Life lessons from a fishing village.
When Ken Chang ’81 MD’85 took a year off between his third and fourth year of medical school, he sought a different kind of medical education in a small fishing village in South Taiwan.
“I was in the seven-year program and I figured I was a bit young to graduate,” he says of his decision to go abroad.
Chang, the son of Chinese and Hong Kong immigrants who grew up in New York, joined a medical mission to a Taiwanese village with four American physicians. Working in a 40-bed hospital required doctors and other volunteers to both learn the local languages and improvise solutions that were not readily available. The experience provided Chang a short directive he has carried through his career: “innovation fueled by compassion.”
“To see physicians who first had to learn the language—and they were eager to learn all of it—that solidified innovation fueled by compassion,” Chang explains. “That is the tagline for our institute. We think outside the box to come up with solutions.”
Last June, Chang became the executive medical director of the Hoag Digestive Health Institute in Newport Beach, CA. In addition to addressing individual patient needs using the latest technologies and enrolling them in clinical trials, he can examine community digestive health on a larger scale. Hoag’s patients are drawn from the 3.5 million residents in the Orange County area.
“One illustration is esophageal cancer,” Chang says. “Most cancers have been flat or decreasing. Esophageal cancer rates have risen. Why?”
Barrett’s esophagus—linked to chronic heartburn—can develop into esophageal cancer. The silent symptoms go unrecognized unless an endoscopy is performed. “Most people think of heartburn as a nuisance,” Chang says. “It is a progression. When people can’t swallow and are losing weight, it’s too late.”
Since clinicians don’t routinely perform endoscopies, one recent innovation that has simplified the process is EsoGuard, an esophageal DNA test in which a balloon-based device is able to capture genetic samples to screen for precancer. The test requires no sedation.
Chang, a professor emeritus at UC Irvine School of Medicine who has published nearly 500 papers, co-authored a study last year in the American Journal of Gastroenterology that evaluated EsoGuard for efficacy and safety, and determined it was a “promising” tool for Barrett’s esophagus screening.
The late gastroenterologist and Brown professor Joseph DiMase, MD, introduced Chang to some of the cutting-edge tools of his future trade, allowing the medical student to use scopes that were early-generation fiber-optic instruments. “They were less precise than what we have now,” Chang says. “Dr. DiMase handed me the scope and let me drive. That helped me.”
Chang learned the human side of gastroenterology by shadowing Ed Iannuccilli, MD. “Ed spent a month with me, showing me how to conduct myself in terms of bedside manner,” Chang says. “He underscored what a privilege it is to be a physician.”
His student’s attention to detail made an impression on Iannuccilli, now a clinical professor emeritus of medicine. “Ken was a professional from the start,” he says. “He was respectful to his teachers, fellow students, and above all, the patients. He had a unique ability to assess a difficult case, express his opinion with confidence, and open his mind to learning. My only regret was that he left us for other pastures.”
Chang and his wife, Christina, moved to California when she attended seminary. The couple planned to continue their careers overseas—but that journey never happened. Forty years later, Chang is still in the Golden State, and still relying on the lessons learned as a medical student.
“Innovation is so important,” he says. “When there is a new drug or another path and you get introduced to a new technology, what else can we do and where can we apply it? If you only practice what is proven, you never progress.”
