A Surgeon--Against All Odds

The squeaking of Dr. Serena Young’s leg braces cuts the silence as, swinging along on her crutches, she hurries down a corridor at Rancho Los Amigos Medical Center. She laughs and says, “I need oiling.”

Young, an orthopedic surgeon, has just completed two surgeries--a 3 1/2-hour multiple limb repair and a 1 1/2-hour procedure to straighten a claw-like hand--and now she is on her way to the intensive care unit to look in on a brain-injured boy.

Her patient is a heartbreaker, a handsome blue-eyed teen-ager who was supposed to die but didn’t after being horribly injured three years ago in a car accident. Now, at Rancho Los Amigos, doctors are patching up his broken body.

Crutches Agains Wall

Young props her crutches against the wall, hoists herself onto a footstool and braces her body against the bed to improve her leverage as she removes a half-cast from his left arm. Two pins jut like miniature antennae from the patient’s left shoulder, where a dislocation has been fixed.

He cannot talk but groans in pain as Young lifts his arm. She works deftly, explaining each move to him, reassuring him. As she leaves, he reaches his hand out to hers. His eyes follow her as she walks away. She promises to stop by tomorrow.

Horrible deformities are the norm in this ward at Rancho Los Amigos, where the majority of patients are victims of car or motorcycle accidents, all of them brain-injured. But Young knows, “These are human beings capable of love and feeling, not just deformed bodies.”

No one could understand better. Young, 34, has been a paraplegic since age 2, when she was stricken with polio.

Young remembers the hospital room in her native Taiwan, remembers her mother keeping a bedside vigil. Her mother, a Roman Catholic, was praying: “God, if you bring her back, I promise I’ll devote her to you.” And, Young says, “at that moment I opened my eyes.”

She thinks about her life against all odds--medical school, a residency in orthopedic surgery and, as of July 1, the post as assistant chief of orthopedic surgery, adult brain injury service, at Rancho Los Amigos in Downey. “I really believe it’s God who’s given me the strength to pursue this,” she says.

Dr. Robert Waters, medical director of at Rancho Los Amigos, puts it another way: “She’s a gutsy girl.”

Polio immunization was not widespread in Taiwan in the late ‘50s. Stricken overnight, Young was paralyzed from the neck down.

“I had every treatment from Chinese herbs to acupuncture,” she says. Particularly painful was a procedure where she was placed in a dark room on a slatted wood bed, from which rose incense-scented, scalding steam. Her parents had to bribe her with sugar cane, her favorite treat.

Over the next year, she gradually regained use of her arms, as often happens with polio victims.

But her legs did not respond. “I remember crawling around on the floor, getting from place to place. I used to look like a mermaid, with my legs dragging behind me,” she says.

When she was 4, her father, an American Embassy employee in Taipei, and her mother, a seamstress, both in their 30s, pulled up stakes and moved to America with their little girl and her two brothers. “They thought the medical technology was so much better here,” she explains.

Los Angeles was chosen because they had a relative here. From the time Yi-Len--as Young then was called--was 5, until she was 21, she was treated at Orthopaedic Hospital. There were four surgeries--muscle transplants and transfers to enable her to straighten a knee, fusions to stabilize a foot and ankle.

“I came to America crawling with my hands,” she says. “They got me up and straightened out my legs.”

She was grateful and fascinated. Somewhere along the way, Young decided: “Maybe I’ll be an orthopedic surgeon just like my doctor. I thought the reason I went through all this suffering was so I could help someone else.”

She smiles and says, “I didn’t realize how crazy it was. I had no idea what I was getting into.”

In seventh grade, she transferred from a school for the handicapped to Luther Burbank Junior High; then came John Burroughs High. In both schools, she was the only student who had had polio, a curiosity.

“I have to be honest,” she says, “it was really hard. I had to come to grips with accepting my disability. But my parents never let me use my handicap as an excuse.”

With a degree in biological sciences from UC Irvine, Young enrolled at UC San Francisco School of Medicine, where she was the only visibly handicapped person in her class. She told people there of her dream of being an orthopedic surgeon and, for the most part, she says, they told her, “You’ve got to be out of your mind.”

