Heather Lee (Host): Hi there everyone. Thanks so much for joining us for another edition of Medically Speaking, our podcast and vodcast. I'm your host, Heather Lee, and joining me today is Dr. Brian Rambarran from Western New York Urology Associates, also Clinical Assistant Professor, uh, the Urology Department, Jacob School of Medicine and Biomedical Sciences. That's a mouthful.

Brian Rambarran, MD: Yes. Thank you.

Host: You do a whole lot.

Brian Rambarran, MD: I do a bit. Yes. Thank you. And thanks for having me, Heather.

Host: Yeah. We appreciate you being here. Um, first of all, I want to say usually with guests and, you know, interviews, I immediately go to Instagram and you do a little scroll and you just try to find out a little bit more about a person. And I feel like your Instagram is you, your bio in a nutshell. Western New York Urology. Pilot and Dog Rescue.

Brian Rambarran, MD: That's right.

Host: Yeah.

Brian Rambarran, MD: Short and sweet.

Host: We're going to touch on all of those topics today, but there seems to be an overarching theme of saving lives, whether it's in the pet world, but obviously in the human world as well. Um, talk a little bit about your path to becoming a urologist. What led you in that direction?

Brian Rambarran, MD: Sure. You know, as a young child I was always interested in the medical sciences. And as I was growing up, I started volunteering in a hospital. Uh, my mother was a nurse. Uh, my father was a social worker, so it kind of naturally led me in that field and, uh, spending time in the hospital, seeing what the physicians did and the surgeons did, uh, naturally I just started to kind of head in that direction as I went through college and studied biology. Um, that kind of passion turned into more of a love for the field and, uh, onto medical school. As I was kind of going through the clinical clerkships, I learned what urology was and what a urologist did.

Uh, not a lot of students, uh, know what urology is. We know what surgeons do, we know what heart surgeons do, but not many people know what a urologist did. Um, but I was attracted to the field, uh, we make a big difference in patients' lives. Uh, 25% of cancers are actually urologic malignancies.

Host: Oh, wow.

Brian Rambarran, MD: So we treat, uh, more cancers than almost any other specialty. Uh, we deal with cancer surgery, we do, uh, kidney stones, we do female, uh, pediatrics. We touch almost every type of patient. Um, and that's what I really enjoyed about the field. In addition to the fact that we also follow the patients through. So we follow from beginning, middle, and end, and even after having surgery. So we have longitudinal care as well.

Host: When you're talking about some of the things that you do as a urologist, we were talking about sometimes for folks there might be a, a, an embarrassment factor or even a stigma. They don't want to talk about you know, certain body parts and problems with certain, you know, what would you say to those folks that may be hesitant about getting care or just, you know, knowing what's wrong and reaching out to the people that can help fix them?

Brian Rambarran, MD: Sure. It's a great question. You know, a lot of times patients, particularly men, have issues, uh, talking about sensitive subjects, whether it's erectile dysfunction, which is one of the big things that we treat, um, uh, and female sexual dysfunction and sexual dysfunction in males as well. So, um, it's tough to, to break some of those barriers sometimes.

Um. But, uh, most of us have seen a lot of it. And, uh, we understand what the patients are going through, um, and we're able to help them. So, you know, they don't have to feel like they're helpless or coming in and talking about an embarrassing subject. Uh, we've heard everything, um, it's not embarrassing. Um, and we're there to help you.

Host: Yeah. And most of, more, most importantly, you're professionals, so.

Brian Rambarran, MD: Of course. Yeah.

Host: Um, and how long have you been practicing for?

Brian Rambarran, MD: Uh, since 2011. So 14 years now.

Host: Yeah. So again, you've seen a lot and, you know, I don't, uh. At this point, I don't think that there's anything really new for you.

Brian Rambarran, MD: There's not much new for me. And again, you know, we're there to help the patients. Um, there's really nothing that anyone can say that's going to change, you know, the fact that we're there to help you and, uh, hopefully get you to a solution to your problem.

Host: Yeah. Let's talk a little bit about, um, prostate cancer. Um, I know that that is one of your special interests, prostate cancer and, and radiotherapy. Um, and talk a little bit about how many patients you see and, and the types of procedures, uh, from diagnosis. That they might have to walk through.

