How could a machine do her daughter’s uterine cancer surgery and make serious medical decisions?
“My mother had doubts because she didn’t understand the technology,” reflects Verdoorn. “I wasn’t worried because I knew my doctor, Jowell Wilder, would be fully in charge and directing that robot every step of the way.”
Verdoorn’s surgeon, Dr. James L. “Jowell” Wilder, one of San Antonio’s busiest gynecologic oncologists, uses a remarkable machine called the da Vinci Robot in about half of the 10 female cancer operations he does each week at North Central Baptist Hospital.
Though the da Vinci named after legendary Leonardo isn’t suitable for every situation or every patient, the surgeon still maintains that it’s a modern marvel that can make certain operations — primarily those for female cancers and male prostate conditions — much less traumatic.
According to Wilder, robotic-assisted surgery can mean less pain, less bleeding and usually less time spent on the operating table and in the hospital. Additionally, the operating room staff can be smaller, which, along with the previously mentioned factors, makes the method promising for driving down health care costs. It’s also the likely harbinger of even more efficient and versatile high-tech devices to come.
“Possibly, this is the future of medicine,” the surgeon says.
It’s a glowing prognosis. But be forewarned: If you’re expecting something cute like little R-2 D-2 of “Star Wars” fame, you’re going to be disappointed.
The da Vinci is a faceless, four-armed, no-nonsense, clinical-looking contraption made up of two major components. One component has the four arms that really act like surgical hands — a hand to hold a camera; three to hold laparoscopic operating instruments. The hands access the surgical site through small incisions and ports, making large incisions common in open hysterectomies unnecessary.
“A definite plus,” declares the doctor.
The surgeon is stationed at the robot’s second component, which features a sort of View-Master. Gazing into this gadget, the medical expert can see the affected area and by zooming up, down and manipulating the robotic hands, he’s hopefully able to eliminate the cancer with amazing precision and accuracy.
Eliminating female cancer became Wilder’s passion after seeing his beloved grandmother stricken with the disease. The experience changed his direction in life.
“I wanted to be a pilot originally,” recalls the surgeon who was born in Kingsville. “However, with doctors on the Lowell side of the family, I guess medicine wasn’t too far afield. Anyway, in many respects sitting at the controls of the da Vinci isn’t much different from flying a plane. A pilot has to handle the craft right to get passengers to their dest inations safely. And it’s the same thing with the robot. I have to be up on the technology to get the job done.”
The surgeon acknowledges that all this is a big responsibility. Despite loving his patients and his practice, his medical career can be stressful. To unwind, he likes to spend time enjoying outdoor activities with his children Mary, 9; Hank, 7; and Sam, 5. And if you ask him about his ultimate goals, he emphasizes that being a good doctor is what matters most professionally but being a good father is what counts personally.
“I want to help my children grow up healthy and happy. That’s my top priority,” Wilder declares. “They’re such wonderful kids.”
Another priority: exploring the “cerebral aspects” of medicine. The more you study and the more you learn, the more you can do for your patients, he points out. And it’s the advice he passes on to young men and women just entering medical school, encouraging them to master all aspects of surgery — and not just the newer less-invasive methods but traditional open surgery as well.
Dr. Jowell (his nickname combines first name James and middle name Lowell) got his medical degree at the University of Texas Health Science Center, did his residency in obstetrics and gynecology at the Medical University of South Carolina and furthered his expertise with a fellowship in gynecologic oncology at the University of Kentucky Medical Center.
In 2005, he moved to San Antonio and opened his private practice, South Texas Gynecologic Oncology. And In 2007, a couple of years after the da Vinci Robot appeared on the medical scene, he began studying the system’s benefits and became an expert in the technology.
Admittedly skeptical at first, he wondered if the machine could really do all that was advertised. That skepticism faded, however, as his abilities at the controls and skill at handling the device increased and satisfied patients praised the procedure.
Dr. Dilma Ruiz-Friel, a general surgeon who has often been in the operating room with Wilder, admires her colleague’s surgical skill. But she admires his humility and willingness to ask for advice even more. Ruiz-Friel also is impressed with the way Wilder cares about his patients’ feelings and considers the person, not just the case.
Seventy-three year old Gerry Seaman, diagnosed with stage-four ovarian cancer, saw this caring attitude when she was facing surgery. As she sat on the examining table, Wilder gently asked: “Mrs. Seaman, what do you expect after all this?” She mulled it over and then spoke of simple hopes and dreams:
“You know, doctor, I just want to cook, clean house, work in the yard and be like I was before this was discovered.”
So, Wilder went into the operating room, not only to fight a virulent cancer but to restore the small satisfactions in life that had always mattered to a sweet woman. And to date, he has been successful.
“They tell me there are no signs of cancer pathologically now,” Seaman reports, “and I’m back to doing many of the things I enjoy, which really is a miracle. That Dr. Wilder is a great surgeon — with or without any robot.
