This End Game is No Laughing Matter Colorectal Surgeon Finds Great Satisfaction in This Emerging Specialty

Like other surgeons, Kelly Tyler will often receive thank-you cards and notes from patients she has brought relief and a better quality of life. But because she’s a colorectal surgeon — specifically, director of Colorectal Surgery Services at Baystate Medical Center — many of these missives will have a humorous twinge to them.

Like the card she received recently that featured an image of a human backside with grass growing on it, a juxtaposition intended to convey the Spanish word for ‘thank you.’ There’s more of the same around the holidays, she continued, noting that she has a good-sized collection of Christmas cards featuring Santa moon shots.

“There’s a lot of jokes that come with doing this kind of work,” said a smiling Tyler, who’s been called a pain in the butt — in a comical manner — more times than she could count. But there is nothing at all funny about the conditions treated by someone who has chosen this specialty, she continued, listing everything from colon cancer to diverticulitis; from fecal incontinence to severe, chronic constipation.

“These are serious matters, and real quality-of-life issues,” said Tyler, 34, who joined Baystate and its department of surgery two years ago. “It’s very rewarding to bring relief to patients with these conditions.”

Before she does that, however, Kelly must first get her patients to open up and talk about their problems, something that most people, especially men, are often quite reluctant to do. She succeeds in this mission by assuring those who come to her that they are certainly not alone with regard to any of those afflictions listed earlier, and that, in most every circumstance, what ails them was not of their doing.

“It’s hard to get people to bring themselves to talk about things like hemorrhoids,” she explained. “My first challenge is to get people to feel comfortable discussing such things. When they reach that comfort zone, it’s easier for me to help them with their problem.”

This month, The Healthcare News talked with Kelly about what she and others say is an emerging specialty, and what prompted her to choose it.

Butt Then Again …

Tyler told The Healthcare News that it wasn’t exactly her lifelong ambition to be a doctor. In fact, it wasn’t until she was roughly halfway through her undergraduate work at Colgate University that she first started thinking seriously about a career in medicine.

Always fascinated by science, Tyler, a native of Northern Conn., concentrated in molecular biology at Colgate and did some volunteer lab work at a nearby hospital. While peering into a microscope to help doctors solve patients’ problems was rewarding and intriguing, it ultimately lacked the human interaction she desired.

Tyler attended UConn medical School and had her residency in general surgery at Boston University Medical Center. She developed a strong interest in colorectal surgery, and eventually won a colon and rectal surgery fellowship at the Robert Wood Johnson University of Medicine and Dentistry.

She told The Healthcare News that she ventured into this specialty because of a desire to battle cancer — much of her work falls into that realm — but also because of the satisfaction that comes from treating people with everything from Crohn’s disease to potentially cancerous polyps.

She had a number of options with regard to where her career might take her, but chose Baystate because of its proximity to family, and also because it represented a chance to meet a recognized need in the local health care community.

“I could have gone almost anywhere,” she said. “But this area made sense. It’s not far from my family, and it’s a huge area with minimal colorectal services.”

Indeed, Tyler said she is the only colorectal surgeon at Baystate, and one of just a few in the area, meaning that she has a quite a workload. Her position — director of Colorectal Surgery Services — is a relatively new one at Baystate, and part of a national trend to direct more resources to this specialty.

“It’s something happening across the country … hospitals and medical systems understand that they need that kind of expertise,” she said, adding that many of those who come to her do so after seeing someone else who doesn’t have that expertise.

Using mostly laparoscopic surgery techniques, Tyler treats a number of colon problems, including colon cancer, rectal cancer, various types of inflammation and infection of the bowels, polyp removal, blockages due to twisting of the colon, and others. Many of these problems may eventually lead to removal, or resection, of a part of the colon, and reattachment of the ends (anastomosis). And at times, the entire colon, or even the colon along with the rectum and anus, are removed.

A typical day for Tyler may involve everything from major surgery to a colonoscopy administered to detect those various problems and determine a plan for treatment.

But Tyler said her work with patients — referred by primary care physicians, gastroenterologists, ob/gyns, and others — begins long before they arrive at the operating room together.

Indeed, there is a good deal of education involved in this work, she explained, adding that this is all part of the process of reaching that aforementioned comfort zone. “I won’t operate on someone who doesn’t understand what I’m doing for them.”

And usually, by the time they reach Tyler’s office, they’re in a good deal of pain and discomfort.

“It’s often not until someone is really bothered by something that they will seek help,” she said, “because these just aren’t things that people want to talk about. It’s part of my job to put them at ease.”

The Bottom Line

In addition to those humorous cards she mentioned, Tyler said she also receives many much more serious messages from the loved ones of her patients, including those who succumb to their afflictions, especially cancer.

Some 50,000 people die every year from colorectal cancer, she explained, emphasizing, again, the very serious nature of her work, which is sometimes obscured by the ‘grassy ass’ missives and one-liners from patients who often use humor as a defense mechanism to cover their embarrassment — and mask their fear.

“This is not a laughing matter,” she concluded. “But if making jokes helps people get through it, then that’s fine. I’ve heard them all already anyway.”