A. Osama Gaber, M.D., FACS
The director of the Houston Methodist J.C. Walter Transplant Center, sat down with Texas Medical Center Chief Strategy and Operating Officer and Executive Vice President William F. McKeon to talk about his vision for a community center for transplant recipients, and the mission of the foundation he started in his daughter’s memory.
Q | Tell us a bit about your formative years.
A | I was born in Alexandria, Egypt. At that time, Alexandria was a beautiful Mediterranean city. It was just amazing. Very cosmopolitan. We lived in an apartment right on the Mediterranean, and we had two Jewish families, one Greek family, one Italian and then us. And actually, the owner of the apartment building was an older Jewish gentleman. He was one of the reasons I learned English so well. I could come home and speak to him. He also was a stamp collector and taught me that, so it was just a really beautiful time growing up in Alexandria.
My father was in the textile business, but he was a lawyer by schooling. He never really worked as a lawyer. He worked in textiles, and he was very smart man. Self-taught, very hardworking, really wanted, from the very beginning, wanted us to explore the world and know about the world beyond Egypt. He was one of the first globalists; he believed the whole world was one place and that you really need to know all of it. He was a fantastic guy.
Our family had four boys, and we went to the English boys school in Alexandria. Very British at the time. Really fun, and I played soccer. I was on the school team. I was the goal keeper, and really liked it. It was a good time. Then about the early 60s, my dad was chosen to run this textile conglomerate of ten or eleven factories, so we had to move to Cairo. I was in the 6th grade when we left, so I started middle school in Cairo.
We lived actually across the street from the school. And the school became sort of the center of our lives. It had a boarding school, so we had kids from all over the world who, because of their parents, came to Egypt. And the school had enormous playgrounds, so our soccer got a lot better. It was a magical time. It was the 60s, so there was a lot of change internally in Egypt, and in the world. I have a lot of memories of the day John F. Kennedy was assassinated and the day we landed on the moon. Just being part of the world, from Egypt, was an amazing thing. And of course, wars that happened in Egypt. I went to take exams during air raids and had to spend some nights in bomb shelters.
But because of where we grew up, we spoke English, we spoke a little bit of French, we had excellent teachers…it was easy to really think of the world like my dad had intended it to be. I always knew I was probably going to go to England and study medicine there. And I tried that, after medical school, but England at that time was going through a lot, and America was the place. So I came here and started my life, and I met my wife in medical school.
Every textbook I studied, I figured out who the professors were and what schools they taught at, and then I just wrote them all letters. And there was this professor at Cornell in New York. I wrote him a letter and said I want to do some surgical training, and amazingly I got a response. And it said, ‘We interview people between February and March, and you are welcome to come for an interview.’ I put that letter into my pocket and headed to the United States. They sent that letter to everyone. I was young and naïve.
But it was a different world. I sat in my room and made phone calls to different people in the states and someone in Washington D.C. said, ‘Our department always needs people. Why don’t you come stay for a couple of days and see what happens?’ So I fly into D.C., and the next morning one of the residents quits. They said, ‘Why don’t you talk to the chief of surgery? He is looking for people.’ So I walked into his office and it turns out he was the physician for Camp David, where President Sadat had just negotiated a peace treaty. He had known him, and he was very sympathetic to Egyptians. And he said, ‘Okay, I can give you a job,’ and I started and the rest is history.
I haven’t thought of it for a long time…but what an amazing country.
Q | How did you know you wanted to be a surgeon?
A | I don’t know that answer. I always wanted to be a surgeon. My personality sort of fit it. Because you made judgments, you went ahead and acted on them, and then you very quickly learned if you were right or wrong. It was that gut feeling, depending on your intuition, and I knew that I had those things. Even when I was in Egypt doing my residency, I really loved doing things. I just couldn’t see myself sitting in a clinic. Now, as a surgeon, I spend 50 percent of my time doing medicine, actually, and I like it. But it is those hours in the operating room that really make me feel like I can keep going. Different people have different things. And that was my thing.
