Hello, my oral surgery friends. This is your host, Dr. Grant Stuckey. In this podcast, you will hear surgeons discussing ways to improve the practice of oral and maxillofacial surgery. The goal of this podcast is to evaluate every aspect that a surgeon can improve in order to create a better experience for patients, staff, and the surgeon. Most of the information shared in this podcast will be based on personal experience and opinions. The methods discussed are meant to provoke thought and should be supplemented with research and to the approved studies. Prior to making changes to one's way of practice, without further ado, please enjoy this episode of "Everyday or Also Drate." Hey guys, before the podcast today, I just wanted to mention a great course that's coming up. This is a great opportunity to learn psychomatic and terrogoid implants by our own Arsia Shirafi. He's a good friend of mine. He's been on the podcast. His episode is awesome. You should listen to it. But it is in Southern California on March 18th and 19th, 830 to 5 pm, and it's a cadaver course. So it's going to be awesome. You can look it up through 4M Institute, and you can contact me or him as well if you have other questions. But please look into this and try to go if you can because it's going to be awesome. All right, enjoy the episode today, guys. Welcome to the episode of "Everyday or Also Drate." Today, I'm with Dr. Michael Markowitz. He is an oral max-efficient surgeon practicing in Buffalo, New York. Michael, thank you so much for being willing to be on the podcast today. I really appreciate it. Thanks for having me on, Grant. Yeah, for sure. I've been looking forward to talking with you, kind of know you distantly through the University of Illinois, and awesome to kind of connect with you. My first question for you is if you can just kind of give us a brief history of your training and your current practice setup. Sure. Yeah. As I was just telling you, Grant, thanks for having me on. I've heard a lot about this podcast, and I know everyone listens to it and the residents around the students, so I'm excited to be a part of it. I think so, start off in the beginning. I did my dental school training in Buffalo, New York at the University of Buffalo. I took one year hiatus and went off to Boston and completed a Master's in Public Health and Epidemiology and Biostats, spent some time at Mass General Hospital, and then came back and completed dental school, and then went out to Oregon to Oregon Health and Science University, where completed residency, general surgery, and medical school. And then from there, knew I wanted to do a fellowship and was lucky enough to go to Orlando at the Arnold Palmer Hospital for Children, where did a pediatric cleft and cranial fellowship, and then just went north to Jacksonville, at the University of Florida with Dr. Fernandez and completed a fellowship and had an econtology and reconstructive surgery. And then landed in Chicago, where you and I got to meet a little bit and talk. And then where really there was just a wonderful place to start a career. And I think I really got lucky to be in a place where I wanted to be a city, I wanted to be, and really a bunch of partners and with a boss I wanted to be with Michael Muloro. He was incredibly supportive and really very quickly, you know, I always tell residents and fellows come out, if you're an oil maxill facial surgeon who does cancer, you want to get busy, and pretty soon you just really are busy because you know walks in your door and you have self-referrals, you have referrals from your partners and from other providers and other dentists as well. So that guy really busy and was really able to have a lot of fun working with the team there, able to quite busy practice and had neck cancer and with reconstruction, obviously trauma and cranial facial. And at the time I'm from Buffalo and I was coming here about once a month just to do, they needed hand and collective cranial surgery at the Children's Hospital. So I was doing that and, you know, really had no intention of moving back to Buffalo, but actually, you know, made me an offer, I couldn't refuse with becoming the head of the department here, be the part of the department, co-director of the cranial facial center, and then practicing at Rouseville Park, which is where I do all my cancer and reconstruction, which is a really unique cancer center. So currently, you know, my practice is an academic practice. You know, we have a couple partners who do the full scope of oil, maxial facial surgery. You know, any given week or day, we'll be doing a head neck oncology case, cancer case and recon case versus a cleft case or a cranial facial case or just your typical jaw surgery case or sometimes trauma as well. And so that's kind of where I'm at now and hasn't changed much, maybe has gotten a bit busier, but it's kind of a fun practice. That's awesome. And can you tell us just a little bit about how you decided to do a fellowship and maybe a little bit about your experience during that? Yeah, that's a great question. I think everyone thinks about it a little bit. I think, you know, we all like doing surgery, the full scope of our specialty. And I knew actually, ironically