Dr. Lisa Cannada

Whether it was the drama of childbirth or the trauma of the ER, Dr. Lisa Cannada, Associate Professor in the Department of Orthopaedic Surgery at St. Louis University, was exposed to medicine early in life. “My dad, an OB/GYN, brought me around our hometown of Steubenville, Ohio, when he delivered babies. My grandfather was a general practitioner who let me visit his office and watch him see patients. Later on he let me come to the local ER and observe. I was so impressed by how both my dad and grandfather evoked such love and appreciation from patients…and how they genuinely improved people’s lives.”

Her appreciation for the workings of the human body, however, took a detour prior to settling on medicine. “I was heavily into sports during college and told my parents that I wanted to become a physical education teacher. They basically said that this was not something they wanted for me. I became an athletic trainer, majored in health and sports sciences, and worked with athletes 40 hours a week at Ohio University. And I was constantly working with orthopedic surgeons.”

Busy, but not stretching her intellectual muscles, Lisa Cannada began to look elsewhere for something that would engage her mind. “Within three months of earning a masters degree in athletic training I realized that the work wasn’t sufficiently challenging. ‘I should go to medical school, ’ said the resounding voice in my head. I waited awhile, both because I needed to take several classes, and because my husband, a track athlete in training for the Olympics, needed me to wait for him. At least I knew before starting medical school that I was going to be an orthopedic surgeon. From my days as a trainer I could see that it would be a perfect fit.”

Learning Through Trauma

Lisa Cannada did her medical training at the University of Maryland at Baltimore, and, while reveling in the unpredictable, she found her professional love. “As soon as I spent 10 minutes at the acclaimed Shock Trauma Center I knew what my future entailed. The busy, stimulating environment was so exciting. I liked that fact that you never knew what was coming in the door, had to think on your feet, and got to work with different specialists.”

Agog at all there was to learn about trauma, Dr. Cannada delved into her residency at Case Western Reserve University and squeezed the most knowledge out of every minute. “During residency I took my vacation time to do research and attend trauma meetings. We had to teach an anatomy class for medical students, something that led to my strong interest in education. New learners are like sponges, always asking questions and keeping the teacher on top of things. It was in this period that Dr. Jack Wilber came into my world and taught me his sophisticated reduction techniques and handling of soft tissue. I also enjoyed learning from Dr. Brendan Patterson, a strong leader who supported my work and showed me how important leadership qualities are for success. On a personal note, it was good to be back near family. My grandfather had died and I had been away from everyone for quite some time.”

Her mind never far from the nerve center of urgent care, Shock Trauma, Dr. Cannada completed her residency in 2001 and then returned to that esteemed facility for a fellowship. “I had worked toward a fellowship at Shock Trauma my entire residency. The volume and breadth of trauma was so compelling; they get 7500 trauma admits per year so you could essentially operate around the clock. In my first week there I only went home twice to grab fresh clothes. We had so many mangled extremities come in the door that a great part of the education was related to saving limbs or deciding when to amputate. I recall one particularly unusual and challenging case of a person trying to race a train on his ATV. The train won, and he was tossed into a sewerage pool. This resulted in an upper extremity amputation, and was complicated by the fact that we had to contend with infection issues.”

Working alongside senior trauma surgeons propelled Dr. Cannada into new realms. “A clinical ace, Dr. Andy Burgess taught me basic things that would make, for example, sacroilliac screw placement, easier. Dr. Andy Pollak, who will head the Orthopaedic Trauma Association (OTA) in a few years, taught me the finer points of leadership. For example, he let me know how to ask for something without feeling like I’m asking for everything. Dr. Alan Jones served as a model of meticulousness, and was the only attending that scrubbed in on every case.”

Rapid fire trauma coupled with the rigors of practice building would give Dr. Cannada a new understanding of her profession. “After finishing my fellowship in 2002, I then went to Grady, a county trauma center in Atlanta. We were incredibly busy with caring for a large underserved population. When I got there more than 90% of the patients were uninsured, so I learned about trying to build a practice in a very challenging setting. In particular, I learned how to get people who were just putting in time at work to help you out. The socioeconomic impact of trauma, both for the hospital and the patient, was also made clear.”

Following the advice of one’s mentors is often easy; actually following them can be tricky. Dr. Cannada: “In 2004 I was hired by Drs. Alan Jones and Dr. Bob Bucholz at the University of Texas Southwestern Medical Center at Dallas. I was eight months pregnant and on bedrest when I got a call that Bob was no longer Chair and Alan had just left. I had gone there for the opportunity to work with my mentors, but fate had other plans. I did accept the position, which afforded me the chance to work with Dr. Maureen Finergan, a talented trauma specialist who encouraged my efforts to become a leadership fellow through the American Academy of Orthopaedic Surgeons. I also learned from Dr. Charlie Reinert, who had such an incredible work ethic that at times he would stay up all night long. He was very supportive of me; in fact, he was my professional ‘rock.’”

Advocating for Families and Mothers

Several years later Dr. Cannada joined a family of orthopedists who had, for the most part, known each other for years. “In 2008 I began working at St. Louis University with some of the ‘giants’ of trauma. We have seven traumatologists, including Roy Moed, the Chair of the Department and Tracy Watson, former President of the OTA. Roy recruited Tracy, along with three other trauma surgeons from another institution; they have been together for10 years. This group of surgeons is truly showing me what it’s like to have partners who are thoroughly encouraging and supportive.”

Helping to create the wave of the future in education, Dr. Cannada has worked to establish the fellowship match process for trauma programs. “I have worked on the OTA fellowship committee with Tracy Watson since 2002. We had always been working toward the goal of a fellowship match, but we knew that in order to get everyone’s agreement, the right circumstances would have to be present. We took baby steps, beginning with a computer application process, followed by holding interviews at the OTA meeting, and then demonstrating the need for match due to the increased interest in trauma. All of orthopedics is going towards a fellowship match process but I think we have set a good example for other subspecialty societies.”

Digging into important, but under-appreciated topics, Dr. Cannada has put substantial effort toward understanding the nuances of treating the pregnant patient who experiences an orthopedic trauma. “Interestingly, my results indicate that even with a minor distal radius fracture the pregnancy becomes a high risk trauma, with a significant chance of preterm delivery. Some of my related work, childbirth after pelvic fracture, has been accepted as a podium presentation at the fall OTA meeting. There is a real complexity in this multicenter project in identifying patients who have had a pelvic fracture…and then getting them, as well as their OBs, to respond to a questionnaire. I began working on this topic during my fellowship, and was assisted by Dr. Carol Copeland, also at Shock Trauma. She was a true role model, in the sense that she was a female faculty member at one of the largest trauma centers in the U.S. She was also raising a son.”

Discussing her other current research, she notes, “I have started getting studies together for a multicenter, retrospective look at retrograde femoral nailing, something which hadn’t been accepted as the norm but is now more popular. The results of retrograde nailing are promising, in particular the fact that you don’t increase the risk of infection if you do it in an open fracture or gunshot wound.”

Having gained so much from mentoring through the years, Dr. Cannada believes in the importance of helping one special ‘mentee.’ “My husband and I have one child, a daughter. My very adaptable husband supports my career so that I can travel to meetings and work at home when I need to. In the mornings I leave before the nanny arrives and then return after the nanny leaves, so he is a very involved dad. On the whole, I’m a much better mom because of my work. Not only does it mean that my daughter has a role model for what is possible for women today…it also shows medical students and residents what they can accomplish.”

Dr. Lisa Cannada…for when trauma needs an advocate.