Cheryl Martin (Host): Welcome to Healing Heroes, PDX, the podcast series from the specialists at Shriners Children's Portland. I'm Cheryl Martin. Today we are spotlighting one of our pediatric orthopedic surgeons, Dr. Bryan Menapace. We'll learn about his specialties and his path to Shriner's Children, Dr. Menapace, welcome. We're delighted to have you on.

Bryan Menapace, MD, MBA: Yeah. Thanks so much for having me.

Host: First, tell us a little bit about yourself.

Bryan Menapace, MD, MBA: So I'm Dr. Bryan Menapace. And I'm one of the newest surgeons that's joined the Shriners practice here in Portland, mainly focusing on pediatric spine conditions. But then I also take care of our patients with brittle bone conditions like osteogenesis imperfecta, and then our patients with skeletal abnormalities like skeletal dysplasias.

Host: Many of the doctors at Shriners have had different journeys that led them here. How did you initially get interested in orthopedics as a career path and why pediatrics?

Bryan Menapace, MD, MBA: Things kind of began when I was in Wisconsin. Well, I grew up in Michigan, but then I attended college at Wisconsin. I was spending a lot of time doing research in pediatric oncology for pediatric cancers, specifically one called neuroblastoma. And that was what got me really interested in healthcare and specifically wanting to be a doctor. So then when I went to medical school in Chicago, I started becoming separately very interested in a lot of the different procedural fields. So I explored a lot of different fields, including neurosurgery, ophthalmology, plastic surgery was another one on the list, ENT, but it actually wasn't until I did a pediatric orthopedics rotation, that I became very much interested in orthopedics specifically. I fortunately had a year off during medical school between third and fourth year when I was doing a master's degree. And during that year I got to spend even more time, with a group of pediatric orthopedic surgeons, specifically pediatric spine surgeons down at Atlanta, at Atlanta Scottish Rite and Children's Hospital of Atlanta. And so, this really kind of jumpstarted the whole process of not only orthopedics, but also pediatrics. I've worked with kids for a long, long time. I was a lifeguard. I was a camp counselor, a new student leader at the university. A lot of different things, both with work and volunteering.

I spent a lot of time tutoring and so working with kids was kind of always the goal. And then orthopedics eventually became the venue to get there to help take care of these kids.

Host: Well, you've shared a little bit of your path because I've been told that the path to pediatric orthopedic surgery can be quite long. How long did it take and tell us about your training. You've, you've touched on that a little bit.

Bryan Menapace, MD, MBA: It can be a longer journey compared to maybe some other career paths. So, you finish up college and then you go to medical school, which is typically four years. Mine was an additional year because I was doing that separate degree, so it ended up being five. And then, all of us train actually in comprehensive orthopedics.

So, that includes pediatrics, but all the way through adult type issues like joint replacements and trauma, injuries and all that was at Cincinnati, where I got to spend a lot of time at Cincinnati Children's Hospital, which is a very large children's hospital there in Ohio. And on top of that, most of us who work in some more complex fields, like pediatric orthopedics, will spend extra time in what's called a fellowship, which is additional training after residency.

And so for the most part, we end up going to a separate location to learn from even different surgeons, different techniques. And for me, that actually brought me over to Delaware where there's a pediatric orthopedic specific hospital and institute there called duPont, which is one of the oldest pediatric orthopedic fellowships in the country.

And so there I got to work with a number of surgeons, including many of the thought leaders and skill leaders in pediatric spine along with osteogenesis imperfecta and skeletal dysplasia. So I trained with them specifically for a year in these three areas.

Host: What brought you to Shriner's Children's portland? What attracted you?

Bryan Menapace, MD, MBA: So my wife and I are both in healthcare and so part of it was trying to find in the job search, locations for both of us. But, we both really very much love the Pacific Northwest. Love the opportunities out here. Being so close to the mountains and the ocean and outdoors are important to us.

So that was part of our search process, but, ultimately what it really came down to is that a lot of our lives are spent taking care of our patients. And so finding a place to work that we could really take care of the patients that we want to take care of was kind of at the forefront of our search.

And so for me in particular, having a strong interest in pediatric spine surgery, there's only about 200 or so pediatric spine surgeons in the country. So when you're looking for one of those jobs, you need to find an opportunity in order to take care of those patients. And I was very fortunate that the year that I was searching, that they happened to have an opening here for a pediatric spine surgeon to join the practice.

So that was fantastic to be able to join a group that was looking for exactly what I wanted to do. And then it was incredibly lucky and kind of unpredicted that they also had a need for someone who had experience and training in skeletal dysplasia and osteogenesis imperfecta, because there are probably less than 10 surgeons in the country that do those separately.

I only know of three surgeons that specialize in osteogenesis imperfecta in the US and probably about 20 that do skeletal dysplasia. So the fact that they had those patients here at the Shriners. And they also had a need for surgeons to come in to help take care of those patients; it just ended up being an absolutely perfect fit.

Host: I would say. So you knew with all of that information, this was the right place for you. So you've been with Shriners Children's, Portland since 2024. What has the experience been like for you?

Bryan Menapace, MD, MBA: The experience has been fantastic. It's really incredible. The hospital here, the draw that they have for the patients. I'm seeing patients on a daily and weekly basis, not just from the Portland area, but all over Oregon, all the way over to Idaho, all the way up to Northern Washington. Even a couple patients that drive across the border, from the Vancouver, Canada area.

