Episode 14 of “What is Innovation?” is out! Jared interviews Maria Lucia Madariaga, MD, a general thoracic and lung transplant surgeon. She is a graduate of the Harvard-MIT Program in Health Sciences and Technology at Harvard and completed her general surgery and cardiothoracic surgery training at Massachusetts Gen Hospital. Dr. Madariaga is also the principal investigator of the Organ Perfusion Laboratory and a founding member of the Complex Airway Center at the University of Chicago.
Dr. Maria Lucia Madariaga talks about her passion for discovery, research, and patient care.
More about our guest:
Maria Lucia Madariaga, a general thoracic and lung transplant surgeon. She is also the principal investigator of the Organ Perfusion Laboratory and a founding member of the Complex Airway Center at the University of Chicago.
------------------------------------------------------------
Episode Guide:
1:46 - What Is Innovation
2:25 - What Isn't Innovation
2:57 - Being one-to-one
4:55 - Big and small leaps
6:19 - Establishing trust with patients
8: 02 - Smoking dependency
10:26 - Physician Burnout
11:11 - Helping out Physicians
13:37 - Organ Perfusion Laboratory
17:37 - Connecting the dots and step-by-steps
24:24 - Advice to future innovators
--------------------------
OUTLAST Consulting offers professional development and strategic advisory services in the areas of innovation and diversity management.
/This transcript was automatically generated using AI; please forgive any inconsistencies. We are working to provide the correct and more concise copy of the transcript. For urgent needs, please send us an email.
----------------------
Jared Simmons 00:05
Hello, and welcome to what is innovation. The podcast that explores the reality of a word that is in danger of losing its meaning altogether. This podcast is produced by Outlast consulting, LLC, a boutique consultancy that helps companies use innovation principles to solve their toughest business problems. I'm your host, Jared Simmons, and I'm so excited to have Maria luthier madariaga Maria luthier madariaga md is a general thoracic and lung transplant surgeon. She's special specializes in treating people with lung airway is effigies and media style conditions. Dr. madariaga graduated from the Harvard MIT program in Health Sciences and Technology at Harvard Medical School, and completed her general surgery and cardiothoracic surgery training at the Massachusetts General Hospital Boston mass. She also trained at the Mayo Clinic thoracic surgery, and the Toronto General Hospital lung transplant programs. In addition to her clinical practice, Dr. madariaga has extensive background in transplant immunology and large animal research. She's the principal investigator of the Oregon perfusion laboratory, and a founding member of the complex airway Center at the University of Chicago. May I call you here? Yes, you may. Okay. Livia, welcome to the show. Thank you so much. Thank you for joining us. It's quite a background you have in quite an amazing amount of work you're doing. Currently, a lot of lot of interesting stuff there. Can't wait to talk to you. Thank you. Well, why don't we just start with what what is innovation.
01:46
But to me when you say the word innovation, I studied Latin a lot when I was growing up, and I think about the word Nova or Novus, and that means new. So innovation definitely means something new. Whether it's a new solution to a problem, a new discovery, a new way to view some wrinkle in, you know, a patient's condition or something that comes up unexpectedly. So innovation is like making a leap, something new.
Jared Simmons 02:18
I like that a lot of energy in that, making a leap. I like it. What isn't innovation,
02:26
I feel like innovation is a buzzword. And I don't think it needs to be a buzzword. I don't think it needs to be splashy. I don't think innovation necessarily needs to be on a worldwide scale. I think innovation can be one to one. And I view myself as more of a one to one person rather than a worldwide person. But I think you can make innovative leaps. No matter where you are, what your environment is.
Jared Simmons 02:53
Well said Well said. And when you think about one to one, tell me tell me what that means.
02:59
Well, for me, in my job as a doctor or a healer or surgeon, I really feel like the number one thing I need to care about is the patient. I feel it's very important to get to know the person to understand their understanding of what's going on. And oftentimes, I found that no one has really explained to them what's going on, you know, no one has taken a piece of paper and drawn out what's going on inside their bodies, or showing them their images. And especially in places like where I'm practicing now on the south side of Chicago. I feel like people need more knowledge, and people need teachers to teach them what's going on. So I find my role that I really like in clinics, especially as a teacher, I love teaching my patients. So then then we embark on this journey together where we decide based on the information we have what's the best course forward, particularly shooting for that patient. Sometimes I have to give good news sometimes that give bad news, but um, then we make a plan, and then we go through it together.
