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Catching up with a UNMC legend

Image with caption: Byers W. (Bud) Shaw Jr., MD

Byers W. (Bud) Shaw Jr., MD

He could have gone just about anywhere he wanted to start a liver transplant program in 1984, but Byers W. (Bud) Shaw Jr., MD, chose Nebraska.

The chair of the UNMC Department of Surgery at the time, Layton (Bing) Rikkers, MD, a former faculty member at the University of Utah, where Dr. Shaw did his residency, and Michael Sorrell, MD, world-renowned specialist in liver diseases and the chairman of the UNMC Department of Internal Medicine, tried to recruit Bud to start a liver transplant program at UNMC.

Dr. Shaw demurred, saying his next move would be to a place with a seacoast or mountains, or both. Instead, he agreed to be a consultant. During his visit to campus, he gave a lecture on "How to Start a Liver Transplant Program" and met with key faculty.

By the end of his visit, Dr. Shaw said, he realized UNMC was the perfect place for him. "I was astonished by the preparation and commitment at UNMC."

It was a Saturday — a beautiful, sunny December day. After the lecture, Dr. Rikkers took Bud hiking in Fontenelle Forest.

"Pittsburgh’s winters are cold, wet and oppressively gray. It can get to you," Dr. Shaw said. "My day in Omaha was gleaming with sunshine. But, more important than that, I’d come to realize that I’d be crazy not to work with all the incredible people I met."

Dr. Shaw’s decision to come to Omaha was an historic day for the medical center. Now, more than 35 years later, UNMC/Nebraska Medicine continues to be a leading solid organ transplant center, transplanting not just livers, but kidneys, pancreases, small intestines, hearts and lungs.

"Bud Shaw is one of the most important recruits ever at UNMC," said James Armitage, MD, who started the medical center’s renowned bone marrow transplant program a couple years earlier.

Dr. Shaw served as chief of transplantation from 1985 to 1997 and as chair of the UNMC Department of Surgery from 1997 to 2008. He stopped doing transplants in 2004 and performed his last surgery in 2007.

It hasn’t been without challenges. In 2002, he was diagnosed with lymphoma and became a patient of Dr. Armitage. Nineteen years later, he considers himself cured — just another UNMC/Nebraska Medicine success story.

In 2006, Dr. Shaw’s life took another unexpected turn. He was at home preparing a talk while watching the Pittsburgh Steelers and the New England Patriots on television when he was struck with a severe anxiety attack.

He was eventually able to get the problem under control with medication. But it was a life-changing event.

"That’s not supposed to happen to a surgeon. We’re too tough," Dr. Shaw said. "I was devastated and deeply embarrassed."

A man of many talents, Dr. Shaw excels in writing and photography, is a world traveler and flies his own plane. In 2015, he wrote a book, "Last Night in the OR: A Transplant Surgeon’s Odyssey." In the book, he referenced his anxiety issue.

In studying his family genealogy, he learned that he wasn’t alone — three generations of Shaws had similar anxiety issues. "When I was in grade school, dad sent me to stay with his parents on their farm in north central Ohio. Grandpa Shaw often disappeared into his bedroom for days at a time. I never understood what that was about — not until 2006."

Leaving the operating room can be a struggle for surgeons. "We get tremendous reward and a vital sense of accomplishment from doing difficult procedures," he said. "It’s addictive, and sometimes being a surgeon can become too much of your self-identity."

Dr. Shaw said it’s important to find a substitute.

"Something meaningful that feels important," he said. "My dad was a general surgeon. For him, he started making knives with handles he carved from found wood. He got so many orders that he hardly had time for anything else!"

For Dr. Shaw, now age 71, teaching medical students has become his latest passion and a perfect way to help the next generation of physicians. He teaches students in all four years of medical school, participating in problem-based learning (PBL) courses, patient communication exercises and surgical skills labs.

He also hosts several elective courses centered on medical humanities and stress reduction and serves as the director of the Enhanced Medical Education Track (EMET) in Medical Humanities.

In addition, Dr. Shaw shares his personal struggles with both anxiety and leaving surgery through a lecture he titles, "Elvis Left the Building and So Will We." He has been a guest speaker at multiple venues including Yale, Johns Hopkins, Stanford, The Examined Life Conference in Iowa City, the annual meeting of the American College of Surgeons and several departmental grand rounds at UNMC.

In PBL, Dr. Shaw works with Laurey Steinke, PhD, who is impressed by Dr. Shaw’s "good humor, eagle eye to important issues and huge fund of relevant stories."

"I love teaching students — new students in particular. I never had the chance to teach the first two years of classes. Most active clinicians are just too busy to do so. Now I realize how important those initial experiences can be for students."

Perhaps because of his own struggles, Dr. Shaw also is concerned about the well-being of students.

"I worry about them," he said. "It’s hard work — always has been. We’ve all faced long hours in classrooms and studying for grueling tests, then faced even greater demands once we started clinical training. But for my generation, the drudgery and fatigue felt worth it. Often, though, we felt like valued team members, involved in a great mission.

"But now? I know too many students who are dealing with anxiety and depression. Some say they have little sense of belonging, that they feel alone in their struggles. I worry that these days many of our faculty are pulled in so many directions by the business of medicine that they have little time and energy for supporting students."

