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OneThousandOne represents the amount of time, verbally, that it takes to count to one second. In this one second of time, a great thing happened at Nebraska Medicine. In fact, several great things probably happened. A patient was cured, a researcher found the missing link, a nurse treated an injury, a doctor comforted a family or maybe a child just smiled.
MOMENTS IN MEDICINE
Spring | Summer 2013

Lasting Impressions

Michael Moulton, MD, recalls with admiration the first few times his eyes were opened to the field of medicine. He was a young child standing beside his grandfather, Gordon Schulz, MD.

Dr. Schulz was a general practitioner in Union Grove, Wis., a small town at the intersection of U.S. Highway 45 and Wisconsin Highway 11, proud home of the Racine County Fair. His practice encompassed everything from setting fractures and delivering babies to performing emergency surgeries in the office within his home — or atop the kitchen table.

“There was one instance when he had to take a fish hook out of some boy’s head,” Dr. Moulton recalls. “My grandmother and I cleared everything off the table in the kitchen so he could do the work. Then we cleaned up afterward.”

And though Dr. Schulz died when Dr. Moulton was 7 years old, those first impressions of his grandfather’s skills, dedication and genuine concern for his patients — most of whom were neighbors and friends — have stayed with him throughout his own 23-year medical career.

Today, Dr. Moulton serves as professor and chief of Cardiothoracic Surgery at the University of Nebraska Medical Center (UNMC). Respected for his expertise in cardiovascular and thoracic surgery, he leads the collaborative effort to design and launch a lung transplant program at The Nebraska Medical Center’s Transplant Center.

MICHAEL MOULTON, MD

“This facility already has an excellent program in heart transplantation,” Dr. Moulton says, “which gives us a tremendous base to build upon.”

Dr. Moulton was born in Bourne, Mass., on Cape Cod when his father, Harry, was a pilot in the United States Air Force and stationed at Otis Air Force Base (now Otis Air National Guard Base). His mother, Jane, taught fourth grade. He has three younger brothers.

The family moved to Madison, Wis., when Dr. Moulton was very young. The move brought him nearer to his grandfather, Dr. Schulz, and they became close.

Dr. Moulton’s father had earned a Master of Business Administration degree at the University of Iowa. After Dr. Moulton’s paternal grandfather died, the family moved to Des Moines, where Harry Moulton took over the family business, a donut equipment and supply company. Dr. Moulton’s parents, both retired, continue to reside in Des Moines.

Dr. Moulton earned his bachelor’s degree Magna Cum Laude in mathematics in 1986 from Amherst College in Massachusetts, where he played rugby and was a wide receiver on the school’s football team. While an undergraduate at a rugby game, he met his wife, Marylee (Guida), who was a student at nearby Mount Holyoke College. Married 27 years, they have three daughters: Erica, 20, a junior studying English and film at Mount Holyoke; Alex, 18, a freshman in pre-med at Vassar College in New York; and Samantha, 13, a seventh-grader.

Although Samantha hasn’t yet decided on a career, at her age Dr. Moulton had pretty much made up his mind.

“I wrote a report in fifth grade on why I want to be a heart surgeon,” he says. “It was 1970. Dr. (Michael) DeBakey (a pioneer in the development of an artificial heart) was on the front page of Time and Life magazines. Cardiac surgery was a hot topic, and I was fascinated.”

His report reviewed the study of circulation, the history of heart surgery and the introduction of devices including shunts. “It was a very detailed report,” he says, smiling. “My mother still has it.”

He obtained his medical degree from Harvard Medical School in Boston, Mass., in 1990 and went on to post-graduate training at the Washington University School of Medicine in St. Louis, Mo. He trained under Joel Cooper, MD, who in 1983 performed the first successful single lung transplant at the University of Toronto.

Upon completion of his residencies in general surgery and cardiothoracic surgery, Dr. Moulton went on active duty in the U.S. Air Force. “They had paid my way through medical school, so I owed them eight years,” he says.

He served as chief of Cardiothoracic Surgery and acting chief of Surgery at Keesler Air Force Base in Biloxi, Miss., until Hurricane Katrina “wiped out the hospital” in 2005. He moved on to become staff surgeon at Davis-Monthan Air Force Base, then at the Southern Arizona VA Health Care System, both in Tucson, Az.

“It was one of the busier places in Iraq at the time. I did mostly trauma surgeries.”
Michael Moulton, MD

In late 2006 and early 2007, Dr. Moulton was the surgical flight commander at Balad Air Force Base in Iraq. “It was one of the busier places in Iraq at the time. I did mostly trauma surgeries.”

While in Tucson, Dr. Moulton served as a professor of Cardiothoracic Surgery at the University of Arizona College of Medicine. He became involved in the lung and heart-lung transplantation programs there, and in 2007 he was named surgical director for the programs. He performed approximately 100 lung transplants in five years.

He also served as director of the cardiothoracic residency program, as chief of staff elect for the University Medical Center, and as vice chief over the division of Cardiothoracic Surgery.

He left Arizona and came to UNMC in February 2012. “The opportunity to be the chief of a division and implement a lung transplantation program presents a lot of potential,” he says.

Creating a lung transplant program at The Nebraska Medical Center requires a university-wide collaboration that includes hospital and university administrators and the UNMC strategic planning committee. “We have to coordinate personnel, resources and equipment,” he says. “Because we have a very successful solid organ transplantation program, we already have a good idea of what we will need.”

Those needs include hiring a pulmonologist experienced in transplantations, as well as integrating many other elements, from infectious disease control and nurse practitioners to social workers and the pharmacy. “We also have to restart a pulmonary rehab program, which we haven’t had here for 15 years,” he says.

DR. MOULTON WITH WIFE, MARYLEE; AND DAUGHTERS,
SAMANTHA, ERICA AND ALEX

The new program will follow procedures established by the United Network for Organ Sharing (UNOS), a private, nonprofit organization that manages the nation’s organ transplant system under contract with the federal government. UNOS maintains the national transplant waiting list and organ transplant database, and it helps develop policies to make the best use of the limited supply of organs available.

The lung transplantation program at The Nebraska Medical Center must record 10 transplants in its first year to qualify for Medicare approval. “After that, we anticipate performing 30 to 35 or more per year,” says Dr. Moulton.

Dr. Moulton makes the most of his free time by reading, traveling with his family and playing golf. “Although the busier I get,” he says, “the less I play.”

He may have to put the clubs away for a while, as the new lung transplant program is certain to be all-consuming once it gets underway. “There is definitely no shortage of people with end-stage lung disease,” he says, anticipating significant demand for the program. “We’ll be limited only by the availability of donor organs.”

Establishing a major lung transplantation program is a long way from watching his grandfather work at that kitchen table so many years ago. But those skills Dr. Moulton witnessed as a child, and the values he learned, continue to guide him today.

Next article in the Spring | Summer 2013 issue of One Thousand And One:
A Special Connection