Surgeon-In-Chief Looks at Milestone Moments that Led to History-Making Surgery
By Heather Duge
As the Surgeon-in-Chief for Cook Children’s Healthcare System, Eric Hubli, M.D. knows that every surgery needs a backup plan. In many cases, one backup plan is not enough.
“The key to a really good surgeon is the ability to adapt. When operations move in a unique or unexpected direction, you have to be able to create plans b, c, d and e,” Dr. Hubli said.
During the separation procedure for 16-week-old conjoined twins AmieLynn and JamieLynn Finley, multiple layers of plans were considered and vetted in order to give the girls a chance at life on their own. Dr. Hubli has been a colleague and champion for surgeons at Cook Children’s for the past 15 years. Now he is part of a multispecialty team that came together in an effort to understand and manage every nuance of the separation surgery.
Dr. Hubli’s primary role before the surgery was to assist the other surgeons with the organizational process to remove any barriers so their vision could be realized.
“We put our minds together, reviewed all the clinical data and thought about where the challenges would be," Dr. Hubli said. "We then worked to solve them. One person cannot figure it all out, so it was truly a blessing that we had surgeons, anesthesiologists and multiple doctors from different backgrounds. The various viewpoints allowed us to see things from many angles and these collegial interactions were critical to our future success. There were no egos for we were all focused on one goal – a safe and successful surgery.”
Journey to Plastic Surgery
When Dr. Hubli started medical school at Tufts University School of Medicine, he planned to become a pediatrician, but one surgery changed everything.
“During my first clinical rotation, I saw an operation for the first time in my life," Dr. Hubli said. "It was the coolest thing that I had ever seen. The patient went to sleep and woke up ‘fixed.’ I thought the procedure was nothing short of miraculous so right then and there, I decided that I was going to be a surgeon. There are many surgical fields, but I decided on pediatric craniofacial/cleft and plastic surgery because I love working with kids and I enjoy the challenge associated with the uniqueness of every surgery. No two cases are alike, so every operation requires its own unique solution.”
As medical director of Craniofacial and Cleft Services at Cook Children’s, Dr. Hubli brings more than 29 years of craniofacial, cleft and pediatric plastic surgery experience. His focus is exclusively on children with reconstructive craniofacial and cleft issues.
“One of the things I love about pediatric craniofacial surgery is that I get to be with my patients throughout their childhood and teenage years," Dr. Hubli said. "I meet them as a baby and then travel along with them as they grow and develop. Facial structures change as we grow so I monitor my patients and make surgical adjustments when needed. I have two kids of my own, but I consider all these patients to be mine as well.”
Giving the Twins a New Lease on Life
Early on January 23, Dr. Hubli felt more than ready. Gathered outside the Operating Room doors, he joined the twins’ team of 25 medical staff as the group took a moment to pray for the long day ahead. All the hours of planning and replaying different scenarios in their minds would play out in real life.
Once they walked through the Operating Room doors, Dr. Hubli was confident that each team member knew their role and that the group was up to the challenge ahead. He wore green scrubs along with AmieLynn’s team and worked with the pediatric surgeons to perform her closure after the separation. Dr. Hubli said mental nimbleness is an essential part of the surgery – something his team is very familiar with and practices every day.
“In surgery, you have to expect the unexpected," Dr. Hubli said. "Even the most straightforward case may have a surprise. On top of that, surgeons who practice in the pediatric realm face the unique challenge of changing patient size. One day you may be operating on a premature baby who weighs less than three pounds and the next day a 300-pound, 16-year-old offensive lineman from the local high school’s football team may be on your OR table. You have to be able to adjust.”
This ability to adjust is demonstrated by all those who participated in this unique surgery. Surgeons, anesthesiologists, scrub techs, nurses, CRNAs, administrators; every member of the Cook Children’s team understands these challenges and each one is uniquely prepared to rise to the occasion.
Milestones Lead to Historic Moment
Many milestones brought Cook Children’s to this historic moment of separating conjoined twins.
