Sean Goheen (Host) 00:00:01
Greeting scholars and welcome to Following the Gong, a podcast of the Schreyer Honors College at Penn State.
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Following the Gong takes you inside conversations with our Scholar Alumni to hear their story so you can gain career and life advice and expand your professional network. You can hear the true breadth of how Scholar Alumni have gone on to shape the world after they rang the gone and graduated with honors and learn from their experiences so you can use their insights in your own journey. This show is proudly sponsored by the Scholar Alumni Society, a constituent group of the Penn State Alumni Association. I'm your host, Sean Goheen, class of 2011, and college staff member. If this is your first time joining us, welcome. If you're a regular listener, welcome back.
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Dr. Eric Gibney joins Following the Gong to discuss careers in medicine and organ transplant science and care. Dr. Gibney graduated from the Eberly College of Science in 1994 with a BS in biology and with honors in nutrition, and then earned his doctor of medicine from the Emory University School of Medicine in 1998. He now serves as the director of the Piedmont Transplant Institute in Atlanta, where he specializes in internal medicine with a focus on nephrology and transplant care with the special emphasis on kidney transplants. Eric shares his experiences at Penn State, including Lion Ambassadors, lifeguarding, and the Disney College Program before turning his attention to giving insights on med school and mentorship. He also shares an overview of the transplant process, making this episode of interest to any Scholar and not just those interested in healthcare. Eric's full bio and a detailed list of topics are available in the show notes on your podcast app. And with that, let's get into our conversation with Dr. Eric Gibney, following the gong.
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Joining me here today from Atlanta, Georgia is Dr. Eric Gibney. Eric, thank you so much for coming on. As always, to set a framework for our conversation, let's talk about what brought you to Penn State and then the University Scholars Program all the way from Plowville, Pennsylvania and the Governor Mifflin School District.
Eric Gibney (Guest) 00:02:09
Thanks, Sean. I'm really happy to be here. As, uh, I was saying, I listen to a lot of podcasts now and it's fun to be on the other side, so happy to join. Probably like many people, my journey at Penn State started with a football game, so kind of, and then back backward into the Scholars Program. So I was a first generation college student at the time. My parents went to school after, after my brother and I did. And so in 10th grade we had family friends that asked us if, uh, I wanted to join them at a, uh, at a game. And I was like, sure, sounds great. And it turned out to be November and it was a, had to look it up, it was 1987. It was a Notre Dame game, and so it was a big one. It was a night game, and it snowed somewhere after halftime. And Notre Dame was on a pretty big winning streak and was poised to go to like the Orange Bowl or something big and Penn State upset them, and it was just a joyous, joyous occasion. Um, and then, you know, fast forward a year or so, I was looking at colleges, decided to apply to Penn State, and then, you know, you you mentioned Plowville of course, and, uh, my high school was 400 people total. So when I looked at Penn State, I thought I could really enjoy the, the opportunities that a really big school had. But then learning about the Scholars Program really, really helped solidify it for me, sort of that school within a school phenomenon, the academics, the smaller community, and also, you know, hopefully this is still the case, but there was really good financial aid available also, so scholarship money, et cetera. And so it really made the choice a clear one.
To Eric's last point, we have a student aid counselor now embedded right in the Honors College. So if you have questions about scholarships, financial aid, come talk to Austyn, you will, uh, be able to learn more about those opportunities. And I did mention Governor Mifflin only because tie into your football origin story here, obviously that's where one of our new star freshman running backs, Nicholas Singleton went to high school. So there's a nice little connection there between generations.
I was actually went to Governor Mifflin from third to eighth grade, and a, so a friend of friends of ours that came down for the Auburn game. I just went to the Auburn game. I, I live in Atlanta and they were on a plane with his father and, uh, enjoyed con uh, conversation. So yes, love the connection.
So Eric, what drew you to major in biology? Did you always want to be a doctor or was that something that you discovered a passion for once you got on campus?
Yeah That probably happened around the time I was 15 and I had, you know, sort of a long career as a hypochondriac began at that age when I, I I started getting sort of low grade fevers and abdominal pain after lifting weights at school that day kind of went home and instead of just blowing it off, opened up a book in our house and slowly figured out that I had appendicitis and I told my parents, and we had a family friend who was a surgeon who met me at the hospital and said, actually, he does have appendicitis and that's not good positive feedback if you are prone to worrying about things. So he took my appendix out and uh, got to know him a little bit and invited me to come, you know, spend a couple days rounding in the hospital with him. I enjoyed the interaction with patients, the scientific aspects, you know, really that, just that one-on-one connection with patients and thought that maybe I wanted to be a physician. I didn't really have an idea about what kind at the time, but yes, so when I came to Penn State, I thought biology and pre-med was a good focus.
Excellent. And we'll dive back into the academics in a minute, but you mentioned lifting weights, so I was curious what kind of opportunities you pursued on and off campus when you were a student. You listed in our questionnaire kind of a litany of different opportunities that I think would be really good for students to hear that you can still pursue these and still go to med school and become a surgeon like you did.