Jared Simmons 04:03
Hmm. Interesting. I can imagine that No two days are the same in your line of work.
04:08
Yeah, that's
04:09
true. I mean, we trained so much to understand the standard steps of things like this is the way to take a lung cancer out. This is the way to, you know, perform an airway surgery. But every patient is different. And every every anatomy is different. So after you start opening up the body and cutting into things, you run into unexpected situations, and sometimes it requires some thinking on the spot. Sometimes you definitely need to rely on what you've learned from before and not necessarily have done. Sometimes you rely on things you've read or heard about or watch. So those are all things that kind of come together in one moment.
Jared Simmons 04:51
Right, right. If you think about sort of these these leaps you're talking about, I can imagine they're giant leaps where you know you Maybe inventing a new process or approach or treatment or a new tool or drug or something like that. But I'm also intrigued by the smaller leaps that may happen on a one to one basis that you're talking about or digitally in the moment,
05:17
right? Yeah, I definitely agree. I think at least in my, in my life, I've made many more smaller leaps. And I'm not sure I've made a big leap yet for mankind, but so I would say that if I really think about it, you can make a leap by, you know, just opening a person's eyes to what's going on. by picking the right words, you know, taking something, to put it in their perspective, using simpler languages, looking at someone in the eye and really caring, or just sitting down and spending some time, I feel like, there's a lot of things going on in patients lives, you know, and they come to you for help. And some of them are really scared, because they've never had surgeries before or cancer scary. And so I think there is a connection that you make, and, and there's different ways to make that connection. But I think it's important to make that connection, because then you establish a trust relationship, and then you can get through the disease together.
Jared Simmons 06:20
Right, right. And trust is a big part of a lot of the, you know, innovation work processes we talked about on the show, we've talked to folks in a lot of different industries, and the concept of trust or connection relationship, those things come up in the context of how to, you know, really move innovation forward, or how to make change stick. And what struck me about what you were just describing is sort of the change management aspect of trust on an individual level, because what you're describing here, you build that trust in that environment. With that, with that, with that patient, I can imagine that has a knock on effect, you know, in the community and with, you know, with other people in terms of their ability to trust.
07:14
Yeah, and, and also, what's a little bit tricky, is that you need to establish this trust right away, you know, I mean, like, so I'm coming in the room, I have a white coat on, I've never met this person before, I'm also probably younger than them because I'm still new at my job. And then I need to with a couple of words, set them at ease, make sure to not scared, you know, convey information, establish a relationship that then you know, they'll trust me with cutting them open, right? So they also have to trust me, like changing their lifestyle, for example, we really want patients to stop smoking before we do surgeries on them. Because that increases their rate of complications and prolonged hospital stay.
Jared Simmons 07:56
Is that a difficult thing?
07:58
Was it so that depends, I think, you know, smoking dependency is very cause it's like an addiction. And for some people have been, you know, doing that for a long time. But, for example, when I do airway surgery, airway surgery is very tricky, because so many things can go wrong. So I explained to them that, you know, we need to make sure you're the best person, you can be health wise, before you come into the operation. So we minimize all the risks that can happen. So I need you to lose weight. I need you to control what foods you eat so that your diabetic sugar's are not out of control, I definitely need you to smoke. And so the patient needs to realize that for him or herself, that that's important. They need to do it.
Jared Simmons 08:39
You're almost enrolling them in the process as a participant, you know, yeah, yeah. Yeah. And there's so many parallels to influencing and getting, getting things done in a business environment in terms of building that trust. Quickly, building rapport quickly establishing a collaborative relationship, because I think when I think of doctors and surgery, I do not think of it in the collaborative way. You just described it. Oh, yeah, I think of it in terms of Okay, I'm gonna go in here and they're going to operate on me, you know, but yeah, but just the entire way you view that process shows that even something that one sided, right, seemingly, one sided can be a clear thing.
