This episode is part of our My STEM Career series. Explore the entire My STEM Career offering, and sign up for our newsletter to be notified of new episodes.

The STEM Career lesson that matches this interview, “Doctor”, can be found in Codelicious Computer Science Foundations. Explore our Computer Science Foundations courses for kindergarten, first grade, and second grade. In addition, download a free lesson that matches the K-2 grade band. In Idea Generation, students learn different ways to communicate an idea and will practice generating ideas with a visualization activity.

Name: Dr. Kokoska
Title: Pediatric Surgeon
Company: Peyton Manning Children’s Hospital

STEM Career Lesson: Doctor
Course: Computer Science Foundations 1

Prepare for an operation with a pediatric surgeon! Explore a career as a Doctor with Dr. Evan Kokoska of Peyton Manning Children’s Hospital. As a surgeon that specializes in care for kids, Dr. Kokoska ensures that children under 18 get the procedures they need to feel better.

Learn more about Peyton Manning Children’s Hospital: http://www.peytonmanningch.org/

Katie: Have you ever been sick and had to visit a hospital? You may meet different medical professionals, like doctors. A surgeon is a special type of doctor that can perform procedures to help patients feel better. Today, you’ll hear my conversation with a surgeon that treats children. Dr. Evan Kokoska is a Pediatric Surgeon at Peyton Manning Children’s Hospital, which provides all kinds of medical care for kids.

Welcome to My STEM Career, inspiring the next generation of leaders. This show is brought to you by Codelicious Computer Science Curriculum; I’m Katie Baird.

In this first section of the episode, we’re diving into questions from our Doctor STEM Career Lesson from Computer Science Foundations, built for grades K to 2. Then, we’ll transition and learn more about Dr. Kokaska’s life, career, and advice.

Katie: Dr. Kokoska, thank you so much for joining us on My STEM Career today. And part one of this interview, we’re going to go over some questions from our Doctor STEM Career lesson from Computer Science Foundations for grade one. So if anyone listening right now on the podcast or watching on the video, do you want to learn more about that course you can find more information in the description box below. But Dr. Kokoska, I would love to start it. If you could introduce yourself, what is your name, your job title and where do you work.

Dr. Kokoska: My name is Evan Kokoska. I’m a pediatric surgeon, which basically means somebody who operates on children, children being defined as less than 18 years, and I work at Peyton Manning Children’s Hospital, which is a children’s hospital north of, just north of Indianapolis within the city itself.

Katie: Great. And can you talk a little bit about what a pediatric surgeon does?

Dr. Kokoska: So pediatric surgeon takes care of problems that may or may not need an operation. When a child comes to a hospital.

Katie: And what are some of the things that happen when patients come to see you either in your office or in the hospital. So really, there are two components of my job one is outpatient and one is impatient. A typical scenario for an impatient might be. If, say, a 10 year old has really bad belly pain. They might go to the emergency room to get things sorted out. And if in the emergency room, studies are done that might suggest this as a problem with the appendix or the intestines that might need an operation to get better, They will ask us to come see the child, talk to the parents, talk about options, and take care of things with an operation if need be.

The other scenario might be if somebody is in general doing okay but has sort of a problem, such as. One thing we see in clinic is pectus excavatum where the chest wall goes in, or caves in, and so that child may come to clinic and we may look at the chest wall, maybe get some x rays, and talk to the parents about whether anything needs to be done with an operation or not and whether the timing is good for that.

Katie: And let’s say you decided to move forward with an operation. What are some of the tools that you use and surgery?

Dr. Kokoska: So, I am more people high maintenance than stuff high maintenance, but some of the tools we do use in the operating room are little instruments I call them sticks, and a little camera that we can put through little incisions or cuts on the belly, or in the chest to go inside and look and find things, and potentially remove things.

When I say on people high maintenance high maintenance means I have a lot of needs. And it really takes a village to do my job. In that we interact, or talk to, pretty much every different person in a children’s hospital, such as the emergency room, such as lung specialist, such as heart specialist, such as doctors who read x-rays, radiologists.

And then if we have to go to the operating room, we rely on nurses who are specialized in taking care of children and making sure that children are too awfully worried going into the operating room. We are blessed with workers called Child Life workers who help distract the children with games and toys and that kind of thing so that their minds not on potentially an operation coming up. Then in the operating room, I’m really dependent upon help both nurses to make sure the patient’s doing okay. People handing me and helping me with the instruments that I need, and the anesthesiologist, which is the doctor that puts children to sleep, who really is comfortable with children.

Then after surgery we need folks who are used to children waking up from anesthesia or an operating room or an operation.

Katie: So it sounds like you not only need to have skills with technology, but also skills with people, to manage the entire situation. So that kind of leads to our last question here: What are some important skills that you think a doctor must have?

Dr. Kokoska: Well, three things I pray for every day. Actually four: wisdom, empathy, patience, and humility. And each of those: wisdom would be trying to figure out what’s best to do with a patient given what’s going on with them.

Empathy would be trying to put yourself in their shoes and, and understand why they’re acting the way they are, or in the parents shoes because the parents are under a lot of stress when their children are sick.

