The first time Bruce A. Perler, MD, attended the Southern Association for Vascular Surgery (SAVS) annual meeting, he was a young faculty member who had already started developing the keen interest in carotid disease for which he is now well known, but otherwise a self-described “nobody” in the company of greatness.
It was 1986, and he was attending an evening reception, when, from across the other side of the room, he spotted Jesse E. Thompson, MD, “the dean of carotid disease,” who, to Perler’s surprise, suddenly walked across to introduce himself to the up-and-comer. “Then he led me back across the room to meet his wife,” remembers Perler. “Here’s this major hero of mine, this iconic figure in vascular surgery, talking to a nobody.” It was a seminal moment for Perler, an interaction epitomizing to him the culture of SAVS, “what makes it such a special organization—not just great science, but the collegiality, friendship and mutual respect.”
The encounter might be viewed as a portentous moment in the career of the Johns Hopkins Hospital, Baltimore, Maryland, Julius H. Jacobson II, MD, endowed chair in vascular surgery, vice-chair for clinical operations, and chief emeritus of the division of vascular surgery and endovascular therapy. Thompson was the first-ever recipient of the prestigious Rudolph Matas Lifetime Achievement Award, which SAVS bestows to recognize a lifetime of excellence, achievement and contributions to the field of vascular surgery. Now, Perler joins a small band of Matas awardees as the latest following in the wake of the man for whom the accolade is named and who was once hailed “the father of vascular surgery.”
Perler’s route to the gilded award is not inconsiderable. The list of career milestones and accomplishments belonging to him require breathless delivery to achieve relative brevity. But incoming Society for Vascular Surgery (SVS) President Ali AbuRahma, MD, one of a trio of former SAVS presidents behind his nomination, makes a fist of it in his formal letter of recommendation.
A sampling: Vascular chief. SVS president. A consultant to the Circulatory System Devices Panel of the Food and Drug Administration (FDA). Executive vice president of the American Board of Surgery-Vascular Surgery Board (ABS-VSB). Chair of the SVS Foundation. President of the Eastern Vascular Society. And, the most relevant past role in the context of AbuRahma’s compiling of the list: SAVS president.
“It seems that we tend not to see much of the past presidents, but not Dr. Perler,” AbuRahma commented in his letter. “In spite of Dr. Perler’s busy schedule, he has not missed one single [SAVS] meeting over the past 25 years. In summary, I believe Dr. Perler is most deserving of the Matas award given all that he has done, not only for the SAVS, but the field of vascular surgery.”
Rarely bestowed honor
Gilbert R. Upchurch Jr., MD, the immediate past SAVS president, who formally handed Perler the award, pointed out the accolade is not given yearly but to individuals who have shown continued and persistent leadership to the Society over the years—last being awarded in 2017. “Dr. Perler has accomplished everything there is to accomplish in vascular surgery,” he said. “He is a brilliant scholar with a quick wit. He is functionally undefeated in any debate regarding vascular surgery as his debate skills are unparalleled. He has edited the JVS and presently serves as the editor of Rutherford’s Vascular Surgery and Endovascular Therapy. He remains a tireless supporter of the SAVS.”
Yet Perler himself, presented with this list, first returns to his presence in the company of Thompson 35 years ago, commenting, “I’m obviously proud of my contributions to the specialty and the leadership positions I’ve been entrusted with over the years, but, ultimately, I still consider myself primarily and, most importantly, to be what I was in 1986, a vascular surgeon,” he tells Vascular Specialist.
His career interests cover the entirety of the vasculature and beyond to vascular surgery’s place in the firmament of medicine. “I take care of the totality of vascular disease but I’ve always had a special interest in carotid disease and stroke prevention,” he continues. “I feel truly blessed to be a vascular surgeon, and to be entrusted to care for the vascular surgical needs of my patients. I’m a great fan of James Collins, the business writer, who wrote something along the lines of, ‘It’s impossible to have a great life unless it’s a meaningful life, and it’s difficult to have a meaningful life without meaningful work.’ I can’t think of more meaningful work, or a better way to spend one’s professional life, than caring for the surgical needs of our patients.”
Longitudinal vascular care
Perler holds up vascular surgery as a singular discipline within the treatment of the vasculature. “We’re truly unique among those who care for vascular disease,” he says. “I talk often about vascular surgery exceptionalism—not that we’re better than the others; we’re not; but we are unique in so many ways. We’re exclusively devoted to the care of vascular disease; we provide the totality of care—medical therapy, endovascular and open surgery—and we follow our patients for life. I literally have patients I’ve been following for 20 years or longer.”
Perler considers himself fortunate to have been entrusted with numerous leadership positions, but one role in particular stands out. “I think one of the most important jobs I’ve ever had was to be co-editor of the Journal of Vascular Surgery, which not only symbolizes vascular surgery leadership in the care of circulatory disease, but as an incredibly important financial asset of the Society for Vascular Surgery, and I’m very proud of the nearly eight years that my co-editor, Tony Sidawy, MD, and I had, and the condition in which we left the journal, and also that we started two new journals, the Journal of Vascular Surgery: Venous and Lymphatic Disorders, and the SVS’ first open access journal, the Journal of Vascular Surgery: Cases and Innovative Techniques.”
Looking ahead, Perler sees a bright future for the vascular specialty. “These are tough times for medicine in general and tough times for vascular surgery, but I think it was Albert Einstein who said, ‘In difficulty lies opportunity,’” he says. “I think vascular surgery has enormous opportunity moving forward. The patients we serve are only going to increase in number, we’re one of the—if not the—most innovative specialties in medicine and surgery. New treatments, whether they be technological or medical, stem cell or the use of artificial intelligence, I think the future is bright. It’s really incumbent upon us senior surgeons to encourage as many bright young people to become interested in the field, get them into the field, and make those contributions.”
For those potential future vascular surgeons, Perler has a message: Seize on opportunities when they present themselves. He also offers pearls of wisdom for the vascular career beyond. “I’ve always believed the toughest thing in the world is to try to be somebody you’re not,” Perler says. “The easiest thing to do is to be yourself, and that’s how I’ve conducted my professional life. I’m honest, I think I do the right things for the right reasons, and try to treat people right. I think people pick up on that, they recognize that, and that’s how you get to be asked to be president of this, or editor of that. Once given those opportunities you have to deliver.
“I’ve observed that people aspire to positions of leadership for one of two reasons: Some people want to be something, and other people want to do something. I think ultimately the people who want to do something are the ones who are going to be successful. That’s how I’ve tried to conduct my professional life. As in basketball, let the game come to you. But when opportunities arise, seize those opportunities and give it all you have. To receive a lifetime achievement award, for this old burned-out taxi driver that I used to be, and who still carries his taxi driver’s license in his wallet to remind him of his roots, is enormously humbling and kind of overwhelming.”