So I had a, I just had a phenomenal experience at Penn State absorbing all the stuff that was out there. Just, you know, physical activity, art, I lived in Atherton Hall and yes, yes, the jokes about Atherton, but you know, but these are, you know, it, it was a great experience. We had a dorm floor that was really into intramural sports and had had multiple, like whatever it was, college-wide intramural sports titles and, and the, the whole point of that was you had to show up for everything. So we showed up for badminton and volleyball and you know, and football and just every sport that was out there, we always fielded a team trying to get those coveted little blocks that they would give out for winning intramural titles. So we were really into that. I swam and lifeguarded at the White Building right across the hall and then also did some, stayed for summer and Lifeguarded in the outdoor pool. I was a Lion Ambassador. That was my biggest commitment of time and effort during school. So started that in my sophomore year and continued that through junior year. And that was a tremendous experience and really taught me about leadership and interacting with people from all walks of life, you know, not just on campus, you know, sort of our group, but then, you know, tour leading tours and interacting with alumni and people who'd gone to school 30, 40, 50 years ago. So that was really a valuable experience. So those were some of the, the big highlights.
Excellent. And one that you mentioned off campus was the Disney College Program, which kind of was surprising to me given that you went to med school. So can you tell us about that program and how that's influenced your career in medicine?
First of all, it's one of those things that probably when I'm 90, I'll keep it on my resume because <laugh>, you, everyone wants to talk about this summer you did at Disney World. So, you know, I mentioned that I was a lifeguard at the White Building, and one of the women I worked with had just come back from her summer and she's like, you totally need to go. They need lifeguards, et cetera. The college program comes to recruit at big schools. They came and uh, they, they needed lifeguards and I decided to to do that and spent the summer at Typhoon Lagoon working as a water park park lifeguard. And then the college program also had, you know, once a week you'd meet and learn about business and marketing ideas and how Disney, you know, the Disney corporation worked. So there was an educational component also.
And then as you can imagine, it was a lot of fun, you know, like a couple of condos full of lifeguards all living in the summer together at Disney. So we had a really good time. So how did that influence my career as a physician? You know, I think just that idea of exploring things that are curious to you. So that was, that was a big journey for me getting on the train with my bag and going down to Orlando for the summer and just learning to take advantage of all that life has to offer, I think was a good way to, to set up a career pretty much any career. But for me, the career in medicine, really exploring things that I'm interested in.
Absolutely. And I know Disney's obviously known for their customer service and the experiential. Did, did that influence your bedside manner or how you approach working with patients at all?
Sean, that's such a great question. I've never been asked that. I still, it's kind of a combination of Disney and, and I'm doing it now even though this is a podcast, but it's a, I still point with two fingers, which is a combination of Lion Ambassador and Disney experience. And you know, that idea that even at 19 at Disney you always, like, if you had a little bit of scruff on your face, they would bring you a razor to do dry shaving on the lifeguard stand and, and just, you know, the idea that you have to get ready to be your best self and, and look your best when you're coming to work and approaching every guest like they're important, et cetera. I, you know, I think that's, yeah, it probably, it probably did influence your bedside manner. You learn that you can be authentic and professional at the same time, and that's a really important lesson.
We've had a few healthcare professionals on this show. We've had a few other physicians. We've had an athletic trainer, a physician assistant, and I think a common theme is that all these experiences that you have in undergrad, whether it's being a cast member at Disney, being in the Blue Band, a Lion Ambassador, working with a volleyball team, they can really influence how you actually put the medicine into practice. So if you're on the fence about med school, I think a key takeaway here is like, you need to be involved on campus because that will be a huge impact on you, not just the academic side.
That’s a wise observation. I agree with you, Sean. Thanks.
But diving back into the academics, I noticed when you shared about your story with me in prep for this, you earned honors not in biology, but actually in nutrition. So what was that experience like? What influenced that and what was your thesis process like?
Eric 00:10:19 So I took an honors level nutrition course a little early in my career, and that was with, uh, John Milner, and he was probably, I would guess in his late fifties at the time, and was an internationally known nutrition researcher and studied how garlic and other supplements had active materials in them that could potentially have anti-cancer, anti-aging properties. So this was sort of at the forefront of the antioxidant time when, when people were really looking into antioxidants in foods and supplements. And he, he was really cool, he was smart, he traveled, he was, you know, he had written textbooks and it's the kind of person that you sort of gravitate toward. And it's funny, I probably had a little connection looking back, my parents were, were sort of early on the hippie food craze in the seventies. And so as I was growing up, you know, I didn't think of it as abnormal, but they were part of a food co-op and we had like, you know, the peanut butter in the big tubs that you'd have to stir the oil in and, you know, you know, our Easter candy would, would be healthy and health, health food and have carob and other things in it.
So I probably had this early idea that nutrition was important, and then meeting him and having his class, I thought that would be really interesting. So I engaged with him and decided to do my, my senior thesis with him. Uh, which again, we, we can get into that, but that was another really great learning experience. It was sort of a negative study. We were looking for the activity of a sort of an esoteric enzyme in bovine milk and cows milk, and I didn't really find any, so it took a lot of work and, and we didn't really find activity of this specific enzyme, but the process of scientific exploration was, was interesting. And I, I do have to share one story about that. Part of this was getting the milk, you know, you had to get the milk to get this, uh, to, to very look for this enzyme.
So Dr. Milner said, well, you just go up to the Penn State Dairy Barns and ask the guys for some milk. So I, I got up to the barns early one morning with my ice bucket and a couple of vials and said, hello, sir, I'm, you know, here to get to some milk for a sign, a study with the nutrition department. And he and guy looks at me and he goes, cows are over there <laugh>. So fortunately growing up in Plowville, I had gone to a few, you know, agricultural fairs and had a chance to milk goats with one of my aunts. And so I, I just had to walk up to the stall and find a cow and get to milking and, and that was a challenge. That was one of the more challenging aspects of my scientific career. The cow sort of kicked at me, but I left unscathed.