Brian Rambarran, MD: Sure. So, you know, prostate cancer is a big cancer that we see. About one in six men eventually may be touched by, by prostate cancer. So, uh, it's one of the most common types of cancer that a man faces.

Um, the changes that I've seen in the last 14 years have been tremendous. Um, whether it's patients, uh, who are caught early now that we can surveil. Uh, whether there's patients who are younger that need surgery or patients who need some type of other therapy, whether it be radiation therapy, um, or some other type of therapy that we have, the treatment algorithms that we've had have come, uh, such a long way. Um, what used to be, we would almost consider incurable nowadays can be a curable disease process. So, uh, we have a lot of tools that we can utilize now to help patients.

Host: Yeah. And I know with, as with a lot of cancers, early detection is key. I was talking with a patient recently who was a prostate cancer survivor. And now he is sounding the alarm for other men, especially in his community. And he does a lot of work with Kaleida. For screenings and, and telling people, this happened to me, it could happen to you and this is why you need to pay attention. How important is it that folks listen up and, and realize that they could be that one in six?

Brian Rambarran, MD: Sure. And you know, and that's important that he does that, you know, and really God bless him for doing that because it gets it out there that, you know, he's a real man that had this and went through it. Um, talking about stigma, you know, prostate cancer is a big stigma and what a lot of men hear about prostate cancer, immediately they start thinking about the bad side effects that come along with it. But again, with advanced treatments, with the, uh, robotic surgeries that we're able to do, and we probably do more robotic surgery than any other cancer care specialist in this, in western New York, uh, with, uh, the, uh, different types of medical therapy, hormone therapy, radiation therapy, um, you know, we can treat men with very minimal side effects nowadays.

So those old things where men worry about the erection problems afterwards and the leakage. A lot of that was, you know, the old 1990s medicine. In 2025, we have cutting edge technology now, um, that spares a lot of that function.

Host: And you can't worry about the future if you don't take care of it in the present.

Brian Rambarran, MD: That's right. So, you know, early detection is key and you know, when you catch them early, you can even have the option of just watching it sometimes, you know, but it allows us to monitor you closely.

Host: And let's talk about the robotic surgery. That's just one of the new technologies and the procedures that is changing the way that you do medicine. Um, what was it like in the old days and how does that robotic surgery make a difference?

Brian Rambarran, MD: Markedly different. You know, when I trained, I did open surgery, so we used to have to make big incisions. The patients would be admitted to the hospital. They would spend days with catheters, uh, with robotic surgery, minimal blood loss one day, hospital stay, minimal pain.

They go home the next day. Uh, preservation of function a lot of the times. Back in the early two thousands when we trained, patients would come back with leakage, incontinence, erection problems. Nowadays it's, uh, most patients come back and I tell them, you're probably going to be dry. Yeah. You know, now you're probably going to be dry.

You know, maybe you wear a pad. Most likely not. Um, and they can get back to their function and their activities of daily living a lot sooner. Robotic surgery really changed the game.

Host: Yeah. Is there any way that you prepare for robotic surgery? I've heard of other physicians playing a video game, literally a video game, to try kind of warm up to what you're about to do in, in the operating room.

Brian Rambarran, MD: Sure. Yeah. I mean, video games is one thing. It is actually a study done that looked at surgeons and video games and it actually was helpful in the OR. Um, you know, we do probably more robotic surgery again than anybody else in Western New York. Uh, we have access to six robots, and we have seven robotic surgeons in our group that just specialize in doing robotic surgery.And they're doing it every day in and out. So they're dialed in, they're honed in to this procedure.

Host: And I know that there's an incredible amount of training that goes along with it, but think back to that, those early days in 2014 when you did the actual, um, would you say open surgery?

Brian Rambarran, MD: Open surgeries, yeah. Early two thousands. Yeah.

Heather Lee (Host): Yeah. What was that like when you did your first robotic surgery? I would imagine that had to be really, really strange. Right. Compared to those, it's,

Brian Rambarran, MD: It's completely different. Yes. It's a lot different, you know, looking through the lens of a camera, uh, being 10 feet away from the patient rather than 10, you know, inches away.