So I started my surgical training in Washington D.C., and you talk about mentors…after two months of being there, I took a rotation at the Children’s Hospital, which is across the street. And I met Dr. Judson Randolph, one of the giants of pediatric surgery. I had no idea; I was just a kid from Egypt trying to find his way. But after I had been there for about three weeks, he calls me into his office and he says, ‘You know I have watched you, you are a really good doctor. What do you want to be in life?’ And I said, ‘You know, I really want to be an academic person. I want to do research.’ So he said, ‘Here is the list of schools. Go apply and I will be happy to help you.’
And that changed my life.
A couple of months later, I get this letter from Boston University, and they say come on in for an interview. So Dr. Randolph writes me a letter, and my wife and I drive to Boston.
We rent a car, and I keep driving all night long, it was eight and a half or nine hours, so we finally make it, the interview starts at noon, we arrive at 11. I change my clothes into my suit in the hospital, she is waiting in the car, sleeping in the car in front of Boston University, I go in to interview, and the interview doesn’t go really well. I am just completely unprepared for this. And then I meet Peter Decker, another mentor, just an amazing person. Peter is the head of surgical oncology, the chief of surgery, and he looks at Randolph’s letter, and he said, ‘You know, the guy who wrote you this letter, I know him, and I know that if he writes a letter like this, you must be really special.’
So we start in Boston the next year, Lillian starts a job at the Deaconess, very prestigious. Boston sort of unlocked our careers and our future. It just fell into place. My career was a series of events that resulted from me not really thinking anything was impossible. Of course, now, when I see young people, I recognize it is so much more complex for them. They have so many more barriers.
Today, I see young people who are just starting medical school, and they know exactly what they want to specialize in. For me, every rotation I went to, I loved. Everything I did, I wanted to do. And it is that which makes you dig deeper into everything, and creates the sort of doctor that knows a lot. I think one of the biggest problems—and it really affects how we do health care in this country—is that everybody needs 25 consultants, because everybody knows one very specific thing. And that fragments care.
As I went through my surgical career, I really focused on learning the medicine. So, for example, I tried to learn about diabetes, and it turns out that doing that was very good for me because that’s what I do my research in, and it really helps in taking care of the patients because you aren’t just doing the surgery, but you know the patient. And it is really very powerful.
Q | What is something that surprises you, as you look back now, about where you have ended up?
A | I think Houston was a great surprise for me. I interviewed quite a few places for my first job. I traveled and I gave lectures in lots of places. But I think when I came to Houston, it was completely different. The Texas Medical Center is an amazing place. That was the biggest surprise.
You come here and all of the doctors are really good. It’s like the quality of the people is superb. So it’s so easy to look around and say, ‘Take care of my patient. Fix this. Do that.’ Everywhere here, the physicians are very high quality people. And I think that enables building programs and knowing no limits. Because you can’t do it by yourself. Everyone around you pushes you. They demand more, all the time. And you have to really keep up with those guys. They are all smart. It’s not cutthroat competitive, but you have to be just as good as all of those good people.
Q | Organ donation is different in different parts of the world. In some countries, you are automatically opted in. What steps would you like to see in educating our community, or our country, about organ donation?
A | I think that what is really challenging with organ donation is if you talk to people, they completely understand that organ donation is necessary. They say they will do it. But I think the situations in which organ donations happen are so dramatic, that it impacts that decision.
Denial is probably the most profound and common human feeling, and I think that the biggest education one could do is really demystifying transplantation. It is not about taking people who are going to die tomorrow and then letting them live in a wheelchair in a nursing home. There are people living normal, healthy lives because of transplantation. If we can take that to people, I think that would make a huge difference in organ donations. People understand fundamentally that this is good, but facing the situation, the death of a loved one, is very traumatic.
I can tell you that people spend months after somebody dies believing they are going to turn a corner and see them back. And it’s hard to make that decision. So when people make that decision, I have a lot of respect for it, because they were able to grasp the finality. Because I don’t think it’s just education. It’s human nature.
