Inside Dr. David Roe’s office – among the displays of hunting memorabilia, IU sports novelties, and family photos – is a stack of brimmed caps. The caps, carefully displayed on tiered shelving, represent the Indy 500, Chicago Bulls, Delta Airlines, and Pioneer Seed.
Mostly, the collection of nearly 20 caps represents Dr. Roe’s connection to his patients. In some ways it’s also a connection to his small town upbringing. This is a guy who uses the word “humble” often and drives a pick-up truck through back roads to and from work while listening to country music. Part of his hat collection includes one with a John Deere logo.
His youth was spent in a small town with one doctor.
And yet at 47, Roe, is perhaps one of the best-known doctors in his field, part of a Methodist Hospital team that has performed nearly 900 lung transplants since the first in 1989. As he converses about being part of that history, Dr. Roe rarely talks in first-person. He acknowledges not only his team at work but also, his team at home.
He has been married for 24 years to Lauri. Together they have four children ages 15, 17, 19 and 21. The couple met at IU Bloomington. They were engaged after nine months and were married after his first year after medical school.
“She’s been with me the whole time and I couldn’t have done it without her,” said Dr. Roe, who knew in fourth grade that he wanted to become a doctor.
“My father is a retired dentist so I had been exposed to healthcare as a child.” He grew up in Pinckneyville, Ill. a town of about 3,000 residents located 60 miles southeast of St. Louis, Mo. “We had one doctor. It was an agricultural and coal mining community and I grew up like a lot of small town kids – hunting and enjoying the outdoors.”
It’s that childhood that Dr. Roe credits with his humble beginnings.
As he thought about pursuing a career in medicine he initially thought of going into primary care but during his residency he was drawn to pulmonary care. When he came to Methodist Hospital, he said he knew lung transplant was what he wanted to do.
He completed his undergraduate degree at IU; medical school at Southern Illinois University, and went on to Michigan State University for a residency in internal medicine and pediatrics. In his third year, he decided he wanted to pursue a sub-specialty in pulmonary/critical care medicine.
He looks back on that decision as one of the toughest and yet one of the best he’s made in his life.
“As transplant pulmonologists, we take care of patients before transplant and after surgery for the rest of their lives. It’s a collaborative model and a team effort. The unique part of lung transplant is that we take care of the all of their issues – we practice a great deal of internal medicine. It’s about the whole patient,” said Dr. Roe.
As the medical director, typical day for him starts at 5:30 a.m. in the office responding to email or attending to other administrative tasks. Usually he will attend multiple meetings throughout the day in between his clinical duties.
“I’m still 100 percent patient care. That’s where the hats come in. When you’re caring for the patient it extends to the family. After some 20-25 visits just in the first years around transplant you get to know them pretty well. It’s like they are sitting on my couch at home.”
The John Deere cap was given to him by one of those family members – just like all the other caps.
“It’s more than ‘we just did your transplant and its over.’ We are fully vested in these patients and their families,” said Dr. Roe. “We are making a huge commitment to them and to their family. And then there’s the donor side – it’s a true bond between physician, recipient and donor. I think you need all those equal parts or it doesn’t work.”
Those are the rewards of the profession. But there are also some tough times. Dr. Roe said his worst day is when he has to tell a patient, “No.”
There can be any number of reasons why a patient is not a viable candidate for a transplant.
“Because this is a life and death situation there is nothing harder than telling someone with hope that they can’t have a transplant,” said Dr. Roe.
On November 11, Roe spoke at the American Lung Association’s Annual “Evening of Promise” Gala.
“I want to first focus on organ donation because without awareness, there is no transplant,” said Dr. Roe. Secondly, he talked about the disease process and the people who benefit from lung transplants.
“A lot o people think of lung disease as self-inflicted but there are lots of lung diseases that have nothing to do with smoking, such as COPD (including emphysema and chronic bronchitis), lung cancer, and cystic fibrosis.”
Doctor Roe will also talk about innovations in pulmonary care and transplant.
One of those innovations, is the ex-vivo lung perfusion (EVLP), an innovative therapy applied to lung donors outside the body before transplantation, improving the organ quality and making the lungs more suitable to transplant.
“This basically allows us to tune up the lung so it’s a better organ to transplant, then eventually transplant it into a recipient. This way, we can increase the donor pool for anyone on the list so they will have a greater chance of being transplanted,” said Dr. Roe.
What does he see as the future for lung transplantation?
“I see a couple of things. Number one is the advancement of ex-vivo profusion centers, with multiple machines ready to prepare organs when they become available. Number two, there’s a lot of research on chronic rejection that wasn’t done 10 years ago so I think healing will continue to improve. If we can try to reduce that failing graph after transplant, then we can increase the overall survival rate.”
— By T.J. Banes, Associate Senior Journalist at IU Health.
Reach Banes via email at T.J. Banes or on Twitter @tjbanes.