I have to imagine that sometime between then and now, that process might look a little bit different between email and automated milking machines and just not letting some random student come in and milk the cows.
Sean But if you're in the College of Ag, have any insights, let us know. I'd love to hear if that still holds true or not.
One of the craziest, you know, science stories I've ever experienced.
That is fantastic. Now Eric, I want to pivot to med school. Obviously you applied and to and attended med school in the nineties, and I'm sure some things have changed and you are supervising new doctors, med students, residents in your current role. So I'd ask what has changed in the process in that time and what advice would you give to scholars about the med school application and approaching that process?
So yeah, I, I've been mentored a couple of actually Scholar students through the process. I'm working with one now who's going through the process. And what's interesting is a lot is similar, right? So you're going through the process of taking MCATs. I think people put some pressure on themselves to do well and study and prepare, and their friends and peers have a lot of other things going on. So focusing on that at the same time can be a challenge. And then I think one of the main differences is probably like college, the ability to submit multiple applications electronically and then tailor each individual application with essays has made it more common to apply to, you know, upwards of 10 to 15 schools. And so I think in general that's probably made it more competitive for everyone. So that process of just finding that one or that those one or two schools that really where you have a connection and where you, you know, you think you would fit is probably even more of a challenge.
So that's probably, you know, the biggest change is electronic submission. And then in some schools that that desire for students to have a certain number of hours of clinical, uh, volunteering, which that's a whole nother area. You know, I, I sometimes worry that inhibits access. I mentioned I, I was first generation, we didn't have a lot of money and I didn't have the ability to just take a year and go volunteer or, or work a low paying job somewhere, et cetera. So I worry sometimes that medical schools don't realize that they're making it harder for people who would like, who really have a strong desire to get into the field. But regardless, some of those requirements to do some volunteering or some, uh, clinical hours beforehand is a change. But that need to sort of write essays and explore the reasons you went into medicine, the need to be a person that they can envision interacting in teams. I think that's similar, but that focus on teamwork and over individual achievement is probably the biggest shift. Although, you know what I think what, what medical schools want now is both someone who has all of the individual achievement but is also really good at team approach, et cetera, if that answers the question.
Yeah, it does, it does. I think the value of getting involved in different things on campus where I'm sure you had to work in a team of lifeguards or you know, uh, and Lion Ambassadors and groups like that where you gain those teamwork skills. And I think it was also interesting you said you're mentoring a, a Scholar, you've mentored other ones in the past. Is that something that students, if they don't have somebody kind of guiding them through the process, should they look into finding somebody who can be that guidepost for them?
I’d like to think that it's been helpful be, you know, I just in my own personal experience it, these, these, uh, these students have kept in touch through the whole process and continue to schedule meetings and then even after they've gotten into medical school, which you would see as the goal, have kept in touch about next steps, like was kind of fun. One of them got back in touch when she was wanting to go to residency and making some decisions, do I go with the city versus, you know, a more rural location? And that's, so I think that sort of demonstrates some value is, you know, just having that outside voice who's willing to say, you know, have you thought about x? Have you thought about y? If you think you'd like another person to have a conversation with, I think it's really nice. And at least in the Scholars mentor program, you know, it's, it's not like a therapist that you have to pay, it's someone with expertise, with a connection to the school that's willing to help you. So yeah, it’s been great.
And you mentioned the aspect of fit and having a connection. So can you talk about your med school experience and how you found your fit and what scholars can use as identifiers for their own fit and what might be a good program for them to ultimately select if they're admitted?
I think probably to share, I would want to tell you two things. One is a mistake I made in the process and it was a good one. So, you know, I, I mentioned the Disney Summer [Program]. I really wanted to go to a, to, I wanted to go to Vanderbilt. I was excited about like going, going to Nashville, something a little different. And you know, I had obviously put that I was gonna be working with Dr. Milner on my resume and submitted that and the name of the project, but didn't really totally understand the project yet because I hadn't begun working on it. So that was one of the classic rookie mistakes of my lifetime. So when I got to Vanderbilt for my interview, my first interview with a faculty member was with an internationally renowned nutrition scholar who knew everyone on Dr. Milner's floor, not just him but the other professors and was very intimately involved in that exact type of research and started to pepper me with questions about my project and, and the people that worked with
Dr. Milner at Penn State in that capacity. And obviously that didn't go well <laugh>. So I was a stammering 20 year old and that was just a great lesson for me. You know, I was prepared, I had a great academic resume and the great, the grades and all that stuff, but you know, if you put something down in your resume, you really wanna make sure you understand it. And so it's just, it was just a great lesson that even if it's something you're about to do, you wanna have a deep understanding of what you're doing or you don't really wanna bring it up or talk about it because it could get you in a little bit of trouble. I ended up going to Emory. My interview at Emory was phenomenal. So, you know, it's a city school, but it had a beautiful campus. It had a, you know, Grady, the university hospital, it had a VA so it had all different types of clinical learning environments.
