Giving Children Hearing and Confidence

This is the second part of a monthlong series in honor of Women’s History Month at Stanford Medicine Children’s Health.

Pediatric otolaryngologist Mai Thy Truong, MD, learned an important life lesson from her father’s work as a senator in Vietnam: to do something with a purpose. Her parents emigrated from Vietnam when her father was in his 40s, and Dr. Truong grew up witnessing him having to start over, having left behind an influential political career that he was passionate about. “He lost his dream, his career, his country,” she says. She saw how hard her parents worked, taking jobs in factories while learning English. “It was a hard childhood, and my parents always taught me to be hardworking and grateful for having the chance to do what I love, and not miss an opportunity.”

For Dr. Truong, having the chance to do what she loves means treating children with microtia, a deformity of the outer ear that happens when the ear doesn’t fully develop during the first trimester of pregnancy, causing the outer ear to be very small, absent, or misshapen. Children with microtia also are often missing an ear canal or have an extremely narrow ear canal, so her work addresses the child’s cosmetic and hearing needs. “It’s a perfect blend, since I’ve always been interested in reconstructive and cosmetic surgery, and I love taking care of children,” she says.

The surgeries to create a new ear are technically challenging. Dr. Truong uses a method she learned while studying in France under Dr. Franciose Firmin. She reconstructs the ear using the child’s own rib cartilage over two surgeries, as opposed to the more commonly used three- or four-stage surgeries. She also uses 3-D printing technology to print lifelike models of the opposite ear re-created in a mirror image to improve symmetry. Using a child’s own tissue, she’s confident that the ear will be stable for the child’s lifetime. Dr. Truong is glad to be at a point in her career where she’s able to train microtia surgeons in this approach and give more international talks to spread the word about this advanced surgical option.

What Dr. Truong likes most about treating children with microtia is seeing the impact that having a normal-looking ear can have on a kid’s life. She has performed eye-tracking studies, which show that the ear receives a lot of attention in the human gaze. “Someone won’t die without an ear, but there’s something significant about living with that malformation‚” she says. “Every time that child looks at themselves in the mirror, they’re reminded they look different. So even though it’s not a vital life function, I definitely see a child go from being ashamed to blossoming.” She has performed research to understand how adults perceive children with ear abnormalities and learned that misperceptions about health or intelligence improve after ear reconstructive surgery.  She is passionate about understanding what makes the best reconstructive outcomes and has utilized artificial intelligence to study this. 

Dr. Truong goes on medical missions each year to Cambodia and Guatemala, where there are high rates of microtia. These missions are always the highlights of her year. In some countries, the pain of living with the malformation can be severe. “One child was ostracized for having this facial deformity and never left the house until having the reconstructive surgery,” she says.

She is passionate about teaching and is the fellowship director for Pediatric Otolaryngology at Stanford, where she is proud to be part of a National and International Fellowship program. Her group trains surgeons who come from countries around the world that don’t have pediatric surgical specialists so that they can return home and provide a higher level of care.

When she’s not restoring children’s hearing and helping them improve their self-esteem, or removing tumors, Dr. Truong savors her other favorite parts of the day: time spent with her family. She particularly loves reading with her kids, swimming, and going to their sports games. And she loves karaoke. “It is important to me that my kids know that I love my job and for them to see that passion,” Dr. Truong says. It’s a struggle to find balance, she says, but she keeps the lessons she learned from her father about fulfillment close to her heart. “Success, for me, is loving your job, loving yourself, loving your family, and loving your friends. You can’t always be successful at all four at the same time. But if you can balance and rotate those things, you can feel a lot of satisfaction in that. But do all things with love—that is how I try to live.”

Finding the perfect fit in orthopedic surgery

Muscles and bones have been natural topics of conversation for orthopedic surgeon Meghan Imrie, MD, since she was little. Her father and grandfather both worked as orthopedists, and her mother just recently retired from working as a physical therapist. So, it wasn’t a huge surprise that when she got to medical school, Dr. Imrie decided that anatomy of the musculoskeletal system was her favorite subject. She was also drawn to the field of pediatric surgery. “I like the idea of using my hands to physically do something to improve someone’s care, and young patients are such a joy to take care of,” she says. Landing in the specialty of pediatric orthopedic surgery turned out to be a perfect fit. “I’m very biased, but I think it’s the best choice you can make as a physician.”

