“She shouldn’t be alive, ” said the physician reading Dr. Claudia Thomas’ EKG. At 98 pounds, a struggling Dr. Thomas couldn’t stand up and her potassium level was well over eight when it should have been four.
After a litany of symptoms and a roller coaster ride of possibilities, Dr. Claudia Thomas was worn out. She explains, “At the end of my residency I started having protein in my urine; the doctors couldn’t find a reason for it and I was told that it was unlikely to cause problems. I put it out of my mind and then undertook my fellowship at Shock Trauma in Maryland. Several years later I began to experience weight loss and fatigue. Then came the signs of kidney failure; I was given the option of dialysis or a transplant—I chose the latter. The night before the operation my surgeon said that he had found a mass in one of my kidneys; the plan was to remove that kidney and biopsy it. After the procedure, I woke up with the surgeon saying that he had found cancer in both kidneys and had removed them both. I would have to be on dialysis for a year before we could consider a transplant.”
Crushing news, to be sure. But the resilient Dr. Thomas had a unique reaction. “My first thought was, ‘Thank God. I had cancer, but the doctor found it and removed it. I am cured.’ Then a grand mal seizure hit me. My dear mother had given up her life to be my caregiver…she and my sister—who had volunteered to give me a kidney—were my biggest sources of support. I lapsed into a comatose state and had bleeding on the brain. On day three of unconsciousness, the I.C.U. nurse gave my mother a Psalm to read to me—alas, I woke up rather miraculously. A new brain scan revealed that the bleeding in my brain had disappeared. The doctor had no explanation.”
One day it had been a Psalm that had provided hope…later, it would be a supply delivery man. Dr. Thomas: “I was placed on hemodialysis and nearly a year after waking from the coma my sister and I were again tested for the viability of a transplant. In some sort of horrible Groundhog Day scenario, the surgeon entered the room and said, ‘We have a problem. There is an antibody in your blood that wasn’t there before…it will cause you to reject any kidney. I was dying.”
“I had been hanging on by faith, but now I was very depressed. I returned home, where I was hooked back up to a dialysis machine. The young man who brought my supplies—a gospel singer—was always in good spirits. One day I said to him, ‘John, did you hear? I can’t have a transplant.’ He immediately, and very matter-of-factly said, ‘Oh, the Lord has already taken care of that.’ Soon afterwards, my sister insisted that they retest my blood. My happy ending? They discovered that the antibody was not the kind that would cause kidney rejection. On September 30, 1991 I gratefully accepted my sister’s kidney.”
Now a fortress of strength, Dr. Thomas is also exquisitely tuned to the suffering of others, even when they don’t express it verbally. “One of the biggest advantages that I have in life is the fact that I have been desperately ill. I can sense that someone is grappling with something, and I invite them to open up. For example, a patient’s husband may be in the hospital. Because of the way my practice is set up, I can take the time necessary to spend with someone who needs emotional support.”
Sometimes, those who need support are the ones in the white coats. When asked about her most valued contribution, Dr. Claudia Thomas sums it up in one word…mentoring. She notes, “Women have challenges just thinking about how to approach a career in orthopedics. Some are discouraged by their chairmen; I recall a young female medical student who was told by her chairman that orthopedics is ‘not for females.’ I strongly suggested to her that she not go to a program that had not already trained a woman. Sometimes people contact me in the 11th hour when they are already in a residency and things are not going well.”
Residency is like an initiation, with a hierarchy/pecking order…the unofficial ‘program’ is to beat up on the person below you. I tell mentees that if you are unsure of yourself or easily embarrassed then people will feed on that.
“This perpetuates the victim syndrome and people like this will continue to be singled out.”
But the clear thinking, fair minded Dr. Thomas demands that those under her tutelage also take a look in the mirror. “The flip side is that I tell young surgeons that they must also examine their contribution to the situation. For example, perhaps someone always feels like the victim. The reality is that women and minorities in medicine consistently have to be at their best. You must double check your work, you must know the labs in and out, etc. The most challenging situation for these young orthopedists is when the people who are supposed to be teaching them aren’t teaching them. Your superiors are not giving you the kinds of cases you need to get sufficient exposure to various conditions and procedures. Whether someone’s situation is real or is just a perception I can’t say. But I usually advise them to talk to the chair or chief resident, people who should be more mature about these things.”
Too seasoned by the vagaries of life to be anything but realistic, Dr. Thomas says, “Some people don’t make it and if you can’t stand up to the pressures perhaps you shouldn’t. Orthopedic surgery is not for everyone.”
One of the things now happening to young people of color and young women is that they have had parents who have not prepared them for a world where racism and sexism still exist. When you encounter people who expect you to fail, and who may actually try to create a pathway for you to fail, you need to understand these dynamics…and you need to have tremendous self esteem.
And you couldn’t get away with Dr. Thomas’ approach to patients without such confidence…and a lot of caring. “As fair and engaging as I think I am, I still have my own biases and I assign personalities to people who come into my office. For example, if someone comes to an appointment smelling of cigarette smoke I take the ‘mean’ route in order to shock them into taking care of themselves. I might say, ‘Oh, I’ve got to get some air spray in here.’ Or perhaps, ‘Do you look in the mirror? I’ve got 80 year old patients who look better than you.’ Sometimes this approach works, and then, of course, that only causes me to do it more. But maybe sometimes I need to find another way to confront the smoker.”
Regarding the field she loves, Dr. Thomas states, “Orthopedic surgery still requires some deprogramming when comes to taking care of people. A disproportionate number of minorities get amputations, and are not offered state of the art treatment. For example, if both a black male and a white male come to the ER with a long bone fracture, the white male is more likely to be given a narcotic for pain. The black male (or Hispanic male) is often presumed to be drug seeking, and is given Tylenol. This has been documented in the literature. I have been fortunate to address many audiences about these issues of bias, including staff and executives at DePuy, who recently invited me to talk about how unequal treatment affects them as implant manufacturers.”
Dr. Thomas in a middle school classroom
Zimmer has also been open to Dr. Thomas’ message, and has supported her and her colleagues in their efforts to reach out to those who might have never imagined themselves in scrubs. “Several colleagues and I realized that during residency recruitment we were fighting over the same one or two African American males. After some reflection, it became clear that we were ‘losing’ boys at the middle school level, so my four partners, all African American males, decided to mentor local boys. We go to a particular middle school monthly during the school year with the message that the only way to a bright future is to do well in school. While we bring in non-surgeons as well—I recently brought in my neighbor who is the head of the FBI for central Florida—our focus is on introducing the boys to the medical field. One of the things that captivated these kids was when the Zimmer bus came and the boys got to don scrubs and simulate a knee replacement. They were absolutely beside themselves with wonder and joy.”
As for Dr. Thomas, she credits her parents’ constant, loving focus on ‘the books’ for getting her to where she is today. “The biggest key to my success was having a functional family with two parents who cared about education. “
Looking forward, she notes, “I am an artist at heart and I when I eventually slow down I am determined to learn how to paint with watercolors.”
As food for thought, Dr. Thomas leaves us with the following riddle.
A man and his son were in an accident in which the father was killed. The son was badly injured and brought to the ER, where it was decided that he needed surgery. The surgeon was called, but said, ‘I can’t operate on him…he is my son.”*
Dr. Claudia Thomas…always challenging herself and others to be fully human.
To learn more about Dr. Claudia Thomas, please visit: http://www.godsparelife.com/.
*The surgeon was his mother.