Host: Yeah. Um. Urology is expanding at Buffalo General Medical Center Yes. In this year, 2025. Um, talk about what is to come and how, again, how that's going to change patient care. A lot of really exciting things are going to be happening.

Brian Rambarran, MD: Yeah. It's actually very exciting. So, uh, cloud administration, um, uh, you know, uh, uh allowed, uh, basically a big expansion, uh, the fifth floor in Buffalo General Urology. Um, they're building and we are building, uh, probably one of the largest hospital-based academic, uh, urology centers in the country. Uh, we're having, uh, they, there's going to be five, uh, rooms for us to do procedures concurrently, in addition to two rooms to do local procedures.

Um, what does that mean for the patients of Western New York? Well, it's going to allow for access of care. You know, we can have all the best technology, but if you don't have access, it's really meaningless and they're going to get cutting edge technology. You know, Kaleida Health is invested in us and invested in Western New York and the patients of Western New York to allow us to expand the care and bring cutting edge care to those urology patients.

Host: And you talked about that, that statistic, one in six, obviously this large expansion shows that there is a need in Western New York, um, to have these services here.

Brian Rambarran, MD: Yeah, absolutely. I mean, and that's just prostate cancer. There's bladder cancer, there's renal cancer or kidney cancer, testicular cancers. We'll deal with a lot of different types of cancers in Western New York. So, um, there's a big need for this. And again, with this expansion, with Kaleida Health, uh, we allow for access to care.

Host: Let's talk about sort of that pathway. Somebody comes to you for, you know, a diagnosis. They get a cancer diagnosis. What are the next steps and and where do they go for that cancer care? They can stay within the Kaleida family.

Brian Rambarran, MD: Oh, yeah, yeah. We have patient navigators who help the patients work, walk through the process, um, from all the way from surgical scheduling to follow ups, to follow ups with the surgeon thereafter. Um, it's a, it's a tough process. So we have patient advocates who help the patient all the way through every step of the way. Uh, we also work with a consortium of doctors within Kaleida Health. So we have medical oncologists who work with us, Cancer Care of Western New York, who provides radiation oncology services to the patient.

Host: Emergency services?

Brian Rambarran, MD: Emergency services, so if the patient has an issue and they need to present to an emergency room, um, we're there to staff it and cover it. So they have the, the physicians who are treating them who know the patient the best, taking care of them every step of the way.

Host: That continuity of care.

Brian Rambarran, MD: It's that continuity of care.

Host: And I would imagine with a cancer diagnosis, I mean, that in and of itself is so difficult. You want to try to remove as many barriers and, um, as many obstacles for that patient. And, and

Brian Rambarran, MD: That's right.

Host: That might not seem like a big thing staying within a system or within a, a healthcare family. Um, but for a lot of folks, it makes things just that much easier.

Brian Rambarran, MD: It does, and it's actually a big deal, you know, if you go to one place and have your surgery done, but they can't provide an ER or service to you, um, and they send you to a different ER, well, the, the, the, the surgeons there don't know you. You have a different surgeon taking care of you and oftentimes, you know, they're trying to garnish records and look for things. And it could be, you know, late at night and you may not be able to get the most prompt or efficient care. So just staying within the same facility with the physicians who know you, uh, is, uh, for again, continuity of care. Absolutely the best.

Host: All right. I want to talk a little bit about your personal life, your, your name, your face, uh, your videos have been out there just a little bit. Um, first of all, how do you balance, you know, a busy schedule, um, as, as a physician with your, your spare time and flyingand doing other things?

Brian Rambarran, MD: That's a great question. So, you know, I volunteer my time. Everyone I think knows at this point to fly and I fly for rescue foundations to rescue dogs. I take them from kill shelters, I bring them back up to Western New York and allow them to be fostered and hopefully get a second chance in life. So, um, where do I find the time? You just have to find the time. Uh, there was an author, Elizabeth Andrews said, you know, volunteers don't necessarily have the time. They just have the heart. So if you have the hard to do it, you're able to just find a little bit of time here and there to do it. Um, it is difficult, you know, running a busy clinical and surgical practice, uh, being a father to two daughters. Um, but I try to get them involved. I try to get them to come in and see that, you know, even though I'm spending a lot of time at work, I still have time to help others. You know, dogs who don't really have a voice. And volunteer my time.