Dr. Imrie specializes in treating children with scoliosis, trauma injuries, and cerebral palsy, and she is one of a handful of female surgeons in the country specializing in spine surgery. She’s been inspired by other trailblazing women in medicine along the way. “As a woman in a male-dominated field, I was lucky to have a mentor in medical school who had a smart, hardworking, take-no-prisoners style that I appreciated,” she says. Dr. Imrie was also supported by female role models in the Department of Orthopaedic Surgery at Stanford. “Seeing people who you can identify with working in places where you want to go yourself makes it a little easier—an ‘If you see, it you can be it’ kind of thing,” she says.

An especially rewarding part of Dr. Imrie’s job is that she can bounce back and forth between taking care of kids who are injured but healthy and those who have serious, chronic conditions. “I take care of kids who fall and break their arm, and after a 20-minute surgery, our team can get them back to their life. And then I follow other patients for years, and my relationship with them is very different.” The significance of being able to go to her dream job every day isn’t lost on her. “It’s so rewarding and fun to operate—and challenging, too,” she says. “There are times when I’m getting ready to go into surgery when I think, ‘I can’t believe I get to do this.’” When patients thank me, I don’t know what to say, because I feel so grateful that I’m in a position to help in this way.”

Finding cures for congenital heart disease

Pediatric cardiologist Marlene Rabinovitch, MD, comes from a family of doctors. Her father practiced medicine for more than 70 years and retired at the age of 96. “His office was in our home, so I was always exposed to medicine and to patients,” she says. She and her brother—who also grew up to become a physician—often accompanied their father on house calls and liked to look through his microscope. “It was very much part of lives and was our inspiration,” she says.

Dr. Rabinovitch was drawn to cardiology because of the challenge it presented. The first open-heart surgery she saw performed on a child was a new, difficult operation to correct a serious heart defect. “I realized that the field was going through a lot of change and that there were unprecedented opportunities to treat children with heart disease. A revolution was happening because of the remarkable advancements made by cardiac surgeons as well as cardiologists,” she says.

Seeing patients with complex heart problems—desperately in need of advanced treatments—became Dr. Rabinovitch’s specialty. She focuses on finding effective treatments for pulmonary arterial hypertension, a complication of congenital heart disease in children and a serious condition in adults, for which there currently isn’t a cure. On her way to becoming a preeminent physician-scientist, Dr. Rabinovitch was inspired by several other women in cardiology who made remarkable achievements. “A number of high-profile women were both inspirational and aspirational, so it didn’t seem to be at all exclusionary … women were part of the fabric of the specialty,” she says. “Congenital heart disease is so severe and so common in infants that maybe seeing this inspired women in my field to try to do something about it—to describe it or try to correct it.”

In her work, Dr. Rabinovitch does both: She endeavors to find answers in her laboratory and brings treatments to patients as a physician. She has received dozens of awards for her research and mentoring over her 40-year career, including the 2023 Research Achievement Award from the American Heart Association. This honor highlighted her major work in describing novel approaches that could lead to a lasting cure for pulmonary arterial hypertension.   

She’s quick to share credit for this and other honors with her trainees in the lab. “It’s such a tribute to the people who worked with me and to the field,” she says. “It’s not just about what I’ve been able to do.” For the next leg of her career, Dr. Rabinovitch is looking forward to a phase II clinical trial, decades in the making, for patients with pulmonary hypertension. And she’s busy helping shape a new program to identify cures for congenital heart disease and is recruiting top scientists to participate. “It’s a dream position,” she says. “I’ve always felt that being a pediatric cardiologist and an investigator is a privilege, and that working hard to be worthy of that privilege is the best attitude you can take.”

Two directions, one goal

Pediatric neurosurgeon Laura Prolo, MD, PhD, now defines success quite differently than she did when starting out as a physician. “During my training, I used to focus more on milestones, learning a new skill in the OR, passing a standardized test, or getting a grant funded,” she says. “Now, it’s more about the connection to my patients and trainees, about really getting to know them and their families, their hopes and goals, and helping them to reach those goals.”

Dr. Prolo, whose father is also a neurosurgeon, didn’t think she wanted to be a physician at first, and she started out doing research in neuroscience. But she felt that something was missing. “I saw the fulfillment my father received from caring for patients,” she says, and decided to do a combined medical scientist training program. During her clinical rotations in medical school, Dr. Prolo fell in love with neurosurgery. “Nothing over the past decade of studying neuroscience could have prepared me for seeing the beauty of the nervous system, the privilege of performing a surgical procedure, the intellectual and technical challenges of surgery, and the team approach in the operating room.” 

