Eugene “Gene” Alford, MD, was at the height of his career in 2007. As one of Houston Methodist Hospital’s busiest facial plastic and reconstructive surgeons, Dr. Alford, then 48, had performed 887 surgeries that year, including airway procedures and big head and neck operations.
On Sunday, December 30, 2007, things changed. That day, Dr. Alford decided to visit his family farm in Bellview, Texas, while his wife Mary and their three children remained at home in Houston. To relax, Dr. Alford had been clearing brush on the farm while riding his tractor with a front-end loader.
A dead white oak tree lay in the middle of the area, and Dr. Alford approached it twice before trying to move it out of the way with the raised front loader. Dr. Alford didn’t know the tree was water-logged and rotted. When he began to move the nearly 1,000-pound tree, the top broke off and fell directly on top of him, crushing his spine. He knew, at that moment, that he was paralyzed.
Dr. Alford called Mary and was airlifted to Memorial Hermann–Texas Medical Center, a Level 1 trauma center in Houston. He was diagnosed with six broken ribs, a broken collarbone, a broken shoulder blade, crushed thoracic vertebrae, and pinched blood vessels in the spinal cord. Today, while he still has some feeling and function in his legs, he can’t walk and is paralyzed from the waist down.
After ten months of healing and rehabilitation, he realized that while he couldn’t use his legs, his hands, arms, and brain still worked fine. He returned to work in October 2008, using a power wheelchair that allowed him to sit or stand, and working out of an operating room with a specialized table. Dr. Alford focused on rhinoplasty, facial cancer reconstruction, and facial plastic surgery—and continues to do so more than a decade later.
“You can find an area that is your passion, focus on it, and become the best there is in your geographic area in that part of ENT that you love,” Dr. Alford said. “I think that is something I should have learned earlier in my career.”
Experiencing a major illness or injury in the midst of a medical career can be life changing. Along with Dr. Alford, several other otolaryngologists share lessons they’ve learned as they coped with serious medical issues and the aftermath that influenced their career trajectories.
Ask for Help
In 2010, Wendy Stern, MD, had been running her private practice in Dartmouth, Mass., when she was struck by a car while cycling. She experienced a whiplash injury to her neck, which she initially thought would heal on its own. But when it didn’t, after months of icing, anti-inflammatory medicine, and physical therapy instructions, she learned she’d experienced an avulsion fracture of her c7 spinous process and a C6 radiculopathy to her right hand. In 2012, she had the first of several surgeries.
“The recovery was just brutal; I couldn’t move my arms at all,” she said. “Having midlevel providers was a godsend … a physician’s assistant would go into all the patient rooms with me and would physically examine the patient and complete the medical record.”
Relying on her two colleagues made the practice work, “because we each subspecialized and were always working collectively for the best of our patients,” she said. But by 2014, she sold the single specialty practice, both because of market trends and because she knew, as the senior partner, she would be the first to retire. With new ownership came transition, including increased typing and documentation with the new electronic health records systems. Dr. Stern was working with a double crush injury to her right hand and with poor response from conservative therapies. She underwent a right carpal tunnel release but experienced a complication, a nicked nerve sheath, which rendered her right hand permanently hypersensitive and weak.
You don’t realize how physical our job actually is. It’s a lot of up and down, bending over, upper body movements, examining patients, and performing surgery—it’s not a desk job. I had to take it slowly and build up my endurance physically and emotionally. —Jayson Greenberg, MD
Despite the hospital offering several accommodations, including a scribe, specialized computer hardware, and no more call scheduling, Dr. Stern realized she could no longer perform surgery and retired from the practice in 2018, at age 59.
Dr. Stern now serves as president of the board of directors of the New England Otolaryngology Society and volunteers with the American Academy of Otolaryngology–Head and Neck Surgery and the Massachusetts Society of Otolaryngology. “My heart and love is ENT; my brain is fine, and I remain active and I’m still determined to help,” she said.
“Developing integrity in your practice, developing relationships, building teams, or having partners—having that network allows you to zig and zag better,” Dr. Stern said, “You need to build relationships with your colleagues and give favors, because you are going to need to take them.”