before going to residency, I knew I had a strong interest in cleft and cranial surgery. In fact, the office I worked at had Jeff Posnick's book on cranial maxial facial surgery in young adults and in children. And so I would pick it up and look at it, look at the pictures and see, cranial facial surgeries and so on and like that's what I want to do. And then you know, you go to residency and you get jaded and you get burnt out and you go to medical school, but I still had a strong interest. But you know, at Oregon, we had a very strong answer in recon program and really just amazing people who were really phenomenal mentors such as Brian Bell and Eric Derbs and Mark Engelstedt and Kevin R.C. You know, the list goes on and most of those were oncologic surgeons. And I think it really had a strong effect on me and very quickly got the edge to do that type of surgery. I think like a lot, I considered another residency to see how that might aid me in being able to do certain types of surgeries and maybe certain types of fellowships. I was able to go during medical school and spend some time in Orlando or I ended up going for pediatric fellowship. And then a week after that went up to Jacksonville and spent a week there. And from then I was really hooked and I knew I wanted to do that and went through had supportive staff such as you know, all this had was able to you know, write and contribute on those topics and really just got more into it. And so that's what happened and then went to Orlando to start the pediatric fellowship, went up to Jacksonville. And I think you know, after you do those, I really never looked back and I think it was one of the best things I ever did. And I feel fortunate to be able to train at both those programs and put the faculty there. It's awesome. Very cool. And how is things going as the chair? I mean, correct me, I found wrong, but I mean, you're kind of on the younger end to see the chair of a program. Well, yeah, so definitely I, you are correct. When I was offered the job, I thought the same thing. And it's still probably think the same thing. I always used to joke because you know, I would get out of a long oncology case, recon case, especially when I was on my own and then Nick Callahan, who was really a great pickup at UIC partner there, was able to lighten the load a little bit. But Irleana was doing everything as far as you know, resection and recon. And I would joke because when the residents were closing, I would start checking emails. And I would see these 100 emails and I would see Michael Molloro and all the emails. And I would joke with him because by the end of the day, six o'clock or so, when I would check the emails, usually the problems in those emails were solved. And actually, I was just kind of copied as a peripheral, a mic just FYI. Michael's an excellent administrator. You know, he really manages this time well, manages his people well. And so I said, joke, I wouldn't have to do that, right? And so, but ironically now, such as nights like tonight, you know, you get down with cases and you'll have the 100 200 emails in your inbox. And the majority of them, I actually have to address now. So it's been really interesting such days like today, where the dean who hired me, who just left and our new dean, give a very long leash, you know, they let me miss a lot of conferences where the other administrators go to my just send someone else in my place. You know, the things I thought were really important were interviews, you know, matching good candidates and interviewing good candidates. And I'm really proud of that. I think we really have increased our applicant pool immensely. We've increased the, you know, we have a wonderful group of residents and our scores and everything have just gone really through the roof and higher. So that's what I'm really happy with. I think things that worried me were interviews, matching graduation and then accreditation, which that's coming up in June. So I'll let you know if we're still around in July, but those are the things I thought either I could screw up or just keep going with. So I think actually the administration role has been the biggest challenge, but it's been the most welcome one because it's just something very new. And I think we all like new things and, you know, I were talking grand how you do this podcast that has, takes so much time and has so much, so many individuals and, you know, on it. I think, you know, we all want a new challenge and this certainly has been a new one. I mean, the surgery is always there, but this is definitely a new thing. And this is kind of the baby now is making this a great program. So that's been the most encouraging and discouraging. I think the last thing would be that, you know, like anything with administration, You feel like some days you. They have a lot of meetings, you talk a lot and you sometimes you like you accomplish nothing right It's almost two steps forward three back sometimes But I think things like you know, we had a guaranteed remodel in our department Which was a really large sum of financial interests of the school that was guaranteed and when I came here the state cup back fund and just Five months after I got here because COVID hit