American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

YFA Member Highlight

Fostering Strength as a Surgeon

Kelly Rosso, MD, FACS, Surgeon and Foster Mom

I started calling her Bunny because when we brought her home from the hospital, she looked like a baby bunny that had fallen out of the nest. For the next several weeks, Bunny did not sleep unless she was held. She would cry and shake when laid in her crib, despite the world’s best burrito swaddles. So, at night, I dozed in the rocking chair I was gifted by my program upon graduation with a tiny baby fast asleep in my arms. By day, I was a surgeon.

Foster care does not allow rest for the weary. When we receive “the call” to take in a child, a mad dash ensues to prepare, problem solve, and make things work. Although it took nearly eight months of training to become a certified foster parent, nothing prepared me more for that experience than general surgery residency. Maybe it was the chair, but when rocking Bunny late at night, I remembered the multiple GSW cases and the swift action by my trauma surgeon mentors to save lives. I recalled my time as chief on the transplant service, once operating alongside my chairman all day, traveling by private jet for a procurement at night, followed by a packed schedule of cases the next day (the unsanctioned duty hour rule breaking of an earnest resident). After the initial chaos and the hurdles Bunny herself had to jump over, we settled into a routine, and I looked upstream, as a surgeon often does, to the root cause. Most often, children enter foster care as a result of vulnerable families going through crisis or addiction (which also led me down the upsetting opioid crisis Purdue Pharma rabbit hole). Because disruption of the family creates a different, often problematic trajectory of a child’s life, foster care should be the last resort, the “nuclear option.” But prevention programs and resources that help keep families together are severely underfunded, and many children stay in the foster care system only to “age out” at 18.

Surgeons are excellent “downstream fixers,” but our strength also comes from looking up the river. The American College of Surgeons STOP THE BLEED® campaign, a grassroots effort to teach bystanders to stop or slow bleeding, was prompted by the gun violence epidemic in this country. A downstream fix. The outcry of physicians on the frontlines prompted the National Rifle Association to admonish “self-important anti-gun doctors to stay in their lane,” which was met the with the rage and fury of those who see gun violence first hand (#thisismylane) and a push toward funding meaningful gun violence research. An upstream solution.

We now find ourselves at the epicenter of COVID-19, an unprecedented pandemic that will cause economic and societal implications for many years to come. This novel virus has exposed shocking disparities that have existed, festering like a cancer, in our health care system for years. Increased infection and fatality rates attributed to COVID-19 in black communities, among people of color, and in those living in poverty are evidence of a broken system. And awareness of that broken system is likely stoking the flames of civil unrest in the streets. Tearing down the structural inequity and bias that is baked into the walls of our health care system starts with identifying the bricks.

We might not have all the answers. We might not always say the right things. But we are surgeons, and we can (and must) do hard things.  

Kelly Rosso, MS, MD, FACS, is a breast surgical oncologist in Phoenix, AZ, who currently wears her white coat for Black lives. After 10 months of cuddles, Bunny left to live with her own wonderful, loving family. This outcome is not the case for all children in the system. If you are interested in foster care, please watch the TED talk “The Power of One Caring Adult” by Josh Shipp, a youth advocate and former foster kid.