Doctor to step out of protege's shadow

By Luis Fabregas

Tribune-Review

August 22, 2004

Keith Hodan Tribune-Review In the six weeks since announcing his departure from the University of Pittsburgh Medical Center, Dr. John Fung has held meetings with his successors, put his Fox Chapel home up for sale and passed on the reigns of his beloved hockey team.

One thing he's found tough to do: Talk with his mentor, Dr. Thomas E. Starzl, about his decision to leave.

"He hasn't just been a mentor, he's almost like a fatherly figure to me," said Fung, surrounded by stacks of medical journals and boxes in his office at UPMC Montefiore. "I respect him not only as a scientist but for all the opportunities he has bestowed upon me."

In their 20 years together, Starzl and Fung have become one of Pittsburgh's most celebrated medical teams. Starzl, the steady pioneer, and Fung, the loyal protege, made transplant discoveries and breakthroughs that today are the subject of textbooks.

That the protege is leaving -- to take a post at The Cleveland Clinic -- is not easy on Starzl.

"I am heartsick," said Starzl, 87, who performed the first successful liver transplant in 1967 and remains active on several research projects at the transplant center that bears his name. "It breaks my heart that John is leaving. He's moving on to a different level, and I suppose it was inevitable. People who are that talented, they tend to do that, they tend to fly on to newer heights."

Starzl said he took Fung under his wing because of his skills and intelligence.

"He would have been anyone's protege," Starzl said. "I was just lucky that he came here."

A native of Rochester, N.Y., Fung first came to Pittsburgh in 1984 to work on a fellowship. He left for a few years and came back in 1988. Three years later he was named Starzl's successor as UPMC's chief of transplantation, a job that some colleagues say was the equivalent of following Chuck Noll as Steelers' coach.

"John showed promise and talent and Dr. Starzl respected his brain and his clinical skills," said Dr. Bartley Griffith, a long-time friend of Fung's who is now chief of cardiac surgery at the University of Maryland. "John understood clearly that he had a privilege of working with one of the great masters in transplant surgery. When others appeared to leave Tom because they sought more independence, I think John, to the contrary, looked at the relationship as one that would be empowering."

Over the last two decades, Starzl counseled Fung in matters that transcended medicine. Having experienced the anguish of divorce from his first wife Barbara, Starzl urged Fung never to lose sight of his family life. And just a few years ago, he offered words that stuck with Fung: "When it's time to leave Pittsburgh, you'll know."

Fung, 48, says he had contemplated leaving in the past. Two years ago, he considered a job at the University of Rochester in New York, his alma mater. When the call came this past Christmas to consider a job in Cleveland, he listened.

"It's an opportunity to build something, to take some of what I have done here and build on it," Fung said.

Since joining Pitt in 1988 he has performed more than 700 organ transplants and several broke new ground: In June 1992, he led the team of surgeons who performed the world's first baboon-to-human liver transplant.

A year later, he participated in the historic heart-liver transplant of then-Gov. Robert Casey, who was suffering from amyloidosis, a rare genetic disease.

And in the last seven years, Fung restarted the practice of performing liver transplants on HIV-positive patients. Through it all, those who know Fung say he remained focused, humble and approachable.

"Despite the fact that he's so well known in transplants, he's always been very accessible," said Dr. Tom Cacciarelli, who worked with Fung at UPMC and is now chief of transplant surgery at the VA Pittsburgh Healthcare System. "If you had a problem, you could always go to him. His door was always open. You could always talk to him and he was always very supportive."

Those who were with Fung before Casey's surgery recall him as being calm and at peace with what he was doing -- especially because of the media attention they expected and the inevitable questions about Casey's speedy move up the organ wait list.

"I told him no one should get an organ because of being a celebrity, but no one should be denied one because of being a celebrity," said the Rev. George Werner, a long-time UPMC board member and then-member of its transplant oversight committee.

Fung has always focused on saving patients -- whether in the operating room, through research, or as an advocate fighting to change the organ distribution system. He became the voice of UPMC in 1996 and once again received national attention when he spoke passionately and forcefully at federal hearings about the organ allocation system.

He argued for changes in a federal policy that distributed donated organs to patients based on where they live, instead of their level of sickness. His efforts led to new rules, even though their implementation has been spotty at best.

"It made people realize that transplantation wasn't a boutique thing to do, that it was basically trying to help patients who would have otherwise died," Fung says.

Fung's greatest achievement, Starzl and others agree, was his work in developing one of the leading drugs used to prevent rejection of transplanted organs. The development of tacrolimus, also known as FK-506, "put Pittsburgh square on the map" of transplantation, Fung says, and opened the door for surgeons to perform a record 471 liver transplants in 1990.

Fung is passionate about research, and in the last several years has drastically cut his time in the operating room. He's also convinced that a yardstick for success is how effective you are at teaching what you know.

"When he was teaching, he was able to stay in control and systematically take me through the steps," said Dr. Velma Scantlebury, who worked at UPMC 16 years and is now director of transplantation at the University of South Alabama. "I still have this picture in my mind of him teaching me to do surgery, he has the elbow on the table and he's looking at me. It was so memorable."

Starzl believes Fung is responsible for the slew of accolades won by Pitt's organ transplantation program in the last two decades. Despite Starzl's world-wide prominence, Fung cast his own shadow, Starzl said.

"He was a star, that's all," Starzl said. "He is a star that's growing brighter."

Fung is quick to return the compliment.

"Tom was always very generous in sharing the limelight," he says. "He was very good at giving people credit even when credit wasn't due."

Ask Fung what he'll miss the most and the topic turns to hockey. He is one of the leaders of the Pittsburgh Celebrity Hockey Team, whose players include Steelers great Jack Lambert, Penguins assistant coach Joe Mullen and KDKA radio personality Larry Richert. The team plays about a dozen games a year and raises about $50,000 for several charities.

So great is his love of the game that he's been known to take a hockey stick to medical conferences and coax fellow doctors into a game or two.

Fung said he has too many friends in Pittsburgh to not come back.

"I'll be coming back," he said.

His mentor will be glad to hear that.

Luis Fabregas can be reached at lfabregas@tribweb.com or (412) 320-7998.

Copyright © 2004 The Tribune-Review Publishing Company.

This article posted September 18, 2004.