Host: Yeah. How did you get into flying and how long have you been flying?

Brian Rambarran, MD: So, I got into it back in 2011. Uh, I've been flying now, so again for 14 years.

Host: Um, that was a lot in, in that 14 years. Yes, yes. Starting a medical practice, becoming a doctor, and becoming a pilot.

Brian Rambarran, MD: I did it all at the same time, concurrently.

Host: Just check it all off the list.

Brian Rambarran, MD: Yeah. I checked it all off the list and as, uh. As, as a pilot, you know, we always look for reasons to fly, number one. And number two, I just wanted a reason. I wanted a good reason to go out and do something. So I started flying dogs outta natural love for animals and dogs and just rescuing them. And it was something that struck me. So I started flying in for an organization called Pilot and Paws that links the pilots to the animals that need rescues. And I did it about 14 years ago and really have never looked back.

Host: That's awesome. How many flights would you say you've done in terms of the, the animal rescues?

Brian Rambarran, MD: Good question. Hundreds. Yeah.

Host: Wow. Yeah. How often are you flying?

Brian Rambarran, MD: More recently? Once a month. Okay. You know, it varies, but, uh, about once a month.

Host: What is a flight like that with a bunch of animals loaded into the back?

Brian Rambarran, MD: Yeah. It can be challenging. Um, one of the rescues I did had 20 puppies.

Host: Oh my goodness.

Brian Rambarran, MD: And so you have distinct odors of urine and feces.

Heather Lee (Host): Yeah. And a lot of noise, I would imagine. Right?

Brian Rambarran, MD: A lot of noise. They settle down. Yeah. They settle down when you start to get up to altitude, the dogs do get a little bit hypoxic, so they'll get a little bit sleepy.

Host: Okay.

Brian Rambarran, MD: Um, but when you're climbing, they're awake, and when you're descending, they start to wake back up. So they, they let you know that they want out of those crates.

Host: Yeah. No, and that has to be such an amazing feeling when you land here in Buffalo and the rescuers on, on the ground.

Brian Rambarran, MD: Yeah.

Host: Take them off of your hands. What, what goes through your head when, when you land the plane and know that they're getting a second chance?

Brian Rambarran, MD: Yeah. You know, you're full of emotions. I mean, everybody there is doing it because they love it. You know, it's not just me. There's a team of us, you know, from the people who foster them, coming from wherever they're coming from, to the people who foster them here. Um, and then ultimately to the families, that they go to. Um, I think one of the biggest rewards is seeing the pictures of, because we all share pictures with each other and videos, uh, all the rescuers do. But seeing them with the, seeing the family with the dog, and holding the puppy or the dog, you know? Two months. Two weeks.

Host: And knowing their story continues.

Brian Rambarran, MD: Two weeks later and the story continues, and this dog found a loving home, and this family found another family member. You know, I can't describe that.

Host: Yeah. Well, your, your name, your face, your videos, your photos, they were all over the place. Yes. Not that long ago. I saw you on, I think it was Good Morning America. Yes. Jennifer Hudson show. That's right. You were all over the place. You're like a little a celebrity now. How have you been taking the fame?

Brian Rambarran, MD: Ah, yeah. This is coming from a guy who didn't have Instagram up until recently. I just made that, my kids actually made it up for me. Yeah. I never was on social media before that, so.

Host: Well, now you have to be so.

Brian Rambarran, MD: No, I kind of had to be.

Host: So yeah. I mean, who doesn't love stalking a good Instagram page for some cute dog photos, right? That's right. What do your girls think about all of that.

Brian Rambarran, MD: Oh, they love it. Um, they're a little upset because they've always, you know, growing up as young girls, they always wanted to be Instagram stars and influencers or whatever. And dad stole and dad beat 'em in, you know, one month, you know, in one month their dad who never had anything. You know, I have more followers than them, but, uh, you know, they like it though. They're, um, you know, I think you know, they're proud of me of what I do and also themselves for coming out and helping. Yeah. Um, you know, and they share an enjoyment too, of seeing, you know, these, these dogs being placed and I show, you know, we all show them the pictures and you know, some of their friends have actually taken dogs and.

