Scott Webb (Host): This is One-on-One with Regional One Health, your inside look at how we're building healthier tomorrows for our patients and our community. Join us as we get to know some of the individuals who help provide life-saving, life-changing care for our community.

I'm Scott Webb. And today, we're talking with Dr. Leanne Grafmuller. Dr. Grafmuller is a vascular surgeon at Regional One Health, who provides care for everything from common vascular conditions to life-threatening emergencies.

Doctor, it's nice to have you here today. We're going to talk emergency care for vascular conditions and what that entails and what that means. But before we get there, I want to have you tell us a little bit about yourself, your background, why you decided to pursue a career in medicine, particularly in vascular surgery.

Dr. Leanne Grafmuller: Sure, Scott. Thank you. I'm very excited to be here, first and foremost. I was born and raised in the suburbs on Long Island, about an hour outside of New York City. I was always strong in math and science, so I studied bioengineering in college at the University of Pennsylvania in Philadelphia. I also love the Spanish language, so I minored in Hispanic studies and spent time abroad studying in Madrid.

I had always been interested in medicine since I was a child, but I graduated with a lot of college debt. So, I had always planned to work for a few years after completing my undergraduate degree. And I graduated during the Great Recession in 2009. So, it was difficult for many graduates to find a job. I was able to get an entry-level scientist position at a medium-sized pharmaceutical company in the town that I grew up in. So, I worked there in drug development, trying to help discover new medicines for a couple years, then moved to a similar position at Pfizer in Groton, Connecticut. While there, I finalized my decision to pursue medicine and matriculated into SUNY Upstate in Syracuse, New York. While there, I struggled to pick a medical specialty, because I found everything interesting.

It was in my final clinical rotation, during my third year, I discovered my passion for vascular surgery. It married the use of advanced technology to perform minimally invasive surgeries, but still required the delicate open surgical skills required to operate anywhere in the body. It also has a variety of surgeries and disease processes to keep me from getting bored. And it allowed me to take care of patients over a long period of time and build long-lasting relationships.

I also felt drawn to patients suffering from vascular disease more so than other disease processes, just like some physicians are drawn to pediatrics or oncology.

Host: Yeah, it's very cool. And what a life you've lived already, right? So, what brought you to Memphis and Regional One Health? And what do you offer patients at Regional One Health?

Dr. Leanne Grafmuller: Several things brought me to Regional One. First and foremost, our Chief of Vascular and Endovascular Surgery, Dr. Erica Mitchell. Dr. Mitchell is world-renowned in research, a distinguished vascular surgeon, an excellent leader. And I was excited for the opportunity to work with her to build a premier academic vascular surgery program in Memphis.

Second, the opportunity to teach residents and fellows is always something I've been passionate about. Training other surgeons to safely perform vascular surgery is what will keep me coming to work after I've mastered the field of surgery myself. Regional One has partnered with UTHSC, this opportunity aligned with those long-term career goals.

And then third, the opportunity to build a strong vascular program from the ground up offered an exciting challenge for me to pursue early on in my career. Our department has doubled in size in the last year, now growing to a full complement of five vascular surgeons with a nice spread of early, mid, and late career surgeons, which in my opinion is a perfect balance.

Lastly, the volume of trauma, Regional One drew me here as well. The open surgical experience you gain while urgently controlling bleeding and repairing blood vessels sets you up to be comfortable operating anywhere in the body in any setting.

Host: Yeah. And you mentioned trauma there, and that's kind of where I wanted to go next. I know your team treats traumas and emergencies. So, what are some of those conditions and how serious can they be for patients?

Dr. Leanne Grafmuller: Yeah. So regarding vascular trauma, traumatic injury to a large blood vessel can be one of the most dangerous things that can happen to a person since uncontrolled bleeding is life-threatening. On the other end of the spectrum, injury to smaller blood vessels don't necessarily need emergency surgery, and some can even be monitored closely without requiring any surgery at all.

Our team rapidly diagnoses and repairs injuries to blood vessels in the arms, legs, neck, belly, hip crease, armpit, really anywhere except the brain and the heart, that are caused by high speed car, motorcycle accidents, outdoor tools or farm equipment, firearms or knife injury. And the treatments can range from making incisions on the skin to find and repair the blood vessels or, when possible, using minimally invasive techniques without large surgical incisions. Regardless of whether we choose open or minimally invasive surgery, the goal is always to stop the bleeding and preserve blood flow throughout the blood vessel to the organs and tissues downstream.