09:26
And every patient is different. Some patients do want a more paternalistic, didactic, you know, this is what you should do. Right, you know, sign on the line, right? But I tend to find that patients, most patients are not like that. And you know, they might like a little less information and I always ask them, Do you want to see everything all your blood, guts and glory? Yeah, show it to you. But I feel like it's better for us to be partners, both through things together. I find it more fun.
Jared Simmons 09:53
Yeah, yeah, I can. I can imagine. I just, I'm just I'm marvelous. The kinds of the kinds of things you you described, I mean, you talk about your bio and the things you you, the research you do and the and the life saving, you know, surgeries you perform it. To me, it seems like something that could be difficult environment to operate in on a day to day basis and maintain the joy and the energy that you have.
10:24
That's true. That's true, because and that's why people talk about physician burnout a lot is because, you know, there's a lot of stressors, personal life stressor, professional life stressors, what if something goes wrong? And the patient? You know, I mean, and I think, you know, different workplaces have realized that now and are trying to make programs for physicians so that they don't have this much burnout or as risk for burnout. Because we need to have a resilient well, to, to care for someone else, because that's what we're doing. Right. Right. Like putting ourselves out there where we're carrying them. We're carrying their cross at some point.
Jared Simmons 11:02
Yeah. No, that's, that's, that's amazing. That's great. And it feels to me like another space for innovation. How, how can doctors care for themselves? And how can other people that help physicians and other medical professionals care for themselves and in a way that is fit for the current environment?
11:23
That's right. I mean, I think one of the ways that we learn from other fields is, for example, when we learn about resting, I would say in the old school days, you know, you don't sleep, you just work in the hospital all day long, and all night long. But we've learned from different industries, the importance of sleeping, you know, shift work does not necessarily have to mean that it's suffering in quality, like all different things that are slowly coming into the field of medicine.
Jared Simmons 11:54
Right, right. It's encouraging to think that the field of medicine can learn from, you know, from the broader business world, as well, and that some of the more old school ways of thinking that that existed Also in, you know, just for me growing up in the in the corporate world, you know, there was, you know, he didn't want to be the first one to stand up from your desk and, and walk out, you know, you've stayed till the boss leaves, and you know, those kinds of old school. Yeah, ways of thinking and, and then the new things we've learned about human beings and how they work best in our most effective and efficient and focused. So it's good to hear that, that, that those things are being kind of incorporated in, in the medical field as well.
12:40
Yeah, it's really hard, because, you know, a lot of good doctors, they want to take care of their patients, and they put their patient's needs above their own. And that's how, that's how we operate. Because that's, that's what we like to do. And that's how we care for our people. But we also have to sometimes take a step back and say, if you're not healthy yourself, and you can't help someone else, right,
Jared Simmons 13:02
right. And be open to new and different ways of caring for yourself, even even, you know, in that environment. Yes, yeah, that's, that's, that's so good to hear. I'm curious, specifically curious about particular part of your bio, it says you're the principal investigator of the Oregon perfusion lab laboratory. Yes. Okay. All right, I don't want to put you on the spot. But I really do want to know what that means.
13:30
Well, so I would say, you know, as part of a doctor and a surgeon, I think science is very important, because that's where you get the new discoveries and new treatments for, for patients. So it's very important to seek new knowledge. And as I was going through my training, there was always a research component to it, or would take, you know, either a year out for fellowship, research, etc, and exploring different fields. So for example, transplant immunology was one of the fields that I was exploring, right. And that was in my back pocket. And then as I went through training, as I spent some time at the University of Toronto and learned more about lung transplantation, and one of the emerging technologies that they use is that they put organs so when you do a transplant, you need to transport an organ from the person who donated to the person who's receiving it. And it's used to be you just put on a box of ice and then ship it on a bus to the to the next hospital. Right, but now they're putting those organs on pumps. So kind of keeping the Oregon Wow. So like a kidney or heart
Jared Simmons 14:38
is still doing still
14:40
beating. Yeah, exactly. So the heart on a pump is still beating the lung and the pump is still breathing. So the idea is to keep it at its more normal state are the guys frozen on ice? Right? And so that was an idea I was exposed to and combined with my transplanting window background, I wanted to start a laboratory at University of Chicago where we could use both of those things, and kind of combine expertise from all the other people who work there, to make discoveries about organs on pumps, and potentially make new treatments for those organs, for example, treating those organs before they go into people so that when they go into people, eventually, they'll work better.
