Introduction
In this episode, learn about Dr. Nolan Bruce, a trauma surgeon and intensivist here at UAMS. We discuss his career and research interests, as well as his take on different aspects of a medical education/career. We also discuss some of his interests outside of medicine, including sand volleyball, and his pets!
Transcript
Weijia: Welcome to the next episode of Mentor Spotlight, your very own UAMS student led podcast to help connect students to faculty mentors. We are Weija, Hannah, and Manasa, your hosts for this episode. Today we have Doctor Nolan Bruce, another great surgeon in the Division of Trauma and Surgical Critical Care.
Manasa: Doctor Bruce received his M.D. from the University of Oklahoma, then finished his general surgery residency here at UAMS and then made a stop at UT Southwestern to complete a fellowship in surgical critical care before returning to become a faculty member. He has been a part of numerous work groups and committees to improve care for patients, including the ECMO program here, as well as initiatives to improve ICU outcomes, such as improvements for vent cleaning as well as pressure wound care.
Hannah: He also volunteers to be a mentor to students during the surgery rotation in our M3 year. If you get a chance to work with him on the floor, and in the OR, count yourself as lucky, because he’ll make sure that you learn at least one new piece of information every day, that you’ll get to actively participate, and that you get positive feedback when you do something right. Which, let’s be real, can be one of the biggest pick-me-ups when you’re stressed out during rotations. We’re very excited to have you all meet him, so let’s get started.
Hannah: Hi Doctor Bruce, if you could just start off by telling us a little bit about yourself.
Dr. Bruce: Sure. Hello, my name is Nolan Bruce. I’m one of the trauma surgeons here at UAMS. I am an Oklahoma boy, born and bred. Came out here for residency and fell in love and haven’t left since really. Other than as they mentioned, a brief stop in Dallas, TX. I’m a rather private person. I’m a simple guy. I’m married. I don’t have any kids. I have some dogs, but I live a relatively quiet life and just outside of Little Rock, so there’s not a whole lot to tell about myself.
Manasa: So, you’re a trauma surgeon, but you also hold a few other positions. So can you tell us a little bit about all the job titles that you hold and what you do for them?
Dr. Bruce: Yeah, I think one of the more interesting parts about my job is really, no day is the same. We have a lot of different hats that we wear amongst our group. So I would have to say that trauma surgery is probably one of my favorite parts of my job, but it’s certainly only a small percentage of it. So my partners and myself split duties caring for trauma patients as we’ve already talked about. Emergency general surgery patients. We also do the surgical critical care for the hospital. And then we have, because it’s kind of a 24 hour day business, we also have a night shift rotation where we cover all of those things at night, so everybody else can go home and get some rest. And then in addition to that, we also are the ECMO team here. So we are responsible for putting patients on and taking patients off of ECMO as well as caring for them in the ICU. So it leads to a lot of variability in your day-to-day practice because you kind of never know what’s going to roll through the door or what surgeries [you] are going to be doing that day or what’s going to be happening until you get here, to be honest with you.
Weijia: That’s pretty cool. So how did you end up picking this specialty?
Dr. Bruce: There’s a lot of reasons. Being introspective about it, I would have to say that it’s actually where my mentorship came from. I would say that the personalities that taught me surgery, most of them, were actually trauma surgeons. And I kind of, for lack of a better word, vibe with them the best. And a lot of those people are still my same mentors, like Doctor Robertson, and many of the surgeons here. And then there were some, some aspects that appealed to it. I enjoyed the shift work lifestyle. I like that there’s, you know, if I’m not in the hospital, one of my partners is in the hospital to care for him. And I think that our patients get good care that way. I don’t have to worry about going home and still answering phone calls and worrying about them. I know I can go home with the peace of mind saying that one of my partners is there to kind of deal with any issues that come up. So I enjoy the kind of shift work lifestyle in that sense. I also like that it keeps you on your toes. I think that you can become very passive in your kind of growth and learning if you just do the same thing every day. So I really appreciate, king of, the variability that it provides us. And then I think it’s really rewarding to take care of some of the sickest patients in the hospital. The critical care aspect of my job is honestly not something, at least academically, that I thought was the most interesting. But I’ve come to see that working with the patients and their families and you know successfully navigating through the sickest and worst times of their life is a really rewarding part. So there’s a lot of reasons, but those are the top.
