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Doctor Q&A: Madhulika Varma

Dr. Madhulika Varma is chief of colorectal surgery at UCSF Medical Center, where she uses her lifelong love of medicine to help care for patients suffering from diseases of the colon, rectum and anus. Varma did much of her training at UCSF, and while she left briefly for colder climes (Minnesota), she's happily been on the UCSF faculty since 2000.

Where did your passion for medicine come from?

When I was in fourth grade I read this book called Helen Keller's Teacher. It was about Annie Sullivan, who taught Helen Keller to communicate despite Keller being deaf and blind. Sullivan spent time at the Perkins School for the Blind in Boston and I was so moved by how they helped children. It was founded by a doctor and that was the genesis of the desire to be a doctor. I immediately knew I wanted to be like that.

Originally I wanted to be an eye doctor. I left the eye thing early on, but the desire to be a doctor stuck.

So how did you get into surgery?

For the first few years of medical school you're in the classroom and learning from books and teachers, similar to what I'd done all my life. The second two years you're in the hospital and you're exposed to all the different specialties.

I did my surgery rotation first because I thought it wasn't something I wanted to do so I may as well just get it over with. Then I did it and I loved it. I think it tapped into an area of my personality that I didn't know existed.

I loved the immediacy of helping people. You see a clinical condition, you treat it and then the patient feels better. That was very gratifying. As I moved through all my other rotations, I realized that that was the thing that really gave me the most inspiration.

Okay, so you decided on surgery — but how did you land on this particular sub-specialty?

I gravitated towards colon and rectal surgery, I think, because you are treating a certain set of organs but you also get to treat a lot of different conditions. For instance, about a third of my patients have cancer, a third have inflammatory bowel disease and another third might have other benign conditions. It's a lot of variety. We do some very short cases that only take 10 minutes. Then I do some cases that take 12 hours. I don't like to do the same thing all the time.

I also just like colorectal surgeons in general. We're a pretty small group and, I think, a nice group. We don't take ourselves too seriously, probably relating to what we do.

What's exciting about your field right now?

We're all working on the whole experience of being in the hospital. In the old days people used to spend a couple weeks in the hospital after a colon surgery — now we're getting people out in two and three days. Part of that has to do with using new technologies to perform minimally invasive surgeries but it's also about how we manage the patient, including what kind of pain medicines we give, how much fluid the patient gets in the operating room or even changing attitudes about how quickly people can eat and drink after surgery. It requires a collaborative approach between all of the staff.

Technology changes things really fast around here. Are you the type to dive right in or to take a more cautious approach to new technology?

I like to think that I take a seasoned approach. I'm always interested in hearing about new technology or anything that will make it easier to treat a condition. At the same time, I'm not interested in just trying things because they're new. They have to clearly be of benefit to the patient.