Jared Simmons 15:25
Wow. That is amazing. It's so many elements of that have so many, so many different avenues on that, that my brain is just kind of pinging at the moment, but you created this laboratory, you found it? Well, I mean, a bunch of other people. Yeah, right. Right. Right. Sorry. I didn't mean to put you on the spot. I know you're very humble person. What I'm what I meant to say was you're part of the founding team. Correct. So this, this concept of that you just described was, is a sort of almost like a hypothesis that you're in an extended proof of through this through this laboratory.
16:07
Yes. And I would say that, you know, I am by no means an expert, in like, most of the topics that we're dealing with, sure, I just need to disassemble, find the people who are experts, and then make them all work together, make them help them work together. So So I so I'm very lucky that I'm surrounded by people who, you know, have enthusiasm, have expertise are willing to pitch in their time to, and then everyone has their own strengths in the group. And so hopefully, we all mesh together so that we can achieve our goals.
Jared Simmons 16:41
Right. That's amazing. And that is another lesson, I think, that I'm taking away from this is just having domain expertise in a specific area is great, but what really unlocks truly, you know, breakthrough, mind blowing kind of innovation is is is being able to also be receptive to and collaborative with folks with different different areas of expertise. I mean, yeah, putting a heart on a pump during transport is something that, in hindsight, makes sense. You know, like, Well, you know, that's what it does. Let it keep doing what it does. And you know, it'll also tell us how efficient it is. And we can help improve it on, you know, once again, all those things make logical sense once you say it out loud, right? connect the dots. Exactly, exactly. Connecting the Dots is just, that's what innovation is all about. That's what that's what's exciting about, about the work you're doing and, and the work that gets done across America, in every day. So many people bring different areas of expertise together and do incredible, incredible things. And this is this is one fantastic example. So how much time video? Do you spend thinking about your training? And I'm going to explain that question. It's kind of a vague question. When you're doing what you do, you're a surgeon. I imagine a lot of it is has been rehearsed and done over and over again. And there are specific procedures and checklists and things and all that. How much of that is top of mind for you is as you're working.
18:24
So it depends on what I'm doing. And it probably will depend on my stage of career too. I'm early in my stage of career, I just finished my training, I'm gaining my independent wings, I have very supportive mentors and colleagues at work. I kind of like run by things when things are difficult. I would say because I am a I want to be masterful at my job, I want to do the best I can for our patients. I rehearse for my operations, okay, like I prepare, I write, I envision things, I watch videos, I think about all the different steps, some are more complicated operations and others. And so that's the proportion of time I spend with them. And then I write a checklist. And like for one of my operations is very complex, the airway ones. And at the beginning, I was quite nervous to do my first couple on my own, you know, I mean, because I've always been with a senior partner or someone who would, who was there if something goes wrong, and when you lose the airway, the patient dies, right? So you have to be very careful, very planful to mitigate any risks. And so basically, I rehearsed and rehearsed I looked at all of my notes and as I trained I drew things like I made drawings of critical steps or like in my mind, in my in my brain, I can see the picture of how things should look like. It's not as if it's not like Okay, do this do this, but it's more like when you get it right and it will look like this. So I see the angle or something like that. And then as for like for this very complex operation I would make a checklist and distill it down to 21 steps, I believe. And then I posted it on the wall. So my first one, two or three, I just had it there. I mean, I never looked at it the whole day. Exactly for eight hours. I didn't look at it, but it was there, right? So basically, before the operation, I write down all the steps and what could go wrong and what to watch out for. And then after the operation, I take a different color pen. And I review, I was like, okay, actually, I didn't do this as much as I wanted to, actually, this didn't need to be done. You're like, give myself some feedback, right? And then the final step is, so I have two senior partners who are very wise. And then I go to them for feedback. I'm like, Okay, what do you think I do?