Develop a New Appreciation
A regular exerciser with normal blood pressure and cholesterol levels, Jayson Greenberg, MD, a clinical assistant professor with the University of Michigan Department of Otolaryngology–Head and Neck Surgery in Ann Arbor, didn’t think twice when he began to feel his chest tingling while on the elliptical machine. A checkup led to surgery; he underwent a successful quintuple bypass procedure in January 2018 at age 48.
“You can’t ignore family history, which I have, and I was fortunate to listen to my body when it was telling me something was wrong,” he said.
Returning to work—a position he’d begun only two months before his surgery—was eye-opening.
“You don’t realize how physical our job actually is,” he said. “It’s a lot of up and down, bending over, upper body movements, examining patients, and performing surgery—it’s not a desk job. I had to take it slowly and build up my endurance physically and emotionally.
He also reduced his patient load by about 40% to 50% when he first returned, then gradually increased the numbers by 10% every few weeks.
The experience gave him a deeper respect for the patient perspective.
“You don’t realize this until you are a patient, just how much trust you put into your physician,” he said. “I spend more time talking to patients than I used to. I also write in a gratitude journal daily—you can’t recover from a big illness yourself. My family and friends were beyond wonderful, and I’m very grateful I had such a supportive department. You need to learn to accept help and ask for it, which was a somewhat foreign concept for me.”
Embrace a Non-Linear Approach
In 2001, Debra Gonzalez, MD, noticed her right eye ptsosis.
“Back when I presented with a droopy right eyelid, I had a busy practice and knew enough to know that that was bad,” she said. At the time, an MRI indicated she had multiple sclerosis (MS). She immediately began interferon injections every two days.
While her eyelid felt better within a week and a half, she experienced flu-like symptoms, and eventually developed an orbital pseudotumor, where the orbital fat in her eye swelled up. “Every other day, I felt like I was dying,” she said. Her physician couldn’t tell her if these were MS symptoms or side effects from her medication.
Ultimately, Dr. Gonzalez had to sell her Tennessee-based practice because she couldn’t continue to work as a surgeon. For the next decade, she tried to determine what to do professionally while at the same time striving to feel as good as possible. She did part of a psychiatric residency and then embarked on psychoanalytic training, but disliked it.
By 2010, “my health was better and I was feeling great,” she said. “I began to think, ‘Why can’t I go back and be a surgeon again?’” She sought second opinions and had more MRIs and, ultimately, was given clearance to return to a surgical career.
“My doctors didn’t know if I was in remission from MS, or if perhaps I’d never even had MS,” she said. It’s possible that perhaps food intolerances or leaky gut syndrome, both of which were less understood two decades ago, may have been the root of her health issues, she said.
Dr. Gonzalez yearned to return to otolaryngology. She took clinical medical education courses for didactic retraining but needed to find somewhere to do practical retraining. She reached out to her network of mentors and received three fellowship offers. Ultimately, she worked with husband and wife team Gayle Ellen Woodson, MD, and Tom Robbins, MD, who had the head and neck and cancer experience she wanted. Dr. Gonzalez moved to Springfield, Ill. with her 12-year-old daughter for a one-year fellowship at Southern Illinois University.
“I’m forever indebted to Doctors Woodson and Robbins because, without them, it may have been impossible to retrain,” said Dr. Gonzalez. “I hadn’t been working for ten years, and not everyone was gracious about taking me on. But my attitude was like a horse with blinders: I’d show up every day, work hard, and make up for lost time. Going back and having to retrain is eating humble pie. I was 50 years old and doing a fellowship. My eye was on the goal.”
Her efforts paid off: Dr. Gonzalez is currently an assistant professor at Washington University and chief of otolaryngology at the Veterans Affairs St. Louis Healthcare System in Saint Louis, Mo.
Her path has helped her appreciate all she has.
“When I was younger, before these experiences, I expected my life to be linear and on an upward trajectory,” she said. “I used to sweat every outcome, even if it was out of my hands. With maturity and these experiences, it made me grow. My attitude is different; I’m doing my best. Some things I can’t control, and that’s just life. I don’t expect that linearity. When there are obstacles, I will find my way around that. I have more confidence and peace today.”
Cheryl Alkon is a freelance medical writer based in Massachusetts.