've had many opportunities open for us.”

There were also some less serious challenges that Sandler faced in adapting to a new environment.

“We, of course, drove on the left hand side of the road in South Africa,” he said, “and it took me a while to get used to the change. I remember once driving down West End, and I took a corner and started seeing all these flashing lights and cars driving like crazy, and I thought, 'Well, it's awfully early for people to be drunk already.' I soon realized I was the one driving on the wrong side of the road.”

Fortunately, Sandler's transition into research went much more smoothly. He enjoyed his time in the lab — an opportunity he hadn't gotten during his education in South Africa.

“Dr. Sandler and I certainly worked close together at that time,” said Alan D. Cherrington, Ph.D., chair of the Department of Molecular Physiology & Biophysics and Charles H. Best Professor of Diabetes Research. “I remember that he always had a great deal of curiosity — an insatiable desire to understand 'why' — and, even then, very high aspirations, a clear desire to make a difference.”

But when Sandler's fellowship came to an end, his curiosity led him to a new beginning in Radiology.

“I was working on tracer kinetics and gluconeogenesis using forearm metabolism, and I became very interested in radioisotopes. I wanted to understand what I was working with, so I got involved with nuclear medicine and radiology,” Sandler said.

Mapping a novel path

Sandler made the switch to Radiology and soon found a new challenge and a new passion — technology. With James A. Patton, Ph.D., professor of Radiology and Radiological Sciences and director of the program in Nuclear Medicine Physics, Sandler developed a new diagnostic technology called functional anatomic mapping, which combines X-rays and injected radioactive tracers to create clearer images of affected tissues deep within the body.

“I think developing technology is very interesting — working with the industry to design the technology, testing each part as you go along, writing it up, documenting it and getting it in print — I enjoy the entire process,” Sandler said.

Together, Patton and Sandler have moved their technology through the development process and into a business agreement with G.E. Medical Systems.

“We make a good team, basically because we're opposites,” Patton said. “When we traveled extensively presenting our technology, I would cover the basic science aspects and he would present the clinical applications. We'd go from one country to another, sometimes figuring out which one we were in based on the restaurant menus. I'd start getting worn-out, but nothing stopped him; he just kept on going.”

Sandler's drive is derived from his fascination with technology and how it has changed the way physicians practice medicine.

“We're now in the technological era of medicine — you can look inside the body without opening up the body. And these machines are becoming more and more sophisticated — it's like those science fiction movies,” Sandler said. “You can get inside the vessels and flow down them and see where they are blocked; we can scan the body in 15 seconds, and soon in 7 seconds.”

But the technology era isn't the end point for non-invasive medicine, Sandler said. The next era, he said, is the molecular phase, with positron-emission tomography as the first step in bringing molecular technology to the bedside.

“Medicine has completely changed, and it's impossible to run a good hospital without good imaging technology,” Sandler said. “One of my goals has been to bring good technology access and interpretation to the Medical Center.”

Sandler's colleagues would say he's done this and much more.

Taking the Radiology Reigns

After just 10 years in the radiological sciences, Sandler went from a fellow to the vice-chairman of the department, and in 2000, he was named chairman.

Although Sandler was a bit hesitant to take the position, Harry R. Jacobson, M.D., vice chancellor for Health Affairs, had full faith that Sandler was up to the task.

“I felt confident that Martin would be able to face the challenges the department presented,” Jacobson said. “Clearly, time has shown that it was a good decision. Martin has made remarkable progress, leading the department to be one of the best in the nation.”

While Sandler didn't end up getting a business degree, he did develop a sense of business over his years of technology development, and he brought this experience to the department.

“I don't look at our department as simply a department of Radiology, I look at it as a business, which has five pillars to it: clinical practice, academic/teaching practice, research, billing and entrepreneurialism,” Sandler said. This approach has paid off, as the department has seen improvement in each area.

“Martin is a very special leader, who always thinks of not only his department, but of the institution — for our students, house staff and especially for our patients,” said Steven G. Gabbe, M.D., dean of the School of Medicine. “Under his leadership, the Radiology Department has enjoyed great success, both academically and financially, and has used its resources to support the academic mission of the department.”

Sandler has also helped the department build its reputation throughout the nuclear medicine community. He will become president-elect of the Society of Nuclear Medicine in June, and will assume the presidency in 2006.

“Dr. Sandler's leadership has been outstanding, and his understanding of the complexities of modern radiology — its needs, its goals and its future — has been remarkable,” said Jeremy J. Kaye, M.D., vice-chairman of the Department of Radiology and Radiological Sciences.

“It is due to Dr. Sandler's leadership and vision that Vanderbilt has developed into a world-class department. Understanding the many roles of a truly academic department, Dr. Sandler has recruited both an outstanding faculty of clinical radiologists and a very highly respected group of basic scientists.”

Sandler said creating a collegial, productive environment for the members of the department has been fundamental to its success.

“You want people to be their most productive in the environment they work, so they can channel all of their creative energy into their work versus dealing with conflict,” Sandler said. “So we have tried very hard to do this both within the department, as well as in how we relate to our colleagues in other departments, both clinical and basic sciences.”

Patton said this is one of Sandler's strong points — resolving conflict.

“He is a very good statesman. His ability to make decisions and work out equitable solutions to problems is one of his strong points, and he doesn't mind addressing an issue, whatever it is,” Patton said. “And he's always willing to sit down and work things out — he doesn't tell you he's too busy or to come back later. He addresses things head on.”

“His frequent comment is 'I work for you. You do not work for me.' This attitude has ensured him of faculty loyalty,” said Max Shaff, M.D., associate professor of Radiology and Radiological Sciences. “He is a chairman who really cares and who devotes his full energy to the fulfillment of his perceived task.”

For Sandler, it goes back to his philosophy that was formed at age 16, to give everything he does a full commitment.

Keeping a Wide Horizon

While he recognizes the many successes the department has experienced, Sandler still sees many challenges ahead and is, as always, ready to face them head on.

He hopes to bring the Radiology Department into the top 10 in NIH funding, to develop a research pathway within the training program for residents, and to improve the core curriculum and training of medical students.

“Most importantly, I hope to help the department establish a solid system of operation, so that it will be successful long down the road and flexible enough to meet the changing complexities medicine will surely have to offer,” Sandler said.

The Vanderbilt community will also remain a priority in Sandler's life, especially considering it's a family affair. Along with his wife, Sandler's daughter, Carla, 19, is a freshman at Vanderbilt University and has her eye on a medical career. His other daughter, Kim, 22, is one step closer, having recently been accepted to the School of Medicine; she'll start in the fall after graduating from Emory University.

Sandler also plans to keep up some of his hobbies — running, working on his golf game, studying American history, and he hopes to relax a bit more when he has the opportunity to travel.

But Sandler won't tell you what the future holds.

“As a young man in Rhodesia, I certainly never thought I'd end up in Nashville. I don't think you can plan life and be mentally locked into one mission,” Sandler said. “It's much more exciting to see where life will take you.”