Humility means, we, we really most pediatric surgeons are pretty down to earth people, meaning that we, we really understand that we’re working with sick children and that God’s given us abilities that we need to use, and our right manner.

And then patience. Most surgeons like things to happen right away. And sometimes that’s not the case in medicine so we have to take deep breaths and relax and and wait.

Katie: Very nice. So those are some questions from our Doctor STEM Career Lesson from Computer Science Foundations grade one.

Katie: Those questions drew from our Doctor STEM Career Lesson, part of Codelicious Computer Science Foundations for grades K to 2. You can find more information about the course in the show notes. Now, on to the second part of our show. Join me as Dr. Kokoska explains the important training he needed for his job and some of the different sicknesses he treats on a daily basis.

Katie: And now we’re going to transition our conversation a little bit and talk a little bit more about your career, and some of your advice for students, so I’ll just start with this question. In college you studied Chemical Engineering at Rose-Hulman. So from that, how did you know that you wanted to become a doctor?

Dr. Kokoska: So I pretty much always knew I wanted to be a doctor and specifically a surgeon because I really liked anatomy, and I really liked the body parts. My father was a chemical engineer. He worked for Pfizer, a drug company in Terre Haute, Indiana, and he instilled into me the concept that if you go into engineering, from that, the sky’s the limit and you can do anything you want. You have not burn any bridges at all. You can go into management, you can go into engineering, you can go into research, you can go on to law school, you can go to medical school.

So that’s one reason the other is, I was better at thinking and open book type tests than just memorizing things, and engineering is really about logical thinking and trying to work through problems, it’s not sitting down and just memorizing biology which I was not as good at. So I did struggle a little bit the first year of medical school, because that is a lot of memorizing but by second year, I definitely caught up and I think an engineering mind helps you think through problems, more so than some degrees.

Katie: Absolutely. So you started by giving yourself a lot of choices, but there eventually came the time to specialize. So I’d love for you to talk about the training that you needed to become a pediatric surgeon specifically. How many years to become a doctor?

Dr. Kokoska: So, a pediatric surgeon has a lot of training, but after undergraduate or engineering, most have four years of medical school. And then, as of now still, after medical school, you can’t go straight to pediatric surgery but you have to do five to seven years of general surgery which is both children and adults. And during general surgery training, you have to apply for specialized training which is pediatric surgery, and to be competitive, or to get a spot for no better terms, most surgeons do two years of research during their general surgery training so that makes that seven years. and then another two years of pediatric surgery training. So I would say the average is nine years after medical school, or training.

So, including medical school after undergraduate it’s 13 years, so all my buddies or general practice doctor were out having jobs and contributing to their retirement and most of us were finished in debt, but it was well worth it.

Katie: How many years of study to become a doctor? Where did you do your extra training or extra years of training for pediatric surgery.

Dr. Kokoska: So after Rose-Hulman I had to get out of Indiana for a while, so I I did my medical school and general surgery in St. Louis, but I did come back to Indiana to Riley Children’s Hospital for the two years of pediatric surgery training.

Katie: And now you’re back in Indiana at Peyton Manning Children’s Hospital. So, can you describe a typical day in your work life? What are some of the things that happen?

Dr. Kokoska: The best days I’m in the operating room, and I think a lot of surgeons look at clinic as something necessary, a necessary part of the job, but I think many of us, or most of us, are happiest in the operating room. So a good day might be starting the day off taking a gallbladder out of a teenager with the laparoscope or small incisions.

And if I was on call, appendicitis might have come in overnight, so I may need to remove the appendix with small incisions. After that, I’m ideally with an operating room team that’s slick, which is the majority of the case, an anesthesiologist who’s good at turnover.

And then, many times we do some baby cases after that, which might be putting a button or tube in the stomach of a baby so that they can have their nutrition put into the stomach because, for whatever reason, they may not be able to by mouth because they may aspirate or choke on the formula.

And then after that might be groin hernias. Baby, premature babies are very prone to having groin hernias and those may sound straightforward but sometimes are the, those are the most difficult cases we do.

And then throughout that or between cases would need to go see the patients we’ve operated on or the patients that might be upcoming, called “rounding”, and answering questions from parents and making sure they’re doing well, as well as troubleshooting potential calls, and I work with a fantastic office I’m blessed with that, but calls from parents who have concerns or questions, and sort of troubleshooting those kind of problems.

Katie: So you just listed a bunch of conditions there; are those typically the most common ones that you see? Are there other ones that you’ll see typically too in the operating room?

Dr. Kokoska: So, again, that’s sort of divided by impatient and outpatient. Probably 60 to 70% of our work is urgent emergent, meaning that those patients come to the emergency room or are or are already in the hospital and need something urgently done. So examples of that would be appendicitis is perhaps the most common thing. Premature babies especially have intestinal problems not uncommonly we may need them to emergently deal with those. Bowel obstructions due to various conditions.

