The SUS is Pleased to Honor the 2020 SUS Lifetime Achievement Award Winner
Keith Lillemoe, MD
About the Lifetime Achievement Award
The Society of University Surgeons (SUS) has awarded Keith Lillemoe, MD, W. Gerald Austen Professor of Surgery at Harvard Medical School and Chief, Department of Surgery at the Massachusetts General Hospital, the 2020 SUS Lifetime Achievement Award. Dr. Lillemoe will be presented with the Lifetime Achievement Award by SUS Secretary Dr. Cristina Ferrone on Wednesday, February 3, 2021 at the 16th Annual Academic Surgical Congress (ASC).
The Society of University Surgeons initiated the Lifetime Achievement Award (LTAA) in 2005. This award was designed to recognize individuals who have had a sustained career in academic surgery with contributions to surgical science. In addition, these individuals have demonstrated a commitment to the Society of University Surgeons whereby they have participated in the Society even after superannuating to Senior Membership status. Their participation in the Society is evidenced by the attendance of the meetings yearly and active participation in discussion of papers, attendance of the banquets, society functions, and mentoring the next generation of leaders in the society.
The Society of University Surgeons seeks to honor and recognize these individuals because of their embodiment of the principles of the Society. We seek to recognize these individuals to establish role models for younger generations of surgeons to honor and emulate their contributions to the science of surgery, and moreover to the Society of University Surgeons.
Dr. Keith Lillemoe was nominated and selected by his peers based on his leadership and contributions to academic surgery, as well as his strong support of the SUS. He was described as being an extraordinary mentor of students, residents and faculty and that his legacy will include the mentorship and promotion of countless surgeons through training, academic opportunities and advocacy. His outstanding academic, clinical, research and leadership track record was cited, which included his leadership in multiple societies, particularly with the SUS where he served as Secretary-Elect, Secretary, President-Elect, President, and Past President of the Society and remains an active participant in the Academic Surgical Congress. It was noted that he was the one who forwarded a more inclusive scientific agenda for the SUS, introducing the category of “Clinical Trials and Outcomes” to the program as President, relentlessly pushing academic surgery to stay relevant and lead in challenging times. With this Award, the SUS recognizes the quality and breadth of science Dr. Lillemoe has produced, specifically with the publication of over 510 peer reviewed manuscripts, 140 book chapters, invitations to speak both nationally and internationally, and service as Editor-in-Chief of the Annals of Surgery for 10 years. The SUS wishes to recognize Dr. Lillemoe’s immense contributions to the field of academic surgery.
The Impact of Physicians
Dr. Lillemoe first became interested in medicine based on a very personal interaction with the physician charged with the care of his younger brother, who died of childhood leukemia. Dr. Lillemoe saw firsthand the impact that physicians could have on families in the care of patients. After three years of college at the University of South Dakota (USD), he entered the USD School of Medicine and after two years transferred to Johns Hopkins. Between his first and second year of medical school, he had a summer rotation at a community hospital in his hometown of Aberdeen, South Dakota. Although exposed to all of the services, he ultimately found that Surgery was the most fun and interesting. He had a great role model that summer who took him under his wing, Dr. Bernard Gerber. Dr. Gerber was an academically trained surgeon, who imparted to Dr. Lillemoe lessons in how he took care of patients, how hard he worked and stimulated his affinity for surgery. After transferring to Johns Hopkins and establishing great role models there, it was an easy progression.
A Matter of Timing and Finding Your Niche
Dr. Lillemoe never did a fellowship and considers himself to be a general surgeon, who happened to find his niche in pancreatic surgery due to a specific set of circumstances and timing. John Cameron, MD was named the Chair at Johns Hopkins when Dr. Lillemoe was a 4th year resident. Dr. Cameron wanted to build a program in pancreas surgery, and to do this, he needed a group of faculty dedicated to that mission. The first “wave” of faculty recruited included Drs. Lillemoe and Charles Yeo, who worked with mid-level faculty members as their academic and research mentors, to build a team to do complex pancreaticobiliary surgery. Hopkins went from performing 20 Whipples a year to performing 200 Whipples and many faculty became known as “pancreatic surgeons”. His interest in bile duct injuries was also a matter of timing. Laparoscopic cholecystectomy was introduced shortly after Dr. Lillemoe joined the Hopkins faculty. At the time, the rollout of lap chole training was not one of the prouder moments of American surgery as it really consisted of a few “lectures”, watching a video, doing an animal lab, and then performing the procedure on patients. As a result, there were many complex bile duct injuries. The Hopkins faculty coordinated and delivered multidisciplinary care and created one of the largest databases on bile duct injuries. Dr. Lillemoe’s advice is “if you are developing a niche in your career, you have to publish about that niche. It’s the best marketing that you could ever do. If you publish great papers on pancreatic cancer or how to repair bile duct injuries, people seek you out. It’s great to be busy and it’s great to be a good surgeon and word of mouth will help you in your community but if you want to develop a national reputation, you have to publish. I give John Cameron credit for that, we always had on-going clinical trials, published papers and submitted abstracts to meetings. We tied clinical growth and expertise to academic productivity.”