But then the first two years of didactics were, were, were fantastic. They had a group interview, which a lot of people don't apply to Emory because they heard, they've heard about this group interview. Why would I have ever go to an interview where I was sitting with three other students who wanted to go to Emory and Emory still does that. And you know, what was funny was, and I'm a little bit introverted, I think by nature and so that, like, I love one-on-one conversations. So that, that four students and three faculty did seem a little bit crazy to me. But you know, it's a test of what you're like in a group environment. And I was with three other awesome students. I loved hearing their stories, you sort of would feed off of some of their energy and it, it just was one of those interview experiences that it's, you know, is more unforgettable than a lot of the other ones I've had in my life. And just made a nice connection with some of the faculty, uh, connected with the other students that day and just felt like this was gonna be the right place for me. So, um, that was a, that was a funny ex experience. So again, sort of plugging that, don't be afraid to try something that sounds a little uncomfortable. We tell our kids, if you're not uncomfortable, you're not growing. So, you know, get a little uncomfortable and that's, that's a good way to find a good fit.
And then once you're at med school, what advice do you have for students? ‘Cause you said, you know, at the end of the day that's just step one really like it and when you're an undergrad getting into med school's the goal, but then obviously you want to succeed and go on to become a physician. So what advice do you have for students to get through that process in those four years?
Yeah, I think that when you said get through, you know, get through the process is an important, I think most people who go to medical school or professional school do have a goal oriented and they can sort of put things off into the future and work hard to achieve them sort of delayed gra we're, we're delayed gratification people. And then you have to really try to make sure you're shifting from get through to enjoying where you are. And I'd have the same advice while you're at in college and you know, every step of life is how do you take care of yourself, the wellness aspect, how do you value the relationships and the connections to your other classmates and to your family and to the people that you care about that aren't in medical school with you. So you can talk and listen to them and not talk about medical school. So I think that's super, super important. And then those natural, the things that make you excited when you're in school or a relationship, professional that you're interested in pursuing to, you know, figure out if you really like something. I think all those things come more naturally if you're well balanced and plugged into the people around you.
That is great advice. Enjoy the process, trust the process as a certain NBA team might tell you. <laugh>. Now let's fast forward, you know, towards the, the fourth year of medical school and this is typically when folks are starting to think about residencies and then eventually specialties and fellowships down the road from that. Can you walk us through how that process works and how you picked your specialty?
So I'm a transplant nephrologist. So what, what I do is the medical management of transplant patients. So that is a pretty specialized area. I had done a third-year rotation. I, I knew I was sort of interested in kidney disease in, I had even, you know, in Penn at Penn State. The kidney part of physiology was the part that really clicked with me. So I was interested, did a rotation for a month with a physician who was at Piedmont Hospital. They had a small kidney transplant program at the time, really liked it. So I was thinking about kidney disease and you do internal medicine if you want to do, specialize in nephrology. So internal medicine is just adult medicine. You're generally learning in a hospital setting. And then if you want to go into cardiology or GI or nephrology or rheumatology, which is like lupus and arthritis, all those other specialties branch off of internal medicine.
So I kind of narrowed it down to that. And then during your, uh, fourth year you apply in the fall and you go through this match program, you submit your rank choices and then, you know, they rank you, you rank them and an algorithm spits out where you're gonna go and you go to this big ceremony with all your classmates who are, you're all losing their minds. And you know, probably these days we would talk about panic attacks and the mental health aspects of match day. And back then we just all kind of freaked out and you know, you sort of open your envelopes and find out if you're, uh, cited or some people are crying. It's just, it's the worst <laugh> like if you could plan a bad day for men. But it was really cool. I think the other thing to talk about with fourth years, whether you're fourth year at Penn State or fourth year medical school, is that transition.
I think a lot of people feel like that fourth year is, oh, this is your easy year and you can have fun with your friends and take electives. But for a lot of people, and for me, you know, I met someone and I, I ended up getting engaged and she's now my wife. So, so figuring out like, okay, I, I need to match, I'm thinking about a move, does this person who's attached to me want to do that with me? And moving from to a, a new state and picking a career that you might have to sort of stick with for a lot of your natural life. So what I'm hinting at is there are a lot of stresses in that fourth year that a a 24, 25, 26 year old brain may or may not be totally prepared for. So again, making sure you have those good skills that not just talking and listening to the people around you looking to mentors and knowing how to take a deep breath and figure things out is, is really, really important.
You mentioned this idea of transitions. So what advice do you have for navigating, going from probably University Park, maybe one of our Commonwealth Campuses to, you know, in your case you went to Atlanta, how did you handle that adjustment or, you know, going from Atlanta to your, your residency, what are, how do you, knowing that you only have so many years in a specific spot before you move on, how do you, how do you deal with that?
I guess that does come a little bit natural to me. I, I enjoy the first like, you know, that that exploration new new place and sort of walking around or, so we, we moved from Atlanta to New York and lived in the East Village and had a month, [they] moved there in June to walk around the city and find, you know, restaurants or places and dry cleaners and all that stuff. So I guess I really enjoy that. And keeping your mind interested and being curious. I think curiosity, and it's one of the things I talk to the students I'm mentoring about is, you know, again, it should be authentic, but when you're applying, what, what do people want to see? They want to know that you're curious, that you're in – intellectually curious, that you're curious about people, curious about places and just, just really exercising your curiosity muscles is really, really important. And I think that helps anytime you get to a new place, it's finding the things that are exciting to you, whether it's food or outdoors or cultural experiences, restaurants, how to, how to connect with others and, and the, and the place around you.
So obviously you just mentioned you kind of went from Atlanta to New York and eventually you found your way back to Atlanta and you were currently the program director for the Piedmont Transplant Institute. Did I get that right?
Sean Uh, and you've previously served as president of the Atlanta Medical Staff. So how did you end up moving into these leadership roles and how do you balance the demands of administration and remaining active in the OR with patients?