so We're working on that now again new faculty hires and again those are all new things that are really exciting So stay tuned I guess on that Nice and it's a dual degree program, right? It is it's always been actually since about its inception and they've just a couple years after that Okay, and you have two openings a year we do we have two openings You know as you know adding another spot is very tough We definitely have the volume out to add another spot But it's easier to add a non-categorical spot and we definitely have had the need so we won from one Non-categorical spot excepting three now so we take three non-cats and two categorical residents per year cool. That's great and what is your program heavy in in regards to I mean clearly of course ahead and that cancer because you're there, but what other things are involved with what you guys do That's a good question. We're trying to make it a very even oral and maxillatatial surgery program I think that you know truly our specialty is one here. It's not like other countries In the exception Europe that separate them. I think it's really important to not be the so-called cancer program Which I know residents worry about right because Although I want them all to do fellowship training and would love for them to go out and do all this stuff I think the majority are gonna go on a private practice if we have to train Broadscope people who can do everything but can also take a few thoughts do implants So definitely I do some of that we've other people who do more so I think There's no real focus. It's a great question. I think cancer has gotten heavier But we are by far not among the busiest cancer programs in the country and I think left-cranifacial Lens is self-well to ortho-nathics and jaw surgery and you know Maybe different osteoatobase, but you know we do bread and butter or the ethics which That's actually the thing that has been the slowest now. It's very busy with ortho-nathics because that's the one thing I'm like day one cancer was ready to go Cleft cranifacial ready to go or the ethics as you know you can see a consult and Might not be ready for your year and a half so that's actually the thing now that has gotten really busy You know, I think we all maybe do or do not want to do more TMJ I think we're not super TMJ heavy here, though. I don't know what the few programs that are definitely we do a little bit of cosminx But probably would like to do more so I think those are things probably the focus on but I think it's a great question Grant I think probably were pretty evenly focused on everything throughout the week nice. That's awesome and How cool is it that you grew up in Buffalo, right? I mean and that opportunity was There for you to kind of go back to originally from it was really special again the hard part about leaving Chicago Where I had my first job was that you know, it's one thing is you're unhappy with the place and you go somewhere But that was not the case which is what made it very challenging because I loved everyone I worked with I loved my job I love you know People who you know I was with in Chicago. So everything was really great But it was an opportunity to you know be closer to home or at least where I'm from and you know This is a time especially where I think it's very important with Family and and whatnot you know to be around so it actually worked out very well and so it's definitely unique Cuz I think one of the things that you worry about you hear people who stay on where they train or go where they've been and They're the students forever right or the resident forever and you know, we have in the department I think it's we're all pretty even you know no one's ultimately I guess decisions get made by Someone but we try to take everyone's consideration and some people exactly are older than me and so That's been interesting, but actually it's worked out great and I can't ask for the current group We have to be any more supportive and also I think you know It's like anything in a private practice. I'm sure that you're in and in partnership You know you want everyone to pitch in where needed and it's nice that little family atmosphere and You know the residents, you know, I mean you know you're trying to ask people who who can be hard but I think you Know it's a serious business. We take care of patients who are sick, but at the same time I would hope you know Things are serious and but at the same time we can also have fun as well. So it's been good. Yeah, that's awesome And are you doing a primary cleft repair and a lot of pediatric Creno-facial type cases. Yeah, so this week last week, you know Would include primary lip repair, pal repair Cleft bone grafting, cranial stosis, complex cranial stosis. So yeah doing the full gamut here Really that's another aspect that was a draw in that I think we all want to work with people who we enjoy working with and The team here is a ACPA-proved team which you know now really lucky to be the co-director of with another Ashy at plastic surgeon who has been phenomenal and very supportive and has been here for a while and so we tend to split You know all the cranial gets done by our service here and then so all the bony work for the most part the lips