Dr. Kathryn Chu

Dr. Chu MSS Interview

Phoebe Miller, MS4: What is one thing that you wish you had known during your training? 

Dr. Kathryn Chu: I wish I had known that it's OK to follow what you think is the best path, even if it's not the traditional path that's offered. When I was doing my general surgery training, I was interested in what's now called “global health” or “global surgery”, but back then, there wasn't a name for it. At the time, the traditional direction was to work for two years in a lab, either basic science or translational. A few residents were exploring health services research looking at disparities, but mostly in the US. So, the thought of, you know, wanting to use those research years to pursue something different - I wanted to go to London and pursue a specific master’s in public health in developing countries - wasn't really on anyone’s radar. Things have really changed a lot and that conversation now seems obsolete because I know that UCSF is very encouraging of people going into global surgery. But I guess the message is don't be afraid of going against the grain. I would say that if what you're thinking of isn't traditional, just go with your gut and do it. There will always be a path for you.

Phoebe: How did you find yourself interested in global surgery?

Dr. Chu: I loved other cultures and living in different places before I became interested in surgery. As an undergraduate, I studied in Italy and worked in Switzerland with an obstetrician, and we did a project on the chorioamnion of the placenta. One day, he asked me to translate for a pregnant woman who had recently immigrated from China. Her unborn baby had a cardiac defect, and he needed a translator to explain to her the diagnosis and what her options were. I realized medicine was really interesting because a person’s beliefs and culture will influence their medical decisions. I actually became really interested in the idea that one could marry the humanistic and medical experience. I also realized that medicine was a skill I could use in other countries. In medical school, I took a year off between 3rd and 4th year and went to work at a mission hospital in Lesotho and Kenya. What I saw at these hospitals was that the surgeons were extremely useful. There were a lot of surgical conditions such as tropical infections, injury from road traffic accidents, congenital defects, and acute abdominal emergencies. I decided I would become a surgeon and use my skills to work in lower-resourced settings. I completed a Masters of Public Health in Developing Countries at the London School of Hygiene and Tropical Medicine and the rest is history. There I met all kinds of leaders in global health, including several from Doctors Without Borders. My career moved into humanitarian surgery.

Phoebe: Who do you admire?

Dr. Chu: Diana Farmer is a pediatric surgeon, now the chair of surgery at UC Davis, and was one of my early surgical mentors. She had worked in Singapore and was one of the few surgeons at UCSF who had worked abroad. I think more than that, she was very supportive of all the trainees, but particularly female trainees. I think surgery can be kind of a difficult discipline to manage with all the long hours and all the things you have to learn, and she treated all of her residents like they were chief residents. She was always very encouraging of my ideas to do something off the beaten path. 

After my career has moved towards academic global surgery and research in the humanitarian setting and low resource settings, I found a different mentor, Dr. Nathan Ford. He's not a surgeon, but a researcher who worked for Médecins Sans Frontières (MSF) for many years. He was my first research mentor. He really took me under his wing and turned my interest in global surgery into an academic pursuit. It wasn't a topic that he necessarily knew that much about either, but together we found our way. I got some real encouragement and guidance in the field that I was passionate about

Phoebe: If not surgery, then what would you want to be doing?

Dr. Chu: Within medicine I was one of those people that liked just about every rotation. I think if for some reason I couldn't practice surgery, I would have been drawn to psychiatry or internal medicine, where the diagnosis is challenging.  I also love critical care as well. So I mean, I think that I like working with people. Medicine is such a privilege to allow you into people's lives, in a very intimate way, because people will tell you stories about themselves that they wouldn't share if you were like a random guest at their restaurant in Thailand.

Phoebe: What are you most proud of? 

Dr. Chu: Personally, that is pretty easy. I think being a parent has probably been one of the most amazing things that has happened to me. I have eight-year-old twins and I think that seeing the world through their eyes is really fascinating. They say things without any filter whatsoever. I feel lucky that I've been able to become a parent as well as be a surgeon.

Professionally, I am proud of my time in Rwanda helping to start their surgical training process after the genocide. They lost most of their doctors, including their specialists. Although they restarted the medical school, they didn't really have postgraduate training, and if you wanted to be a surgeon after 1994, you had to go outside the country and not everybody comes back. So, this was a really neat collaboration between the government of Rwanda and the funder, USAID. The program was led by Rwanda and their Minister of Health, Dr. Agnes Binagwaho, who is quite a strong personality. She wasn't going to take any nonsense from any of the US doctors or US surgeons. I quite enjoyed that dynamic, being guided by the Rwandans. Some other global health programs are too colonialistic in their approach where the high-income partners dictate the agenda. And just last week, I went back to be the external examiner at the University of Rwanda, and like 14 out of the 16 examiners, I had helped train. That was really cool, to be able to go back and feel like you've helped train a generation of surgeons in a country. I feel very proud about that.

Phoebe: What inspires you to do what you do? 

Dr. Chu: My main passion these days is improving the inequities in access to surgical care. In South Africa, you can see the inequities more harshly than in many other countries. You have private and public hospitals sitting less than a mile from each other. One has 14 CT scanners and the other has one that barely works and is broken half of the time. It's the same country and it's hard to believe that there's that difference in resources. Here in South Africa, there are people now who cannot get through the system. The system is broken and not set up to help them. I feel like if we can help change that system, it'll be better for every individual patient. I think that's what inspires me now.

Phoebe: Is there a piece of advice you would share?

Dr. Chu: Well, I definitely think that throughout one's career you have to follow what you're most passionate about. It sounds really cliché, but I think that if you do seven years of surgical training or choose a career in academics versus private practice, whatever is your interest, you have to really feel motivated and passionate about it. Medicine pushes the boundaries for most people because it's a world that they've never been in. But I remember when I worked for MSF, I really wanted to do it, but it required riding on the back of motorcycles, in helicopters, in tanks, and in boats on the open sea. All of which I was quite afraid of. But I think that it allowed me to do and see the contexts of health care that I really wanted to see and was certainly outside of my comfort zone. So you have to trust and say OK, well, I'm not that comfortable, but I trust that it's all going to work out.

Phoebe: Do you have a favorite drink?

Dr. Chu: There is a drink here (South Africa) called amarula. It's a liquor made out of amarula nuts and people always like to tell the stories that when the amarula fruit becomes ripe and it ferments, the elephants go crazy for it. I think it's pretty tasty too for humans. We used to live out in Kruger Park. My husband was running a research site there and it's true when those amarula fruit become ripe, the elephants come in and they break down every barbed fence to get to the amarula and dig up roots and you know pull up your whole garden and your sewage lines just to get to the amarula. It's quite a nice drink too.