Q | Tell us about Nora’s Home.
A | If you look at the Texas Medical Center as a conglomerate, they have the largest transplant program in the country. Methodist isn’t the largest, but if you put us all together, we are the largest in the country. And for the largest program to not have a place for transplant patients to stay is a real problem for all of these patients that come from all over the world.
What’s amazing about this place is the support that people give each other. And I knew that. I just kept telling people, let’s just build it, and then you will see what I mean. And when I walk in Nora’s Home, it is phenomenal. There are almost 900 transplants done here every year in the Texas Medical Center. That’s a lot of transplants. So there is a huge need. And my idea is not only to give them a place to stay, but to create a transplant life center, so it is a place to come before and after you have had a transplant, to see other people, maybe to exercise, maybe learn how to cook for your new life, learn about your medications.
You know, one of the hardest things people face after transplantation is finding a job. Because of the stigma, people think that you are sick. So these transplant recipients can form communities, to do things together. That’s where I see this eventually needs to go. So that these people, after they have stayed together, worked together, lived through the transplant experience together, now they can help each other for the rest of their lives. And that is what I think is so amazing about the transplant community, is that people understand each other. They know what they have to go through.
Q | I would imagine that there are benefits to being able to share the same discussions, the same challenges, the same worries…
A | I always think about it this way. You’ve had a really long day in the hospital. You’ve seen 20 doctors. Some say you are a little better. Some say you are a little worse. Some say you need to start this. Some say you need to stop this. And then you walk in here and all of these people say, ‘Yes, I have had that happen. Don’t worry about it.’ ‘Yeah, I know that doctor…He’s great. He will take care of it.’ So then you can tell your story and nobody says, ‘What’s that?’
Everybody understands. So you have that strength to then, the next morning, go and face it. And I think that’s what’s so unique about this. It’s about people being able to walk in here and just lay down and not be afraid that anyone is going to think ‘Why are you telling me these stories?’ People want to know your stories, they want to give you support.
Q | What can we expect for the future of Nora’s Home?
A | This is an amazing place. We have enough space that I think we can make it bigger. I think we can create this life center and community center for the transplant patients, and it would be a place where they can come not when they are sick. Not when they are waiting. Not when they just left the hospital. But just come for sports, cooking, education and everything they need in one place. Eventually that’s what I would like to see happen.
People might think of the individual transplant departments. But if you look at transplantation at the Texas Medical Center, it is now a much bigger endeavor. We have a unifying power.
The transplant business is growing, unfortunately. Because the diseases that cause organ failure are some of the fastest growing diseases, not just in this country but in the world. Diabetes, hypertension, liver failure, heart failure, pulmonary diseases, asthma, emphysema are some of the fastest growing diseases in the world.
I see us going in a direction where we can talk prevention. You would talk to a transplant surgeon, like myself, asking what can we do for obesity, in terms of prevention? What can we do in terms of hepatitis? Asthma? Because that eventually makes our endeavor more than not treating people until they get into organ failure and then we give them a transplant. If we are to actually advance care, we should be on the front lines to prevent people from getting here. And only use this treatment for those diseases we are not able to stop. That’s what I think about constantly.
ABOUT NORA GABER
Nora Gaber was a beautiful young girl with an incredible sense of compassion and kindness. She was known for her giving heart and desire to help those in need, especially those less fortunate than herself. Nora reached out to everyone she met and made friends easily. In school, she was honored with the “Best
Friend Award” and would always ask her family to stop and help any person she saw on the street in need. In 1997, Nora’s life was tragically cut short in an automobile accident. In recognition of her loving spirit,
her parents, Osama and Lillian Gaber, donated her organs to help save the lives of other sick children. Inspired by their daughter’s unique sense of kindness, Nora’s parents created the Nora’s Gift Foundation
in 1998 as a way to carry on their daughter’s legacy. Nora’s Home serves to help, house and support transplantation patients and their families. Located near the Texas Medical Center, Nora’s Home provides private bedrooms, a chapel, community room, education center and free shuttle service to the medical center.