Mark Briesacher, MD: I'm Dr. Mark Briesacher, Chief Physician Executive at Intermountain Healthcare. Today we have a guest host, Dr. Anne Pendo, who is interviewing one of Utah's healthcare heroes.

Dr. Anne Pendo: Good morning. I'm Dr. Anne Pendo, a practicing internist and Medical Director for the Intermountain Medical Group. I'm pleased today to be here with Dr. Kent Jones, a Cardiovascular Surgeon who was recently awarded a lifetime achievement award by Utah Business as a healthcare hero. Kent and I have shared many patients throughout our careers, and I've always been so grateful for his expertise and kindness in caring for patients with complicated cardiovascular illness.

We wanted to take some time today to have a conversation to acknowledge the great work that you've done over these years, and I believe that a lifetime achievement award means that you have had consistent excellence in your work, so congratulations.

Dr. Kent Jones: Thank you, I appreciate that. Probably it partially means you're just old, too.

Dr. Anne Pendo: Well that's also a possibility. I thought it would be interesting for our audience to learn a little bit about how you got into medicine in the first place, and share a little bit about you before you became a physician.

Dr. Kent Jones: Well, ever since I was seven years old, my goal was to be a professional baseball player. I played all the way through college, and then finally realized that I'd met my peter principle and I wasn't going to, that was not going to be my career, so then, I decided I needed to find a job. I really liked the sciences, and I had a good friend who was a dentist here in Salt Lake, who talked me into becoming a dentist. I went through pre-dent, and got accepted to dental school at the University of California, and about ten days after I got there, I realized that I made a big mistake.

I didn't know really how to get out of it, so I knew I liked, just from anatomy, I knew I'd like the surgical part of dentistry, I guess you say, so I sort of resigned myself, "Oh, maybe I'll be an oral surgeon."

Dr. Anne Pendo: Okay.

Dr. Kent Jones: I applied to medical school, and didn't hear, didn't hear, and my friends who were in pre-med were all getting accepted in November, December of that year, and I never heard a word, so I was resigned to the fact that, "Well, I'm going to be a dentist," and then just out of the blue on the 12th of March, that following year, I got a letter in the mail from the University of Utah Medical School saying I'd been accepted. I assumed there was some poor fellow or lady that decided they didn't want to be a doctor, and so they opened up that spot.

I took it that day, quit dental school that same day, and came back. I had a job with the highway department while I was in undergraduate school. They gave me my job back, so I worked on the highway department until medical school started. Then, shortly after I got into medical school, just in comparative anatomy, I'd had comparative anatomy in dental school, and the heart fascinated me, so I really knew as a freshman that that's what I wanted to do. I wanted to be a heart surgeon.

Dr. Anne Pendo: What was it about the heart?

Dr. Kent Jones: It was just fascinating to me, how it worked, what it did, and how it did what it did. I'm sure that people that work with the brain, it's sort of the same way, but anyway the heart was sort of what fixated, I was fixated on that, and just ... I worked, in the summers, I worked initially, my first summer and after my freshman year, I worked in cardiology, and then for my sophomore and junior years I worked up at LDS Hospital with Dr. Russell Nelson, just in the summers. That's how it all began. I'll never look back.

It's interesting, and I've told my kids this too, it doesn't matter if you go down a road and you feel it's the wrong road, as long as you back up and find the right road, because that's the main thing. If you stay down the wrong road for the rest of your life, then your job is not a pleasant one.

Dr. Anne Pendo: No, what's the joy in that?

Dr. Kent Jones: Exactly. I had to back up a couple of times, but finally found the right road.

Dr. Anne Pendo: You've been doing this for many years, so it must have ...

Dr. Kent Jones: I finished, I went to Duke University and did my internship and residency, and then for two years, and then I went to the National Institute of Health, up in Bethesda, Maryland at the Heart Institute up there. Then, I came back and finished the residency at Duke. I came back here in 1977, so this is my 40th year of doing what I love doing.

Dr. Anne Pendo: That's so great, congratulations.

Dr. Kent Jones: Thank you.

Dr. Anne Pendo: When you think about a 40 year career, there are moments that stand out. Can you share some of those with us today?

Dr. Kent Jones: Probably the first one was, when I came back, they didn't have a heart surgery program at the university. The fellow that had been chief there left to go back to Los Angeles in 1973, I think it was, so I sort of restarted the program there in 77. I was hired at the university, but I also worked at LDS Hospital with Dr. Nelson and Dr. Conrad Jenson, so it was sort of a hybrid. I was working at both places, but the first case I did was at the university, and I looked across the table, and the resident we had was about five foot six, not that height had anything to do with it, but as I looked across the table and thought, "You know, if I get into trouble here there is not one person in this hospital that can bail me out."

