This spotlight series features the ongoing research of the department’s surgeon–scientists, beginning with those highlighted in the 2018 fall issue of the Duke Surgery newsletter.
A vascular surgeon at Duke, Dr. Kevin Southerland uses his close proximity to patients and disease to inform his research, an opportunity that offers him a unique perspective. “That’s one of the things about being a surgeon, you operate on them, and you can get tissue from them, and then you can study the problem in patients who have the actual disease, rather than mouse models or other things,” says Dr. Southerland.
“What really got me interested in being a surgeon–scientist was during the 2-year research fellowship. I didn’t really know that I wanted to do basic science translational research until I got into the lab and enjoyed cell cultures and studying the mechanisms of how things work. I was thinking about two paths, one in medicine, and the other in pure clinical outcomes research.”
Much of Dr. Southerland’s research focuses on the causes of blockages and discovering new, less invasive treatments. With his mentor in the Department of Medicine, Christopher D. Kontos, MD, Southerland has begun creating a biorepository of patients with peripheral arterial diseases, aimed at discovering why patients’ symptoms can present so differently.
“Patient A could lose their leg, and Patient B who has the exact same blockage could walk around the mall, or do activities with no problem,” says Dr. Southerland. “All of our treatments are aimed at fixing blockages. There must be more to it, when patients have the same blockage but have drastically different presentations.”
He and Dr. Kontos are in the beginning stages of this research. The last couple of years have been the early steps and studying the mechanisms of how things work in mice and in cell culture lines. “We are just on the cusp of being able to look at this experiment in humans,” says Dr. Southerland. “We think that the population of muscle stem cells, called satellite cells, are key to patients who have, for example, poor blood flow. The question is, is this population the type of patient that has fewer satellite cells, or do they have the same number of cells but they just don’t function well?”
At Duke, he has the ability to build his practice and work with great clinical partners who are supportive of his research and respectful of his protected days in the laboratory. “I honestly think that this is the only place in the country that would support me in both areas. There is so much pressure on surgeons to produce financially, through the clinical realm to support the hospital. There are very few places that are willing to bring on new surgeons who are able to have truly protected time,” says Dr. Southerland.
As a new faculty member, Dr. Southerland has the opportunity to learn from more experienced faculty who have balanced the dual-role for decades. In 2018, Department chair Allan D. Kirk, MD, PhD, FACS, formed a small, cross-disciplinary cohort for faculty to share ideas and experiences about balancing careers as both surgeons and scientists and to support each other. “So being in a place with surgeon–scientists like Dr. Kirk, these are people that have figured out,” Dr. Southerland says. “This is how you do it.”