Skilled Hands of a Cardiac Surgeon and Violinist
By LAWRENCE BUSER
Baptist Medical Group's John Michael Craig, MD, has demanding morning warm-up
John Michael Craig, MD, said with a laugh that his interest in medicine began soon after high school at Harding Academy when empirical reasoning told him his 85-mph fastball was not going to be a ticket to the big leagues.
He liked working with people, he liked challenges, and he liked science, but what he really liked was providing care to another human being.
"There were no other careers like medicine that provided that depth of interconnection with people," recalled Craig, a thoracic and cardiovascular surgeon with Baptist Medical Group since 2012. "I try to impress that upon my students. I'll ask them 'What's the most important thing we do in medicine, and why are we here?' You might say it's to do the best cardiac surgery we can do, to perform our specialty at the highest level. You might say it's to perform the most skilled surgical operations possible or provide cutting edge medical technology.
"Those are good answers, but the number one, most important thing we do in medicine is alleviate the suffering. When you think about things in that context, you see your mission as a physician much more broadly than 'Hey I'm here to perform the technical aspects of a cardiac surgery.' There's a much bigger picture."
Craig majored in biology and chemistry at Southern Adventist University in Chattanooga. He then graduated from the University of Tennessee College of Medicine at Memphis, where he also did an internship and residency in general surgery and a fellowship in vascular surgery.
"I was planning to go into general surgery, but during my second year of residency when I did my first rotation on a cardiac-thoracic service, it just blew me away," he said. "Cardiac surgery wasn't even on my radar, but it was so fascinating: the physiology, the cardiovascular system, the laws that govern blood flow, the physics behind it, the surgical techniques and seeing the machinery of the body at work while looking into the chest during cardiac surgery. It was like standing at the edge of the Grand Canyon. It can make you feel very small.
"It is a really special moment every time, and I haven't ever lost that sense of reverence and respect for the human body. There was nothing else I'd seen in any field of medicine that really captivated my sense of awe like cardiac surgery."
Craig was then accepted to a three-year training fellowship at Harvard's Massachusetts General Hospital in Boston. He was happy, though, returning to Memphis to be with family and friends.
"Going to Mass General was like winning the lottery, and at the beginning of my career in Memphis it helped me get my feet on the ground in a very established, very good field of surgeons," said Craig, who calls himself a Memphian by choice as well as by birth. "It can be daunting for a younger surgeon to break into that, so (the Harvard training) added a little curiosity on the part of the referring doctors. I also had the support of those surgeons who trained me here, and you know when you train somebody you look at them like they're your kid. You want to see them go far and do well."
The Baptist heart transplant surgeons perform 15 to 20 heart transplants per year. The life expectancy of patients averages 10 to 15 years, although some of their heart transplant recipients are 30 years out and still doing well.
"Now keep in mind, their average life expectancy before they get these transplants is about six months so you can see what a miracle that is," said Craig, adding that they range from the teens to the 70s in age. "I just saw a guy in my office who is 20 years out from his transplant and in his 70s. He's been under very close surveillance and his heart's working beautifully.
"It takes a lot more than just a surgeon to perform an operation and have a good outcome. You develop confidence through repetition and history, but it also comes from knowing that you're surrounded by a robust team of professionals who will go all out for the patient.
The COVID-19 virus that can ravage the lungs has created a new demand for a cardiac-respiratory support treatment called extracorporeal membrane oxygenation or ECMO. It is a treatment of last resort for a select group of critically ill patients who have run out of options.
"We basically use the lung component of the heart-lung machine to support or do the work of their lungs," said Craig. "We normally would have a patient with respiratory failure on ECMO for about two weeks, but with COVID we've seen patients survive runs of 10 weeks, which is not something we previously thought was possible. We've learned to just persist through the ups and downs because some may survive a really long run. We are still trying to understand the long-term effects of COVID infection on the lungs but many of the ECMO patients have made tremendous recovery."
There is no typical day for Dr. Craig. He's often putting out fires, large and small, which can be disruptive to a "routine" schedule. He may be part way into his morning, but then find himself making a time-sensitive surgical trip to another hospital in another state.
"It is not unusual to embark on the plans and commitments for a given day and then unexpectedly find myself in Texas a few hours later harvesting a heart."
Perhaps the one constant is his unique morning routine to warm up his body and his mind.
"For me to feel like I'm on top of my day I get up at 3 o'clock in the morning, then do some fairly intensive exercises since surgery's a bit of a physical job," said Craig, who was a triathlete during his residency. "Then I play the violin as a mental exercise. They know from doing PET scans that playing music uses more parts and functions of your brain simultaneously than just about anything else.
"There's the playing, the reading, the music, the right and left hands doing different things. You're using fine motor skills. You've got to warm up your body and your mind in order to perform at your absolute best."
He credits his wife Julie for her support and for the sacrifices when medical emergencies call him away from holiday gatherings or for the three birthdays of their four children - Thomas, 14, Emily, 11, and 7-year-old twins Catie and Andrew.
Craig enjoys coaching his sons and their teammates in baseball. Recently they were practicing outside despite some chilly January temperatures. During their workout, their head coach happened to show up unannounced.
He made sure the moment was not lost on the boys.
"You're working hard out here in the freezing cold, doing the right thing when you think no one is watching," Craig told them. "That's real integrity."