and palates get Almost split down the middle so given in a week maybe give it take morph to me or more to someone else But we kind of split those and it's been very collegial and Working together in the same clinic and I think you know it's always good to treat these children in a team atmosphere. So You know as you know the ACPA we just re-accredited last year they are very strict on that stuff So they actually pointed out something that was missing we didn't have a good psychologist on our team for one particular focus and so it was really good So it actually forced us to go out there and recruit someone from from the university to help out in an aspect So I think with that being said we have five speech pathologists social workers We have a prostitutist we had an ortho who did nasal be all her molding so it's really a good comprehensive group Yeah, and that's cool as well I'm sure you're and that's probably kind of maybe unique to your program I'm sure there's other programs, but I don't think there's a lot who Provide those cases for residents to get like that close to the case and really see what's going on and you know as far as Pediatric and cleft repair and cranial facial stuff And you don't have a fellowship there right so you're probably working with your chief residents and they're right there with you Yeah, we don't have a fellowship as them now So that's that takes more work than I thought So we have a fellow at the Cancer Center who's an American head next society fellow and he scrubs on all my major cases You know if it's you know any kind of recon here she will scrub on those but with the residents and they all know That was the agreement that you know we would help to work with the fellows And I think it's a good educational experience to be exposed to our specialty But at the same time it wouldn't take away from the experience and to be honest some of the residents I think I think like it because they don't have the you know Yeah, some as you know This isn't Chicago. There's some are really interested in certain cases and some aren't so I Don't they may mind but no with the cleft and cranial that is always With our residents who are first assist some once while some other specialties will come in to hang out during those cases But always our residents are you know safe safe for tomorrow It'll be our chief resident intern with the neurosurgery resident and they're intern, you know hanging out for a cranial case So it's good to build a collaborative team so for dental students that are listening Can you just kind of give us a basic summary of how to become a cleft and cranial surgeon? Sure, yeah, there's really three avenues to do that as far as specialties and that would be Plastic surgery which you do the most common most likely Oval air and biology and then Austin or maxal facial surgery and then in other specialty you can do this stuff without fellowship training It becomes more challenging than just 10 years ago where a lot of hospitals and even here They want you if you check that box They want you and either especially they want you to have a fellowship and that's true in head neck Necology Microvascular for sure but definitely even here in pediatric Facial surgery so if you're gonna do one of those specialties first Probably would have to do a fellowship most are one year in duration. There's only a few that are two It's very rare. So you know for all maxal facial surgery, which I think is a great choice a dental school Residency and fellowship plastic surgery would be the same thing and then being in T as well just doing the residency and And training and I think a lot of people think about other specialties and the training or opportunity they could offer to do this and certainly sometimes The road to doing this type of surgery might be easier through another specialty But I think it's all about content and I was really fortunate when I was applying for fellowship probably interviewed at about five plastic surgery pediatric prenatal fellowship programs and they were wonderful and they were really busy and in the end I was actually very lucky with Rwandao. I was given the chance to do that and if there was good opportunity
to maybe look at those. And to be honest, I looked at the volume and I looked at the volume that Ramon Ruiz was doing in Orlando and the primary lip series doing in pallets and bone grafting and then Cranston and Stosis and it was incredible. And I think and I looked at the volume of other fellowships, especially a plastic surgery and even compared to a few of them, it was a no-brainer. So I think the content is definitely important. You know, and plastic has about 25 to 30 fellowships but there's not a lot of jobs out there for any kind of cleft cranial surgeon, even in our specialty or in plastic. So I think that's something to consider, you know, when you're looking is what the job market is. So some people would say, well, if I can't get a job, you know, should you apply, should you go ahead and do a fellowship? And I definitely think that it can't hurt. You know, I definitely think it makes you a better surgeon. People will hallow this cancer surgery and recon relate to cranial surgery. And I think there's definitely techniques