Gene Deune, MD, MBA, joins the UNC Department of Surgery as a Professor, in the Division of Plastic and Reconstructive Surgery. He sat down to discuss what brought him to UNC Surgery, his aspirations, and goals while here and the advice he would share with his younger self.

Dr. Deune received his undergraduate degree from the Massachusetts Institute of Technology and his medical degree from the University of Pittsburgh. He completed a combined General Surgery/Plastic Surgery residency and a fellowship in Hand/Microsurgery at Washington University in St. Louis. He received an MBA in Health Care Management from the Johns Hopkins Carey School of Business. At the Johns Hopkins School of Medicine, Dr. Deune was a member of both the Departments of Plastic Surgery and Orthopedic Surgery. He was the previous Chief of Hand Surgery. His primary concentrations will be in Hand Surgery and extremity reconstruction.

 

What brought you to the Department of Surgery at UNC?

The UNC Department of Surgery/Plastic Surgery was looking for a Plastic Surgeon who had expertise in hand surgery, and I was looking for a new challenge. I had been embedded in the Department of Orthopedic Surgery at The Johns Hopkins School of Medicine, and I felt that it was time I returned to Plastic Surgery. North Carolina is a great area with a growing population and great potential. UNC provided me with that opportunity to continue my work in patient care and resident education in a more conducive environment.

Why did you become a doctor?

I liked the practical application of medical science combined with human interaction. It’s great to see advancements in science put into practical use for patient benefit.

What inspired you to become a surgeon?

During medical school, I enjoyed Internal Medicine and the challenge of making a diagnosis based on symptoms and history. At that same time, the personal computer was becoming more common, and I quickly realized that the knowledge base of the Internist would be easily overshadowed by the computer. I wanted to have a skill and a profession where I knew that at least in my professional lifetime, the computer would not make me obsolete. Plus I liked the technical aspect of surgery, to physically treat a physical problem: to cut, to sew, and to reconstruct.

Why do you do what you do? What gets you up in the morning?

Hand surgery is a very problem-specific specialty. Somebody comes in with a problem, and you give a diagnosis based on the symptoms, or if you don’t know, you order tests (imaging or neuroelectrical tests), you present treatment options, and you proceed with the treatment.  It’s a very logical problem-solving profession.

How did you choose your specialty?

I wanted to do a lot of suturing, repairing, and reconstruction and Plastic Surgery allowed me to do that. Within Plastic Surgery, there are many subspecialties that you get exposed to during your residency, though you really don’t learn in great detail. I did a Hand surgery/Microsurgery Fellowship so that I would be more knowledgeable and adept at hand surgery and microsurgery. By the time I was finished with my training, most of the Plastic Surgery opportunities were in Hand Surgery, and that’s why I’m now a hand surgeon.

What exactly does hand surgery involve?

It treats all aspects and ailments of the hand involving the skin, soft tissue, and the deeper tissues including tendons, nerves, blood vessels, bones, joints, and muscles. Over the course of a person’s lifetime, the hand can be exposed to significant UV radiation and chemicals, resulting in skin cancers. There are also small subdermal/subcutaneous lesions and tumors that predominantly affect the hand. Deeper down, the nerves, blood vessels, tendons, muscles, and bones that can be injured by trauma or made less functional by acquired medical disorders such as autoimmune conditions, nerve compression, tendonitis, and arthritis. In the pediatric population, I treat various hand anomalies such as syndactyly (webbed fingers), polydactyly (extra fingers), missing fingers or thumb, and other congenital birth anomalies.

Has your specialty met your expectations?

Yes. I find particular enjoyment in working with children because the reconstruction you do of their fingers/hands will change the quality of their life by making their hands more functional. Examples include separating fingers when they have syndactyly, creating a thumb from the index finger, or removing an accessory finger.

What are your contributions to your specialty?

I have authored multiple papers in Hand surgery and extremity reconstruction detailing the treatment of hand disorders and treatment options. Also, I hope that one of my contributions is in the teaching of residents and instilling knowledge and enthusiasm about hand surgery. I also have educated the medical community and the patient population, what the scope of Hand Surgery is so that when someone has a problem involving the hand, they seek a hand surgeon specialist so that the problem can be treated more expeditiously.

Why did you decide to pursue academic medicine?

My first job after my Fellowship was in private practice. It was not long before I got bored with it. At that time in my life, I also could not see myself in the same office with the same people for the remainder of my professional career. More importantly, during my year and a half in private practice, I realized that my knowledge and clinical skills were on the decline as I was not in a stimulating medical environment. That was why I returned to academics.

So what are some goals you would like to achieve during your time here at UNC surgery?

I want to develop an integrated and cohesive hand surgery program between plastic surgery and orthopedic surgery with combined residency education and teaching sessions. Another benefit of this combined effort is for patient care standardization so that a patient comes into the hospital either through the Emergency Department or through the clinics, that patient will receive the same care regardless if it is from an Orthopedic Surgery or Plastic Surgery trained hand surgeon.

If you could pick the brain of someone alive or dead who would it be?

Albert Einstein. Be great to know what his thought process was behind his scientific discoveries and equations. I would like to know what motivated him and how he overcame his obstacles.

Can you give me an example of a time when you faced a challenge in your career and how you dealt with it?

In 2008, at my previous institution, there was an agreement with all the parties involved (Plastic Surgery, Orthopedic Surgery, General Surgery), including approval by the Dean of the Medical School and the School of Medicine Board of Governors, that I would have my primary appointment through the Department of Orthopedic Surgery. As I did mostly hand surgery and extremity reconstruction, the primary appointment in Orthopedic Surgery was in alignment with my professional career. Four years, later, in 2012, Plastic Surgery had a new Chief, who did not like the previous agreement. He tried to unilaterally abrogate that agreement and threatened to revoke my privileges in Plastic Surgery unless I returned to Plastic Surgery. He also tried to amend the Institution’s Bylaws to prevent me from having a primary appointment in Orthopedic Surgery. His efforts did not succeed. During that ordeal, which lasted 1 year, I learned that you need to stick to your principles, you need to be mentally strong, and you need lots of friends and colleagues for moral support. In the end, the rule of law, mutual respect, and orderly conduct won over individualistic agendas.

Is there a specific failure in your career that you learned from and became positive?

I wouldn’t say there’s one big failure. I think through your career, there are always small failures or things that don’t go quite as well as you want. Through these setbacks, you modify your actions or behaviors. It’s an evolution of process improvement, where you constantly refine your surgical approach or your management of the patient.

If you could give your younger self a piece of advice, what would it be?

Take some time to enjoy life. There’s a lot that you have to give up to achieve your goal. Any successful individual, be it a surgeon or a CEO had to make choices, sometimes difficult ones, to get to where they are today. I would tell myself to think about what it is you’re giving up.

How would you describe yourself in one word?

Hardworking.

If you could have one superpower, what would it be and why?

Telekinesis, to make things move with thought. Imagine doing surgery just by thinking about it. That would be great.