Dr. Anne Pendo: Wow.

Dr. Kent Jones: That's the first time that occurs. As long as you're a resident, you think, "I'm doing this case, and I'm really cool, and I can put this aortic valve in," but in the back of your mind, whether you know it or it's subconscious, you know that there's this guy across the table that, "If I get into trouble, I've got somebody that's going to bail me out. I've got this mentor," and all of a sudden the mentor was gone and the buck stops here, so to speak. That was a very sobering moment.

Dr. Anne Pendo: Yes.

Dr. Kent Jones: I think that sometimes that becomes a very hard reality for residents, especially in cardiac surgery, for instance, where all of a sudden you're driving the bus.

Dr. Anne Pendo: Right.

Dr. Kent Jones: That reality never really hits until it's there. That was a, and then I got interested in heart transplantation, and that was really when it was in it's infancy. I went, Dr. Norman Shumway was sort of the leader in that at Stanford, and I got to be pretty good friends with him, so I went out to Stanford and sort of hung around with him and learned the procedure, watched him do the procedure, did the procedure on animals, and finally I decided I wanted to do it in humans. That was a very, what would you say, almost satirical experience, I guess you'd say.

The patient was a fellow named Sam Hart. I'm sure he doesn't mind that I mentioned his name.

Dr. Anne Pendo: I like that his last name is heart.

Dr. Kent Jones: It was a very appropriate name. Sam lived for almost 30 years. He just died last year.

Dr. Anne Pendo: Wow.

Dr. Kent Jones: That was, and then there's been instances along the road, and I think that's what has really been the stimulus for me, has been just the appreciation that you see in patients, that you possibly give them another chance in life, so to speak.

Dr. Anne Pendo: Yes.

Dr. Kent Jones: I think that it's almost an endorphin type effect. It is a real stimulus, and it is what makes you want to get up and go to work every day. That's been the real stimulus for me over the years, is just the patients that I've had the opportunity to work with and hopefully the majority of them helped.

Dr. Anne Pendo: Yeah. On a personal note, my father had his first bypass surgery at age 57, right when my oldest son was just six weeks old. He passed away just this year, this last year, and my son is now 30. I think of that not infrequently. The years that he, my father, got to spend with our family, to see his grandchildren grow up. You called it a gift, and that's really how I and my family see it. It was a gift that we were given and that he was given, and I think that the technical components and the touching the heart, and doing all of that is obviously critical, but I think your comment about, it's the patients and their families, is the motivator for...

Dr. Kent Jones: Yeah, no question about it. I think that's been the major, as you say, motivator that ... You know it's great and you probably found the same thing, it's great to be able to get up in the morning and enjoy going to work because I think the majority of people don't have that privilege.

Dr. Anne Pendo: Yes.

Dr. Kent Jones: Where you really look forward to going to work, because you know, obviously some days are hard.

Dr. Anne Pendo: Yes.

Dr. Kent Jones: It's that, but that's the component that really makes it enjoyable. It's not the pats on the back that you get. It's the true appreciation that you see from patients and their families, and I think that's the real, what would you say, the real driver that keeps you going.

Dr. Anne Pendo: Yeah, I love that.

Dr. Kent Jones: Yeah.

Dr. Anne Pendo: Before we started our podcast, you talked about at times doing surgeries and feeling as if someone else was guiding you. Are you comfortable sharing a little bit more?

Dr. Kent Jones: Yeah, I don't mean to sound like a religious zealot, but I, yeah there have been times when I have felt that someone else has guided my brain and my hands, and that's a, what would you say, it's an experience that you can't quite describe.

Dr. Anne Pendo: I think powerful and humbling at the same time.

Dr. Kent Jones: Yeah, and I've had situations where I've done things in the operating room that somebody said, "How did you do that," and I've said, "I don't know." Yeah, I have had experiences like that, and I think in life, we all probably experience it in one way or another, situations like that where we don't exactly know where we got that idea, or who told us that, or how we ended up doing what we did, but yeah, I've had experiences like that, that have been very, well, spiritual, I guess you'd say.