Then we also have patients that fly in. I've had patients that I've taken care of, all the way south to Arizona, all the way north up through Alaska. And then beyond that, we also get international patients that are coming here. So this hospital is truly a special place that brings in incredible patients and fantastic experiences that we're able to offer them.

And then, separately, the hospital itself, all the providers here are fantastic. This is a really great group that they've assembled, between all the physicians, nursing staff, physical therapists, everyone that's supporting all these different roles, this has just been a really great place to work from that perspective also.

Host: Go into more details about your specific practice here in Portland. Your areas of interest. You mentioned pediatric spine surgery, but your practice in the context of Shriners Children's.

Bryan Menapace, MD, MBA: Yeah, so, my practice, just because they had a specific need and I had a specific skillset, is fairly focused already, even though, I've only been here for about a year and so, right now, I'd probably say about 75 to 80% of my practice is pediatric spine surgery. This is mostly taking care of kids that have conditions like scoliosis or kyphosis or a thing called a pars defect or spondylolisthesis.

Those are some of the most common spine operations that we do. But then the remainder of my practice actually fills in these subspecialty clinics that we have. These are multidisciplinary clinics. We're working with geneticists and therapists and, Dr. Nichol, who's our endocrinologist, and that's where I'm seeing our patients who have skeletal dysplasias and bone health conditions.

So, and then on top of all that, we all cover call and then we also cover what's called a fracture clinic that we have here. So kids that have injuries can come through, and have their fractures looked at and taken care of. So, separately from all that, I also have a non-elective practice, where I take care of kids that have broken bones.

Host: Now, an important pillar of the Shriners Children's Mission, as you know, is education and research. Share more about your practice from an academic perspective.

Bryan Menapace, MD, MBA: Yeah, so a lot of my interests academically kind of span and are extensions of the patients that I'm seeing on a day-to-day basis in clinic and in the operating room. So, from a research and education perspective, so we have trainees here, which include residents and fellows that are not just from the US but we also host international trainees from Australia.

And we also have another person with us right now from Israel who have all come here to learn from us and help take care of patients here. So that's kind of the education part. Then from a research perspective, I'm in a number of different research groups that are all kind of related to my areas of interest.

So one is called the Scoliosis Research Society. Another is the PSSG, which is a pediatric spine study group. These are all large national and international study groups. And then, for some of my separate skeletal interests, I'm, I'm a member of the LPA, which is the Little People of America, which takes care of our patients with skeletal dysplasias.

And then I'm also, one of the surgeons in the OI foundation, which is a North American based foundation that, helps provide information and is a kind of a thought medium for our osteogenesis imperfecta surgeons across the country to discuss some difficult cases and, come up with creative solutions for these patients.

Host: Let's delve more into patient care. What would you like to tell patients is the benefit of coming to you and our team at Shriners Children's for their orthopedic care?

Bryan Menapace, MD, MBA: The strongest thing that our hospital has to offer from an orthopedic perspective is that this is truly a specialty hospital. It's been here for over a hundred years, taking care of pediatric orthopedic conditions. We have 11 different surgeons here. All of us have different areas where we're highly, highly specialized in.

And then there's an entire ecosystem that's been built around patients with these rare and unique conditions that helps facilitate care from their clinic visits down on the first floor, easy access to patient friendly imaging, such as our EOS x-ray machine or our DEXA scan. Up to physical therapy and orthotics and prostheses, which are made right here in this hospital on the second floor.

And then, beyond that, we have our inpatient units and then our operating rooms above that. So essentially we can provide comprehensive care, comprehensive imaging, with up-to-date technology and very experienced and skilled providers here at this hospital. So I think that coming here, you get the benefits of having a system that knows what they're doing and has been doing it for a very, very long time.

Host: Well, it's obvious that you are passionate about your work and you love what you do, so let's talk on a personal note. What do you like to do outside of work? Any hobbies?

Bryan Menapace, MD, MBA: Yeah. So my wife and I are both pretty busy at work, so we really like to try to take the time when we have it, to relax and kind of explore. So we're both relatively new to the Pacific Northwest, so we've been taking a lot of weekend trips over to the coast, up to the mountains, driving up to Seattle.

We haven't driven all the way down to California yet, but that is something in our plans. But most weekend we like to do hiking. I also have a son who just, earlier this week just turned 1-year-old. So, we like to do fun stuff with him, take him swimming, and do all the little newborn baby things.

So, we like to really enjoy ourselves and take advantage of the Pacific Northwest, but, family is kind of paramount outside of work.

Cheryl Martin (Host): Well, it looks like you are already practicing work life balance. So to close things out for patients that you take care of, what are your words of wisdom for them?

Bryan Menapace, MD, MBA: I see tons of patients with variable conditions, some of them relatively benign, and some of them very serious and significant. And I think really what it comes down to is I hope that the patients who come here to not only see me, but also come into the Shriner system, feel that they're at the right place because we do see a lot of folks who kind of have visited various healthcare systems and providers trying to find the right home.

But I truly feel that with the amount of experience and resources that we have here, that our patients should feel comfortable and supported. And know that, we'll do our very best to give them the very greatest care that they could possibly be hoping for.

Host: Dr. Bryan Menapace, thank you for sharing your distinct journey, your expertise, and your passion with us, and I'm glad that your path led you here. Thank you so much.

Bryan Menapace, MD, MBA: Yeah. Thank you so much. Happy to be here.

Host: That concludes this episode of Healing Heroes PDX, with Shriners Children's Portland. To learn more, head on over to our website, shrinersportland.org. And if you found this podcast helpful, please share it on your social media and check out the entire podcast library for other topics of interest to you.

Thanks for listening.