Inspiring! Meet Nigerian, Dr Olurotimi Badero, The World's Only Combined Heart and Kidney Specialist Doctor
By Kemi Mobuse - Monday, May 02, 2016
During
a visit to Nigeria late in September/early October, Jide Akintunde, Managing
Editor, Financial Nigeria Magazine, and Director, Nigeria Development and
Finance Forum, sat down with Olurotimi Badero, a Nigerian U.S.-based
interventional cardiologist, nephrologist and peripheral vascular specialist to
discuss his amazing, superlative training in medicine, becoming the only doctor
in the United States or anywhere in the world to have full specialist training
and certification in nephrology and cardiology.
Dr. Badero is Executive
Director, Cardiac Renal & Vascular Associates.
Jide Akintunde: There is a string of professional titles to your name. What is
your training?
Olurotimi Badero: By training, I specialized in internal medicine,
cardiovascular medicine, invasive & interventional cardiology, nephrology
and hypertension, interventional nephrology & endovascular medicine,
nuclear cardiology as well as peripheral vascular interventions. Putting all
that together, I would like to think of myself as an interventional cardio
nephrologist as well as a peripheral vascular interventionalist.
JA: How did you come about this extensive training?
OB: I came about this training as a result of the things I had to go through in
the United States and also because of my personal quest for knowledge. I
started from one specialty to another, and kept looking for answers. I have a
passion for patient care; and a passion for creativity. When you put that
together, a rare opportunity is born. The ability to make a difference between
sickness and health is one of the greatest forms of wealth and
that doesn't stop as long as you continue to strive to get better.
For me, it was just a continuous process of trying to get better, staying the
course and finding the things that really define who I am and what I really
want to do to make a difference in people's
lives.
I've always been a competitive person right from childhood. I attended St.
Mary's Private School where I skipped 4th grade due to my academic performance;
and then Federal Government College, Odogbolu, Ogun State, for my high school
education. In my fifth year, I, alongside some students, won a nation-wide
science quiz competition in the country and that heralded a quest for
professional dominance. That marked the beginning of a journey for me. One that
will eventually lead me down the path of medicine. I gained admission into
University of Ife (now Obafemi Awolowo University) to study medicine. I really
didn't want to study medicine, but my dad, who was a great man, wanted me to be
a physician.
When I graduated from medical school, I moved to the United States where I
began my specialist training, first in Internal Medicine at State University of
New York Downstate Medical Center, in Brooklyn which was a three-year
programme. Following the completion of my programme, I proceeded to Emory
University School of Medicine in Atlanta, Georgia, for a two-year Fellowship in
nephrology and hypertension. Following completion of my Nephrology training, I
returned to State University of New York Downstate Medical Center for another
three years of Fellowship training in cardiovascular medicine. Upon completion
of my general cardiology training, I gained admission into the prestigious Yale
University School of Medicine for two fellowship training in invasive &
interventional cardiology as well as peripheral vascular intervention, a
fellowship training I completed with distinction.
I then returned once again to State University of New York Downstate Medical
Center in Brooklyn for yet another year of fellowship training in
interventional nephrology, dialysis access care and endovascular medicine.
Altogether, I spent ten years of continuous post-graduate medical training
which I later found out was unprecedented. I currently specialise in seven
different areas of medicine. I am a Fellow of the American College of
Physicians, a Fellow of American College of Cardiology, a Fellow of the
American Society of Nephrology, and a Fellow of the Society for Cardiac
Angiography and Interventions.
JA: Perhaps you would like to elaborate more on your personal motivation for
the pursuit of this incredible professional excellence, particularly because
Nigeria is noted internationally for the conflicting profile of churning out
con artists, some of the world's best professionals, and inept political
leaders?
OB: I learnt very early in life that a goal without a plan is only a wish and
that there is no testimony without a test. The only time that success comes
before work is in the dictionary. I also learnt from my dad the value of hard
work as well as perseverance and not letting the moments define you but
defining the moment by embracing the challenge. I remember when I was in
primary school, I would be top of the class on many occasions, but my dad was
never really satisfied. He always told me to do better. I couldn't understand
why he wanted me to do better when I was scoring around 96 percent on
average.