So one thing, Sean, I'm gonna correct it since it's on the record. So again, I do medical management, so not a surgeon <laugh>. So that's one thing I had to figure out too. I think a lot of times you think about surgery as a career and standing in an OR for like eight hours bundled up in hot clothing and a mask and not being able to eat or drink coffee was not a fit for me. So again, I do all the medical management and I have a surgeons that work with me and nephrologists and what we call hepatologists or liver specialists that we what work together for the transplant program. It's funny if you work hard and care about your work, I think in some ways you can prepare yourself in case leadership opportunities happen, but often they happen in a fashion that is either accidental or appears accidental or sudden.
And so that's kind of how things happened to me. I think I, I had good relationships at work and took my job seriously and tried to do a really good job and help grow the program, et cetera. And we had a situation where, you know, somebody left suddenly <laugh> a a person in leadership and they needed someone to help and step in. And so, you know, when they turn around and look around, sometimes your name is called and, and not all leadership happens that way, but I, I think when you talk to people who've had careers, often it does, it's not that three year plan to be someone's successor, it's someone doesn't show up one day and all of a sudden they need someone to help. And so it's that process of preparing yourself so that if there is opportunity, you have the right education, work skills and history. You've gone to conferences, you've published, you've, you know, attended the meetings and you have good relationships at work. And, and I think that's, you know, that's probably the key of how, how it happened to me. And similarly with the president role at Piedmont Atlanta Medical Staff, it's something that, that I was asked to, to consider and then took it seriously. So yeah, some, sometimes good fortune just kind of comes your way.
So you're managing all of these other surgeons and medical professionals and obviously you referred to the med school application and there's a lot of high achieving individuals. You, you have to have that certain level of individual success to even get into med school and then to thrive as a physician and in healthcare generally. So how do you approach actually like nuts and bolts leading all of those folks and and inspiring your team and and managing them?
Well it's a really good question Sean, and I think a lot of probably really good leaders wake up every day wondering if they're failing at a lot of those things, <laugh>. So like I think if you are at all self-aware, self-critical, you're, you're just, you know, thinking about what could I, what could I do better? And I think for, for me it, it again comes back to the relationships. So understanding the people that you work with, listening to them, I could always do better, but communicating what's going on, you know, you think that people know what's happening at your organization or greater forces in either the healthcare market or the world that are impacting our day-to-day lives. But just talking through what's in your head is a really important skill that I think we all need to work on. Just make making sure you remember to share what you're, what what's going on. I think for me, really trying to be the best listener in the room is sometimes not a skill that everyone always would emphasize in every part of your training, but if you can come out of each meeting or room you're in, really understanding the people around you and making some connection to what their concerns or cares are, then that's a big step in your career and in life. So be a great listener and I think good things happen
And that is great advice even if you're not going into medicine, is to be a good listener. Now going back to the, the science side of things and I guess a blend of patient care and bedside here as well. Hopefully you never have to deal with this in your personal life and obviously you go into medicine, you might touch this, but Eric, could you give us a just, a general walkthrough of like the transplant process, like from identification that this is something you need to recovery?
Absolutely. So kidney disease is special. I'll, I'll focus on kidney transplant. It's something that's often, uh, a silent disease. So people that have had high blood pressure, maybe diabetes for a long time and didn't realize that it was poorly controlled. Uh, and those are two common diseases that are known, you know, by most lay people. But there are a lot of kidney diseases like lupus and others that are a little less commonly understood that can start with high blood pressure or protein in the urine and can lead to kidney failure. And for many people their first experience with their kidney disease is when they have a headache and they're nauseated and they're feeling bad, they go to their emergency room and find out that they're in kidney failure. So we have a lot of patients that don't, haven't accessed the healthcare system, uh, haven't been seeing a doctor for years and suddenly find out they need to be on dialysis.
Uh, which you know, is a, usually a three day a week procedure can be done at home, where people go to a dialysis center, have their blood cleaned and excess fluids filtered by a machine and anyone who's on dialysis or has less than 20% kidney function would be referred to a transplant center. So they would come to a place like Piedmont or in Pennsylvania, there are multiple transplant centers in Philly, Hershey, Pittsburgh, et cetera. And they're referred there, they see a team of nephrologists may be a surgeon but a social worker, a dietician, blood work, et cetera. They might have some cardiac testing and if they're passed through the various aspects of testing, they may be placed on a waiting list. Now you could have a living donor. So if there are friends and, and we would encourage or teach them how to talk to their friends and family about finding a living donor and if they had living donors volunteer, we would test to see who might be compatible.
Otherwise they're on the deceased donor transplant waiting list waiting for a kidney from someone who's passed away. And that can take anywhere from two years to eight to 10 years depending on blood type and circumstances and where they live in the country. And then we would see them intermittently until they got that magic phone call, ‘Hey we have an organ for you where you sort of have to drop everything and come to the hospital.’ And then that's when that process of our relationship with them continues where we take care of them in the hospital for that four to six days that they're in the hospital. And then a lifetime of transplant care that involves suppressing the immune system, preventing rejection and dealing with any health complications that come with that.
And that's interesting about kidneys in particular. And I there, this also probably applies to liver as well, but the, the idea of how you coach folks to approach family and friends for living donors. Can you tell us a little bit more about that?