Jared Simmons 20:42
Wow. Wow, that is, that's fantastic. I love the security blanket of the steps that you probably never even glance over at. But it just gives you the confidence that the move forward. And the rehearsals step. And the feedback steps, I think are things that we all can benefit from because, you know, you're extremely accomplished at what you do. And yet you still take the time to rehearse and rehearse and and you're very accomplished at what you do. And yet you still take the time to go give yourself feedback review what you did take the time to talk to other people and, you know, get feedback from them as well. I think a lot of times people associate the back end steps of feedback and peer review kind of things with failures or mistakes. Yeah, but I didn't hear you distinguish between those you have a successful surgery, you probably still do the same review steps. Oh, yeah.
21:43
And I mean, I haven't done anything perfect, right? Like, there's always room for improvement, there's always goals to strive for. And I always want to do that. Because at the end of the line, it's a person there, you know, I'm taking care of someone's family member, and I can't afford not to be good. So I need good, right. And it's all this knowledge, I learned I should apply it, you know, I mean, it's like my ancestors, my teacher ancestors, you know, come through me.
Jared Simmons 22:14
I love it. That's good energy. The, the rehearsal step is also super interesting to me, especially the language you use to describe it around visualizing, and not necessarily thinking through steps, but visualizing the outcome and what things should look like when you're done. kind of seems like that leaves you the space, because that's what I was trying to figure out. I'm thinking, if you've trained and trained and trained, you've probably got specific steps. But then earlier, you mentioned that when you you know, open someone up, everything's different, and you know, you're going to have to improvise at some point. Yeah, and so, maybe, so that is maybe that's where you can you kind of leave yourself the space to improvise,
22:56
right. And not only is the person different, but the people you're working with are different, too. So surgery is usually a two person sport, like, at minimum, it's me, and my, my assistant, and our hands are dancing. So someone is retracting, or pulling or exposing some way so that the other person can cut or, or burn or so it's always a give and take, give and take. And depending on the person across from me, you know, the level of expertise comfortableness, how they can see things, then you need to adjust for them to, that's also different when you're starting out. Because, you know, when I was in training, the person across from me was already an expert. So I was just like to do you know, there was like, nothing to think about on that level of like, who is surrounding me, but now I also have to think of my team members. Right. And you're right about that space. So now I feel like, um, you know, when I do my rehearsals, I do definitely do a very thorough, maybe one or two run through where I just like every single step. And then as they get closer to the operation, maybe like when I'm in the shower, or when I'm just about to go to sleep, I'll just think about major steps or just like this, this is the tricky spot like this is you know, like just a little hump they need to get Right, right. You do want to be loose, right? In the operation. I'm having fun. I'm dancing around, there's music. You know, I want everyone to be happy. It's just like a happy thing for me.
Jared Simmons 24:21
Right? Right. Because you're here you're healing. You're helping people. That's, that's, that's amazing. That's a fantastic. some fantastic insight into things people probably don't really, really think about very, very often every day. So thank you for that. Any advice? I mean, you've you've been given a lot of a lot of insights for us to think about. But is there any specific advice you'd have for for innovators, people who, who wants to take those leaps and be innovative like you?
24:54
Well, you know that I don't even think I'm an idiot. Well, I guess don't chase the word innovation, I believe in the power of hard work. And opportunities rise up, if you are aware, you keep your eyes open, and to do something that feels right for you, you know, I mean, something that brings you joy and happiness. And it's just like, it's it's like nothing else for me for being a surgeon. It's, it's so wonderful. It's fun, but it can also be sad. But it's also fulfilling and that really makes a difference. And I would say that, you know, we talk about innovation, medicine, making new techniques, making new technology, a new drugs, all that stuff. But they're done for a purpose. And the purpose is to heal someone to take care of someone's process disease process, and yet to make sure that they're right, you know, not just because it's just because something's new doesn't mean that it's good for something, right, we have to make sure that it's good for the patient. Hmm,
Jared Simmons 25:57
that's, that's fantastic. It's perfect. Thank you, doctor for your time. I really appreciate it. And it's been it's been a pleasure. We haven't spoken often, but I always enjoy it and, and I'm looking forward to the next time we get a chance to speak. Thank you so much. Bye. All right. Take care.
Jared Simmons 26:22
We'd love to hear your thoughts about this week's show. You can drop us a line on Twitter at OUTLASTT LLC, or follow us on LinkedIn where we're OUTLAST Consulting. Until next time, keep innovating. Whatever that means.