If it’s possible that something good can come from a tragedy, then Dr. Jane Kao’s (’85) story is one to consider. A summer babysitting job in her pre-teenager years found her caring for a 3-year-old boy suffering from leukemia. The boy died several years later, inspiring Kao then to “someday find a way to help children with chronic illnesses.” Today, the successful pediatric cardiologist brings hope and healing to children and their families coping with serious illnesses. Her passion for life and personal humility overshadow her award-winning success in the medical profession.
Kao was raised in a UT family. Her father, Dr. George Kao, is a UT Martin professor emeritus of political science, and her mother, Janfen, was a reference library assistant at the university’s Paul Meek Library. Her brother, David, earned his industrial engineering degree from UT Knoxville in 1993. She describes her parents as “exemplary role models” both in her personal and professional life. “They really instilled an impeccable work ethic in me,” she said. “And it’s really taught me that if I work hard and set my goals high, I can achieve anything.”
Although her medical training and career have taken her to large cities, she still draws on her small-town upbringing. “I think growing up in Martin has kept me grounded, and it’s provided me with a sense of values and compassion that has created an essential foundation in my medical practice,” she said. Her undergraduate years brought similar experiences in that “it (the university) was like just being part of a large family.”
Faculty mentors included Drs. Charles Harding and S.K. Airee from the Department of Chemistry and Paul Sharma from the Department of Biological Sciences. She also recalled Dr. Nancy Hinds, her freshman chemistry professor, who convinced her that “females can go into the sciences and into the chemistry profession.” She also credited Hinds for creating a strong, basic chemistry background that helped prepare her for biochemistry classes in medical school.
Hinds, a UT Martin assistant professor of chemistry, said that Kao excelled in chemistry. “From the first day, she understood the importance of chemistry to her career goals and she diligently applied herself to mastering the subject,” Hinds said. “These same characteristics have undoubtedly been good ones as she studied medicine and became a master in her field of medicine.”
Kao’s third year of medical school was her initial exposure to pediatrics and a defining moment in her medical education. “That experience re-enforced my passion for pediatrics and in working with children,” she said. After earning her medical degree in 1989, Kao pursued her residency at the Baylor College of Medicine and Texas Children’s Hospital in Houston, Texas, which is the largest pediatrics residency program in the country. “It is there that I received my initial exposure to cardiology. They have a very strong and large-volume cardiology program,” said Kao, who at that time was also considering a specialty in oncology.
“It was in my second year of pediatric residency that I made a decision to pursue pediatric cardiology,” she said. “I witnessed the dramatic impact of surgical intervention in these cardiac patients. It was such a night-and-day difference in a child who arrived at the hospital critically ill and in congestive heart failure, and at the time of discharge they were active and playing. That feeling of immediate accomplishment was vital in my decision to dedicate my career to pediatric cardiology.”
Three years later, she went to UCLA for a pediatric cardiology fellowship. It was during the third year of her fellowship that she began to explore where she wanted to practice. She was recruited to Dallas in 1995 and then later established her own private practice, the Heart Center for Children. In her practice, she cares for children who have congenital heart defects – actual birth defects. “And most people don’t know this, but congenital heart disease is the most common birth defect of all birth defects, and it affects every 8 per 1,000 live births,” she said.
Kao has special expertise in fetal cardiology in which she diagnoses heart lesions before an infant is born. She counsels parents 18 to 22 weeks prenatally after performing a special ultrasound on the fetus. After she diagnoses a heart defect in the fetus, she can then counsel the parents whether the child will require one or more surgeries immediately after birth, “or … (in less serious cases), I reassure them that the child is going to be fine and won’t require surgery.” In more difficult cases, she at times has to break the news that a child may not survive.
In a typical day, she evaluates children for a variety of heart-related problems. “I also round on patients in the hospital and manage the children after heart surgery and transition them as they’re recovering from heart surgery.” She also performs intraoperative sonograms during open-heart surgery and works closely with the surgeon in assessing the status of the surgical repair.