“When I think of the milestones of our surgery program, I think more about our milestones as a medical center because we are all connected to accomplish the same goal," Dr. Hubli said. "In my mind, that is what makes Cook Children’s unique. Across the board, from the police officers to the food services and environmental services employees to the Radiology department, from the lab technicians to the CEO and CFO – everyone is all in. The Cook Children’s family has a vocational dedication to caring for these kids and their families. Every person pulls in the same direction – we are here for the kids and their families. This laser focus is why the hospital and our surgery department are top-notch. I have worked in other facilities but Cook Children’s is special – going that extra step is our standard. The caring and kindness you feel at this hospital is genuine. Every patient and family really matters to our staff.”
With every year that passes, Cook Children’s attracts new highly talented people. Dr. Hubli said over the span of 15 years since he began at the hospital, the main campus has expanded from one building to a destination hospital system that covers eight city blocks. New Operating Rooms, new patient rooms, a new NICU and advanced medical devices were brought to Cook Children’s. A new medical center in Prosper opened this month.
“I’ve seen nothing but incredible growth. Every year we enhance our facilities and our staff. In turn, this means that our patients have access to more service lines and care options. The surgery department is a great example of this growth. In the past few years, every surgical service line has added new surgeons. These surgeons have different specialty training which broadens our ability to meet the needs of our community. If your child has a neurosurgical, orthopedic, urological, craniofacial/cleft, ENT, ophthalmologic, pediatric or cardiac surgery issue, we have the staff to assist. In fact, the breadth of the surgery program at Cook Children’s has been recognized by the American College of Surgeons and the medical center has been recognized as a Level One Children’s Surgery Center. This means the hospital rates as a high-end, full-service pediatric facility.”
By the Numbers
- Surgeries performed at Cook Children’s every year – 20,000
- Sets of conjoined twins born viable in the world each year – 5 to 8
- Percentage of conjoined twins that are female – 70
- Hours spent planning separation surgery – hundreds
- Medical staff in OR for separation surgery – 25
- Total hours in Operating Room for separation surgery – 11
‘Every surgeon is potentiated by our wonderful staff'
Dr. Hubli said surgery involves much more than the surgeon. He firmly believes that surgery is a team sport.
“It’s great to have the best surgeon in the world on your staff, but that surgeon is useless unless the rest of your hospital can meet the challenges presented by complex surgical care. I am happy to say that Cook Children’s has the required talent. From Central Supply to the PICU, from Environmental Services to the C suite, our team is ready, willing and able. This support allows every surgeon to maximize his/her talent as they are all potentiated by this wonderful staff.”
Looking beyond the clinical realm, Dr. Hubli points to the commitment and dedication of the Cook Children’s administration and the surrounding community as key factors in bringing the hospital to this point.
“We can do this case because of the talent we have in the building, the administrators we work with and the community that we serve who supports us unequivocally. I really feel the community is behind us in all we do. The care that we give to children and families when they come in is returned tenfold from the community we serve. Whether it’s time or treasure, the people of our community are 100% behind us. It’s this give and take that makes Cook Children’s great. And that’s why I think we continue to be very successful.”
“I am proud that we have grown to a point where we can meet the challenges presented by the most complex cases. I am also proud that we have the team right here in Fort Worth. But it’s not personal pride – it’s pride in our team. I am humbled to work with a group of caring, dedicated and giving people. Our Promise speaks to caring for the children and families of our community. I am honored to be able to work with a group of people that bring Our Promise to life.”
Dr. Hubli knows what it feels like to hand over his child to a surgery team. Seven years ago, his son underwent surgery at Cook Children’s – an experience that changed his perspective.
“I walked into the building that day as a parent, not a surgeon,” Dr. Hubli said. “Before my son’s surgery, I always used to see the clowns walking through the hall and didn’t think much of it. But then the clowns came to my son’s room, and it was the first time I saw him smile in two weeks. That event reminded me that every member of the Cook Children’s team contributes in their own special way. I love those guys.”
About Cook Children's
Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.
Based in Fort Worth, Texas, we’re 8,000+ dedicated team members strong, passionately caring for over 1.5 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our new, state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation.
And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect — with an extra dose of magical wonder.