An NCI-designated Comprehensive Cancer Center
By Abe Rosenberg | June 18, 2018
Benjamin Paz Surgeons Gone Global | City of Hope Dr. Paz (center) stands with medical residents during a recent trip to Tanzania
Ask him, and I. Benjamin Paz, M.D., methodically lists the highlights of his most recent “vacation”:
  • 2 weeks
  • 12-hour days
  • Rounds at 7 a.m.
  • 20 cases
  • 3 lectures
  • One day off
And truth be told, those numbers don't begin to scratch the surface.

Medicine for All

For several years now, the veteran City of Hope surgical oncologist has taken his “down” time in the African nation of Tanzania, one of the poorest places on the globe. Normally he spends a month there (“Any longer and my wife would kill me,” he said) and although this particular trip was a bit shorter, clearly he got a fair amount done, not the least of which were those 20 complex surgeries he performed.
If that were the extent of it, Paz's story would be noble, though hardly unique. Many physicians donate their time and skills to help underserved populations.
The Tanzania model is different. Centered at Muhimbili University of Health and Allied Sciences in Dar Es Salaam, it is a project of the nonprofit Alliance for Global Clinical Training, created specifically to “train the trainers”: to educate doctors, nurses, administrators and support staff, enabling Tanzanians to grow a modern, self-sufficient, high-functioning, high-quality health care system available to all.
It is here that Paz truly excels and is most appreciated.
Ben Paz is a brilliant oncologic surgeon who brings to the table vast clinical experience, technical expertise and scientific knowledge,” said Alliance founder and president William Schecter, M.D.
“He's one of the favorite visiting professors for the Tanzanians and they love working with him.”
And learning from him.
“Several years ago,” Schecter continued, “he suggested formal courses in various surgical disciplines. His insightful suggestion has grown into four two-day courses so far with more in the pipeline. He has been a key educator in introducing 14 new surgical procedures which were previously not in the skill set of our Tanzanian colleagues.”

Bridging the Gap

Paz is passionate about the nearly blank canvas Tanzania offers. Here's an opportunity, he says, to build a model system from the ground up, one that could potentially be replicated in other countries.
“Just think,” he said. “Tanzania has virtually nothing. They're isolated. Their knowledge and infrastructure are a good 50 years behind us. But the tools they do have can be adequate, if used properly. If we can bridge that gap, if we can somehow fashion a well-run universal system, from designing a triage to training nurses and making efficient use of available resources ... and do it in Tanzania, we can do it anywhere!”
And don't think for a minute, Paz said, that it's a strictly one-way arrangement. “I learn new things every time I go there,” he insisted, citing his favorite example of extreme necessity being the mother of invention:
“Doctors in Tanzania don't do much laparoscopic or robotic surgery. They don't have the equipment. In fact, they don't even have the modern surgical clips and staples that we routinely use. So guess what? They came up with a suturing technique that I'd never seen. It works beautifully! And now I have it in my toolbox!”

Ahead of His Time

His knack for visualizing what's possible, then taking steps to build it, is an impressive quality, and not just in Africa.
“He's 10 years ahead of his time,” exclaimed City of Hope Chief Medical Officer Vijay Trisal, M.D., one of dozens of surgical oncologists trained and mentored by Paz. They've been friends and colleagues for nearly two decades.
“We'd get into these big arguments,” said Trisal, the Dr. Norman & Melinda Payson Professor in Medicine. “Ben's all about health care innovation, with ideas that sometimes seemed crazy. But more often than not, his 'You're crazy!' notions became the standard of care.”
Another Paz “standard of care” is his seemingly boundless energy.
“He's all in, always cheerful, eager and engaged in everything he does,” said Lily Lai, M.D., also a Paz protégé. Their friendship goes back 25 years, and Lai is not the least bit surprised by Paz's workload in Dar Es Salaam or anyplace else.
“He's the Energizer bunny!” she said.

From Chile to Duarte

His path to surgical oncology and City of Hope (he arrived in 1990 as a surgical fellow) took several turns, but Paz's energy and innovative nature were evident early. Raised in Santiago, Chile, Paz planned to be an engineer, like several members of his family. Drawn to biomedical engineering, he attended medical school in Chile to prepare. But when he was exposed to the “manual art, creativity and aesthetics” of surgery, he “fell in love.”
“I started in neurosurgery, in the emergency room,” he recalled. “In Chile at the time, that meant mostly trauma cases ... accidents, fractures, hematomas, usually with bad results.”
He moved on to general surgery but found it “repetitive” and too short-term for his taste. Surgical oncology offered an opportunity to immerse himself in the “science of evolution,” and, more important, to develop deeper relationships with his patients.
Cancer is a marathon,” he said. “My job is to help my patients get back home, whatever it takes. There may be some stumbles and falls along the way, but we'll get there. When you travel anywhere, your real destination is to get back home, isn't it? Same with cancer. The goal is to get you back home. Back to your healthy life.”

The Emotional Side of Illness

Patients making that journey with Paz rave across online medical review sites, calling him a “guardian angel” and someone whose “eyes are full of compassion.” Colleagues say they've tailored their own bedside manners based on watching Paz interact with patients, and personally experiencing his kindness and honesty.
“I don't know many doctors who can look back at the way they handled a difficult case,” said Trisal, “and say, in front of everybody, 'here's where I went wrong.' Ben does that all the time.”
“He's so many things to us,” added Lai. “He cares about each and every one of us, doctors and patients alike.”
“Cancer carries an emotional component,” Paz said. “Patients come in looking for help with all parts of it. Their life, their body image, their independence, their relationships. I tell them, 'There may be some things I can't cure, but I can help you accept and live with the challenges of cancer over the course of your life.' That's healing."

The Value of CARE

His healing philosophy is a big reason why Paz advocates so strongly for a healthy lifestyle (“most breast cancer patients actually die of heart disease!” he pointed out), as well as for “value-based oncology care,” a novel idea slowly taking hold in other areas of medicine, but Paz sees great potential benefits to cancer patients, too.
“Cost makes you constantly reevaluate your care; what you can afford at each step,” he said. “But what if we could package a year's worth of care and put a price on it?” Paz believes it would remove much worry and uncertainty from patients' minds. “I think that's what patients want.”
As for Paz's own future, he knows what he wants. And where he wants it. Once he retires, Paz expects to spend three to four months each year right back in Tanzania.
“Here in America, we doctors are so privileged,” he said. “We have the best facilities, the highest pay, superior work environment. Our challenges are so minimal compared to places outside the U.S.
“I just think we're obligated to give back.”

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