Dr. Anne Pendo: Yeah. Thank you for sharing that. As you're talking, you've got a big smile on your face as you're sharing those moments, and I can tell how meaningful it is to you. Thanks. We also talked a little bit before about medicine in the future, and I think having had a 40 year career gives you an appreciation of where we've been in medicine, and where we're going. I'm wondering if you would share a little bit about your thoughts of the changes that we're seeing, and what your opinion is of medicine in the future.

Dr. Kent Jones: Yeah, I think, I've really enjoyed, appreciated and respected where we've been. I, in many ways, worry about where we're going.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: A long time ago, I wish I could remember his name. There was a professor at Harvard who gave a talk at the American Association of Thoracic Surgery, just talking about, and this was probably 15 years ago, where medicine was and where it's headed, but I remember him showing a slide of a pyramid, and showing a different compliments to medical care, but at the apex of that pyramid was the patient. I hope we never lose that focus.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: Because in ways it's easy to do. With all of the scrutiny now that's placed on physicians, on hospitals, that we almost, at times forget about the patient because of all the other things we have to worry about.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: That concerns me. I understand there's only so many dollars to go around, and everyone has to be very cognizant of that, but at the end of the day I just hope that we never forget that your Dad was a patient, and he needed medical care, and he needed certain things done that were done, that gave him 30 years of quality life.

Dr. Anne Pendo: Yes.

Dr. Kent Jones: I hope that we never forget that part of it because we have to take so much time worrying about the other things, and that concerns me. In many ways, in the past it was a lot easier to do what we loved doing, and what we really were good at doing, than it is now.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: What do you think? I mean you're a, you know, it's harder to devote the time that we need to devote to patient care because there's so many other things that we have to ...

Dr. Anne Pendo: Right. I call them distractions.

Dr. Kent Jones: Yeah.

Dr. Anne Pendo: You know, there're distractions, and I mean I chose medicine because I like patients, and that's the work that I want to be doing. I agree with you that sometimes we lose sight of the work, of the why, and it's the patient. As I attend huddles, or meetings really, I talk about pause and be present. I do that when I go in to see patients. I get rid of the distractions that are in my mind, whether it's the EMR distraction or a difficult conversation distraction, and I try and do that very same thing when I go into my administrative meetings, that pause and be present. Remember: we're here for the patients.

Dr. Kent Jones: Yeah.

Dr. Anne Pendo: I think that's a good reminder of why we do what we do.

Dr. Kent Jones: Yeah, I agree with that, and I think that it's becoming more of a challenge in that respect. I hope that we never lose sight of that, that we never, that we can put those distractions where they need to be in order to take care of the business at hand, that being, "How am I going to get this patient well?"

Dr. Anne Pendo: Exactly.

Dr. Kent Jones: I think that's becoming more of a challenge, no question about it.

Dr. Anne Pendo: Yeah, that's true. I'm leaving today, our meeting, to go see a patient in the hospital, who's on Hospice, and I don't see patients in the hospital anymore, but I know it's going to be a sad visit, and hopefully it will bring her family, and her, some comfort, but I also know that it's important for me as well. As I think about my career, your career, doing what we do, those patient moments are important in both directions.

Dr. Kent Jones: Yeah, no question about it. Sometimes those times are hard.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: It's certainly the times that you can sit down with a patient's family after you come out of the operating room, and say everything went fine and I think he or she is going to do well, and luckily those far outweigh the times that you talk about.

Dr. Anne Pendo: Exactly.

Dr. Kent Jones: Those are the tough times. I think that those are the times that a patient, a family, needs us as much or more than any.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: For you to take the time and the effort to spend time with somebody that's in a very difficult situation, I admire that. I think that's part of being a doc.

Dr. Anne Pendo: It is.

Dr. Kent Jones: That's the hard part of it. Luckily the positives outweigh, I'm not sure that's a negative as much as it is just a difficult situation.

Dr. Anne Pendo: Right.

Dr. Kent Jones: Families need that, and those times even more than in the good times.

Dr. Anne Pendo: Exactly. We have just a few more minutes, and I want to talk about heroes. Obviously you are one of our hometown heroes in Salt Lake. Who do you think of as your hero, or when you think of a hero to you, who is that?

Dr. Kent Jones: I'm not sure I have one.

Dr. Anne Pendo: Okay.

Dr. Kent Jones: Dr. David Sabiston was my chief back at Duke, and was a very world famous physician, cardiac surgeon, but I think what he taught was, he never sat me down and said, "Kent, let me give you a list of things you need to do if you want to be successful," so to speak.

Dr. Anne Pendo: Right.

