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March 2024If there’s any person who epitomizes the Triological Society, it’s the ever-present Myles Pensak, MD, who has served as the executive vice president of the Triological Society for 12 years and will retire from the presidency and active practice following COSM in April 2025.
Throughout his lengthy career as an otologist, Dr. Pensak has seen many changes to the society and the practice of otolaryngology. ENTtoday had the chance to sit down with Dr. Pensak and review his career, his time in the Triological Society, and the changes he sees coming in both.
Start of a Career
ENTtoday: How did you get started in medicine, and what made you choose otolaryngology?
Myles Pensak, MD: I grew up in Brooklyn, N.Y., and attended the State University of New York in Binghamton. I majored in medieval European history and philosophy, which, I know, is different. I knew I wanted to attend medical school, but I figured I would never have an opportunity to just study disciplines and topics I was interested in, so I took the minimum number of required classes to go to medical school and studied other cool stuff. I’ve never regretted it because it opened a world of reading, thinking, and writing that I wouldn’t have been exposed to as a chemistry or a biology major.
In medical school in New York, I was fascinated by the universe of pediatric cardiothoracic surgery, and following graduation, I started my surgical residency with this field foremost in my mind. I had one elective in otolaryngology as a second-year surgical resident. When I saw my first head/neck surgical dissection, and subsequently otologic microsurgery, I was smitten and fell in love with the specialty.
I was most fortunate to get a position as a resident at Yale and finished my residency education there, then on to Nashville to train in neurotology with Mike Glasscock, MD. Once I finished my fellowship, I had an offer to go to Cincinnati from both Dr. Shumrick and the young new chair of neurosurgery, John Tew, MD, who wanted to develop an investigative interdisciplinary clinical skull base practice. I told my wife we’d be in Cincinnati for two to three years before going back to New York. Clearly, that didn’t happen, and here we are 40 years later, with my entire medical career happening in Cincinnati.
ENTT: What was it about otolaryngology that captured your imagination?
MP: I think it was a combination of two things. First, I loved the aesthetics of microsurgery, and second, the complex anatomy of the ears, nose, and throat had huge appeal to me.
The Triological Society
ENTT: How did you get involved with the Triological Society?
MP: When I was a second-year otolaryngology resident, Rick Pillsbury, MD, who was junior faculty at Yale at the time, had plans to attend the Triological Society meeting in Palm Beach, Fla. There was very little travel money available to residents and medical students at the time, so Rick told me and my chief resident, John Covington, MD, that if we could get down to Palm Beach, we could bring sleeping bags and sleep on the floor of the motel room he was renting in West Palm Beach, saying he didn’t have the money to be at The Breakers Hotel anyway.
So, off we went to Palm Beach, winding up in Rick’s motel room sleeping on couches. On the first day of the meeting, we went to The Breakers and ran into John Kirchner, MD, who was the otolaryngology section chief at Yale and the Triological Society President at the time. He said, “Because I’m president, they’ve given me a big cabana with a fully stocked bar, but I have to attend meetings all day. Why don’t you guys enjoy it?” and handed John [Covington] the keys. It was quite the first impression.
But seriously, the meeting was outstanding. John and I, being non-fellows, initially weren’t invited to the traditional black-tie dinner on Thursday night, but John [Kirchner] insisted we go. We went through the receiving line where the president, his guest of honor, and their spouses welcomed all these luminaries from otolaryngology. President Kirchner positioned me between himself and Frank Netter, the famous medical illustrator who was his guest of honor. I literally got to meet the entire upper echelon of senior members of the Triological Society, and I thought, there’s a life lesson that it can really make a difference when you take someone under your wing.
One of the principles that has endeared me to this society is the tradition going from generation to generation of mentors, introducing mentees to the people who were there before—that’s a most treasured part of the Triologic fellowship. So, I left Palm Beach convinced that if there was any organization that I was ever going to be involved with, it would be the Triological Society.
A decade later, on the faculty of the University of Cincinnati, I submitted my thesis on the surgical anatomy and management of lesions involving the cavernous sinus, receiving the Mosher Award. Much to my absolute surprise and delight, 32 years later, I was informed by Dr. Johnson, the editor in chief of Laryngology Investigative Otolaryngology, that the thesis is going to be published soon.
ENTT: Where did your involvement go from there?
MP: I had attended several regional and Middle Section meetings when Charlie Luetje, MD, a neuro-otologist in Kansas City, Kansas, nominated me at a relatively young age to become the secretary/treasurer of the Middle Section. I was probably 10 years younger than my peer group in the other sections, which meant that when I became the Middle Section vice president, I was also quite a bit younger. At the same time, Rick Pillsbury was the Southern Section vice president.
When we held Triological Society meetings in Oklahoma City, Cincinnati, or Indianapolis in January, as you can imagine, attendance wasn’t all that great. It so happened that that a lot of Middle Section members would go to the Southern Section meeting, because they were in Florida and were held at nice resorts. So, in 2007, Rick and I decided to combine the Middle and Southern Sections in a joint meeting. Not only did we have fabulous attendance, but we also had enormous corporate support as industry representatives could limit their travel and overall expenses. There was a lot of thought that maybe all the sections should meet together in the winter.
