I was surprised at the request to write about myself as a “Legend in Urology.” I thought one had to be dead to be a legend so I asked my younger, but not obscenely so, second wife, “Am I old enough to be a legend?” She just smiled and said, “I’m afraid so.”
I’ve been fortunate to have had preparation, curiosity, opportunity, and a sense of humor with me for most of my life.
Preparation
From my parents, I got a great genetic package and a safe place to grow up in three small towns in Minnesota. I wanted to be a doctor since grade school. This was based in large part on my encounters as a patient with our family’s general practitioner, Dr. Robert Page. I was intrigued by the smell of alcohol in his small office, the white uniforms of his office staff, and that I recovered from whatever illnesses my parents thought significant enough for me to be seen by him. I remember four significant gifts from my parents: a microscope, a chemistry set, a desk, and a typewriter. My first surgical patients were frogs and fish. I was taught the craft of surgery by an immigrant, Dr. Ali Hakim, at the end of my second year of medical school. He offered to teach me how to operate if I would loan him my hand-written notebooks from my basic science classes so he could study for the Minnesota State Medical Board Examination. I learned how to cut, sew and tie, and he passed the exam. Shortly thereafter, he became Chief of Urology at Ancker Hospital in St. Paul, and, at his invitation, I spent 6 weeks of my junior-senior biennium surgery rotation with him. It was like being a junior urology resident.
When I was a junior medical student, I would walk across the street to University Hospital to a medicine ward, spin the rack of patient charts, and when it stopped, pick out a chart and read it like a novel. One of those evenings, I spotted a familiar name on a chart. I went into that patient’s room, and saw that the patient was a grade school classmate whom I hadn’t seen for years. We used to play together, and I remembered him watching him interrupt play one day to give himself an insulin injection. I asked him that night what was wrong, and he said, “My kidneys are shot, and they’re thinking about doing a kidney transplant.” He died later that year, and he’s buried next to my grandparents at Hillside Cemetery in St. Charles, Minnesota. That was the beginning of my interest in kidney transplantation.
After internship at the State University of New York, Upstate and 3 years in the Air Force, I did my pre-urology and urology training at the University of Oregon Medical School in Portland where Dr. Russ Lawson taught me how to do kidney transplants, and the Chief of Urology, Dr. Clarence Hodges, taught me, by example, how to be quietly effective in my professional life. Why Oregon? I made out a checklist of qualities I wanted in a training program, and Oregon was the only place that had all of them. I applied to that one residency program, wrote to Dr. Hodges and told him that I couldn’t come for an interview because I was stationed on Okinawa, and he took me. I’ve been there ever since,Table 1.
TABLE 1. My life
Year |
Event |
Historical reference |
1940 |
Born |
Battle of Britain |
1958 |
Graduated from high school |
First US satellite launched |
1965 |
MD |
First space walk (Edward Higgins) |
1966 |
Entered US Air Force |
Caesars Palace opens in Las Vegas |
1969 |
Started residency |
Neil Armstrong walks on the moon |
1973 |
Joined faculty at Oregon |
OPEC oil embargo |
1976 |
Appointed director of transplant program |
Viking 1 lands on Mars |
1979 |
Acting Chief of Urology |
Saddam Hussein becomes President of Iraq |
1980 |
Chief of Urology |
US Olympic hockey team beats Russian team |
2008 |
Step down as Chief of Urology |
US economy begins to slump |
TABLE 2. Some general urology ideas
Year |
Reference |
Idea |
1976 |
1 |
Corpus cavernosum to dorsal vein of penis shunt for priapism |
1979 |
2 |
Penoscrotal approach for placement of penile prosthesis |
1979 |
* |
Nephrostent concept (manufactured 1983) |
1980 |
3 |
Nocturnal penile tumescence testing with stamps |
1981 |
4 |
Preoperative determination of inflatable penile prosthesis cylinder length |
1981 |
5 |
Actuarial method applied to time-related events in urologic surgery |
1982 |
6 |
Cut-to-the-light for obliterated membranous urethra |
1984 |
7 |
Prediction of semi-rigid penile prosthesis diameter from saline erection |
*Manufactured, not published as manuscript
TABLE 3. Some kidney transplant ideas
Year |
Reference |
Idea |
1973 |
8 |
Cadaver kidney transplant ureteroneocystostomy with double ureters |
1978,1988, 1995 |
9, 10, 11 |
Methods to extend the right renal vein in cadaver kidney transplantation |
1982 |
12 |
Community urologists and general surgeons to do cadaver kidney retrievals |
1982 |
13 |
Percutaneous antegrade transluminal ureteroplasty for ureteral stenosis |
1982 |
14 |
Triangulation method to preserve spermatic cord |
1983 |
15 |
Human kidney preservation beyond 48 hours with simple cold storage |
1983 |
16 |
Unstented parallel incision extravesical ureteroneoycystostomy |
TABLE 4. Other significant milestones/opportunities
Year |
Opportunity/organization |
1982 |
AUA/ABU Joint Examination Committee |
1983 |
Western Urologic Forum |
1983 |
Moderator, Western Section AUA Round Table |
1986 |
ABU Examiner |
1989 |
American Association of Genitourinary Surgeons |
1992 |
Renal Transplantation in Campbell’s Urology |
1995 |
Secretary, Western Section AUA (President 2001-2002) |
1996 |
Trustee, ABU (President 2001-2002) |
1998 |
Clinical Society of Genitourinary Surgeons |
2007 |
Executive Committee, AUA (President 2008-2009) |
AUA = American Urological Association; ABU = American Board of Urology
Closure
In March of 2007 I had a successful radical prostatectomy for localized prostate cancer, but that’s another story. In the summer of 2008, I stepped down as Chief of Urology at Oregon and had my compensation cut in half simply because it was time to do so, and because I had significant new responsibilities as President of the AUA.