There were “a lot of days,” Young admits, when she thought they were right.

Although she kept up an exhausting pace in which “there were no excuses made for me,” she says, it was not the physical demands of her training that got her down, not the pain in her joints. It was, she says, “the emotional drain of having to prove myself over and over again.”

Is she still doing that? She thinks a moment and says, “Sometimes.”

Serena Young stops in mid-conversation and asks, “You know how I got my name? From a telephone book.” When she was 11, and about to become a citizen, she explains, her mother decided she should have an American name. In the directory, she found Serena. She laughs and says, “Serena, right? A good American name.”

The talk turns to her private life. Her husband, Buu Dinh Nguyen, who came to the United States as an exchange student in 1977, is now an engineer. They met through his sister, who was in Young’s medical school class.

She wants to have children but had been putting it off until finishing her residency in orthopedic surgery at UC Irvine. She has such admiration, she says, for women who can juggle both motherhood and a residency.

Young doesn’t think of herself as special and says she is “really embarrassed” by any attention. But if people learn about her life, she reasons, maybe it will help “reduce some of the barriers that disabled people face in society. Maybe people will be willing to say OK, we’ll give you a chance.”

‘It’s No Big Deal’

As she sees it, “Everyone has limitations, whether they be physical, emotional or mental. To me, walking with braces and crutches is like wearing glasses. It’s no big deal.”

Young holds out her hands, palms up, to show the calluses, the result of years of shifting her weight onto them as she manipulates her crutches. She laughs and says, “They look like your heels.”

She describes how it feels to have polio-paralyzed legs. “Did you ever try to wiggle your ears? You think really, really hard to try to wiggle them and they won’t wiggle. I sit here and tell my leg to move, but it won’t move.”

She isn’t one to spend time thinking about what she can’t do, though she does “wonder what it would be like to go skiing.”

And each day, in the corridors at Rancho Los Amigos, Young sees reasons to consider herself lucky. With polio, she explains, “we retain sensation (in the legs), which is a real plus. With spinal cord victims, it’s like that other part of them is not there.”

Rehabilitation Center

Rancho Los Amigos is a rehabilitation center, where patients--most of them men, ages 18 to 25, who have been in accidents--are sent after trauma treatment. In most cases involving massive neurological injury, it takes 18 months for the patient to stabilize; then Young and the other surgeons do what they can to fix their bodies.

This is not the glamorous side of medicine. Rancho Los Amigos doctors recognize their patients’ limitations. As one resident said, “The people we fix aren’t going to go out and play for the Lakers”--but Young and the others are committed to doing for them what they can, making them as physically functional as possible.

On a recent Thursday--her regular operating day--Young was scrubbing in, a procedure that for her is not as simple as washing her hands and putting on surgical gown and gloves. She does all this; then she walks, on her crutches, into the operating room where nurses place another surgical gown over hers, slip her crutches out from between the two gowns and reglove her.

When she was trying to persuade medical people that she could be an orthopedic surgeon, the most-often asked question was, “How would you maneuver in the operating room?”

Easily. With her leg braces, she can walk from one end of an operating table to the other. And, bolstering herself by leaning against the table, she once did a 14-hour surgery. With those braces, Young boasts, “I can out-stand the guys.”

Nevertheless, after graduation from medical school in 1981, she did two years of a general surgery internship and a year of research at Rancho Los Amigos while trying to persuade some hospital to admit her as a resident in orthopedic surgery. Filling out application after application, she recalls: “I would describe my disability vividly. But when I’d walk through the door, their mouths would drop to the floor.”

Residency Nearly Over

Then, in 1984, White Memorial, an affiliate of Loma Linda, took her. When, after she had been there three years, their program lost accreditation, UC Irvine accepted her for the final year. (Her residency will be completed this June 30.)

She smiles and says, “Most of the guys in ortho are 6 feet. I’m about 5 feet (but) I always found ways to do what I needed to do.” That might include, for example, improvising a way to relocate the shoulder of a 250-pound patient without having to bodily lift him.