Hannah: So besides the clinical aspect of your job, you’re also in some ongoing research. Would you mind telling us a little bit about the research projects you’re currently involved in?
Dr. Bruce: Yeah, so my biggest project I have going right now which is actually going to be finishing up this month is a multi-center trial sponsored by EAST, which is one of the national associations for trauma. Looking at using our trauma video review system to collect data and the specific project has to do with what kind of IV access is best, but the subtext of the whole idea is that it’s a fairly novel use of collecting data. Not many people are using video review as a chart extraction type method, so we have some ideas of how to use that going forward. And now that we’ve established, sort of this multicenter collaborative of system, trauma systems, that use video review, we have an opportunity to study a lot of things from that. So I’m really excited kind of, about, the direction that that’s headed. That’s my main research interest at the moment. As far as other projects, I’m mostly interested in looking at trauma outcomes. We in our department do a lot of research towards that. So for anybody that’s interested, we always have projects that are kind of going in that direction as well.
Manasa: So we’re going to switch gears a little bit towards your personality outside of medicine. And I know you said you’re a private person, so we’re sorry if these are a little intrusive.
Dr. Bruce: That’s alright.
Manasa: What are your passions outside of the field/like the hospital itself?
Dr. Bruce: So yeah, well, when the weather is nice, I love to play sand volleyball. So if there’s any sand volleyball players out there that want to get schooled on the volleyball court, I’m always looking for people to play with.
Hannah: I do not excel at volleyball, so that to me sounds like… a very interesting hobby.
Dr. Bruce: It’s a lot of fun. When it’s not time for sand volleyball season, I generally am spending time with my wife and dogs at home. We, as I said, we keep a pretty quiet life.
Weijia: And surgery has the image of having a pretty bad work-life balance. So could you explain on that? Does your job maybe break the stereotype?
Dr. Bruce: That is a… So depending on your practice, your work life balance is going to be different. There’s not a blanket statement on that. I will say that being junior faculty and at 100% clinical, I am on a heavy workload side of things. So I would say my work-life balance is probably not as favorable as a lot of other positions, to be quite honest with you. That being said, I have plenty of time out of the hospital. I just had five days off and took a nice little vacation and things. So I have plenty of time home with my wife and kids. Or sorry, with my wife and dogs, which are my fur kids I guess I should say.
But there are going to be different specialties that are going to afford more time out of the hospital. They’re gonna afford more regular schedule that don’t involve a lot of nights and weekends like mine do. The fact of the matter is, trauma is 24/7. They’re going to be nights and weekends that you have to work. I do work quite a bit to be honest with you.
Hannah: I think that’s fair. There’s a specialty for everyone.
Dr. Bruce: Yeah.
Hannah: So kind of just shifting gears a little bit more towards a little abstract. Hopes, dreams, goals. What are some of your current goals? It can be both, professional, umm like personal, for the future, either long term or short term.
Dr. Bruce: Sure. I have no plans to move. I plan on staying here and working through the professorship pathway here. As far as my professional interests, I love doing trauma surgery. I think that’s my focus. But I also have a pretty steady elective general surgery practice. I would really like to see us expand our practice in a more minimally invasive, and include some robotics in there. So personally I would really like to include more robotic hernia repairs and things into my practice. So that’s kind of on the list of professional growth that I would like. Academics are, you know, you always have to have some sort of research project going on in academics. So I have the expectation that every year I’m going to, when this project is wrapping up, I’ll start another one, you know? Keep that moving. Hopes and dreams. Like I said, I love where I’m at. I have no plans on moving. I want to stay through promotion and tenure here and work through that.
Manasa: So kind of similar but a little bit more different is like what do you want to see change in healthcare itself or are there specific to your patients or just in general as well?