One day, I summoned up the courage and asked him why he wasn't completely
pleased. He said, “Even though you were top of the class scoring 96 percent,
the fact that you didn't score 100 percent means that based on the standard of
your school, 96 percent was good enough. I want you to get to the point where
you tell yourself '96 percent is not good enough for me' and start to set your
own standards.”
I learnt from that early age to set my own standard. That is where my
motivation actually came from. I am aware that some people get involved in
activities that don't uplift the image of Nigeria which in actual fact happens
in many countries in the world as well. However, there are equally a good
number of people who have done Nigeria proud.
For example, the first-ever black neurosurgeon in the United States was a
Nigerian. The man who discovered the post-concussion syndrome amongst NFL (U.S.
National Football League) players is also a Nigerian.
Nigeria has produced very brilliant minds, not only in the field of medicine,
but also in science and technology, music, arts and in other fields. That is
always refreshing to see and hear about. I believe there are a lot of other
young people in Nigeria today who are doing marvelous things that the country
needs to recognize. And there are Nigerians that will still do greater things
than we have done. We shouldn't only hear about the negative things Nigerians
do but recognize the good things they do as well because that's a platform for
motivating the younger generation.
JA: I learnt you have the distinction of being the only doctor in the United
States to hold specialist qualifications in cardiology and nephrology. Why did
you find it necessary to acquire these qualifications, and what difference is
this going to make in managing heart and kidney diseases?
OB: That is an excellent question. The heart and the kidneys are very closely
interrelated. We learnt that in medical school. The heart is a very fascinating
organ as well as the kidneys. The heart pumps blood all over the body to supply
basic metabolic needs. Twenty percent of that blood volume goes through the
kidneys. That tells you why the kidneys are very important. The heart and the
kidneys are so closely linked, that whatever happens to the heart, affects the
kidneys and vice versa. That is a major concept emerging in medicine now called
cardiorenal syndrome and renocardiac syndrome because we are now recognising
the interrelationship between these two organs.
While I was in training at Emory University School of Medicine as a kidney
specialist (and by the way, Emory has one of the most intense Nephrology
training programmes in the United States), I quickly found out that the
commonest cause of death for the patients that died was heart disease and not
kidney diseases. And we were doing a great job taking care of these patients
but ultimately they died from a disease I didn't have much control of as I
would have loved to. That was a challenge I had to embrace being someone, whose
decision to be a physician was to make a difference. I realized it was very
difficult for me to make that difference, albeit we were taking care of
patients and they were living longer.
So that set the stage for me to decide if I wanted to explore ways of becoming
more effective. I started toying with the idea of going back to specialize in
cardiology because I really wanted to get to the bottom of the problem. This
meant another three years of specialist training in cardiology. I was initially
discouraged by some of my friends at the time who felt I was spending too much
time studying. But for me, the value of knowledge is worth the time one spends
in acquiring it. And there is never a time that is too late to acquire
knowledge.
My training in cardiology as well as nephrology gave me a 360 degree view of a
patient with a near total approach to their disease state. I think it puts me
in a better position to actually treat these patients. I realized quite
recently I was the only one with such formal training, holding certifications
in both fields. I currently hold certifications in six different specialties in
medicine.
JA:
As a practicing physician in Mississippi, what similarities and or contrasts
would you like to make between the local population and Nigeria, looking at
cardiovascular diseases from the standpoint of public health and their
prevention and management?
OB: I will start with the similarities. The northeastern states of the U.S
include New York, New Jersey, Maryland, Vermont, Pennsylvania, etc. The
southeastern states include Louisiana, Alabama, Mississippi, North Carolina,
Florida and others. The south bears resemblance to Nigeria. I think that
probably stems from the history of slavery. The southern people have a
deep-rooted culture like we have in Nigeria. Their foods are kind of similar
and their utilization of healthcare is not quite like you have in the
northeast. There are still inherent myths that physicians have to navigate
while treating these patients especially in the black community. The southern
soul food, even though tasty, can be unhealthy at times from the cardiovascular
stand point because of the fat and high sodium content which predisposes to
hypertension and heart disease. But there is no denying the southern
hospitality and the warmth of the people, just like Nigerians generally
are.