that you could draw from both and make yourself a better surgeon. You know, I think in the end, more training can't hurt. You know, you don't want a waist tie but you also, I think if you invest in your training, it's, you know, it's never the wrong choice. Yeah. And I assume for most fellowships and cleft cranial, they want you to have the MD, is that correct? It's a great question because we have a couple of residents here. We don't have a non-MD track but we have attriculated people into the program due to attrition previously. And there's a couple who are stellar residents who, and I know people ask us all the time, you know, taught to students and residents across the country who don't have MDs. And I think actually there's a lot, a couple really well-known younger people in our especially who do this type of surgery at a very high volume and at a very high level. But I think it's definitely more challenging. So I would never want to discourage that. I think fellowships, some limit, due to licensure reasons, it could be challenging to license someone for a fellowship year and a non-MD track. But I think a lot will take it and I think there's definitely opportunities. And so there's definitely young people, definitely the pillars in our specialty, a lot of single degrees, tim turbys and so on are just giants who do this type of surgery. But I think younger people are doing it. But I guess I would tell residents it's challenging to do this even when you have an MD. It could be a little more challenging if you don't. Yeah. That makes sense. Okay. And so in your case, it was, you know, four of Donald, six at Oregon, and then it was the one year in Orlando. And then the one year in Jacksonville as well. In Jacksonville? Okay. Yeah, so it was good. Yeah, that's terrific. I mean, it's such a great opportunity. I'm sure there's a lot of our listeners, you know, who are interested in this type of surgery and would love to reach out and ask you questions about it. And I'm glad you kind of talked a little bit about how the job market is kind of a niche thing where it's pretty specialized and it's not like, you know, tons of opportunities. But certainly, I'm sure there are some that come up every now and then. But yeah, I don't think you can go wrong getting that training. Yeah. Yeah. You know, we had your old boss, Mark Ingolstad on the podcast a month or two ago. And how awesome that must have been for you to train with him. You know, I only know him through different conversations, not spending a significant time with him. But he seems like just kind of the ultimate educator type of a guy who really cares about educating, you know, the actual process. And I think, you know, there's a lot of people in academics who are there, maybe more for the surgery and less for the actual teaching of residents. And, you know, I don't know. So I'm sure that was cool. Any comments or about him and your experience? That's a whole separate podcast probably. Yeah. Mark is someone who came to Oregon probably when I was a second year, just as Kevin R.C. left and went back to Mayo Clinic, which was a big loss. But Mark came along and just was incredible to get to know him. As you know, he's incredibly articulate. He's intelligence beyond belief. Just when you talk to him, you know, you always kind of learn something new. And it's interesting. And he just has a way with words. You know, I always call him the king of the analogies because he knows it because he always, you know, he's so witty that he can very quickly compare something in surgery or in everyday life to something else. And it always makes sense. He was an incredible educator. And a lot of things I do now, I, you know, we always repeat our teachers and mentors and I repeat all of them. But, you know, the way he does a cleft bone graph, I mean, really, it just certain things. Mark has an incredible way of making things that are complex to someone such as the learning, you know, the resident who's in training and making it very simple. So he's a master surgeon for what he does, which I think things that he's well known for. And as well as trauma, ortho-nathics. I mean, again, ortho-nathics where I think it's this kind of like a bis where it's very confusing as a resident. It's, you know, this big dark hole that we don't know much about when you're learning and the cuts for a sagil split and so on. Mark can make things so simple. And he has a logical way of teaching you during that. And I think that might have to do with his association with the AO and how much he teaches there. But he's just incredible. Trauma the same thing. You'd be doing trauma with Mark as a resident. And he, you know, again, put the pieces back together. He would have a very simple way of doing things. And he didn't ever make it look hard. And he made you do it in a way that was easy. And I think that the thing is that educator you really try to work on is that the easier thing to do, you know, is just to do the surgery or do the case or make the tough move. The very challenging thing to do and Mark was excellent at this was to instruct someone to do something that's maybe a bit above outside their comfort zone. And he's just a really good educator. And like you said, he