Dr. Bruce: Oh my gosh. Now there is a question that has a bag of worms. So we could spend an hour talking about that, but to put it briefly, I don’t think that it takes somebody working in healthcare all their life to tell that our system is imperfect. One of the biggest things that I would love to see is just expanded access to care. I think we, whatever form that takes without… I don’t wanna get into any political beliefs here. But whatever form that that takes, I think if you can expand access to care and preventative care, that’s going to prevent a lot of my job, to be quite honest with you. And that’s going to lead to healthier patients and better outcomes. So expanded access to care I think needs to be our priority.
Weijia: So going back a little, you said that you love it here at UAMS, right? And you’ve been to Oklahoma, then to Texas. I was wondering what is very special about UAMS? What makes you love it here compared to maybe another place?
Dr Bruce: Yeah. So as far as places go, locations. They’re just locations. You can have a beautiful beach outside or a bustling city outside your hospital, but it’s not really going to have much effect on the time you spend in the hospital. What really does have an effect is the people you work with. I have great partners. I love working with my partners. They keep life fun. We have great APRNs that I love working with on our trauma and EGS and SICU rotations that I honestly genuinely love going to work with those people every day. The residents are the best sort of learners you could imagine. Any teacher that has a set of students that they can work with that closely and is that vested in the subject that they’re learning about is going to be the best sort of students you could possibly ask for, right? And then they kind of keep me young too, you know. They keep me interested, usually make me laugh during the day and things like that. So those are all important aspects. So for me, what draws it here? It’s got to be the people and the work environment. I mean even the people in the office side, the people in the office here are lovely. Like everybody has a smile on their face. They’re generally nice people that wanna help out. Same for the folks in the hospital and that makes going through your job a lot easier, I think.
Hannah: So you kind of touched on it in your last answer, or like, gave us a little bit of information about the qualities of the type of people who work in the surgery department, at the residency, your colleagues. What kind of qualities do you think you would look for in someone who wants to go into surgery or is interested in surgery, so they can base it and be like “maybe this is a good specialty for me, maybe this is not the best specialty for me.”
Dr. Bruce: Yeah. So as far as qualities that make a good resident, there’s probably no universal qualities, right? I think one of the things that makes residencies work is that everybody brings something a little bit different to the table. And that being said, the best that I can get to universal qualities that are going to be helpful is just a willingness to learn and continue growing. I call it coachability. People who, in general, have learned to work with a team through whatever method they have got there. A lot of times that requires team sports or music or things like that. That they’ve learned how to take instruction and continue to develop. And I’ll take that construction as criticism or personally and things like that. So I think what I call coachability is probably one of the number one things that I look for. Number 2 is you do have to have some degree of emotional maturity when you’re going through surgical residency. So that’s harder to gauge just on interviews and things like that. So we look for work experience, life lessons, things like that, that may have taught some sort of emotional maturity and how to handle bad situations. How to handle failures and things like that. Those are where you sometimes see people kind of make or break. So I think as far as universal qualities, those are some of the best qualities that I look for.
Manasa: So if you could give one piece of advice to medical students, either interested in surgery or not, in general, what would it be?
Dr. Bruce: Just be open minded going into everything. For you M1s that are kind of starting things out, you should go into every rotation and every subject thinking that maybe this is my favorite subject, you know, and at least give it a shot. You’re A., going to learn more if you’re interested in it and you genuinely tell yourself you’re interested in it. And #2, the people that are teaching you are going to be more motivated to teach you more, and more invested if you’re invested in it as well. So yeah, just be invested in every subject that you kind of go through, whether it’s surgery or not, even though obviously it’s going to be surgery.
Weijia: And what’s the best advice you’ve gotten?
Dr. Bruce: Advice is only worth about what you pay for it, to be honest with you. So here I am giving you advice and you’re not paying me anything for it. But if you’re looking up these podcasts, I guess by definition you have some investment and you’re kind of paying your time for it. So what I mean by that is, advice that falls on deaf ears is not useful advice, whatever. So that’s a hard answer for me to answer as a blanket statement, but the best advice I’ve gotten has been timely advice when I needed it through my life from mentors. So I don’t know that I can pass along a single specific word of advice, to be honest with you, other than what I’ve already given.