Yes. So many people have a little trouble sharing intimate and personal details about their health that you can, you know, you could sort of understand how that was would be a sticky for some people. And then combining that with asking people to help them is another part. So a lot of people have trouble asking for help. So first you've got the privacy aspect, second you've got the, ‘I'm asking you for help.’ And the third part is what you're kind of asking is really kind of a big deal. You know, so we think, well we have two kidneys, you can give one with a healthy life, but you're still asking them for a vital organ. And so I think that the combination of those three factors can make it hard for people. So we present them with like social media toolkits where that, you know, how could you put this on Facebook and Instagram in a way that's short but meaningful.
So you know, I, I'll talk to people about, you know, a a Facebook post that has a picture of you and maybe it includes your dog ‘cause everyone likes dogs <laugh>, uh, you and your family or you and your dog and just says, you know, ‘many people don't know this about me, but I have kidney failure and my doctors say I would do much better if I had a living donor. If you're interested contact Piedmont at the following web address.’ And just those three sentences can make a difference in an extra 20 or 30 years of you living life, you know, so the difference between a living donor transplant and staying on dialysis can be decades of lifespan. You know, just trying to listen to people's concerns again about what, what makes them scared to share this information and validating that, but then giving them a plan that's achievable and concrete that could help them get through that is sort of how we handle it.
I really like that. I know there's a lot of challenges with social media, but it sounds like a really good use for it. And then obviously we hope for success every time the transplant goes through. Can you talk about the post-op and really particularly the lifetime care, what does that look like for somebody who gets, say a kidney transplant?
So for kidney transplant, the one year we define a lot of success, which is a little silly, but it's the way we do it by one year success. So is the patient alive and is the kidney still working? And those one year success rates of, you know, being alive is a, is close to 98%, you know, 98% to 99% and then having the kidney be working at the end of that year is somewhere between 95% and 97% depending on the transplant center and unique circumstances, you know, like the covid epidemic was a tough year for outcomes and et cetera, but you know, should be in that 95% to 97% range and liver transplant is similar. So you know, that's something, there's been some real improvements in the last 10 to 15 years where it used to be more like 88% to 90% one year success rates and now are closer to 93 to 95% one year success rates we're also measured on three year success rates.
Eric (continued) 00:35:07
But then, you know, we obviously that's sort of where the government looks at our outcomes one in three years. But then, you know, again, for lifetime people need to take medic medicines that suppress the immune system and that can lead to infectious complications as well as, uh, certain cancers like skin cancer can, uh, be higher risk in people with transplants. And so people do need specialized care, especially for that first five years. And then, you know, they need to have doctors that understand the, their medicines, the interactions that their their medicines have and then when to refer them back to the transplant center.
So I'll say I just learned the part about skin cancer.
Sean Uh, that's something new to me here right now as we're recording Eric, are there other misunderstandings or, or just lesser known parts of the transplant process that you wish folks knew more about or were better educated on?
Yeah, that cancer aspect is really interesting and that surprises people. I think <laugh> our most common question, people are like totally freaked out when they learn that we don't take out their old kidney. Um, so like a liver, you take out the liver, you put the new liver in, but for a kidney transplant you leave the old kidneys in unless there's a specific problem like a cancerous cyst, et cetera. And you place the new kidney in the lower part of the abdomen real close to the bladder and the arteries where it's sewn in. I think really important to us is the problems of medication access. So if you know someone is a veteran or if they're in the, you know, UK for example, and they have unlimited access to transplant medicines, the outcomes are really, really good. Beyond three years and in the United States we've had a real problem where people lose their Medicare after three years of a transplant and can lose the ability to afford, afford their medicines. And so just the basics of the that that we pay so much for dialysis and, and, and organ failure, but then people have had trouble over the years at being able to afford their medicines is a real tragedy. And that's really been helped a lot by some specific legislation, whether it's Affordable Care Act or more recent updates to help pay for Medicare, uh, at least the medic medicine aspect of Medicare. There have been some real breakthroughs, but it's still a real, a real issue for us is having people have access to, to medication.
And you, earlier you mentioned the pandemic. How did that impact, because you know, I work in an office, we social distanced, we worked at home. For the surgeons and for the patients, you can't not be right there with each other. So how did the pandemic impact transplants?
So the pandemic had a tremendous impact on just about any healthcare program, but transplant patients, uh, transplant patients and programs specifically. So from, uh, you know, late March, 2020, you know, when the NBA shut down <LAUGH> and all of society stopped till about early May, we, we really held back, we did a lot of liver transplants because those are really truly lifesaving for people that are, are really sick. And for kidney transplant, there was a brief period where we had to stop and most programs kind of shut down for all but the most life-saving kidney transplants and then gradually brought that back to speed. You know, that first year was just tough. We didn't have vaccination and we didn't really understand everything about the virus, you know, for a while that they weren't sure, you know, do we need to wear masks? And then we did, you know, when we figured out that passing it along in indoor spaces was the probably the most common way of transmission and I think in the northeast they were hit early on by a big wave.
And then in the southeast it really took a little while later until later in the 2020. And so we, you know, know we like other programs had patients that passed away and, you know, died from Covid(-19) and gradually planning for people to have safer transplant experiences from your waiting room spacing, masking policies to vaccination for people on the transplant list. Now we go give a medicine called Ebusheld, which is like a give six months of antibody protection against Covid. So our patients are now vaccinated and they get Ebusheld at the time of their transplant. And now I, I can't really remember the last time I had a patient who passed away from Covid, whereas, you know, 2020 and 2021, it was a really difficult time for our program and for, you know, for transplant patients nationwide. So yeah, the pandemic was, was a time to lead and also as just a, a patient care provider, it was a really, really challenging time. But, you know, learned a lot. Definitely helped my brain in terms of growth, just, just trying to solve a lot of new problems
And I'm sure that was really, really stressful for you and being in medicine is stressful anyway. So how, and, and you talked about this earlier with wellness generally, so how do you relax and unwind outside of work and how do you suggest our Scholars could similarly approach that aspect of taking care of yourself so that you can take care of others?