Dr. Kent Jones: He just did them, and what I learned was, I watched him and realized if I'm going to try to be successful in this career, I need to do this, this, and this, that Dr. Sabiston's doing. I think what he taught me was that you lead by example rather than your mouth.

Dr. Anne Pendo: I love that.

Dr. Kent Jones: I've tried to do that, but my wife thinks almost to a fault, and that, "Why don't you sit down and tell people more of what ...," but I think it was that he taught me that you don't it that way, that you do it by what you do. People, hopefully respect you enough that they will watch you and say, "If I'm going to try and be like him or her, I need to do what he or she does."

Dr. Anne Pendo: Right.

Dr. Kent Jones: He was probably one of the major. I had a mentor back at Duke, who's still really a good friend of mine, Walt Wolfe, that taught me technical surgery, that when I wasn't very good, he stayed there with me and made me better.

Dr. Anne Pendo: Wow.

Dr. Kent Jones: Donald Lappe, a cardiologist here in Salt Lake, I've worked with for almost, well 38 years, I think, and probably been one of my closest friends, mentors. Kind of a funny story, when Don started, I was just the new kid on the block up at LDS, and it was a Saturday morning. In those days, cardiac surgeons put in pace makers, it wasn't the cardiologist, but a pace maker, you know technically, usually isn't a difficult thing to do, and so he would call me, "You're Kent Jones and you're a heart surgeon here. I'm Don Lappe. I just got started here. I've got this patient that needs a pace maker. Can you put a pace maker in," and you know, not saying it but sort of thinking it. He said, "Me? I could do that behind my back."

I take this guy down to the cath lab, in those days, and literally I could not find the subclavius. I took me like four hours to put this pace maker in, and I'm sure at the end Don thought, "this guy's the biggest bozo I've ever seen," but anyway, he stuck with me, and we became good friends, so you know, I think Brian Whisenant, the cardiologist that I work with now who's just a great cardiologist, a very progressive, structural cardiologist that I work with, and that's been a real great experience for me, because I started working with Brian back in 2009, on the transcatheter valves.

Dr. Anne Pendo: Right, right.

Dr. Kent Jones: To be very honest with you, the reason that I got into it was, I'm not going to let those dang cardiologists horn in on my turf, but as I started working with him, we started doing the catheter valves, I started saying, "Hey, this is pretty neat," and so I have really taken a 180 on that, as far as he's been a great partner.

Dr. Anne Pendo: That's so great.

Dr. Kent Jones: There's been a lot of them, if you will, heroes, my partners that I work with couldn't be better people, as well as cardiac surgeons.

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: There's really been a lot of heroes.

Dr. Anne Pendo: I think that's so great. I think it's great that you've got heroes from early parts of your career, and more recently.

Dr. Kent Jones: Yeah. I've never forgotten the early ones because they've sort of laid the path, so to speak.

Dr. Anne Pendo: Yeah. Well thank you. Thank you so much.

Dr. Kent Jones: You bet.

Dr. Anne Pendo: I know this has been, well this is not an early morning for you, but I know that you are headed to the operating room, and we want to get you there in time, so congratulations on your award, and thank you.

Dr. Kent Jones: Oh, thank you. I appreciate the opportunity to meet with, and to talk with you because, and you know, Intermountain's been a great leader in this area. A long time ago, when I sat down with Bill Nelson, who was the CEO of Intermountain at that time, that was probably 25 years ago, I guess, but anyway we were one of the first groups to be incorporated into Intermountain. When we finished that negotiation, so to speak, and I said to Bill, I said, "You know when we get up from the table and shake hands, if in your mind you're thinking man, I got a good deal here, and in my mind I'm thinking man, I got a good deal here, this is going to work. If either one of us are thinking something else then it's not."

Dr. Anne Pendo: Yeah.

Dr. Kent Jones: It's been exactly that, and they've been, Intermountain's been a very great supporter of ours, and I think our group has tried our best to be a good example to deliver what is something that Intermountain can be proud of.

Dr. Anne Pendo: Yeah, absolutely.

Dr. Kent Jones: It was a very, a good match, and they've been a very good, provided a very good foundation for us.

Dr. Anne Pendo: That's so great. The community, in addition to Intermountain, has been really blessed to have you, and your skills and your caring, both.

Dr. Kent Jones: Well thank you, appreciate that.

Dr. Anne Pendo: It's a good deal. Enjoy your vacation.

Dr. Kent Jones: I will.

Dr. Anne Pendo: In the warm sunshine, and get out of the smog here, and thank you. Thank you for taking the time.

Dr. Kent Jones: My pleasure, I appreciate your time.