Developing Mentors in Every Situation
At Hopkins, early on his first mentors were the senior residents and chief residents including Drs. Mike Zinner, Henry Pitt, John Ricotta, Russ Posteir and Mike Sarr. His lab mentor was Dr. John Harmon at Walter Reed, who took him to his first SUS Meeting in Hershey, PA, where he presented a paper in the resident’s session. This motivated him so that the next year, he had a paper at the regular meeting in NYC. Even now, four decades after finishing his residency, Dr. Cameron is still his mentor, as they remain in close contact. Dr. Lillemoe stated that he can’t imagine that his career would have the success he enjoys without Dr. Cameron’s mentorship. Although Hopkins’ Chairs, such as Drs. Halsted and Blalock, trained many surgeons who became leaders of American Surgery, Dr. Lillemoe feels there has been no surgical chair in the last 40 years, more successful at training academic surgeons than John Cameron. Dr. Lillemoe was fortunate to have Dr. Jay Grosfeld as his predecessor and mentor at Indiana University. At the Massachusetts General, having never been at the MGH or in the Harvard system, he credits his predecessors Drs. Jerry Austen, Paul Russell and Andy Warshaw for helping him to understand MGH and its culture. Dr. Lillemoe’s advice is “every surgeon needs many mentors. You have to develop mentors in every situation, clinical and research mentors, leadership mentors and national mentors. I was blessed to have had a national mentor, previous recipient of the SUS Lifetime Achievement Award, Dr. Bing Rikkers. Bing took me under his wing very early in my career. I had been appointed to the editorial board of Annals by Dr. David Sabiston and when he stepped down, and Bing became the Editor of Annals, I was fortunate to become his Associate Editor. This relationship has gone on for more than 20 years. Even though we have never been at the same institution, he has always help advance my career. We have become great friends and colleagues.”
Training the Next Generation of Leaders and Giving Back
Dr. Lillemoe is a big believer in giving back and, having just recited all of the things that people have done for him in his career, he states that one of the most important things a surgeon can do is to serve as a mentor for others. His first and only academic leadership position prior to being a Chair was being a Program Director. Dr. Lillemoe became a Chair in part for the opportunity to expand his ability to mentor surgeons beyond just residents and medical students, and to have the resources to help advance the career of junior faculty. But there is also only so much money and support to offer, therefore mentorship must also mean having the willingness and taking the time to meet with mentees, write letters of support, help with promotions and getting involved in national organizations, and to help them position their careers for their next opportunity. It is important that programs think about training the leaders of the next generation. He stated that he considered himself lucky to have had the opportunity to advance careers of young people at three great institutions – Hopkins, IU and the MGH. He considers his time as Chief at the MGH to be very special, working with so many great people-“I am excited about our great residents, fellows and faculty-and I take great pride in seeing the products of our program gaining success at every level.”
Learn From What You Do
Many surgeons often wonder if they should stay at their home institution or move on to another institution to pursue leadership opportunities. At Hopkins, where a significant number of faculty moved on to take on other leadership positions, including Drs. Yeo, Talamini, Schulick, Pitt, Zinner, and Pawlik to name just a few, who moved on to Chair positions. If the opportunity was right, Dr. Cameron always encouraged the faculty member to take it. Dr. Lillemoe stated “there will be people who can rise to the level that they want to be at their home institution, but if you really aspire to be a Chair, a Program Director or Division Chief in your specialty, you can’t wait around waiting for something to happen to the person ahead of you and so you have to be willing to move.” Dr. Lillemoe left Hopkins after 29 years to take the Chair at Indiana University. There he learned about the nuances of a different system and varying complexities that didn’t exist at Hopkins. He learned from both his successes and failures, but overall it was a great learning experience. Dr. Lillemoe credits being a better leader at MGH due to his experiences at both Hopkins and Indiana. He stated that “my professional life has always been surgery, it’s what I enjoy. For me, being a surgical chair is all I’ve ever wanted to be. Moves can come with risk to your career trajectory, your clinical practice and research, and be tough on your family. But if your goals and aspirations are to pursue a leadership position, moving is going to be necessary for people at certain stages.” He advises that you should “never take a job just thinking it’s a stepping-stone but on the other hand, for every position you take, you want to make sure it allows you to improve your abilities for any future opportunity.” From his perspective, the greatest reward for being a Chair is seeing the success of your mentees, whether it’s a medical student or resident in the match or helping faculty gain positions of leadership or new opportunities. Finally, he has been gratified to see the evolution of the culture in the last 9 years in the Department of Surgery at the MGH. It is this change in culture which he sites as his great source of pride.
Opportunities to Serve Outside of Your Institution
Dr. Lillemoe has held many national organization leadership roles including President of the SUS, Society for Surgery of the Alimentary Tract (SSAT), The Society of Clinical Surgery, the Halsted Society and the American Surgical Association (ASA). He states “societies and associations reward those who contribute…if given the opportunity to serve, whether it be on a committee or as an officer, if you do the job and take on responsibilities, societies will reward you. If you want to get involved in leadership, start at the ground level, work hard, get to know the leadership, make sure the leaders know your contributions, have whatever impact you can at that level and hopefully it will evolve into opportunities at the next level.”
