Surgeon Steven Strasberg has risen to the top of his profession

BY PAM DROOG JONES, SPECIAL TO THE JEWISH LIGHT

Surgeon Steven M. Strasberg, M.D., says he always liked working with his hands. “My father was a furrier by trade, and my mother did a lot of things, including tailoring. We were cutting and sewing on both sides, so maybe it was in my genes!” he says.

Whatever the motivation, Strasberg’s accomplishments and skill as a liver and pancreas surgeon led to his being named a Fellow of the Royal College of Surgeons of Edinburgh last year and more recently, an honorary member of the European Surgical Association. “When you work in a field like mine, people around the world tend to know what you have published and contributed,” Strasberg says. “It’s a little unusual to receive both of these honors so close together but it’s nice.” They are just two of the numerous awards and honors he has won in the course of his impressive career.

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Strasberg is the Pruett Professor of Surgery and head of the section of Hepato Pancreato Biliary and Gastrointestinal Surgery in the Department of Surgery at Washington University School of Medicine. He also is a professor in the Department of Cell Biology and Physiology there. He heads a group of seven board-certified surgeons who have established themselves as the largest Midwestern surgical referral center for disorders of the liver, gallbladder, pancreas and GI tract. In terms of volume, Strasberg’s group does more pancreatic and liver resections and bile duct reconstructions than any other center in the Midwest and it ranks in the top five of each of these procedures nationally.

Born and raised in Toronto, Canada, Strasberg received his medical degree from the University of Toronto and entered its surgical training program. He taught, did research and performed surgery at the University of Toronto Hospitals for nearly 20 years. He was recruited by Washington University to head its new HBP surgery unit in 1992.

“When I was in medical school I became associated with surgeons and I just liked the very confident and direct way they thought. Also, I was very impressed with the surgeons I worked under as a student,” Strasberg says. “There was no question in my mind from very early on in medical school that I wanted to be a surgeon.”

When Strasberg was in surgical training, he became very interested in the liver and problems relating to it. “I’ve always found the liver to be a particularly fascinating organ in many respects, especially in terms of its function and responsibilities in the body. Its anatomy is very complex and challenging.”

However, at the time there was no such thing as hepatobiliary pancreatic surgery. “I’m trained and certified as a general surgeon,” Strasberg says.

Today the specialty is recognized around the world, he notes. There is a journal for the specialty and an organization in the United States, the American Hepato-Pancreato-Biliary Association of which Strasberg is a former president. “We now have about 500 surgeons in the nation who focus on hepatobiliary pancreatic surgery, out of 50,000 general surgeons in the United States,” he says. “So that’s just one percent of the surgeons in the U.S.”

Strasberg used to do transplants but now he mostly focuses on cancer in the liver, pancreas and biliary tract. “Transplants are sometimes done for liver cancer but most of the time we are removing parts of the liver or pancreas or the whole pancreas for cancer,” he says. It’s an area where things are constantly changing. “For instance, 25 years ago, 20 percent of people who had major surgery for pancreatic cancer died in the post-operative period. Now it’s just one percent,” Strasberg says. “We’ve made the operation safer but that doesn’t mean it’s effective yet. We’re working to improve the cure rates in many ways now by finding the cancers earlier and having better drugs to use along with the surgeries.”

Strasberg says surgery for cancer of the liver that comes from somewhere else, usually the large intestine, also has become safer. “Twenty-five years ago, ten to 15 percent of people who had a major liver operation would die, and only about 20 percent had a long-term survival rate. Now the long-term survival rate is up to 60 to 70 percent,” Strasberg says. “So we not only have made that surgery safer but also much more effective. Part of the reason is we now have much more effective drugs for treating cancer as well, so the combination of the drugs and surgery together have made that kind of surgery much more effective.”

In addition to doing surgery and looking after patients, Strasberg also does clinical research to find ways to improve the results of cancer therapies. “For instance we’re involved in a clinical trial to determine if we can shrink pancreas cancer which is inoperable to make it operable,” he says. “We also have trials in liver cancer to improve ways to recognize it, and another one using methods to destroy liver cancer with heat.”

In addition Strasberg teaches residents how to do surgery, and he’s also involved in teaching surgeons in the community how to avoid or fix injuries to the bile ducts when removing the gallbladder.