probably enjoys to teach you know, almost more than the surgery and that he, you know, he's very involved now as you know, in violent formatics and so on. So he really enjoys that part of it. And I think he's always looking for the next thing that excites him and who knows what that'll be next. But he's an incredible speaker. And I'm sure that the great podcast and I'm sure I heard a lot of things before. Yeah, exactly. Well, that's cool. And I'm sure some of that rubbed off on you and you're able to teach your residents in similar fashion. You know, one question I wanted to ask you about is in regards to treating kids, children, you know, I think there's a lot in our specialty. And maybe because a lot of us don't get tons of exposure to treating kids in residency that there's this general kind of fear we have of treating kids. And you know, we prefer to stick to teenagers and up. And it's just simpler. And and you know, if something goes wrong on a an 80 year old person, well, that's not as bad as something going wrong, you know, on a two year old or something. How has your experience been, you know, is that kind of a harrowing experience to work with kids and see complications and deal with all that or how is it? Yeah, I think you said a grant. I think children can be incredibly rewarding to work with and to be honest, you see this I'm sure in your practice, they're actually easier at some time, right? Because they don't have the free determined fears that adults have. And this could be for a tooth extraction. You know, we had a kid recently who we did a biopsy on a clinic and he was the best patient ever. And he actually thanked us afterwards and, you know, I mean, actually you could tell he was over the pain during, but you were talking about today with, you know, with a resident team, how just a joy. And I think the parents rub off a lot on children. And so I think, as you know, the difficulty with children is that you have two patients, you know, you have them, and then you also have the parents. And as you know, as well, the parents could be the more challenging patient to actually deal with sometime. And not because it's anything wrong from them, you know, you try to put yourself in their shoes and they're just a concerned parent and some react differently. And, but it can add a lot to discussions because even that same parent who might be having a procedure might have one minute worth of questions, but now it's their three year old and they're going to ask you questions for a half an hour, you know. And so I think you just have the patience with that. But I think also there's something we said for people to take the kid, you know, child to the operating room. It's one thing to do them in your office. And I have no problem with that. We do a lot of children's procedures in our office, but it's certainly if you need to, I think going to the OR is fine. And if it could be for a colaptor, you know, maybe a simple tooth extraction. But I think it's certainly something that's really good to be exposed to. And I know the faculty session at Amos is really working on that. And they're trying to make sure that exposure to children is placed at a high priority, I think, for training. I think the problem is it's just hard to get that training. You know, it doesn't have to be collecting training facial surgery or anything pathology. It could be just exposure for anesthetics. And that's one thing I think they did well in Chicago. I know we did a lot of an Oregon was, you know, exposure to anesthesia in children because as you know, it's just a different ballgame and we have to keep things safe. So I think it's definitely different world. And I think it's something that should be places a priority with our specialty for exposure. Yeah, totally. Yeah. And it's awesome. I think it's great to hear that you say that it is rewarding. I'm sure it's pretty awesome to see some of the pretty significant changes and really make a course correction in a kid's life by fixing them up. That's pretty awesome. But I'm sure there has to be a level of patience with the parents and
in the whole situation because I'm a father of six kids and I can only imagine what it would be like to have a newborn or two or three year old that's dealing with a major health problem. Like, you think goodness, I have never had experience that, but that's kind of one of my greatest fears as my kids have an illness like that. So I'm sure there's a lot of parents that are in a frazzled state of mind that you have to kind of take by the hand. - Yeah, I think you're exactly right. And I think it's interesting because, like everything we do every day, we take it for granted, but I think, I have to think about it. If my child had to go through some of the stuff that we do, I think, I mean, I can't imagine how I would see it all. And I think we take for granted that, the things that we described to parents and some just say, okay, sounds good. It's like, you know, but I'm not sure if you heard me. This is what you want to do. - Right. - So just to reiterate. So, and some parents are, you know, we take all comers, you know, with patients, you know, and there's all this doing. Some parents are just over the top concern, which is fine, you