Joey Wahler (Host): A look at general surgery on this episode of Curating Care, a podcast brought to you by St. Clair Health. Expert care from people who care. Our guest, Dr. Brent Angott. He's a General Surgeon for St. Clair Health. Thanks for joining us. I'm Joey Wahler. Hi there, Dr. Angott. Thanks for being with us.

Brent Angott, DO: Hi, Joey. Thanks for having me.

Host: Oh, great to have you aboard. I know that General Surgeons in particular, have a very busy schedule indeed, so we appreciate the time. First, what would you say most triggered your interest in becoming a doctor and what led you to eventually join St. Clair Health?

Brent Angott, DO: Well, I guess it's a long road. I'm 51 years old, so I've been in practice for a while. Back whenever I originally started, I would say general surgery interested me because of the instant gratification. You have a patient that is having pain, discomfort, and we were able to take them to the operating room. And, the next day, or a few hours later, they feel much better. Obviously, there's post operative pain, but, still, an improvement in the patient's vitals and then overall health. And you get to see that result, and you get to see them walk out the door in a few days and do pretty well.

Host: And what would you say it was that initially got you interested in medicine?

Brent Angott, DO: So, that, that's an interesting story that actually goes back to high school. So, whenever I was in high school and trying to figure out what to do; my dad was an electrician. No one went to college except for my older brother, which is two years older than me. So I didn't know what I wanted to do.

And, my wife, which at that time was my girlfriend, she actually, said, well, why don't you be a doctor? She goes, I want to be a nurse. You can be a pediatrician. I'll be a pediatric nurse and we can together the rest of our lives. So, that was actually my true introduction on, well, maybe I would look into this medical field.

So, as I looked into the medical field, I actually had a cousin that's a few years older than me who is a cardiologist. And, he went to Westminster College. And I went up and spent a few days with him and kind of learned what he did. And then I spent some days with a couple of the family doctors around the area.

And I decided, well, yeah, I think I want to be a doc and I'll give it a shot. I know it's a long road and it's tough, but I think I'll get through it. So I went through that and general surgery was my first rotation. When you're a medical student, your last two years are all rotations and they're usually four weeks long.

And my first one was surgery. And I got to be honest with you. It was my first love, besides my wife of course, but my first love and it kind of stuck with me throughout those two years and then I went on to general surgery residency.

Host: That's great. And did your wife become a nurse?

Brent Angott, DO: She did, she was a nurse, out in Hershey in the step down unit and then, she became my office manager and my first employee. We had a practice for approximately 20 years in Washington, PA, and we actually had even our son involved. He was underneath the table in a car seat sleeping while we were interviewing our other employees and starting our practice.

So we practiced for 20 years in Washington. It started to become pretty much overwhelming. We had three surgeons at one time and we went down to two and it got to be such a heavy load. I wasn't spending enough time with my patients. And then that's whenever I became concerned about is this the right thing to do? And is this the right way to go?

Host: Wow, so it's really been literally a family affair. That's awesome.

Brent Angott, DO: Yeah, I'm very fortunate.

Host: Indeed. And so, what would you say most drew you to St. Clair Health after having had that other practice for so long?

Brent Angott, DO: So, the nice thing about St. Clair is obviously it's not that far away, but at first, I had to make a decision on trying to figure out should I stay private practice or become an employed physician. I talked to numerous hospitals around the area and I found that St. Clair had the best fit. What they did is something that I really enjoy, and that's actually focusing on the patient care, and on discussing with the patient.

I've actually had my kids here at this emergency room, and I was always impressed with how much time that the physicians took with the patients, the family, and they don't seem rushed, they seem very calm. And that was something that I was envious of, because being in private practice, in a smaller hospital system where we didn't have as many physicians, you were pretty much running around, with your head cut off. So this made it a lot better.

Host: And really, St. Clair Health is renowned for its patient centered approach. So it sounds like you're saying a big part of that is making sure that they're heard. And certainly one way to do that is to give them the time they need, right?

Brent Angott, DO: Absolutely. Number one thing, I think, in being a physician of any sort, is that you can't look at a circumstance of a disease without looking at the circumstance the patient is in, and you need to take that all into account. So when you deliver the care, it's tailored to that patient, and not only just to cure the disease, but also so it fits that person's situation, and it gets them back to what they care about the most.

Host: Gotcha. So can you share with us, please, some common reasons a patient would need a general surgeon? What are some of the procedures that you perform most? I would imagine, doc, you wake up and on any given day, you don't know exactly what is in store because there could be emergency that switches your whole schedule around, right?

Brent Angott, DO: First of all, the scheduled cases, and, and that's probably the majority of what we do, is we do hernias. Hernia by far is the number one case, and most of them are inguinal hernias, in the lower pelvis. But we also deal with hernias on the abdomen, that come from previous surgery, or just develop over time, over wear and tear. Other procedures that we do are gallbladders. We do emergent surgery, such as appendix, if there's a hole or a rupture of the intestine, we repair that as well. If they need any help with any type of trauma case, we can help with that also. And then there's some littler procedures that actually our patients really appreciate is, doing small lumps and bumps in the office.

