I’m Steven Fishman. I’m a pediatric general surgeon and I’m one of the three co-directors of the Vascular Anomalies Center.

What are some of the challenges of working with this population?
There’s a couple of challenging things. One is that there are lots of logistic difficulties with caring for complex patients who live far away. It’s very difficult to not be able to see the patient or have them come to see us whenever they feel they need to. There’s a whole lot of long-distance preparation that has to go into planning, for example, a complex procedure. I think the other thing that’s frustrating is despite all of the wonderful opportunities for improvement we give many patients, there’re some that we can’t help. There’s some we don’t understand, and even the ones we do help, we may not make all their dreams come true. We may make them a lot better, a lot better than they thought they really could be, but we don’t necessarily restore them to complete health and whatever normalcy is.

What are some of the rewards of working with this population?
Well, the best is—this is going to sound somewhat egomaniacal, but there’re very few things more gratifying than making somebody’s life dramatically better when everybody else said it wasn’t possible. So although I enjoy being a doctor for all kinds of problems and I feel gratified when I take an appendix out or fix a hernia or take out a gallbladder, I know that if I didn’t do that, as important as it was for that patient, somebody else could’ve done it. Bu with these vascular problems, with these malformations, if we don’t do it, they might not get taken care of. And sometimes patients have been told that nothing can be done or they’ve had the wrong things done and we can, sometimes simply sometimes not so simply, make somebody’s life a whole lot better. That’s by far the most gratifying thing for me. Like the operation I did today was very simple for me but it will hopefully make a dramatic difference in this young man’s life, and nobody else was offering this option.