SUNDAY 4TH OCTOBER, 2015 – UWI TODAY
13
Laparoscopic Surgery:
This form of surgery, also
known as minimally invasive or keyhole surgery, is
a surgical technique through which small incisions
(less than 1.5 cm) are made in the patient and a
laparoscope (a long optical cable) is inserted through
which the surgeons can see the area from a more
easily accessed part of the body. As opposed to open
surgery, laparoscopic procedures cause less pain,
bleeding and recovery time (patients are often better
within a few days).
Bariatric Surgery:
Also known as weight loss or
obesity surgery, is a variety of procedures that lead
to weight loss by reducing the size of the stomach.
These include placing a gastric band around the top
of the stomach, removing a portion of the stomach
or rerouting the small intestine to a pouch within the
stomach. InTrinidad andTobago, bariatric surgery can
be carried out on peoplewith a bodymass index (BMI)
of 35 and over (the average BMI is 25).
Metabolic Surgery:
This is bariatric surgery carried
out for the purpose of treating type 2 diabetes. Doctors
have discovered that over 80% of bariatric surgery
recipients with diabetes are cured of the disease by the
surgery. Although weight loss has been found to cure
type 2 diabetes, the obesity surgery recipients were
curedof the diseasewithin a fewdays of the procedure,
well before they had the opportunity to lose weight.
This has led a growing number of physicians in recent
years to promote metabolic surgery as a treatment
option for the disease.
Roots in the soil
Making a positive contribution is a recurring theme
throughout Professor Dan’s career. In August he received
a national award – the HummingbirdMedal Gold – for his
work (2015 has been his harvest year). He credits the value
system imparted by his parents for his outlook.
“I have to dedicate all that I have achieved, including
theHummingbirdMedal, theprofessorshipandbecoming
a doctor, to my parents,”he says.“They sacrificed beyond
what is normally expected to ensure that we got an
education. It all started with the values they inculcated
in me and my siblings. Our family didn’t have but we
would always give. If we had to choose fruits to sell or
to give we always gave the best. It’s a philosophy that I
live by. When you give, it always comes back to you in a
multiplied fashion.”
Professor Dan grew up in Rio Claro, one of four
children in a family of farmers.
“I come from very humble beginnings,”he says. “Our
father planted cocoa, coffee and citrus. I grewup planting
the land and taking care of the trees and the produce.
Those were good times. It was hard but we made it work.
The struggle was there but we never gave up.”
Hardwork is another value that the professor stresses.
In fact, he believes it to be the reason for his success. He
cites his experience in Buffalo:
“I wasn’t a bright fellow. I will tell you straight. I wasn’t
bright. But I accomplished a lot. And the reason for that
was just pure hard work. I spent five years in Buffalo and
realised how welcoming these people were. The ethics
that I had, the hard work, that’s what they wanted to see.
And they reward you for it. I topped all the programmes.
I graduated top of the class and top of the country. I
went to work. I worked harder than anybody else. While
people were sleeping I was studying. Working hard is
part of what I do.”
Sitting across from Professor Dan as he recounts
his tale, I’m taken by the lack of arrogance. If you have
had the opportunity to interview powerful people,
you grow to accept an overblown persona as part of
the job, particularly in business. But Professor Dan is
remarkably easygoing and accessible, considering his
accomplishments. It’s a meticulous kind of easygoing.
And even today, the agriculture instinct still buzzes in
him. He has of piece of land where he grows exotic fruits,
oranges and grapefruits.
“I try to go even for 10 minutes a day just to relax,”he
says. “I value where I come from. That is what makes me
happy and calm after all the stresses of work.”
The Pioneer
There is another ingredient to Professor Dan’s career
that can’t be explained by his parent’s teaching or his
formative years in agriculture – a daring ambition. It’s
not necessarily ambition for wealth or fame but looking
at his choices it is clear that he was determined to make
his presence felt in his field. He decided to go abroad to
further hismedical career. He chose fields of specialisation
that were lacking in the Caribbean. Even in his choices of
patients Professor Dan has shown a pioneering streak.
In one case he performed obesity surgery on a five-
year-old girl. She weighed more than 175 pounds and
her knees had buckled so badly that she could not walk.
But the idea of obesity surgery on children was taboo at
the time. Nevertheless, after giving the child psychiatric
counselling, he performed the operation. It was a success.
She lost nearly 80 pounds and they were able to repair
her knees so that she could walk. Today, she is a student
at a prestige school in South, living normally.
Theprocedurewas controversial. Professor Danwrote
a report on it for a leadingmedical journal. They agreed to
publish it but only if an opinion piece by a child obesity
expert could be published alongside. It was scathing.
“He wrote a very long piece – longer than the article.
In essence he said howbad it was andwhat a bad decision
we made,” he laughs.
That was five years ago. Today, not only is the
procedure Professor Dan carried out the surgery of choice
for childhood obesity, it is the one that even the opinion
writer recommends.
Hemade a bold decision and it paid dividends. This is
partly why his reputation in the field is international and
his contribution to the medical literature is considerable.
“Sometimes you have to do things that are
controversial once you believe it’s right,” he says.
“Obesity (bariatric) surgery is one of the operations
that I find most beneficial to the patient. Patients are
the happiest after surgery. When you operate on these
patients and they lose weight you are transforming them
into different human beings. You are taking them away
from depression and difficulty and bringing them into a
life that is totally different. Sometimes I don’t recognise
the patient when they lose weight and come back a year
later.”
Likewise laparoscopic surgery has made the lives of
many patients much easier by reducing pain, bleeding
and recovery times from a host of surgical procedures.
So what’s the next bold endeavour? Metabolic
surgery is essentially bariatric surgery carried out with
the primary purpose of treating type 2 diabetes. It has
been gaining prominence in recent years as physicians
such as Professor Dan have found that obesity surgery
has been highly effective (in as many as 80% of patients)
in treating the disease.
“I want to see this metabolic surgery take off and
to be able to help these patients with diabetes on a
larger scale,” he says. “We are doing it but the problem is
education. We need to educate not just the patients and
the public but our own doctors. This is the challenge, to
get our own physicians and nurses to understand the
value in offering surgery for a disease that you typically
treat with medications. That is a big challenge but it will
come.”
Our family didn’t have
but we would always
give. If we had to choose
fruits to sell or to give
we always gave the best.
It’s a philosophy that I
live by. When you give,
it always comes back
to you in a multiplied
fashion.