My career has been more than I dreamed possible. Here are a few principles that I’ve kept in mind along the way. Leadership is simply helping others do their jobs; if you do that, they’ll help you do yours. Perfection isn’t possible, but it must be sought. Do the best you can with what you’ve got. Opportunity is of no value if you are unprepared. Pick something that’s worthwhile that you like to do, do it well, and money will follow you around. Money is important because it frees you to be a professional so that you don’t have to confuse revenue generation with patient care. Public service is a responsibility of citizenship. If you can’t do it, make it possible for others to do so. Life is only two things: problem solving and the pursuit of happiness. If you do those two things without hurting others, you’ll go to heaven; that’s all there is to it.
It’s been a great ride.
References
1. Barry JM. Priapism: treatment with corpus cavernosum-dorsal vein of penis shunts. J Urol 1976;116(6):754-756.
2. Barry JM, Seifert A. Penoscrotal approach for the placement of penile prosthesis. J Urol 1979;122(3):325-326.
3. Barry JM, Blank BH, Boileau M. Nocturnal penile tumescence monitoring with stamps. Urology 1980;15(2):171-172.
4. Barry JM. Preoperative determination of inflatable penile prosthesis cylinder length. Urology 1981;18(1):82-83.
5. Giesy JD, Barry JM, Fuchs EF, Griffith LD. Initial experience with Rosen incontinence device. J Urol 1981;125(6):794-795.
6. Lieberman SF, Barry JM. Retreat from transpubic urethroplasty for obliterated membranous urethral strictures. J Urol 1982;128(2):379-381.
7. Barry JM. Prediction of semi-rigid penile prosthesis diameter from saline erection. J Urol 1984;131(2):281.
8. Barry JM, Pearse HD, Lawson RK, Hodges CV. Ureteroneocystostomy in kidney transplant with ureteral duplication. Arch Surg 1973;106(3):345-346.
9. Barry JM, Fuchs EF. Right renal vein extension in cadaver kidney transplantation. Arch Surg 1978;113(3):300.
10. Barry JM, Hefty TR, Sasaki T. Clamshell technique for right renal vein extension in cadaver kidney transplantation. J Urol 1988;140(6):1479.
11. Barry JM, Lemmers MJ. Patch and flap techniques to repair right renal vein defects caused by cadaver liver retrieval for transplantation. J Urol 1995;153(6):1803.
12. Barry JM, Fischer SM, Craig DH, Fuchs EF, Farnsworth MA. Effect of donor surgeon on first cadaver kidney transplant function. J Urol 1982;127(2):227-229.
13. Lieberman SF, Keller FS, Barry JM, Rosch J. Percutaneous antegrade transluminal ureteroplasty for renal allograft ureteral stenosis. J Urol 1982;128(1):122-124.
14. Barry JM. Spermatic cord preservation in kidney transplantation. J Urol 1982;127(6):1076-1077.
15. Barry JM, Fischer S, Lieberman C, Fuchs EF. Successful human kidney preservation by intracellular electrolyte flush followed by cold storage for more than 48 hours. J Urol 1983;129(3):473-474.
16. Barry JM. Unstented extravesical ureteroneocystostomy in kidney transplantation. J Urol 1983;129(5):918-919.
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© The Canadian Journal of Urology™; 16(5); October 2009