Dr. Lillemoe was honored to be asked to join the editorial board of Annals of Surgery by Dr. David Sabiston in 1995. He became the Associate Editor under Dr. Rikkers and finally the Editor-in-Chief in 2011. He states that this is the only job where he has never taken a vacation in 10 years. He feels fortunate to work with a tremendous group of associate editors and editorial board members and takes pride when there is a landmark paper that everyone is going to want to read and cite. He takes as much pride in his association with Annals, as he does with his role in national organizations and even his own academic institutions.
Finding the Right Balance
Work-life balance is imperative to a career in surgery. Dr. Lillemoe states that you have to “work hard, see the opportunities and take them, but you also can’t say yes to everything, learn how to be selective. Set your priorities between administrative, clinical, research or education opportunities. You might not be able to be a quadruple threat in all of the areas, but you should contribute to all of those categories, and try to excel in two or three of them. Finally, create the right balance with your family.” He says that he is blessed to be married to the same beautiful woman for over 45 years. Dr. Lillemoe is appreciative that his wife Cheryl has put up with all of the other things he does that have distracted him from the family over the years. He has always tried to put family first, balancing his clinical practice and academic life with his children’s sports activities and even serving as a coach when the kids were younger. Dr. Lillemoe continued “Your family knows when you are there and understands when there are things that take you away. If you make every effort to make the family a priority, it works out”. His priority now is spending time with his six grandchildren.
The Success of the ASC
Dr. Lillemoe served on committees for both the SUS and the AAS and felt fortunate to be involved in both organizations. He was elected to be the SUS Secretary, which opened the door to becoming President. Dr. Lillemoe is extremely proud of what the SUS and the AAS have done by uniting to form the Academic Surgical Congress. He feels the two organizations, combining to form one meeting, and providing an opportunity to offer education, outcomes, and basic science sessions with joint social activities has been a brilliant move. Dr. Lillemoe feels that by going to great locations like Orlando and Houston, brings in a larger attendance, especially young faculty and residents, which has really enriched the meeting. It also provides a chance for senior faculty or chairs to support residents and to recruit young faculty and even medical students.
Amplifying a Message
Back in 2017, Dr. Lillemoe was thinking about the topic for his Presidential Address for the ASA. At that time at the MGH, he was concerned about issues arising related to gender disparity, gender bias and even sexual harassment in surgery and throughout all professions. He credits a great group of MGH residents that brought these issues to his attention and made him realize the message needed to be shared with academic surgery. He decided that his Presidential address would be about gender disparity/bias in surgery. Dr. Lillemoe stated “at the time, the ASA included only 7% women, there were only 11 female Chiefs of Surgery in the US. There had only been one woman President of the ASA.” Dr. Lillemoe thought he had the address set, but then he heard AAS President Dr. Caprice Greenberg’s Presidential Address in 2017 titled: Sticky Floors and Glass Ceilings, just two months before his own address. He felt that Dr. Greenberg’s address had hit on many important points related to promotion, leadership of organizations, service on editorial boards, salary issues and how women are treated differently as residents or even as faculty members. Finally, he also had a daughter who was a surgical resident and was seeing these problems from her view. He therefore chose to amplify Dr. Greenberg’s message to a different more “senior” organization in his ASA address, mixing this message with the importance of surgical mentorship. His address was a huge success but in his closing remarks he stated “I know that the focus of this address was only on gender-related issues, but the bigger task is related to the issues of racial and other disparities, needs to follow.” He felt fortunate that his good friend, Dr. Ron Maier, past SUS President, followed as ASA President and formed a leadership group to further address all disparities in surgery. This group published a white paper in 2018 entitled Ensuring Equity, Diversity, and Inclusion in Academic Surgery: An American Surgical Association White Paper. Dr. Maier’s ASA Presidential Address the next year brought forth those very important ideas. Dr. Lillemoe understands that “we are still working on these issues, the events of this past year still show that there are lot of things we have to do in terms of social justice and inclusiveness”. He continued “if I have made any impact in the ASA or through Annals on these issues, or with the people that I have mentored, this is how I would like people to remember about me”.
Not a Surprise to Those Who Know Me
It does not come as a surprise to those that know Dr. Lillemoe that he is an avid sports fan. It doesn’t matter what the season is, as long as “they are keeping score, he will watch it”. Wherever he is, whatever time it is, he’s never far from not knowing if there is a game on and what the score is. Dr. Lillemoe was an athlete when younger and later enjoyed coaching his kids. He remains a loyal fan of his favorite teams in nearly every sport. Dr. Lillemoe also hunts pheasant with a group of academic surgeons every fall near his hometown in South Dakota. His dream job as a kid was not being a surgeon but rather playing for the Yankees and being the next Mickey Mantle. In the surgical world, there may be surgeons right now who are dreaming about being the next Keith Lillemoe.
The Society of University Surgeons is honored to present Dr. Keith Lillemoe with the 2020 Lifetime Achievement Award at the Academic Surgical Congress on February 3, 2021, taking place on a virtual platform. He is the true embodiment of the type of individual that this award seeks to recognize.