Hannah: Ok. So changing gears just a little, what is like the coolest or the most interesting, unique, one of your stand out, just in your mind, always goes to it, surgery that you have done to date. If you can talk about it.
Dr. Bruce: Yeah yeah, no problem. So I’m sorry, the question is basically, what is my favorite operation? Is that what you’re asking?
Hannah: Yes, or just one that stands out in your mind.
Dr. Bruce: Okay, we can edit that part out by the way if… [everyone laughs]… cut out some of the repetitive parts.. we will fix it in post. Ummm no. So one of my favorite operations, and honestly like what I’ve already told you guys, I love trauma surgery. You take somebody that’s got a penetrating abdominal injury, and that’s always a good day for me. It’s a bad day for somebody obviously, usually one of the worst days of their life, but that’s an enjoyable process for me. You take somebody that’s in an extremis and the bad, you know, the worst situation possible, and you’ve got an opportunity to very immediately go in and fix what’s wrong with them. And there’s very few things in medicine that I found that is as gratifying as that. So yeah, I would have to say good old exploratory laparotomy for trauma is one of my favorites.
Manasa: Is there any specific case that you’ve done that you can remember that’s your favorite or just like in general any kind of ex lap…
Dr. Bruce: Well, yeah, I don’t want to give any specifics or anything like that. So no, we have some standout cases but not, not for discussion.
Manasa: No worries. So if a student wants to contact you, if they wish to have you as a mentor, ask a question, or just shadow you whenever, what’s the best way?
Dr. Bruce: Yeah with. Again, I am not going to broadcast all of my public information on whatever this is going to be posted. The best way to contact me is just through the UAMS directory and my e-mail. So for any UAMS students you can very easily just search my name, Nolan Bruce, and my e-mail will be right there. So send me an e-mail. That’s the best way to contact me.
Hannah: Is there anything that we haven’t covered today in the podcast that you would like us to know? Either like, just general advice, any topics you want to talk about, anything you’re really proud of?
Dr. Bruce: No, unless you guys want to talk about some volleyball or something.
Hannah: Right. I’m afraid I don’t know enough about volleyball…
Dr. Bruce: Favorite restaurants or anything… No, no I don’t think I have a whole lot to add. I enjoy working with, you know, the primary target of this is going to be medical students, I assume. I very much enjoy working with the medical students. I’m always open to new ideas that they may have or if they just want advice. I’m generally happy to help with my time with whatever I can. So while I’ve already prefaced this with saying I’m a private person, feel free to approach me. I’m happy to talk to you about it, okay.
Weijia: So I have something for you. This whole interview, I’ve been staring at this painting. For our listeners, Doctor Bruce has a painting of a dog in a general suit. And it’s very large. It’s right next to his computer. I think that says a lot about his personality, too.
Hannah: I think it’s a German shepherd, for those of you who are wanting to picture a specific dog, yes.
Dr. Bruce: And it’s got like a kind of a spotlight on it too, so you can’t miss it. So yeah, there’s like diplomas and all sorts of other things. But that’s the, that’s the position of prominence really.
Weijia: And I was wondering if you could expand on that picture. Is there a reason?
Dr. Bruce: Do you need more explanation other than it’s my dog and in some sort of like old-timey general outfit? I don’t know.
Hannah: Was this a commissioned piece?
Dr. Bruce: I don’t- I honestly don’t know where my wife got that from- but I’m sure it was somewhere she found online that photoshops dogs’ heads onto old-timey general outfits.
Hannah: I guess the role of this story is, you get to know a lot about your attendings based off what they’re office decor is.
Dr. Bruce: Yeah, very true.
Manasa: Alright, well thank you for taking time out of your busy schedule to be part of this podcast Doctor Bruce.
Dr. Bruce: Absolutely. I’m honored that you guys considered me to be interviewed for this. So thank you.
Manasa: Very excited for all the students to meet you. And listeners, feel free to reach out to us if you let us know your thoughts, concerns, questions, anything that you have to say, and see y’all on the next episode!