So far, she has not had a patient who was skeptical. “Amazing, huh?” she asks. “When I first started, I was always afraid of that, that someone would say, ‘No, I don’t want you to touch me.’ ”

The staff at Rancho Los Amigos has been “incredibly accepting,” she says.

But, in truth, their affection and admiration are abundant. “She’s a delightful lady,” says nurse Peggy Carney, assistant operating room supervisor. “She’s neat.”

‘I’m Just So Proud of Her’

Dr. Robert Waters recalls that, during the year Young had a research fellowship at the medical center, she did some surgery and clinical medicine and “she really convinced me that she was very capable of becoming a surgeon. . . . I’m just so proud of her and delighted that she was able to make it through. She’s met all our expectations, proven herself deserving in every way of every opportunity she was given.”

He notes that “there aren’t that many women,” even able-bodied ones, in orthopedic surgery. “It’s so difficult to get a surgical residency. Only the very top students, a very small percentage, can get into an orthopedic residency,” as orthopedics, which embraces sports medicine, is today considered a “glamour” field.

“When you have all these bright, able-bodied people applying and then you see a short woman with two long leg braces and crutches walk in . . . well, why take a chance when you’ve got someone who’s got all four limbs? She’s just outstanding. I thought she deserved a chance.”

Waters thought for a moment. “Someone in a wheelchair once told me, ‘Able-bodied people are people who just have not become disabled yet.’ We’ll all get older. That’s a neat way of looking at it, I think.”

It is early morning and in Operating Room 2 at Rancho Los Amigos, Young, assisted by three young doctors who are residents, is performing multiple procedures on a male traffic accident victim. The atmosphere is relaxed, low-key, just like the elevator music playing on anesthetist Oleta Dodson’s radio.

As Young goes about straightening the patient’s fingers and toes, she also is supervising the residents’ work, explaining why she wants certain procedures done. Two of them tower above her, this incongruous figure whose knee-length blue surgical gown reaches to the tops of her black Reeboks.

Observing the photographer recording the scene, the residents start ribbing Young about the pictures that will appear in the newspaper. They can see a tabloid classic: “Midget Surgeon Operates.” She enjoys the joke as much as anyone.

The surgery is long and tedious. Then there is only a short break--time enough for a Diet Coke and a few handfuls of microwaved popcorn--before Young returns to the operating room. This time the patient is a young woman and the surgery is to release the thumb of her right hand, which is clenched to the palm, and to straighten the fingers.

As Young places a cast on the hand, resident Dr. Albert Aboulafia asks her to repeat the story of a renowned female orthopedic surgeon who once told Young to forget it, that she wasn’t capable of being a mother, much less a surgeon--”Why, you couldn’t even lift your own baby.”

Young laughs and says she now sees that woman at medical conferences. Aboulafia says he hopes she makes it a point to sit right next to her. “In front of her,” Young says.

After the second surgery, and a visit to a patient, there is one other thing Young wants to do before heading her hand-controlled white Camaro home to Torrance.

A Grim Reminder

She takes her visitor to the medical center’s mini-museum, where a black-and-white photograph of dozens of iron lungs lined up row on row, head-to-toe, in a ward at Rancho Los Amigos is a grim reminder of the polio epidemic of the ‘40s.

Today, she says, some of those patients are back, victims of post-polio syndrome, a muscle fatigue brought on by overworking muscles to compensate for others that would not work.

Will she get it? Young shrugs, “I probably will. It’s usually in active people.” There is no time now to worry about that.

In the adult brain injury section, there are people with so little skull that, as Young says, “If you touch them, you can feel their brain.” She thinks everyone who rides a motorcycle without a helmet or rides in a car without a seat belt “should take a walk down this ward.”

Sometimes, she says, people ask, why bother to patch up people who cannot talk, who do not seem capable of human response? She doesn’t buy that.

“Their bodies may be twisted,” Young says, “but you never know what’s going on in their minds.”