Well, you know, setting boundaries is important for me. I, exercise is important, I play tennis and tennis is social, so it checks a couple of those like wellness boxes talking to other people and physical activity, <laugh> are both really, really important. So, you know, for me, exercise, getting, getting enough sleep, I have two teenage children so I really, you know, I mean I was able to go to really all of their sporting events and so, you know, watch watching them and making sure that they know that they're important, trying to be home for dinner and you know, we have a nice group of friends here in the neighborhood. So a again, it's figuring out what are the things that you like and that relax you and you know, for me, I feel successful if my, if I have good relationships with my family and have, uh, good social outlets and, and making sure that you put emphasis on those things. Absolutely.
And finally, before we go to our general reflection questions, that if you're a regular listener, you know what I'm gonna ask, but Eric, I am not a doctor, I don't work in healthcare, I work in the [Schreyer] Honors College. So is there anything that I should have asked about med school, about medicine, about transplants or medical management and patient care that I just didn't think to as of, because I don't know, not being in that field,
Sean, I, I gotta say you are, you must be a great listener because you had, you just had great questions, you know, just residency, specialty training, et cetera. So I was, uh, <laugh>, I was really impressed. No, I think you really, I think you really nailed it. So I, I, I don't think I would've added anything to your questions. I was, uh, really surprised at your, um, your general knowledge of how many things you must know about if you know so much about this process. <laugh>
Sean 00:41:26 Well, I will say I've interviewed a couple of medical professionals at this point and my best friend's a pediatrician, so I kind of wow, kept up with the process from interviews to residency interviews. So, uh, tangentially aware of the process, but I appreciate the, the, the feedback. And Sean Miller, if you're listening, please take note of that <laugh>, so thank you. All right, Eric, what we do here on the last part of the show is I just asked some general reflection questions to benefit all of our Scholars. So first this is your chance to brag a little bit. What would you say is your biggest professional success to date?
Running a transplant program is almost always something that, that's done by a surgeon. It's usually at an academic medical center. So I, I co-direct the program with the surgeon, but being asked to run a program of this size and growing it, we we're now in the top 10 in the nation by volumes when you add up liver, kidney, and pancreas transplant and just opened an organ recovery center at Piedmont, which, which means that when people are going to donate their organs, deceased donors come to Piedmont in a special wing and they're managed in a way that's protocolized so that their gift is maximized. You know, there more organs can be recovered if the donors are managed according to protocols and most correctly. So I think just stepping into lead that program at a time when it was needed and having it grow and become a program of nationwide importance is something that I'm deeply proud of.
So I do wanna ask one more medicine question based on that, ‘cause that is fantastic that you've been able to grow that if you're a scholar listening down the road, you decide this is transplant medicine is something you wanna go into it, do they seek out opportunities at a center like yours or do they go and kind of be on a surgical staff at a, a regular, I don't, I don't know if it's the right word, but like a regular hospital or, or university hospital say in like all the ones in Philly or Pittsburgh?
Yeah, usually the training, you know, you are going to go into transplant medicine if you do either nephrology or GI you would do an extra year of transplant medicine or if you're a surgeon, you do a general surgery residency followed by a two year fellowship. It's uh, then it's not a match day, right? Then you've gotta start reaching out to connections and most of them are in cities, you know, so Geisinger is in Danville, Pennsylvania, that's an unusual example of a non-city, you know, sort of a rural transplant center, but most are in big cities. And so you would reach out to connections, mentors, where do you wanna live? I kind of cast a wide net in the southeast and directly reached out to programs. My first job at a fellowship was in Richmond (Vriginia) and then I did have some connections in Atlanta and Piedmont that let me know when something opened up. So yeah, as I was saying, a lot of times probably four fifths are about 80% are at academic medical centers, but there are community health systems like Piedmont that run, you know, there's one in Charlotte, that run big successful transplant programs despite not being a, a classic academic medical center.
Excellent. And we did find something I didn't think to ask about. So there we go. Now, Eric, on the flip side of my two questions back, what would you say is the biggest transformational learning moment that you've had in your career, uh, other than what you called your kind of rookie mistake with your resume and what you learned from that experience that could be beneficial for our scholars to hear about it?
It's hard for me to give specific examples, but I became a chief resident in New York. Um, and so you're sort of the in-between, you're, you're not a resident anymore and you're not faculty and you're kind of an interface situation and it's one of your first times that you get involved with, uh, you know, sort of, you think that you're, 80% of your colleagues are like, they're, they're just like you, they're hardworking, they're just doing everything they can and, and then some of your problems come from a small group of people that maybe don't have the same professionalism or have some other behavioral or other issues that need to be worked on. And learning young, you know, again, you're 25, 26 and so do you have the maturity and skills to listen to those people to get both sides of the story? That's been something, you know, whether it was Lion Ambassadors, but then chief resident year and then later on in life as an administrator, really not jumping to conclusions the first time you hear about something horrific, you know, and then you ask the other group, well, what happened? And you find all these nuances and details that make it a really much more complicated story. And so that's probably been the key is get not just both but multiple sides of a story before making important decisions.