The big difference is the obesity rate in the southeast. They have some of the
highest obesity rates in the country. Mississippi used to have the highest obesity
rate in the U.S. Not sure what the statistics are now, but it's almost
approaching 40%.
I would argue that our obesity rate in Nigeria is on the rise as well because
of the westernization of our diet and lifestyle. Many decades ago, there
weren't as many cars in Nigeria. People trekked and walked which was good
exercise. There weren't as many elevators either but it's not uncommon nowadays
to find private 3-storey homes with elevators. People don't like to walk or
exercise. When you live a sedentary lifestyle, you are at increased risk for
cardiovascular disease. Hence cardiovascular disease in Nigeria may be fast
becoming close to what you have in Mississippi.
Cardiovascular disease remains the number one cause of deaths since the 1950s;
and in women it's even worse. One woman dies every minute from cardiovascular
disease in the world today. It's an equal opportunity disease that doesn't
discriminate on the basis of sex or race. There are more than a million women
living with cardiovascular disease in the world today.
What is also fascinating is that most men would call 911 when they are having a
heart attack. But a woman is likely to wait 20 more minutes to call 911. That,
as you know, is related to many things. Your wife, whom I happen to know well,
is a very loving woman like most women in this country and in the world and
they take care of everyone in the family before themselves. In Nigeria where we
don't have an effective first responder service, this can be quite a tragic
situation. We don't have the necessary medical as well as ancillary services to
combat this growing problem. For example, I learnt one of my former
teachers at (OAU) Ile-Ife, who was a cardiologist, recently passed away from a
heart attack when he could have been saved if the teaching hospital had a
cardiac catheterization lab.
JA: In terms of management, are there things you would like to emphasize with
regard to cardiovascular disease in Nigeria?
OB: Yes. I have met with my alma mater, University of Ife (OAU) and I have also
met with Cardiac and Renal Centre in Gbagada, which is an annex of Lagos State
University Teaching Hospital. I met with the staff at the CRC. I also met with
the Faculty at (OAU) Ife, where there is currently no cardiac catheterization
lab. Without a cardiac catheterization lab, you cannot diagnose the more acute
cardiac problems like heart attacks. They don't have fully-functioning nuclear
cardiology services to perform nuclear stress testing procedures that help
diagnose the sub-acute heart conditions that lead to heart attacks. Devices
like pacemakers and defibrillators are not available to manage some heart
conditions. Patients needing dialysis cannot afford the catheters to perform
these procedures in places where they are remotely available. You'll
agree with me this is a big problem for a tertiary and training institution
like University of Ife (OAU). However, having said all of this, I
don't believe in dwelling too much on the issues without proffering solutions.
I echo the mindset of being solution-oriented and not problem-oriented.
At Cardiac and Renal Centre, they have a wonderful facility there for dialysis
and coronary care patients, and a cardiac cauterization lab. But it's
semi-functional at this point, probably because of bureaucracy. These are some
of the problems we have in Nigeria. It's not that we don't have the capacity to
put the infrastructures in place, but after we put the infrastructure, there
has to be a transfer of skills and knowledge. The first major laboratory and
diagnostics center in Lagos was put together by Indians, not Nigerians.
We have the technical skills, the knowledge base, and the patient population
but there has to be a way to facilitate skills and knowledge transfer from
doctors who have learnt the skills to manage these conditions. Without that
happening, we are only a shell of ourselves. Currently, there is probably only
one Interventional Cardiologist in Nigeria or at the most two. That is grossly
inadequate to take care of patients in the varying states.
We have to rise together as a nation, both the private and public sectors, and
put health into consideration because health is wealth. Life expectancy in
Nigeria is probably around 52. In the United States, it is around 78. If a lot
of Nigerians are not living beyond their early 50s, it tells you the workforce
is shrinking.