And then there’s the issue of student debt.

"Today’s medical students will have astonishing debts to pay by the time they finish school," Dr. Shaw said. "One student called her indebtedness ‘terrifying.’ She said, ‘I think it’s natural to have days when you think about quitting this and becoming a park ranger, but that’s when the debt-monster grabs me by the throat to say I have no choice in the matter.’"

Dr. Shaw says that in the humanities-based electives he hosts, he strives to renew students’ passions for medicine through reflective writing, reading books and watching celebrated films.

"We invest so much in them. I just hope they will leave us still inspired and looking forward to the reward of a career in medicine. Most of it should be fun!"

What others are saying

"A story in the Omaha World-Herald once said that Bud came to Nebraska for ‘the beaches’ — just a bit of insight into his sense of humor. He also is thoughtful, insightful, caring and dedicated to those he cares for … and creative in the operating room. If there was an emergency, and there were many, he was calm under fire. He was able to problem-solve through the toughest medical problems and was humble and down-to-earth while explaining these complex problems to patients and families. He was proud to let others shine — to give credit to nursing and other departments for the success of our program over the years. What a career, what a fine physician and genuinely unique and talented human being."

-Laurie Williams Salonen, liver and intestinal transplant coordinator, Nebraska Medicine

"Bud was an avid pilot and had partial ownership in three different airplanes. For my 40th birthday, Bud took me on an airplane ride in a 1939 Piper Cub. Bud was so tall that he could not pilot the plane from the front seat and had to pilot the plane from the back seat. I rode in the front seat. I was white knuckled all the way, and when Bud would make right bank turns, the door of the plane would open, and I could see a straight shot to the ground. Like every other experience with Bud, he was unflappable in the moment, and he made a left turn and closed the door. Bud is a great guy and has been a great friend."

-Rod Markin, MD, PhD, associate vice chancellor for business development, executive director of UNeTech and the David T. Purtilo Distinguished Professor of Pathology & Microbiology

"It was a privilege to come in as the next chair of surgery at UNMC after Dr. Shaw stepped down. I remember my first recruitment visit to Omaha. Even though my flight was delayed until midnight, my transportation that night was Bud Shaw. It told me everything, as not everyone would do that and instead would just have had me get a cab — but not Bud. I’m still amazed at the quality of the transplant program at UNMC, which didn’t exist before Bud arrived. Moreover, the caliber of the fellows who trained under him is nothing short of extraordinary, as many are now leaders of their own transplant programs including our very own Dr. Alan Langnas. Bud remains one of the busiest faculty in our department when it comes to teaching first- and second-year medical students, and he teaches a creative or reflective writing course, which is open to all, including faculty."

-David W. Mercer, MD, professor and chair, UNMC Department of Surgery

"Bud Shaw’s coming to Nebraska and his establishment of a leading organ transplant center vaulted UNMC into national prominence in an important academic arena. It melded with our ongoing already successful bone marrow transplant program under the leadership of Dr. James Armitage. The recruitment of a charismatic, young surgeon signaled the intent of UNMC as a leader in the rapidly developing field of organ transplantation. Bud was a demanding but generous leader with enormous academic ambition and vision. The continuing success of organ transplantation at UNMC validates his drive and vision. What cannot be quantified and appreciated in retrospect is the impact of his success and the generation of excitement that resulted."

-Michael Sorrell, MD, professor, internal medicine

"Bud Shaw is one of the most important recruits ever at UNMC. We already had an excellent hepatology program, but Dr. Shaw initiated the liver transplant program and made it one of the premier programs in the world. This is a reflection of his extraordinary technical skills and the team of people he recruited. He’s been a friend for a very long time, and I’m happy to see him continue to make a difference at UNMC."

-James Armitage, MD, Joe Shapiro Professor of Medicine in the division of oncology/hematology

"Bud’s range of skills and interests is legendary. He’s a superb storyteller in person and on the page. His matter-of-fact, mildly self-deprecatory viewpoint is disarming, and I suspect it’s among the reasons students are drawn to him. If someone of his stature recognizes the essential nature of medical humanities, like-minded students are emboldened to do the same."

-Rebecca Anderson, retired, associate professor, UNMC College of Public Health

 "Bud Shaw had the vision, determination and creativity to start the solid organ transplant program with Dr. Mike Sorrell, which helped transform the medical center. Bud is a multitalented individual, an innovator, photographer and writer, who continues to contribute to the humanities in medicine."

-Jon Thompson, MD, professor, surgery-general surgery

"Bud Shaw is a colleague who has turned into a friend. He has stayed active in Problem-Based Learning (PBL), where we pose medical problems to the first-year medical students and guide them to ask questions and do research to answer those questions. In addition to facilitating the sessions with good humor, an eagle eye to the important issues, and a huge fund of relevant stories, Bud assists in preparing the cases for the students. He writes sample patient presentations to help his fellow facilitators (many of whom are not medical professionals) guide the students to improve their skills. PBL would be a much poorer experience for the students without Bud!"

-Laurey Steinke, PhD, associate professor, UNMC Department of Biochemistry and Molecular Biology

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