just have to help manage them through that. Some, it's incredible. We'll say, you know, okay, sounds good. And so I think it's always, honestly, a surprising, but it's always really interesting to see, you know, I'll just say, I think the one thing that we offer in our specialty is the functional aspects of craniofacial care. And by that, you know, if it's a robust sequence kid who needs some distraction, I think that's something that we do very well, you know, and some that most maxillofacial surgeons can do. And for sure, you know, lip repair or pallet is very functional, especially the pallet repair, but that is something that we can offer that in three years, and we've seen these now, where the kid's thriving and he's going to school and, you know, speaking well and no ET tube anymore or trache, it's really phenomenal to see that. So I think that's one thing that are especially, you know, I think we shall be proud of that we focus on the functional aspects of growth in the development in surgeries for these kids. - That's awesome. Very, very cool. Well, I mean, I guess one of the last questions is just, what advice do you have for, you know, young students, residents, surgeons who want to be involved in cases like this? - Yeah, I think just seek it out and, you know, I think take advantage of all that you can with the program that you're in. So your first goal is to get into A-resonancy, hopefully the one that you want, but if you go to a program that doesn't do a lot of a particular area of, especially that you want, you know, that's what fellowships are for. And so I think you see amazing surgeons in these sub-specialties who come from programs who maybe don't do a lot of that particular surgery. And, you know, just do a fellowship. I think, you know, the one thing that those always instilled in me is, we have such an amazing specialty in that. In five years, if this gets old, you can go and do complex implantology, which is very rewarding. And teeth and titanium and so on. And that's great, that might happen. But I think, you know, it's always amazing to me, you know, I was told by this in my interview at Oregon by Brian Bell, who I think is really wise in the time surgeon, a teacher. You know, it's kind of funny where, you know, that we're in the mouth every day, we treat everything in the mouth. That's our area of surgery, you know, lesions, tumors, whatever. But for some reason, when the diagnosis comes back as a cancer, we're done. You know, and we, not anymore, but at the time, we kind of will refer to someone else to treat that. Whereas we probably feel the most comfortable to treat in that, 'cause that's our real house where we are every day. And I think the same thing can be said, you know, which always stayed with me for craniofacial surgery. There is no other specialty other than orthopedics that cuts bone more than we do. Whether you're doing theriumolors, you're doing implants, you know, we're always cutting something in the maxillofacial skeleton. And I think we do it quite well. But as soon as you go, you know, and we do trauma, I think very well. And I think that's pretty well respected. We do manable fractures, upper, you know, mid-face fractures, upper-face fractures, and frontal sinus, and the we fractures, so on, cranials. But once it becomes bone usurgery involving a congenital deformity, you know, changes, you know, so we all of a sudden are not the experts in that. And certainly, I have no problem with other specialties, doing that type of surgery, 'cause I do it very well. But we can cut a sagil split, which is probably the hardest procedure to do. And I think all craniofacial surgery, but, you know, we can't do a frontal orbital advancement or cranibault remodeling. So I think it's always stuck with me that I think we are in an employees position to do this type of surgery very well, whether it be cancer resection, reconstruction, or pediatric cleft craniofacial surgery, I mean, that's where we are every day. So I think just, you know, that's an important thing, though, is remember, and I think that's why this especially will thrive. And I think students and residents should continue to be interested in to try to do this type of surgery. - That's awesome. - Yeah, really, really good points. And it's good to hear your perspective on that, 'cause it makes a lot of sense. And I think that will resonate with a lot of our listeners. If there are people out there, you know, who kind of are more interested in this, are you okay if they contact you? - Absolutely, you know, and my number and email are pretty public. So they're all over the place. So anytime. - Okay. Well, good, good. We end every podcast with some rapid fire questions. So we're not bringing the heat to you now. - Okay. - No, just kidding. They're really easy questions. The first one is, what is the best book you've read in the past year? - It's a book I am rereading now, which I know that you have read, 'cause I just checked a few weeks ago, is Be In Mortal. - Yes. - By a Tula Gawande, who is an amazing author, and it's a really good read for a lot of good reasons. And I highly recommend it. - Yeah, he's one of my favorite authors of read, I think all of his books, but really good at