I learnt a while ago, if you want to go fast you go alone but if you want to go
far, you go together.
JA: What does Nigeria need to do, at least to stop losing its trained medical
talents to foreign countries, and at best to be able to attract Nigerians
abroad with your training and experience back to help lift clinical practice
and the overall healthcare delivery in Nigeria?
OB: To answer that question, you have to get to the root of the problem and
find out why people leave the country. I don't think you have a lot of
petroleum engineers or bankers leaving Nigeria as much as doctors do. Brain
drain disproportionately affects the medical field. The question really is, why
is that statistic skewed?
Most university students want to work in the oil or banking industry. That
isn't surprising, considering that those are some of the highest paying
industries compared to the medical industry. I have a cousin who trained as a
doctor but has never practiced before and is currently into oil and gas.
I have tried to intellectualize the process of justifying spending so many
years in school without a commensurate compensatory mechanism. If you
send your child to medical school, it is no brainer that you would have to
spend more money because of the longer years of training. So here you are
investing in this child but the return on the investment is not what you would
expect compared to his colleagues. I must be fair to add that the situation is
actually getting better with the pay rate now becoming more favourable.
I think the root of brain drain in the medical field is, first, poor economic
compensation. Second, there is no strong structure put in place for effective
training. We don't have many training programmes for doctors in Nigeria
compared to the population. I don't know the statistics but I would say half of
the doctors produced in Nigeria don't go on to specialist training and hence
are not consultants. The doctors who eventually get higher pay are the ones in
specialist training who end up as consultants.
I
think if the compensation improves, people will come back. The other thing is
safety and basic amenities that are involved in computing standard of living
index. Uninterrupted power, communication, transportation, water as well as
food. If these things which we take for granted are put in place, you'll see a
reverse migration as well as foreign investors. It's a good sight to see more
foreign investors in Nigeria than I did the last time I was here. That is
refreshing because it signifies a trust that is needed for change.
JA: You were one of those boys who misled their friends in school. You played
hard like everyone else, but then you were able to optimize the little time
commitment to study as a gifted student, while others who were not as endowed
continued to play and play. Are you still a player; or shall I say do you still
find time to play, given societal expectations and the demand for your
professional skills?
OB: In school I wasn't an ideal student. I will be the first to admit that. And
guess what? I paid for it. I didn't attend classes when I should have attended
classes. I guess I was still basking in youthful exuberance. I was quite
playful. But as I became more mature and grew in my career, I realized that I
was into something great. I had a rare opportunity to take care of people and
achieve something great. I started getting more serious.
I
got to United States and realized that you have to study. There is no short cut
to success. There is no “let my people go” grades. You are not studying just to
pass an exam, which is what we sometimes did back then in Nigeria. You are
studying to apply your knowledge; you are studying to be functional. If you
have knowledge that is not functional, it cannot translate into any kind of
therapy. Within a practical framework, knowledge has to be functional to be
able to impact the community and the nation.
I don't study much naturally, but the fluidity of my mind is always iced in the
quiet of my thoughts. My attention has a tendency to drift sometimes but it's
much better now. I usually read once and try to grab as much information as I
can. I guess everyone has something that works for them. I think the problem
started when I was in high school. We were the first set of 6-3-3-4 educational
system in Nigeria. I didn't want to spend an extra year in high school before
heading off to college. So I told my dad to enroll me in G.C.E programme in my
Form Five which he did. I had to study on my own as it was not allowed for us
to take the G.C.E exams at the time and I certainly didn't want my teachers to
know. I was in boarding school at F.G.C. Odogbolu then; hence, no tutorial
classes. I started avoiding classes to go into an uncompleted building with
some of my friends to study.
When the results were released, I had distinctions in all the six courses I
registered for. So I thought I was invincible after that. I figured if I could
study on my own and still do so well, I didn't have to attend classes. Looking
back, that was erroneous on my part. I wouldn't advise any student to do
that. There is a lot you learn by being in class. When you learn on your own,
you can't ask questions. The teacher always knows more than you, trust me,
regardless of how smart you are.
