If You Could Do Anything You Want, What Would You Do?

In 1975, a young man immigrated to the US from Argentina. The impetus for this move was to ensure his safety given the political situation during the “Dirty War” era in his native country. 

In his pocket was $92 and a work visa for entry into the US.

The young Carlos A. Pellegrini, MD, FACS, was a graduate of medical school and had completed a surgery residency in Argentina. He was alone, but he had been a foreign exchange student in Michigan some 11 years before—and he had a job waiting for him at The University of Chicago in Illinois with David B. Skinner, MD.

The way forward for this young immigrant was uncertain, his prospects equally unsure. Like millions of people escaping repression, Dr. Pellegrini saw in the US the opportunity to live a life of his choosing and to serve others.

A year passed. He worked hard, enjoyed his work, and became close to his mentor; but a foreign medical graduate without an American residency had no way to really practice medicine, at least not the sort of medicine of his choosing. Dr. Pellegrini decided he would repeat residency in general surgery, a situation common to many physicians from other countries.

He sent out 22 applications, but no interviews were offered. He didn’t match. Ultimately, Dr. Pellegrini secured a preliminary year at The University of Chicago in a so-called pyramid program. These programs deliberately accepted more residents than they intended to graduate, creating intense competition and persistent uncertainty about advancement. Such programs no longer exist.

Through his hard work and intelligence, he won the job and graduated from the program.

Now with the credentials of his residency and years of experience, Dr. Pellegrini needed a job. He had come from a small town where his father and mother were general practitioners on the Argentinian plains.

Years ago, while still in his native country, he had hoped to do the same and applied to a special program for rural surgery practices; his best friend got that job.

Now, Dr. Pellegrini hoped to achieve his goal of being a surgeon in a small town on the Midwestern plains of the US. Administrators at the University of Missouri in Columbia accepted him into the program, but it was not to be. 

At the same time, another opportunity became available for Dr. Pellegrini—a job at the new King Faisal Specialist Hospital & Research Centre in Saudi Arabia. This position had a great salary, offered interesting work, a month off each year to study and travel, an around-the-clock driver, and other perks.

Around the same time, Dr. Skinner asked him, “If you could do anything, what would you want to do?”

Dr. Pellegrini replied immediately, “I would do what you do. Be a chief of surgery.”

The next day, a call came from the University of California San Francisco (UCSF). Paul A. Ebert, MD, FACS, chair of the UCSF Department of Surgery (1975–1986) and later ACS Executive Director, would be willing to meet Dr. Pellegrini in Salt Lake City, Utah for an interview. 

This meeting led to a job at the San Francisco Veterans Affairs Medical Center with Larry Way, MD, and later an appointment at UCSF at Moffitt Hospital as Dr. Way’s partner. Dr. Pellegrini’s interests focused on pancreatic and esophageal surgery, and his practice expanded.

Dr. Pellegrini was now a US citizen and had served in the US Army Reserve. In 1991, he was called to active duty for Operation Desert Shield, which became Desert Storm. During the conflict, he served at Walter Reed Army Medical Center in Bethesda, Maryland. By the end of his service, other surgeons had taken up the load at UCSF in his absence.

So, Dr. Pellegrini—surgeon, teacher, soldier—decided to fulfill his dream and eventually was appointed chief of surgery at the University of Washington in Seattle—a position he held for the next 23 years until his retirement. 

During that time, Dr. Pellegrini became a world-famous esophageal surgeon, including doing the first minimally invasive esophagomyotomy in the US. 

When he received his Fellowship in the ACS, he was sent a letter from the College signed by C. Rollins Hanlon, MD, FACS, then ACS President, and the final paragraph stated, “I encourage you to remain active in the affairs of the College, and if you have any questions, do not hesitate to call me.”

Dr. Pellegrini did have such interest, and in his first-year post-residency, he called the ACS and asked to speak to Dr. Hanlon.

After a long pause, Dr. Hanlon came on the phone asking what he could do for Dr. Pellegrini.

Dr. Pellegrini explained that he was interested in being part of the ACS International Relations Committee (IRC). However, Dr. Hanlon shared that the IRC usually is composed of Fellows with considerable experience.

“I have looked at the committee membership, and it seems to be composed of members from the US. I am from Argentina and speak four languages. I believe I can speak with international surgeons in their own language and offer a perspective to this committee,” said Dr. Pellegrini.

A few weeks later, an invitation was sent to Dr. Pellegrini to join the IRC. He worked hard on the committee, eventually becoming its Chair. Dr. Pellegrini then was offered roles on other committees as well. 

Years later, Dr. Pellegrini received the news that he had been chosen to be an ACS Regent. This opportunity would eventually lead a young man from a small town in Argentina, who wanted initially only to be surgeon in a small town far away from the US, to become President of the ACS and a major contributor to the science and practice of surgery in a career spanning 50 years. Dr. Pellegrini had become the person of his dreams. 

He now lives in a small town along the Puget Sound with his wife, Kelly, and has transitioned from surgical icon to executive coach, working with healthcare leaders to help them develop their full potential. 

Dr. Pellegrini has enjoyed his life serving all with skill and trust.

Disclaimer

The thoughts and opinions expressed in this article are solely those of the author and do not necessarily reflect those of the ACS.

Dr. Tyler Hughes is a retired Kansas rural surgeon. Born in Texas, he trained in Dallas but spent most of his career working as a surgeon in McPherson, Kansas. In retirement, Dr. Hughes is traveling the world in search of surgeon stories.

Note from Dr. Hughes: Talking about the “average” surgeon is like referring to an “average” astronaut. Every story is unique; there is no average. In this article series, I will feature surgeons of different specialties, backgrounds, ages, and practice types. Some of the surgeons you may know well, while others have worked in near obscurity. As surgeons, they serve all with skill and trust. If you are an ACS member and would like to meet with me to share your experiences, contact bulletin@facs.org.