So if you have, a skin lesion or something like that, we can help the patients out with that and, they can get them back to, feeling good about themselves and taking care of these lesions.

Host: So hernia, lumps, bumps, anything else?

Brent Angott, DO: Gallbladder, intestinal surgery. We do do hemorrhoid surgery. And again, as I mentioned, all the emergent surgeries that come through the emergency room.

Host: Sure so St. Clair Health of course has a commitment to innovation as well. How do you and yours incorporate that into your practice? And I would imagine robotic surgery is a big part of that because it seems to have touched just about every branch of medicine now.

Brent Angott, DO: It has. And, the great thing about being the age that I am, that I was very fortunate to start off with laparoscopic surgery in its infancy. Laparoscopic surgery started in the early 90s, and in the late 90s, it was pretty much commonplace to have a gallbladder removed laparoscopically. However, cases where we would remove colons and do intestinal surgery, hernia repairs, were just in its infancy and just starting.

So I got to see the techniques of the open procedures. Then I got to see the laparoscopic procedures. And as crazy as it is, and of course this is the way innovation happens, ten years later, we started to do robotic surgery. Robotic surgery is unique in the fact that it was actually invented by the government.

The government hired Stanford University in order to develop a robot that could do simple procedures on the battlefield to keep the medics and to keep everyone out of harm's way that they could. It didn't really pan out. It was kind of a little bit clunky and hard to maneuver these.

So, a company called Intuitive ended up buying the rights off of Stanford. And then they started to do robotic surgery in the public sector. And in the public sector, when we first started to do this, it, again, was maybe a little bit clunky, but you could actually operate at a console and have the robotic arms working at the table.

A lot of times we have patients that think that the robot is actually doing the operation, but that's not true. It's actually just you maneuvering the console to maneuver the arms at the patient's side. And I did that. Oh, I'd say I started about 10 to 15 years ago and I actually taught robotic surgery to several different areas.

And we were teaching a single site surgery that was popular 10 years ago, but seemed to fall out of favor, only to bring it back. And actually, when they developed the new robot, Intuitive came out with, and now the robotic surgery is robust and strong, It's part of every residency program around. So it's a great program. But what makes it great that we still are just touching on is the computer that's involved in it. There is a computer involved in every robot, so that could help us use imaging to put imaging in with procedures, eventually the computer will probably dictate some of the way we do the procedure just because of the information that can be provided through the computer.

I think right now, this is great innovation, but to be honest with you, in another 10 to 15 years, I would compare our robotic surgery now kind of as the, Blackberry, and eventually we're going to end up with an iPhone.

Host: Yeah. Great analogy, Doc. And, just one other thing to follow up on that a little bit. I guess, as you point out, it's important to note to people as you did that robots have not taken over the operating room, that there are still human doctors behind this robotic equipment. And, correct me if I'm wrong, but in essence, it's really the preciseness that's increased with doing this and that results, doesn't it, in both less scarring and quicker healing time and getting people back on their feet sooner, right?

Brent Angott, DO: Sure. It's been able to level the playing field, per se. And, robotic surgery definitely adds some added dexterity to our laparoscopic procedures.

Host: A couple other things, you touch so many lives on a daily basis, literally touch them, so can you share one memorable patient success story that you would say kind of highlights the impact that your work had on their life?

Brent Angott, DO: I gotta be honest, it's really hard to pinpoint one. Actually, when I closed my practice and started to come up to St. Clair, I saved every thank you that I received. And I had hundreds of cards and letters and just different memos that were sent to me. And they're all really special. But you know, one of the most special and most memorable things that I really enjoy is whenever I operate on a fellow surgeon or physician or a person who works in the operating room who actually sees your craft and they ask you to take care of them. That's very flattering for me, because they see the results and they actually see what I can do. And along with that, even today, I had a patient that was in Washington and came all the way up to St. Clair because they knew that I was up here today and they came through our emergency room for surgery.

Host: Well, you led me beautifully into what would have been my last question, but you kind of answered it there. I was going to ask you what's most rewarding. So you love the thank yous, of course, as you said, but when it comes from a colleague, that has an extra little impact, doesn't it?

Brent Angott, DO: Right, because they know what you do and knowing what you do and knowing you do it well, they're going to pick that person. So I think that that means a lot and it's very flattering.

Host: Absolutely. Well, folks, we trust you're now more familiar with general surgery. Dr. Brent Angott, a pleasure. Keep up the great work and thanks so much again.

Brent Angott, DO: Thank you.

Host: And to schedule an appointment with Dr. Angott, please visit stclair.org. That's S-T-C-L-A-I-R.org. Or call 412-942-7880. 412-942-7880. If you found this podcast helpful, please share it on your social media.

I'm Joey Wahler. And thanks again for listening to Curating Care, a podcast brought to you by St. Clair Health, expert care from people who care.