When Gary Lieskovsky, MD, joined the faculty of the Keck School of Medicine of USC in 1980, he and then-chairman Donald G. Skinner, MD, were the only two full-time faculty members in the Catherine and Joseph Aresty Department of Urology.
After nearly four decades on the faculty, Lieskovsky, MD, professor of urology and holder of the Donald G. Skinner Chair in Urology since 1997, is retiring at the end of June. Lieskovsky, who recently was granted professor emeritus status, leaves behind an impressive legacy.
He is credited with helping establish the department into a top-rated program, known for its surgical innovation and research. He also is leaving an endowment in his name that he hopes will continue to help the department build on the success that he and his colleagues created.
Lieskovsky sat down with HSC News recently to discuss his legacy. The interview has been lightly edited and condensed for clarity.
What was it like coming to work at Keck Medicine of USC in 1980?
There were only a few buildings on the Health Sciences Campus when we arrived, compared to the many that are currently present. We had our offices at Los Angeles County + USC Medical Center and we operated on our private patients at Good Samaritan Hospital until the original USC Norris Cancer Hospital opened in April of 1983. At that point, we started performing our private patients’ surgery and providing for their care at that facility. It’s been wonderful to see the transition from virtually nothing to the development of a really major health care campus.
What were some of the major surgical advances you saw in your 37 years that put the Department of Urology on the map?
Two things come to mind. First was in the field of urinary diversion and the development of a urinary reservoir made from one’s own intestine. A urologist from Sweden, Dr. Nils Kock, published an article in the early 1980s about this technique we found very interesting. Before this, patients who had their bladders removed had to wear a bag on the outside of their abdominal wall that would collect urine in an external appliance apparatus, requiring periodic emptying. Dr. Skinner and I felt that by making some modifications to the original Kock procedure there was the potential to create an internal reservoir, which would obviate the need for an external appliance apparatus.
Our work eventually evolved into connecting this high-capacity reservoir to the urethra and relying on the patient’s own continence mechanism, allowing patients to void naturally by simply increasing intra-abdominal pressure and pressing on their lower abdomen. We were one of the first to really popularize this procedure, which is now done around the world. So that was one major innovation at that time.
The second significant development came about in the late 1980s with the discovery of the position of the neurovascular bundles and their relationship to the prostate itself. With better understanding of the anatomy, we had vital information that allowed us to spare the nerve bundles in order for men to retain their potency following radical prostatectomy.
This discovery helped help us get on the map as well. Patients would come to our center to undergo not only nerve-sparing radical prostatectomy, but also procedures where patients needed their bladders removed because of bladder cancer, requiring some form of urinary diversion, preferably a continent neo-bladder instead of having to wear a bag.
From there, these surgical innovations continued to attract thousands of people to USC Norris who were seeking alternatives that weren’t being offered at many other institutions across the world. One of my largest contingents of patients came from Italy, but they came from all over the world and across America. It really was an exciting time for the department and that gained us a reputation for first-class urologic surgery at a world-class National Cancer Institute-designated cancer center.
Early on, you and Dr. Skinner were intent on supporting faculty research. What did that support mean to the department?
We started having philanthropic gifts come our way from many individuals, and received some generous support from the Aresty family and others who helped establish the Butch Walts and Donald G. Skinner Urologic Research Foundation. These funds helped the department flourish because it made it possible for us to recruit some outstanding scientists and clinicians to support their research and get them started in their illustrious careers.
You created the Gary Lieskovsky Fellowship in Urologic Oncology, an endowment of more than $1 million for the department to support faculty research. Why was that important to you?
Endowments are so critical. Without endowments, it’s hard to recruit faculty and give them start-up money so that they can get going and apply for National Institutes of Health grants or other federally funded opportunities. The endowment was made possible by generous support from grateful former patients and some of my personal friends, as well as Dr. Skinner’s contributions from the Butch Walts and Donald G. Skinner Urologic Research foundations. Rather than just use the money one time, this way the money will remain in perpetuity to support someone looking to further enhance their research in the field of urologic oncology.
My hope is it will foster outstanding research by a fellow and benefit patients in the future. That endowed fellowship is part of my USC legacy, of which I am extremely proud.
What words of wisdom do you have for the young people in 2017 who are embarking on their medical careers?
Be resilient and persistent; be prepared to face adversity but follow your dreams and never give up. A lot of people are discouraged by the administrative burden that’s placed on physicians nowadays rather than taking care of the patients themselves. But it’s still a wonderful career. I really enjoyed doing what I did. I loved surgery immensely and will I miss it dearly. I had a phenomenal career, which I have cherished, and I am eternally grateful to Donald G. Skinner for recruiting me to USC and to the university for providing me the opportunity to be part of this great institution and the Trojan family. Fight on!
— Hope Hamashige