Other vascular emergencies aside from trauma include ruptured aortic aneurysm, ulcerated arterial venous fistula, which can both lead to life-threatening bleeding. We also treat emergencies in which blood clots get stuck in the blood vessels in the leg or arteries that supply the abdominal organs, which can all lead to lack of blood flow and death of those organs. If left untreated, any of these vascular emergencies can lead to death or loss of an arm or leg.

Host: Yeah. And along the lines of the emergencies that you're referencing there, what are some of the treatment options you offer to patients with those emergencies? And how is Regional One Health unique in the care that it provides?

Dr. Leanne Grafmuller: Yeah. So at Regional One, we tailor the treatment of vascular emergency to the blood vessel affected. For injured arteries in the arms or legs, we usually create an incision, find the blood vessel, and repair it with our own eyes using either stitches, a little piece of vein or a plastic tube, depending on how severe the injury is.

If there's a tear in the aorta, the large blood vessel coming off the heart, or if the blood vessel injury is difficult to reach by making a surgical incision, we try to place a stent in a minimally invasive way similar to how stents are placed in the heart during heart attack.

Host: Sure. Yeah.

Dr. Leanne Grafmuller: If a patient presents with a blood clot that's causing injury and death to the organs or tissues downstream in the blockage, we work to quickly remove the blood clot by minimally invasive ways when possible, or open surgery when needed to pull it out and reestablish the blood flow.

Regional One is unique in that it has vascular surgeons that are extensively trained in both open and minimally invasive surgical options, so we can pick the best option for the patient. This is in contrast to physicians trained only in minimally invasive procedures. We know that, in some cases, open surgery can provide better treatment outcomes for patients. And in those instances, we're more likely to offer open surgery since we see patients do better in the long-term. We're also the only group in Memphis affiliated with the University of Tennessee Medical School, which affords us access to the most cutting-edge technologies to offer to our patients.

Lastly, being the only trauma center in Memphis and the surrounding areas, you have some of the most well-trained surgeons for quickly treating emergency situations, which in my opinion makes us more skilled in treating patients who are not necessarily having a vascular emergency, but also have a blood vessel problem that needs surgery to fix.

Host: Yeah. Wondering about your approach to care? You seem like a very, you know, knowledgeable and compassionate person. But, like, when you're approaching patients and families and you're trying to provide support and compassion, what's your approach?

Dr. Leanne Grafmuller: I really think providing patients and their families with the support they need requires making a genuine connection with them. I strive to be honest, first and foremost, honest about what the diagnosis means for them and their family, what available treatment options exist, what I think the best option for them is, and what to expect down the road.

I try to clearly communicate in simple language and give them as much one-on-one time as possible to ensure their questions are answered. I also take the time to help them with other problems they're encountering, even if they're not related to their vascular health. For example, helping them refill their medicines, referring them to other providers when appropriate, ensuring they leave the office with everything they need to be successful. I feel like this all helps build trust.

All this is even more crucial when I'm conveying bad news to a patient and their family. One of the hardest things a physician has to say is that there's no medicine they can give or surgery they can perform to save your leg or extend your life. It makes us feel like we're failing our patients. But being sincere and listening during these moments are how I try to connect with and support my patients. I try my best to put myself in their shoes and treat them the way I would want someone I love to be treated.

Host: Yeah. Well, it's been great to get to know you today and learn a bit more about what you do, that you and the team there. I'll give you a chance here at the end, tell us about your life outside of work. I've only been to Memphis once. And that was more about going to Sun Records and Graceland and, you know, that sort of trip. But what are some things you enjoy doing outside of work, you know, in your free time?

Dr. Leanne Grafmuller: So outside of work, I love doing outdoor activities and being in the fresh air since. We spend so much of our time under the fluorescent lights and in the windowless operating room. So, you can often find me strolling through Overton Park or biking down the green line to Shelby Farms Park. My husband is really into cycling outdoors, so I'm starting to get into that with him. I just got a new bike, and I can't wait to try it out. Otherwise, I go to spin class or group fitness classes at the YMCAs in town.

And I also love the theater, and Memphis is really scratching that itch. I've been to the ballet, Overton Shell Park and the Overton Square Theater. A show at the Orpheum is next on my list. I also love exploring the food and drink scene here. Memphis really has so much to offer. I couldn't be happier to settle down in this amazing and historic city.

Host: Well, like I said, it's been great to meet you. Great to have you on. I really appreciate your time, your expertise, your compassion, all of that. Thank you so much.

Dr. Leanne Grafmuller: Thank you, Scott.

Host: And you can learn more at regionalonehealth.org/vascular. For appointments in downtown Memphis or East Memphis, call 901-545-7222. And thanks for making One-on-One with Regional One Health part of your journey to better health. Join us next time as we introduce you to another member of the Regional One Health Family. I'm Scott Webb. Stay well.