The Leading Edge
Everyone in plastic surgery either knows - or knows of - Susan Mackinnon, MD. In addition to serving as chief of the Division of Plastic Surgery at Washington University in St. Louis, Dr. Mackinnon is also one of the world's foremost experts in peripheral nerve surgery. My conversation with her reveals that she not only succeeds, but excels at the challenge many plastic surgeons face in striking a balance between their professional and personal lives. I only wish our interview could have gone on longer so I could learn more tricks to manage my own life more effectively.
PSN: What experiences were formative for you?
Dr. Mackinnon: I grew up in a family of strong women. I have a younger sister who is a Superior Court judge in Canada. My mother was from a family of eight (five girls and three boys), and she grew up in a small northern town in Canada, which is a rough place to live. My grandfather worked at a paper mill, and all five of his daughters went to the University of Toronto and got degrees. My mother was a physical therapist. We come from a very strong background for honoring women's education.
My father grew up in eastern Canada and had one brother. His father died of tuberculosis when he was age 5. My dad was brought up by a single mom in the Maritimes in Canada, and he became a civil engineer with a master's degree and my uncle a cardiologist. There was a strong ethic to education. Despite having no money and a single mother, my dad and uncle were very well-educated.
My father's maternal uncle was a medical missionary, and he started the first leper colony in Taiwan in the early 1900s. I knew this, and when I went to Taiwan with my husband in 2005, I found that leper colony and an elderly doctor who had been an intern with my great uncle. It was clear my great uncle really did significant things. I talked to my father about what I saw in Taiwan, and I was surprised to find that while he was interested, he was not thrilled. He told me his memory was of his uncle coming back to Canada every seven years and saying to his mother, "How do you think you can raise two boys without any male influence?" When he talked about it, I thought: Wow! He never warmed up to this guy. My father grew up with a lot of respect for women.
Becoming a successful woman in a male-dominated field was shaped by the attitudes my mother and father had for gender equality.
PSN: What is your leadership style?
Dr. Mackinnon: When I became plastic surgery chief at Washington University in 1996, and I started to read and learn about management skills. I've been interested in leadership and the role of women in the workplace.
I've read several books on leadership. I particularly like Tribal Leadership: Leveraging Natural Groups to Build a Thriving Organization by Dave Logan, John King and Halee Fisher-Wright. The authors write that companies are effectively composed of "tribes" of people who work together. Many surgical departments can be classified as "Tribe 3," with a powerful person at the top and everyone else falling in under that person. I like to have "Tribe 4" or "Tribe 5." In Tribe 4, everyone in the team is valuable and honored, but not all the teams are so great. In Tribe 5, every team is excellent. You can run into problems when you approach a Tribe 3 environment with a Tribe 4 perspective.
I've studied and read other fields of scholarship, where you can take what they say, add your own perspective and make it more applicable to your own field. K. Anders Ericsson, PhD, is a psychologist who studies expertise (Malcolm Gladwell mined his work for Outliers). Dr. Ericsson outlined three critical factors to develop expertise in any area, beginning with an extraordinary amount of hard work with an area of focus and deliberate practice. Then you can start to innovate, and then you need a coach. My two additions are that you need to be coachable, and you need to be partnered with someone who supports you and all of the other four ingredients. The two additional factors make Ericsson's concept work - I can't imagine the initial three being sufficient without the last two.
PSN: How do you communicate with your group in your role as leader?
Dr. Mackinnon: I don't boss people around or try to control them. This comes from how I like to be treated. Everyone in our division does something nobody else does, and that makes them feel good about themselves. We work hard and have high expectations. There's a lot we can't control. Adding another layer to that with a "bossy" leader is not good, but then you might get chaos - I occasionally get that. I really value people getting along. I don't like conflict. In my role as leader, I don't let conflicts go anywhere.
I hate politics. Everyone is respected and honored equally, and we get along. We also only have full-time faculty in our division. We're all in same boat together, with the same environmental stressors. Nobody has an unfair advantage.
PSN: What are qualities in individuals that impress you the most?
Dr. Mackinnon: I value honesty, humility, hard work and respect for others. From a surgical point of view, I value excellent technical skills. I don't like fighting, narcissists or dishonesty.
PSN: What do you predict are the next big innovations in plastic surgery?
Dr. Mackinnon: We innovate in plastic surgery - that's what we do - but we innovate based on a lot of hard work, traditionally decade-by-decade. Science today is moving so quickly. The next big innovation will happen more quickly than we would normally think. Within five years, there'll be a logarithmic jump in something that's hard to imagine now. My guess is that it may be related to stem cell research.
I thought 10 years ago that composite tissue allotransplantation would be huge, and I'm sure it will be huge - beyond hand and face. I recently asked one of my interns what he thought his future focus in plastic surgery would be, and he said, "microsurgery." It's interesting - microsurgery is a technique, not a specialty in plastic surgery; however, once composite tissue allotransplantation takes off, there will be a huge need for skilled microsurgeons. The only stumbling block now is immunosuppression - once that's perfected, all missing parts will be transplanted.
I foresee plastic surgeons restoring parts that aren't working, fixing muscles that have deteriorated and replacing lost skin with tissue-engineered skin. New muscle cells will be put into dwindling muscle to protect it - the same with skin.
I predict plastic surgeons will also focus on health and aging, because we're interested in form and function.
I've been impressed with my own experience with yoga. While I get older, my body is getting stronger as I become more capable and skilled in yoga and meditation techniques. They also help with stress and attitude, which is important.
PSN: Who are your personal mentors?
Dr. Mackinnon: My husband, my husband and my husband. Mentors come and go - that's the way it's supposed to be. If we all realized that, it wouldn't be so jarring when bad things happen to good mentors and good mentees. I met my husband in 1969, and we've been married for 39 years. He's been my consistent mentor with respect to my professional surgical career - I wouldn't have been as successful as I have become without him. He's highly accomplished and technically outstanding. He performed the first double-lung transplant - and has performed more lung transplants than anyone else in the world. He has ROI grants.
While he and I both have accomplished a great deal, there is definitely a male vs. female difference in communication. He helps me translate situations about the way men interact with each other. He helps me pick up cues and learn how to better interpret situations. It has little to do with gender and everything to do with power - my husband mentored me in that. I didn't know a female surgeon until I became a female surgeon. I had no brothers. I have two daughters and two sons. My daughters are much better at gender communication differences than I am - brothers provide the big advantage.
PSN: What would you be doing if you hadn't become a plastic surgeon?
Dr. Mackinnon: Probably dress designing or interior decorating. I collect art. My house was in Traditional Home magazine in the 1990s. I really enjoy creative outlets.
PSN: What are some of your favorite pastimes outside of work?
Dr. Mackinnon: I'm passionately grateful for everything in my life. I value my family so much. I have a wonderful husband who supports my dreams. The time I spend with him is important and rare. I have a son who is a famous chef; my daughter is an orthopedic hand surgeon at the University of North Carolina, Chapel Hill; my youngest daughter is in health administration; and my youngest son is an orthopedic intern. My kids have done so well - they are the biggest contribution I've made to the next generation. Can you have it all? Yes you can! But you have to work hard - if you want it, you can have it.
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