And I think that's true for anybody, just as a person, not just as a medical professional.
So we've alluded to this a little bit, but let's talk about mentorship for a moment. How do you approach being a mentor, but also you've still got a lot of your career ahead of you. How do you approach being a mentee despite the role that you play in your healthcare system?
In terms of how do I approach being a mentor? It's fun to get to know someone. So just, you know, asking a lot of questions, making sure I understand their motivations, what they're interested in. You know, most people being mentored want a specific thing, but they also may benefit from talking about some other stuff. So you find out, you know, well the people I've mentored, they want to go to medical school, but they often have similar issues that other people have when they're going through the process. They're trying to figure out where they wanna live and relationships and family and other things. And so that's important. And I think the other thing about mentorship is not just making it a focus on them, but sharing. So that's something I've learned in the last four or five years of leadership is that people trust you more if you talk about yourself a little bit. So not to mentor someone by talking about yourself for an hour, that's nobody wants that, but just sharing a few important details about things that have happened to you or something that happened to you yesterday. I think when people don't see you as this, oh, mentor or you know, hey, you know, my, my teenage my teenager hated me this morning. I think just making yourself more regular is really helpful for people to build that trust. And then being a mentee, honestly that's something that's just a little harder for me is, is working on asking, just we, we touched on that earlier, asking for help, what do you think I should do? And I think learning that people, I know how I feel when I'm being a mentor and so giving that to someone else as a gift is really important. So I, I've realized that, you know, when you make that appointment or have coffee with someone and ask them for their opinion on something they feel good about themselves and learning that that's okay to make yourself vulnerable and that that person is probably enjoying that process is something that's been good for me to, to learn.
Now you mentioned earlier, Eric, when you were interviewing at Vandy, that the professor there knew all of the professors in the department here at Penn State. So in medicine it's not the biggest field, there's probably a lot of connections and known webs of, of connections throughout. So how do you suggest that students, outside of something like Mentoring with Honors, which, and opportunities in other colleges and campuses here at Penn State, how do you suggest that students go about finding mentors, whether it's now in college or in med school or beyond?
You wouldn't wanna get too far ahead of yourself. Like if you're in college, you probably wanna focus on mentors that are, are more local to you. So as things move along. So if you're in residency, you're going to have peers or people one or two years ahead of you in training. So you know you're residents that are supervising you or a faculty member that you meet who you know, sort of lights something in you that you might want to explore something more deeply. Or you know, you go to a conference. So that's a big one. Doing some research is anything that's independent or original will get you involved with other like-minded people. And even if that's not the path you choose for the rest of your life, it's an avenue to meet other, you know, interesting and motivated people who are different phases of their career. So yeah, I think travel and, and being awake and aware to the people that are around you are really the two biggest areas.
Excellent. And speaking of people, are there any professors or friends from your days at Penn State that you want to give a shout out to?
<laugh> You know, my, like the three guys that I hung out with the most on my dorm in the first year are the ones that I still keep in touch with the most. So Mike Baska, who I lived in the same [room], it was 356 Atherton Hall, for three years. I've never met anyone who stayed in the same room for three years with the same roommate. And then we moved off campus with a group of five of us. So Mike Baska, George Motley, and Doug Hoover. Uh, we entered as freshmen together. We had a lot of, lot of good times. So those are the, the three that I wanted to say hello to.
Excellent. Now as we're wrapping up our time, is there a final piece of advice for students, whether ones who are looking into medicine or just Schreyer Scholars generally to make the most of their time at Penn State that I just didn't ask a question that it was a good answer to.
I think people know this, but the Schreyer experience in being at Penn State as an honor student is just, it's tremendous. Your access to coursework, the peers and I, I think that's probably the advice I'd give to people is really appreciate being surrounded by smart, interesting, fun people. Like there just aren't that many times in your life really. There are very few, where you can live and, you know, breathe and study around. Just so many brilliant and really fun and interesting, curious people and really appreciate that.
I will certainly echo that, Eric. Now if Scholars wanna reach out to you and connect with you and take this conversation a little bit further, they have questions based on what they've heard. How could they connect with you?
I'm on LinkedIn, so Eric Gibney, uh, have a LinkedIn profile and happy to connect. I've had a few people connect with me that way, so that's probably the best way to reach me.
And finally, if you are a flavor of Berkey Creamery ice cream, which would you be not your favorite, but which would you be, and most importantly, rationalize this Eric for us, why would you be that flavor?
Okay, so I appreciate, I did get a little bit of prep on this one because, you know, there are so many creamery flavors now and I want to get this correct. Right. So I would be Crazy Charlie Sundae Swirl. I always like the peanut butter versions of Penn State [Berkey] Creamery ice cream, but the fact that there's now one with chocolate also makes me, you know, just, first of all, that's what I would order. And then, you know, it's vanilla, it's peanut butter, it's chocolate, it's a combination of a lot of things. And so I think at any phase in your life, you're a product of a lot of different experiences you had. And if you can swirl those all up in a good blend, and hopefully that makes you a good, complete, and you know, like an ice cream cone. Very good. So I, that's the one that I gravitated toward.
Well, I can say you were the first person to choose that one, so really you have, so you have the first tick on that one there,
Dr. Eric Gibney of the Piedmont Transplant Institute class of 1994 here at Penn State and the Honors College. Thank you so much for joining us and sharing all of your great advice and thoughts on the medical profession and med school for our Schreyer Scholars. We really appreciate your time today.
Thanks, Sean, really enjoyed it. Have a great day.
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