I was appointed treasurer of the Triological Society by Pat Brookhauser, MD, when he became the society’s executive secretary. I served as treasurer for 11 or 12 years until Pat’s untimely death, when I became his successor as executive secretary and then EVP. I’ve been surrounded by thoughtful, intelligent, dedicated, markedly talented, and supportive colleagues, which has really made things much easier from a leadership perspective.
ENTT: What do you think have been the most important changes that you’ve seen in the Triological Society during your time there?
MP: First and foremost, we’ve maintained excellence in terms of the intellectual property, the scholarship at meetings, and the value add-ons of The Laryngoscope, Laryngoscope Investigative Otolaryngology, and ENTtoday. We have expanded the Executive Committee, focusing on social media and, more formally, on education. Moreover, with the recent passage of our new bylaws, expanded committees will allow for greater membership participation. International and DO membership, and an increased focus on encouraging private practitioner engagement, will result in a more robust and diversified membership. Our current president, Andy Goldberg, MD, has been a superb voice in messaging this to our colleagues.
We’re now giving away almost $700,000 a year in travel awards to residents, fellows, and students, as well as career development awards, and research grants made in conjunction with the American College of Surgeons. We’ve also revamped significantly both the scope and breadth of topics on which people can submit theses. There are now many support mechanisms for people who need assistance, especially to help guide otolaryngologists in private practice in optimizing their thesis submission.
This last year we had a record number of thesis candidates. The Thesis Committee, under the guidance of Dan Deschler, MD, has created an environment that’s supportive and nurturing rather than being a point of intimidation to those who wish to join.
The composition of the society has changed as well. Membership reflects a diverse younger group joining. Furthermore, as with our specialty, the demographics of the society’s membership has shifted across ethnic, racial, geographic, and gender identities. Since I joined, we’ve had our first woman president, Vanderbilt’s Gaelyn Garrett, MD. Presently, Dana Thompson, MD, MBA, is our associate executive vice president. Robin Lindsay, MD, MBA, is our first woman editor [of ENTtoday], and Romaine Johnson, MD, is our first Black editor in chief [of Laryngoscope Investigative Otolaryngology]. Finally, the composition of our program committees, including the chairpersons Sujana Chandrasekhar, MD, and Sonya Malekzadeh, MD, reflect the diversity of our specialty interests, as well as those who practice in disparate areas. Finally, I feel that by action and deed we’ve lived into the principles of DEI to enhance our society and benefit its members and the house of otolaryngology.
Changes in Otolaryngology
ENTT: What are some of the most promising changes that you’ve seen in the specialty of otolaryngology during your career?
MP: For me as an otologist/neurotologist, cochlear implantation was, without a doubt, the most exciting event to take place. From patients in the early 1980s who were profoundly deaf, all the way up to kids as young as six months today who have congenital hearing impairment, are being implanted. At five years of age, they’re equal to age-matched controls in terms of linguistic and reading skills. Currently, we’re at the dawn of employing gene therapy for congenital hearing loss; the future is indeed exciting and bright.
The employment of effective protocols and standardization amongst management teams in assessing and treating benign and malignant tumors optimizes patient care and outcomes. Technological advances, including microsurgical instruments and scopes, interventional techniques, neural reanimation, and free-flap reconstruction, complement the contemporary integration of more sophisticated chemo, therapeutic radiation, and surgical approaches for the most challenging and complex oncological cases we as a specialty face.
I’ve also seen a different overall approach from a philosophic point of view. When I first started, your focus on career was primary. It’s only within the last 10 to 15 years that physicians have paid attention to wellness and lifestyle, trying to mitigate some of the obvious stressors .
One of the things that I don’t think is healthy is the monetization of modern American medicine. I think there are far too many people who are focused only on business, and healthcare takes a backseat to making as much money as we can. I think the role of physicians as advocates, champions, and protectors of their patients has significantly eroded as the corporate universe of medicine has come to the fore, and that isn’t good for our patients, practicing nurses, physicians, and other healthcare workers.
ENTT: Is there any advice that you would give to other otolaryngologists?
MP: I’ve been incredibly fortunate in that I have loved what I’ve done, and never felt like I was going to work. I love the surgery, the teaching, and even the administrative jobs.
First, I suppose, take your work very, very seriously. But don’t take yourself too seriously. Second, at the end of the day, remember that medicine is a human endeavor, and patients don’t understand medical-speak. When you’re talking with patients, irrespective of their backgrounds, speak with clarity. Third, never, ever suggest or do anything to a patient that you wouldn’t suggest or do for your child, your parents, your spouse, or your best friend.
And lastly, be kind. I’m convinced we live in a world where there’s a profound absence of old-fashioned kindness. Keep learning, and have fun.
Amy E. Hamaker is the editor of ENTtoday.