Kao notes that prenatal visits often involve bad news. At this point, the obstetrician has likely spotted a problem, which statistically indicates “between 50 to 80 percent of the time that there is something wrong with the baby’s heart.” She acknowledges that the work can be extremely stressful. “Families express so many types of emotion to me, whether it’s fear, anger or sadness,” she said. “I try to really maintain a sense of objectivity when I talk to these families, but I certainly feel their pain.
“I have to keep in mind that for every parent that I have to relate that there’s something wrong with their child’s heart, there are hundreds of other parents that I tell them their child’s heart is normal. I therefore keep focused on the fact that there are a lot of children that do well and live particularly healthy and normal lives.”
Typical workdays are hectic in that Kao has several clinic locations, so she often begins the day making sure that she’s headed to the correct location. (She laughed, remembering that she has started several days at the wrong clinic.) She arrives at work about 7:30 a.m. and spends the first hour making patient rounds. She starts her office hours at 8:30 and sees a new patient every half hour, performing pediatric ultrasounds as needed to see if heart problems exist in her young patients. This continues until 5 p.m., and if there are any breaks, she goes back to the hospital to check on the status of her patients.
Throughout the day, she is called to surgery and has to make a quick change into scrubs to perform intraoperative ultrasounds. She also takes calls from pediatricians who pose questions about their patients. “I’m constantly on the phone in between patients, calling pediatricians or them calling me, and answering their questions on how to manage a child,” she said. “Sometimes these pediatricians are from out of town. They’re from rural areas, and they don’t have accessibility to specialists.” She also takes calls from parents who are concerned about their child, and she consults with these parents by phone and determines whether they need to have an office visit.
Besides these responsibilities, Kao also manages her practice, which involves everything from keeping equipment up to date to meeting the needs of 10 employees. She usually leaves the office between 6 and 7, and then she and her associate head to other hospitals to interpret ultrasounds before going home.
But, the day isn’t always over. If she’s on call, which occurs every other week, her beeper brings calls from parents and doctors as babies are born with suspected heart problems. Trips to the hospital in the middle of the night then become part of the workday. Total cases in any given day can total 25, and nothing is routine.
Even though cases have similarities, several specific cases stand out. One involved a 10-year-old Mexican girl who had been blue (cyanotic) all of her life, which is a symptom of a heart lesion. No one in Mexico had successfully diagnosed her problem, but after a foster family in Austin, Texas, took the child in, Kao received a call from the family and accepted the girl as a charity patient. Kao diagnosed her with a severe heart lesion, but this determination came late. “She was really past the point of being operable and in her last stages of life,” Kao said. A local hospital agreed to perform an experimental operation to relieve the symptoms of the girl’s condition, and she made an initial improvement.
The girl eventually went back to Mexico, and when she returned a year later to see Kao, the girl showed further improvement. She brought a family photo, and a simple note on the back said, “thank you,” a gesture that greatly touched Kao. About four months later, Kao learned that the girl had died in Mexico, “But it made me realize … that we can make a difference in the lives of so many children around the world if only they had accessibility to health care.” This experience has inspired Kao to dedicate some of her time to mission work in other countries over the next several years.
Kao, a practicing Catholic, said that “faith plays an extremely vital role in my life,” and this faith has practical applications for her patients and for herself. When medical and surgical treatments are maximized, she often finds herself telling families, “It’s in somebody else’s hands now.” From her view, she said that physicians often do all that they can for a child, and in the end, they can’t explain why the child isn’t getting any better. “This is an extremely humbling experience,” Kao said, adding, “and we at times have to rely on our faith in another higher being to provide the fate for these patients.”
The good news is that innovations in her specialty are coming quickly. During the next few years, Kao said that new, minimally invasive techniques will help patients avoid open-heart surgery to repair holes in the heart, open valves, replace valves and correct other problems. Related benefits will be shorter hospital stays and less stress on the heart. “I’m learning something every day, not only from my peers, but from my patients,” she said.
In October, Kao traveled to Martin to accept the university’s Outstanding Alumni Award during the 2008 Homecoming celebration. In true form, she gave credit for her success to others and expressed humility for what she does. Her words rekindle the memory of the young leukemia patient whom she cared for many years ago. His life, cut tragically short by illness, inspired Jane Kao to treat chronically ill children and bring hope to families in their darkest hour of need.
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