storytelling, but also bringing in really pertinent lessons for all of us as healthcare providers. - Absolutely, very cool. Next question is, what non-oral surgery thing, do you do in your life, or have you done that helps you with your daily oral surgery skills? (laughs) - I don't know if I do much to help out my daily oral surgery skills. To be honest, I just had this discussion today, is to try to be active. And I think I'll talk into another surgeon today, actually a general surgeon who does had neck surgery, and I think one thing that we all feel bad about is taking some time for ourselves and going for a run or working out or being active, but one thing I am realizing as I age, and the body's breaking down a bit, is that if you don't take care of yourself and of your body, it's not being selfish. And if it's just 20 minutes a day, which is sometimes all you can render, I think if you're not taking care of yourself, you really can't take the best care of your patients and of your friends and family. So I think it's worthwhile to take some time for yourself and just put it be a run or a workout or just some meditation or reading and just I think that clears the mind a bit and lets you be a better surgeon. - Yeah, that's a great one. So important. Next question, which you may or may not be able to answer, but being from New York, I would hope you can answer this. What is your favorite episode of Seinfeld? (laughing) - You obviously have been talking to Dr. Meloro. - There is so many. I'd never met anyone who knows that show more than him. And I think he says the same about me. But anyway, that's a tough one. I think we all like soup Nazi. I think close talker. Now it's on Netflix, right? So I have pointless TV in the background, which I love during email time. So I think I was actually talking to someone today. I was trying to, when you tell someone who doesn't know what joke about Seinfeld, it's tough. But I think what George advises the swimmer, Elaine, is dating on how to live the rest of his years being bald. I think that's a classic one. So they're all good. - Oh my gosh. Yes, equally as good as when George tells his girlfriend that he's a marine biologist. - The situation arises for him to save a beached whale. It's just so hilarious. And he pulls the golf ball out. - Pulls the golf ball out. - Yep. - Pulls the floor hole. Geez man, so funny. Well good, I'm glad that tells us all that you're well-rounded human being if you watch Seinfeld. - You have to be. That's right. Oh my gosh. This next one too is probably been a while for you. But which four steps do you use to extract tooth number five? When was the last time you extracted tooth number five? - I'm extracted. I've taken out a tooth number five recently. It's okay. I mean, honestly, whatever they have, right? It would be the upper universal. Or if they're in a line down position, like supine, maybe even the ash force out. - Yeah, okay. - Malaro was a big ash man. And I think that rubbed off on us. But you said he was an ash man? - Yeah. - Oh, okay. Another good aside by that. - Yes. So that's what you do. And I do, you have to have a wide opening to use the ash because that 90 degree makes it just require more room compared to the upper universal. Anyways, ash is nice because it usually can grip a tooth better than a universal. - Agreed. - Last question.
What is your favorite quote? Do you have a quote or a mantra or something you come back to? Ooh, I know I'm a big, it's funny. Someone's, I had this on my desk. It's one everyone uses now, but it's the old Wayne Gretzky quote, and I'm a hockey Gretzky fanatic. So you must 100% of the shots that you don't take. And I think that holds true. And I think, I think that's true in life or in profession. And I think, you don't give it a shot, you'll never know. So that's probably it. Yeah, love that. As a side note, that's also a line in the movie Uncle Drew. I don't know if she's watched. I don't think I've seen that. I think it's Reggie Miller, leans into the actor who's kind of a guy who doesn't want to take the shot. And he says, young blood, you're 100% of the shots you don't take. But probably a close second is, you know, if you're not first, you're last, which is Ricky Bobby, Ricky Bobby, tell dig a nice. So. Oh my gosh. Well, that's class of quotes, good food for that for us. So just to chew on. Well, thank you so much, Michael, for taking the time to talk, give our listeners a little kind of experience with your program. Sounds like it's just getting better each year and that's awesome to hear makes me happy. This is fun, Grant. Thank you so much for having me. Yep, my pleasure. Well, cool. Have a good rest of the night and let's reconnect sometime. I appreciate it. Sounds good, man. Okay. Thank you for listening to this episode of Everyday Oral Surgery. If you are an oral and maxifacial surgeon and would like to be on this podcast, please email me at Grant
[email protected]. Or text me at 7204416059. Also, if you have any topics that you'd like to hear discussed or feedback on a certain episode that is already aired, please call or email or text me. Thanks again for listening. We'll catch you on the next episode.
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