What inspired you to choose a career in healthcare, and how did your Hispanic heritage influence that decision?
I was inspired to choose a career in healthcare after attending various medical missions in low-income communities in Mexico as a high school student. Seeing children with poor access to health and education has always motivated me to get up everyday and work for those who have less opportunities than what I have had.
Can you share a particular experience where your cultural background positively impacted a patient's outcome?
When I was a junior attending in New York, we had an infant with Biliary Atresia that needed a Porto-Enterostomy early in her life. The Chief of Pediatric Surgery, who knew I was Mexican-American, asked me to approach the family who wanted to take the kid home with no treatment. By embracing the cultural barriers, leveling the field, and building trust, we convinced the child's family to move forward with the procedure and give her a transplant. She is now in high school and potentially thinking about a career in healthcare in Guadalajara.
More recently, we had a young boy with a hepatoblastoma in Utah and the case was very similar. In this case, the family didn't want to continue chemotherapy after the first cycle due to side effects. With teamwork and now a whole community understanding the culture, we were able to proceed and eventually get the tumor out. Unfortunately, there are hundreds of stories like these and many have poor outcomes. We need to build bridges and not only within our own circles but also have a global perspective, and collaborate with professionals around the world who will take care of these patients.
How do you balance maintaining your cultural identity while navigating a field that has traditionally lacked diversity?
It has been really hard, and 25 years later even after climbing the academic ladder to be Professor in Surgery and being the incoming President of one of the most important Pediatric Transplant Societies (SPLiT OCT 2024-OCT 2026), this “impostor syndrome” we all talk about lives with me everyday.
I am very proud of my heritage, and I love visiting my family in Mexico and working with my colleagues there. I am also a very proud father of two American children that often teach me new words in English and correct my accent almost everyday. All that said, as hard as it is, it was harder for my mentors before me. My goal is to make it easier for the generations after mine. The most rewarding part of my career has been to mentor and sponsor healthcare professionals from underrepresented minorities and remind them that it can be done (in Spanish we say “Si se puede”), and that even if they help one patient or one student, they can make a difference.
What unique challenges have you faced as a Hispanic professional in the transplant field, and how have you overcome them?
What we do in an operating room in NY, Utah, Mexico or Mongolia is technically the same and we all are in this field to help our patients with end stage organ failure. It is what happens outside the operating room or the transplant unit that is challenging. We all must adapt to the environment we are given, and the best way to overcome the challenge of diversity is to have "purpose." For me, this means do what is best for the patient, and my guiding light is that benefit of the patient and their family comes first.
In what ways do you think the transplant field could benefit from more Hispanic perspectives and leadership?
Globalization is a reality, we are all interconnected, and being a Mexican-American living in Georgia, I see the diversity in the city of Atlanta in every corner. I saw it in NYC when we all worked together during 9/11. Most importantly, I see it all around the world. I was in Toronto this month at the DEI in Transplant meeting and outside there was a huge celebration of the Mexican Embassy for their Independence Day. In recent months I have been in Australia, India, and France. Hispanic culture and the values of friendship and pursuit of happiness are everywhere, and in my journey it has helped me to be humble and look people in the eye by leveling the field. When I forget or try to hide the Mexican in me due to shame and doubt, I lose my authenticity and nothing works. Every day at home I am reminded how proud I am of being Hispanic.
What role do you believe community outreach and education play in improving transplant access for Hispanic populations?
The work that Juan Carlos Caicedo-Ramirez did with his team in Chicago Children and Adults in the Hispanic community is an incredible example. They have given every center a road map of what they have learned to improve access to minorities. One key lesson I have learned from them is the value of educational material, in person education in Spanish, and adapted to the culture of the population. We need to do that with all the different communities in our area and in all fields of medicine.
I have a son with a chronic medical condition; Santiago has been the driver of every decision my wife Patricia and I have made since he was diagnosed at 15 months of age. We are both highly educated successful professionals that happen to be Hispanic and we still struggle everyday with access to care, and I can’t even begin to imagine the battles less fortunate members of our society have to face.
How can healthcare institutions better support Hispanic professionals in advancing their careers in transplant surgery?
Underrepresented minorities are very proud, and we have had incredible leaders in Transplantation of Hispanic heritage. Names like Oscar Salvatierra, Carlos Esquivel, Jorge Reyes, George Mazariegos, and Juan Carlos come to mind among many others who have been trailblazers in our community. However, it is almost an unwritten rule to talk about our heritage and, we don’t want to be treated any differently. We just know we have to work harder to reach our goals, but I personally never want anyone to say it was because it was my diversity that helped me get to my goals.
I believe giving young students of color the same opportunities and education through sponsorship, mentoring and coaching is key. Most of us owe much of what we have done to our mentors, so healthcare leaders and societies need to always be aware of the importance of building bridges among different groups.
Finally, most will agree that part of being Hispanic is “sharing.” We love to share our culture, our music, our food, and our friends. We love to build networks, teams, and share our ideas with others. This is a strength that, when embraced, will continue to advance the careers of many professionals, no matter the color of their skin or the sound of their accent.