He also has written hundreds of journal articles and medical book chapters, and he’s constantly invited to present papers at meetings of surgeons all over the world, from London to Hong Kong, Vienna to Buenos Aries, Tokyo to Paris and more. “I enjoy the traveling. Internationally there are only about 1,000 people who do what I do so we get to see each other over and over. I’ve developed friendships with people from around the world, and that’s very gratifying and fun,” Strasberg says.

It’s a busy life, he acknowledges. “It’s hard to make time for everyone and still remember there is a family to make time for as well,” he says. His wife, Yona, is a retired nurse. “I’m very fortunate to have someone who is supportive of my career and who understands that I’m not always there when I’m supposed to be,” he says.

The Strasbergs have four children who live in Canada and include a lawyer, a teacher and two family doctors, one of whom is his daughter, family doctor Jessica Strasberg. “I admire many things about my father,” she says. “He has always been a great role model to me. Through his work he has shown me that commitment and determination are important to succeed. In family life, he has shown me how to love and the importance of family. He is also a very humble man,” she adds. “He does not talk about himself or his accomplishments even though they are great. My mom does this for him!” The “other” Dr. Strasberg says during her medical training she often has encountered other doctors or patients of her father from the past in Toronto. “There are always comments about what a good teacher he was or how well he treated a patient,” she says. Recently Jessica met a man whose wife received the first laparoscopic cholecystectomy in Canada, more than 15 years ago, performed by her father. “The man told me how wonderful my dad was to them and they still talk about him to this day. This is not an isolated case,” Jessica notes. “Former residents of my dad frequently tell me how much he taught them and what a great role model he was to them.”

Those feelings are shared by Dr. David Linehan, a colleague of Strasberg’s at Washington University. “Dr. Strasberg leads clinic on Mondays and it’s very fast-paced and high stress but the medical students love it and learn so much from him,” Linehan says. “I seek Dr. Strasberg’s advice all the time. It’s great as a young surgeon to have a teacher who is one of the most experienced and acclaimed HPB surgeons in the world. He has an amazing depth and breadth of experience.” Linehan adds, “Dr. Strasberg is amazingly innovative, even more than a lot of the younger surgeons. He’s done the Whipple procedure thousands of times and still comes in every day.”

Strasberg is a member of Shaare Zedek, though he still “pays his dues” to his synagogue in Toronto “so our children can attend there,” he says. His father’s parents were extremely observant Jews, but his mother was the only one from her family who escaped Europe before World War II. “But I think the values my parents and grandparents instilled in me were Jewish values and they are very important to me,” Strasberg says. “The thought that our religion says in this world, if you do something wrong, you have to fix it before you are forgiven by God, for me that’s always been the central ethic of Judaism and the thing that makes it great.”

Strasberg adds several secular ideas also have influenced him. “In medicine I think the most important thing a doctor does is relieve pain and fear. It doesn’t mean we can cure everything. But we can work to take people’s fear away and make them feel they are in good hands and that people care about them,” he says. “I learned that from watching people in medicine I had great respect for.”

From his patients, however, he learned to smile. “When I was a young surgeon, some patients told me, ‘Dr. Strasberg, you’re a very good surgeon but you frighten us because you never smile.’ I was always very serious, trying to explain things so patients would understand. But when I heard that, I realized that’s smart. It helped me make that emotional connection that puts people at ease and helps them believe they will be looked after by a caring human and not some machine.”

In his rare down times, Strasberg likes to visit with his children and five grandchildren, read nonfiction books and cook. And although he misses family and friends in Toronto, he has enjoyed discovering St. Louis. “Professionally it’s been a wonderful move for me. Washington University is an incredible place to work,” he says. “I tell people in other places, in St. Louis you hardly ever hear anyone honk his horn! I’ve been in places where all you hear are horns honking all the time. I find there’s a lot of kindness and a real ‘Y’all come back now!’ attitude.”

Milton Movitz, President of the Jewish Light board and Strasberg’s longtime neighbor, says, “The St. Louis community ought to be very proud to have a world-renowned surgeon like Dr. Strasberg in their midst. He’s a kind and gentle person and really reaches out to others. I’m proud to be his friend.”

In the long-term, Strasberg plans to keep working at Washington University, continuing to develop and improve his specialty. He’d like to see more gains made in cancer of the pancreas, including ways to screen and diagnose cancer of the pancreas earlier.

“I don’t think it will be too long before we see very dramatic changes in cancer detection, just like we have in cancer treatment,” he says.

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