I don't know contextually what the term “player” which you alluded to in your
question means, but I can tell you right now, I play the drums in church. From
that perspective, I am a drum player, in the church where I also happen to be
the Assistant Pastor.
JA: Accept my condolence on the recent loss of your dad, whose funeral you are
visiting the country to have. What influence did he have on you?
OB: This is a man that had a huge influence on me. My dad was a great man. Very
insightful, and prophetic too. He had a humble background. He lost his dad when
he was 9-months old and grew up with his mom in the village. He basically
pioneered his own life. My last name Badero was actually his father's first
name. He changed it to immortalize the legacy of a father he never knew. Such
was his depth and insight.
He kept asking his mom to let his uncle bring him to Lagos. Eventually, he
convinced her and his uncle brought him to Lagos. His uncle trained him to be a
tailor but he was convinced that wasn't his calling. He eventually raised money
through hawking salt and matches at Obalende barracks and put himself through
school. He was one of 32 people selected in his office to study business
administration at University of Ife (then Ibadan campus) and he placed first in
8 out of the 9 courses offered. He placed third in the last course which
happened to be accounting. He used to joke and say that's why none of his
children is an accountant today. He eventually rose to the position of Central
Administration Manager at SCOA Motors.
My dad was very strict but also very loving. My older siblings all attended
public schools. I was quite close to my dad. We often ate from the same plate
growing up. He taught me how to pray every morning and every evening. Growing
up as a kid, I was the only one who had the chopper bicycle in my village at
the time. You can imagine how big a deal that must have been to a 7-year-old.
Even though he wasn't particularly wealthy, my dad insisted I attend a private school
which was expensive back then. I eventually attended St. Mary's Private School
which was a catholic school run by Irish nuns. My dad took me everywhere he
went. We traveled together. I remember on one occasion, we even had a motor vehicle accident together. I am quite grateful to him for the things he did for
me. My younger brother, who passed away in my final year in medical school
attended the same school as well.
I think that the kind of education and school one attends especially during the
formative years can be critical to one's character formation, level of exposure
in the future as well as self-confidence. Some of those friendships that I
forged then are still part of my social support system today.
My dad also instilled in me the ability to self-believe. He showed me when I
was 8 years old how to set my own standards. I asked myself sometime in the
distant past, where do I get my motivation from? Ultimately, my motivation
comes from God who is my essence. He loved us first even when we did not love
him.
Highlights on Dr. Olurotimi Badero’s professional achievements
Dr.
Olurotimi Badero is currently the only fully trained and board certified
cardio-nephrologist (combined kidney and heart specialist) in the world today.
In all, Dr. Badero completed an unprecedented 10 years of continuous post-
graduate medical training and he is currently board certified and a consultant
in:
1. Internal medicine
2. Nephrology & Hypertension
3. Interventional Nephrology & Endovascular Access
4. Cardiovascular Medicine
5. Nuclear Cardiology
6. Invasive & Interventional Cardiology.
He performed the first trans radial cardiac cauterization and coronary
angioplasty at Central Mississippi Medical Center.
Dr. Badero is a recipient of many awards including:
- The Association of Black Cardiologists scholarship award
for the Best Cardiology Fellow in the U.S.
- The 2014 Mississippi Healthcare Heroes in the state of
Mississippi.
- He was also named one of Jackson, Mississippi's Best
Surgeons.
Dr. Badero has authored many peer reviewed journals and he is currently on the
editorial board of the International Journal of Nephrology & Renovascular
Disease.
He is a:
1. Fellow of the American College of Physicians
2. Fellow of the American Society of Nephrology
3. Fellow of the American College of Cardiology
4. Fellow of the Society for Cardiac Angiography & Interventions.
Dr. Badero is the Executive Director of Cardiac Renal & Vascular
Associates, the Medical Director of St. Joseph Hospice, and he is on the global
Advisory Board of the therapeutics experts on Thrombosis and Atherosclerosis,
Merck Pharmaceuticals U.S.A.
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