Sometimes emergently we need to put a child on a heart, lung bypass machine through an incision in the neck and putting tubes in the main artery and vein, so that the machine takes over their work of the heart and lungs and allows their heart, lungs to rest, which can be a life saving maneuver. Sometimes the lungs collapse and we need to put tubes in to re-expand it.

And then on the outpatient or clinic side, common conditions would be that chest wall deformity I was talking about, or groin hernias that are able to be pushed back in and are urgent, belly button hernias, gallbladder problems, and lumps and bumps on the arms and legs, and sometimes tumors in the abdomen and chest, especially.

Katie: Gotcha. What would you say are some of the major differences between working with children and working with adults?

Dr. Kokoska: Children on a good standpoint bounce back very quickly but on a bad standpoint can deteriorate very quickly so they can get terribly sick very, very quickly. But after a big, big operation many times, say I do a big belly operation, it’s very humbling in that a 10 year old might be running down the halls two to three days after the operation when you and I might be laid up for weeks whining about it.

And so they really, especially the younger ones do recover quite quickly. Another big differences were not only taking care of the patient but also the parents, and so we have to involve them in the decision making, they’re the ones that are consenting for operations and we have to make sure that they fully understand what’s going on, which in the young child is different than the teenager. Ideally you want the teenager to understand and be willing to undergo an operation, as well as the parents, you want everybody to be on board that the plan, makes sense to them and they they want to proceed with it.

Katie: Absolutely. Do you have any success stories that you can share about your patients? And maybe like, how has surgery changed their lives?

Dr. Kokoska: Well, I’ll talk about a couple stories that are also educational for this crowd, but a year ago we had a child who was playing with these Bucky balls and these high powered magnets and he had two in his mouth and went outside his mouth and they were connected through his cheek, and he was rolling around with his tongue and he swallowed the two on the inside, which sometimes may not be a big deal, but if these high powered magnets gets stuck in the intestine, they can burrow hole or ulcer through the intestine, which did happen in him. We follow those magnets, going through the intestine, and they sort of stopped and got stuck in the same space or spot. And so we did have to operate. I did get an ultrasound in him, because I thought it was an area in the appendix (maybe would get lucky) and in fact they were in the appendix, which made it easy to localize. And so we approach this like we would a child with appendicitis and But the instrument enter, it was crazy. But when our instrument, which is made out of metal, got near that area, it immediately stuck to it. And so we were able to find it. And that was fairly gratifying, because it could have been a big big problem.

Another similar story is that 13 year old teenager presented with throwing up and weight loss and was unable to eat much, and we got some x-rays, and it was really worrisome for what we call a trichobezoar, which is basically a big hairball in the stomach. And in hindsight, talking to her she did pick her hair and eat her hair. And so we did have to operate through a bigger incision and her and open up the stomach and her entire stomach was a hairball that extended down the small intestine, and we pulled that out and close the stomach and she did well obviously learned the lesson that you know, pick at your hair, but those are sort of gratifying stories but also educational. Don’t put magnets in your mouth and don’t eat your hair.

I told my daughters who are old now, if I caught ’em eating at their hair they get daddy’s haircut. So, it put the fear of God in ’em. I would say overall though, the children that really stand out to me are the ones that give you a lot of angst and ulcers and keep you up at night and really are quite difficult but end up having good outcomes.

And the those are the dramatic life changers, and those are the ones that the parents send Christmas cards every year, and give you updates and pictures of them and many times these are babies who have been in the NICU with all sorts of problems with the intestines of the abdominal wall where the belly wall’s open and the intestines are born outside, those kinds of things.

Katie: That’s phenomenal. I mean, you can see the impact that you’re having on people’s lives, not just the children but also their families. So with those stories in mind, I’d love to hear what advice would you give to students who are interested in following your career path.

Dr. Kokoska: I would say first and foremost stay well rounded. Have interesting hobbies that make you a three dimensional person, not just a potentially academic person, and whether that be sports, drama, music, there are all sorts of ways to be three dimensional and be an interesting person. So that would be number one. Number two, if, if, test scores matter study your tail off because they are many times used as a guide, and a cut off for applicants to get your foot in the door for an interview.

Number three, I always get the question, “What bachelor degree for doctor?”. I always say, pick an interesting undergraduate degree that that you would enjoy in life, not necessarily pre-med, biology, that kind of thing. So that you can enjoy those four years of college as well.

And I think those are the, those are the big things. Number four, never give up. Y’all probably don’t know the book about the tiger mom by Amy Chua, but in it she describes applying to 100 law schools and having 100 rejections, and she went to her father was ready to quit, and her father said, “Just 100 rejections?”. She continued, ended ended up getting into Duke, because they had a, they had somebody who dropped out. And so, a spot with a drop out’s a spot, and then that gives you a chance at a future.

Katie: That’s great advice. Thank you so much, Dr. Kokoska, for coming on My STEM Career, really enjoyed the conversation today.

Dr. Kokoska: Thank you so much! Good luck to ya!

Katie: Thank you Dr. Evan Kokoska, Pediatric Surgeon at Peyton Manning Children’s Hospital, for coming on the show today. Listen to every episode of My STEM Career at ellipsiseducation.com or wherever you get your podcasts. See you soon!