Host: Oh, that's awesome. So, so if I know that you're busy, obviously, again as a physician, as a surgeon, as a pilot, but it, I asked this question to another one of our guests, if suddenly an hour popped up in the middle of your day and you could do whatever you wanted. Not work related though. What, how would you fill that hour?

Brian Rambarran, MD: Ooh, not work related. Anything I could do. Probably read a good book.

Host: Okay.

Brian Rambarran, MD: Yeah. Just that. You know what, when you're younger, I remember when you get punished, my dad would send me to my room to read a book. I know. You know? And now if I get an hour to sit down and just read, it's, it's one of the nicest things, so.

Host: Have you read any good books lately or are you like me and you have a stack that you have to get to?

Brian Rambarran, MD: So I have a stack, you know, a lot of them end up being aviation related books. So, uh, I'm also a flight instructor. Okay. So I read a lot about flight instruction and, you know, topics related to that so.

Host: Yeah. Any tips for anybody who wants to become either a urologist or a pilot?

Brian Rambarran, MD: Yeah. I mean, first off,

Host: Maybe not do them both in the same year for one, but.

Brian Rambarran, MD: That would be one, you know, um, number one, you know, do what you love. You have to have a passion for it, you know? If you don't have a passion for it, you know, do what, what, what, you know, you have a passion for, um, you know, work hard.

You know, work hard, um, enjoy those little moments. It goes, it does go by fast. You know, when, when you're in the middle of it, uh, when you're in the middle of medical school, the middle of residency, you never see an end. You never see that light at the tunnel. Yeah. Uh, but then you get to me where you're in mid-career and I look back and say, geez, I'm kind of, mid career? You know, I'm, I'm, I'm not, uh, you know, I'm not that new surgeon anymore where they ask me if I'm old enough to do surgery. You know, now when I walk in, I say, I'm the surgeon. They say, okay.

Host: Yeah. Um, you, you wanna go back to those days, right?

Brian Rambarran, MD: Yeah, I wanna go back. They ask me, ask whether you get carded, whether or not you Yeah. They ask me, are you old enough to be a surgeon? Yeah. I am, um, you know, the time does go, does go quickly. So, you know, just enjoy every step of the way.

Host: Yeah. So, well, this was an awesome conversation. Did, did we miss anything that you want to talk about that you want to add?

Brian Rambarran, MD: No, I think we kind of hit on everything. Um, you know, uh, like I said, just to touch on what we said before, you know, Kaleida Health's expanding that urology program. Um, they're expanding the urology fifth floor. Uh, we're going to have a comprehensive center there to help patients, cutting edge technology, excellent access to care. Um, and also, you know, Western New York Urology, Kaleida Health. Uh, we do more cancer surgery than anybody else in Western New York. Than even any other cancer center. So, um, you know, put your, uh, uh, you know, care with us and, uh, we'll take excellent care of you.

Host: Yeah. Any websites that you want to put out there, your, your professional website, then we'll get to the Instagram.

Brian Rambarran, MD: Yeah, of course. Professional websites. Uh, wnyurology.com as in West New York urology.com. That's our professional website there. Um, and then my Instagram is B Ram barran, so B and then my last name R-A-M-B-A-R-R-A-N.

Host: Easy to find, and lots of adorable dog photos on there. Yes. So, yes. Yes.

Brian Rambarran, MD: Thank you.

Host: You're, we're gonna continue to make your girls jealous, because you're just going to get more and more followers out there.

Brian Rambarran, MD: Yeah, that's, that's right. Yeah. I beat them in, like I said, one month that they could do in, you know, two years or however long they've been doing it.

Host: Yeah. Well, thank you Dr. Rambaraan so much for being here today. Yeah. Great conversation and we'll have to have you on again, as things expand and as the program expands and the fifth floor at at Buff General, um, I'm sure that we'll have a lot to talk about in the future.

Brian Rambarran, MD: Would love to. Thank you, Heather.

Host: All right. Thank you.