Catching up with a UNMC legend

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!"