She shifted her focus to taking care of children with diverse neurosurgical needs. “Everyone in the operating room—the neurosurgeon, resident, fellow, medical student, neuroanesthesiologist, surgical technologist, circulating nurse, and neurophysiologist—are all focused on that specific patient, and it’s inspiring to see how well everyone works together to care for that patient,” she says. The immediate impact of neurosurgery is also gratifying to her. “Patients can be very sick from tumors, traumas, or shunt failures,” she says. “Through surgery, we can relieve their symptoms, and they wake up feeling much better.”

Dr. Prolo hasn’t lost her love for research. She devotes a lot of time to studying pediatric brain tumors in her lab. “As a neurosurgeon, I can take out a tumor, but it can return,” she says. “As a neuroscientist, I try to understand what it is about the tumor that allowed it to divide and invade into the adjacent brain in order to find ways we can prevent the tumor from returning.” Dr. Prolo’s long-term goal is to identify which pathways drive tumor cell invasion and how these pathways can be targeted for novel treatments.

It’s rare for a pediatric neurosurgeon to also have a research lab; Dr. Prolo credits mentors she had early on with encouraging her to pursue her dual passions. “I had many mentors who made me feel that I could pursue all of my interests,” she says. She pays that encouragement forward with the students in her own lab. “It’s important for me to support everyone interested in this career, but I know some students came to me because I am a woman, and they were looking for a female role model to openly discuss questions that are more specific to women.”

Above all, she’s committed to caring for children with brain tumors from many angles. “It’s one of the most gratifying groups of patients a physician can help,” she says. “These children can very suddenly transition from being normal, healthy kids to becoming so symptomatic. What motivates me the most is helping these children, who are so determined to recover and to lead fulfilling lives.”

Dedication to cardiac patients and innovation

Pediatric doctors tend to find their calling by following their passion for medicine and then choosing to treat children. But pediatric cardiologist Lynn Peng, MD, came about it from the reverse. When she went to Harvard as an undergrad, she didn’t think she’d go into medicine. She adored kids, so she volunteered at Boston Children’s Hospital in order to spend time with them. “I fell in love with taking care of kids in that setting,” she says. She’d always been good at science and was majoring in chemistry, and it clicked.

Her first year in medical school at Johns Hopkins was serendipitous. Dr. Peng’s mentor happened to be pediatric cardiologist Jean Kan, MD, a trailblazing woman who was the first person to balloon open a narrowed pulmonary valve. “She was so great, and she brought me into the cardiology world—she introduced me to colleagues and faculty, helped me perform my first pericardiocentesis, and had me assist the cath lab attending,” she says. 

Dr. Peng was drawn to the field because of its complexity. “People think cardiology is just about the heart, but it’s also about electricity and hemodynamics—all of the systems that drive blood to the body,” she says. A problem solver by nature, she also liked the challenging nature of interventional catheterization. Unlike in adult cardiology, every child’s heart is different, so no two cases are the same. “I like to work with my hands and having to think quickly to come up with solutions in the moment,” she says. An added challenge is the lack of devices made specifically for pediatric interventional catheterization patients. Many times, cardiologists like Dr. Peng have to adapt devices made for other parts of the body to the heart, or they retrofit devices made for adult conditions and anatomy. “It means that you need to innovate on a daily basis,” she says.

Today, Dr. Peng is the medical director of the catheterization lab at Stanford Medicine Children’s Health, where she leads a team of interventional cardiologists who perform more than 1,200 catheterizations a year. “My goal is to do everything we can for our patients,” she says. “I feel strongly that we need to offer ways to fix some types of congenital heart disease without open heart surgery, so it’s crucial to be excellent in what we do and to provide the best care that these children can get anywhere.”

Dr. Peng is passionate about furthering innovation in the field, and she works on projects to bring more medical devices for pediatric cardiac patients. “It’s hard to do all you need to do to develop a device on your own as a clinician,” she says. “So I appreciate that Stanford is an innovation hub for device development in terms of our ability to work with engineers and start-up companies.” For one of her projects, she’s working with a start-up developing much-needed tools and devices to treat babies born with congenital heart disease.

Pushing the envelope as a leader who is unconventionally innovative and productive comes naturally to Dr. Peng. “I’m a pretty tough person, and my personality is built to be disciplined and hardworking,” she says. As an athlete, she regularly runs marathons and practices the physically intensive martial art Muay Thai. “These require a lot of self-discipline and focus, and I think these traits go hand-in-hand with interventional cardiology. To be successful at interventional cardiology, you can’t give up. You have to keep going and have the mentality that you’re a winner—that you can do what needs to be done to fix your patients’ hearts.”