Tubal Reversal Blog ‘Chapel Hill Tubal Ligation Reversal Center’

By Lisa D. Hourmouzis, RN
Tubal Reversal Nurse

It’s 7:30 am at Chapel Hill Surgical Center. In a moment of solitude, Dr. Gary Berger meticulously scrubs for the first surgery of the day. As he stands there quietly, I can’t help to wonder about the story behind the man in the surgical mask.

How did he become the surgeon he is today? What drives him to succeed?

These questions led to the following sit down with America’s leading tubal reversal surgeon, Dr. Gary Berger:

When did you decide to go into obstetrics and gynecology?
GB – When I was beginning my fourth year of medical school, during the time when we had to decide what direction we were going to go in, I felt like I wasn’t really secure enough in my basic medical foundation to want to jump into a specialty. So, I made the decision I would take a year of internship in internal medicine. But I had already made the decision that year to start my OB/GYN residency after the internship in medicine.

What led you to Duke?
GB – I was always a very hard worker. I guess I believed in the adage, “No pain, no gain.” So, I picked the hardest program in the US which was the medical internship at Duke University Medical Center. They had that reputation at the time. You were on-call five nights out of seven, and it was a very grueling program. But I thought I needed that to feel like I had a basic medical education before I proceeded.

Did anyone influence your decision to enter OB/GYN?
GB – I had been thinking about going into obstetrics and gynecology, and it just so happened that during that time we had a visit from Dr. Carl Tyler from the Centers for Disease Control. He was looking to recruit physicians into the EIS program, the Epidemic Intelligence Service. He came to the University of Rochester where I attended medical school and made contact with one of the pediatric professors there. I remember being on my pediatric rotation at that time.

Unbeknown to me, my pediatrics  professor had been an EIS officer; he also taught the courses in epidemiology and statistics, which I loved. Most of the other medical students weren’t so interested in them. Because I had done so well in those courses, he recommended that Dr. Tyler interview me. That was definitely a turning point in my life.

I was offered the opportunity to be in the U.S. Public Health Service at the CDC, but Dr. Tyler needed me to complete one year of my OB/GYN residency before I could join the program. That made my decision. I immediately started looking for residencies in OB/GYN.  And as it turned out, that two-year period was probably one of the most influential periods in my life. It was an absolute amazing experience.

What did you like most about obstetrics and gynecology?
GB – The thing I liked about obstetrics and gynecology was the obstetrics. I really did not think I would ever have an interest in performing surgery. In medical school, my surgical rotation was one of my least favorites.

What changed your view about surgery?
GB – During my third and fourth year of my OB/GYN residency, I had the good fortune of working closely with Dr. Jerry Hulka, the inventor of the Hulka clip. He made a big impression on me. His interests, aside from developing this technique in sterilization, were laparoscopic surgery and tubal surgery. So, it was during that time I became interested in tubal surgery; and what really solidified it was when I had the chance to see microsurgery performed. I knew at that point, that’s what I wanted to do.

Why did you decide to focus on tubal reversal surgery?
GB – My ideal was always to be able to do this surgery. I’ve done infertility treatment, IVF. I’ve done almost every type of GYN operation there is, with the exception of cancer surgery, but tubal microsurgery was always my special love. Fortunately, that’s where I am at this point.

What drives you?
GB – I think it’s a desire to be successful at whatever I do. If I’m doing tubal surgery, I want to be the best at doing tubal surgery. I want to know the most about it, have done the most and not just have the most experience, but intellectually, collected the most information. To me, that’s enjoyable because then I feel like it’s something that I’ve mastered. And of course, I like being able to help the couples that come here. I really feel that we can help most people. I know that  people are better off coming here than taking any other alternative that they have, in terms of having tubal reversal surgery.

What do you enjoy most about tubal reversal surgery?
GB – I like the challenge, the meticulousness about it. And I like being able to operate on patients and see them be comfortable and safe, and not dealing with complications.

I have a very idealistic view of things. If there’s a better way to do something, let’s find it and do it that way. I just think that’s a good way to practice medicine. But it’s not just about me personally; it has to do with everyone on our staff  who is involved in it.

Where do you hope to see tubal reversal surgery in the future?
GB – I don’t know if the pendulum will ever swing back to tubal reversal, it was there when I started 30 years ago. It was the new, exciting thing. And then IVF became the new and exciting thing.

Tubal surgery is quite different. I don’t think tubal surgery will ever suddenly become widely used or widely taught, but I think there is clearly a place for it. I like the fact that I’m training another doctor. And maybe in the future, one thing we might consider is becoming a training center where we could take physicians who are already at an advanced level like Dr. Monteith, and help them be able to do this type of surgery with expertise.

Tubal reversal helps a lot of patients, and there definitely should be the option for doctors to have additional education in it so that doctors don’t automatically send their patients into IVF programs when a simple tubal operation could be the solution.

Do you have a philosophy in your professional life?
GB – There’s an expression that I heard when I was in medical school, the quote was, “the secret in caring for the patient is in caring for the patient.” And part of my philosophy is that I want to provide the exact type of medical care that I would want for myself, no less.

If I have to go a doctor, I want somebody who knows what they’re doing, is educated and a decent and kind person. Technically an expert, as knowledgeable about it as anyone, or more so than anybody else in the world. That’s the kind of doctor I would want for myself. Someone who will really take care of me if I have a problem and won’t brush it off or be too busy because it’s inconvenient. That’s the same thing that I want to provide for all of my patients.

To learn more about Dr. Berger and Chapel Hill Tubal Reversal Center, call (919) 968-4656 for a free tubal reversal consultation.

After my dream of becoming a tubal reversal specialist, I emailed Dr. Berger to ask for his assistance in teaching me his techniques of outpatient tubal reversal microsurgery. I was a little reluctant to reach out and make contact but, as I previously mentioned, email is a great way to receive rejection.

When I received his return email I was afraid to open it. I thought I would click on the reply and read the typical – “Thanks for your interest but (fill in the blank) – we are not interested at this time.” Instead, I was astounded by his response. One line of his email is still vivid in my memory. The line read,

“I always thought one day I would be approached by the right person…..”

When I read this line in his email, I was ecstatic. I thought to myself, ‘Hey, that is me. I am the right person!’ I felt as is if I were a little high school boy who had his invitation to the prom accepted by the prettiest girl at school. These kinds of things never happen to me. I could not sleep well for several days because of my inner excitement.

The day came when I went to Chapel Hill Tubal Reversal Center for my first meeting with Dr. Berger. I was extremely tired because the night prior to our meeting had been a sleepless one since I had been on call in the hospital delivering babies.

I approached the building and entered through a passageway which led me into a courtyard. The first thing I remember was hearing the sound of a fountain echoing in the courtyard walls. It invoked a soothing feeling. The fountain was placed next to a set of stairs and was standing on a bed of small, rounded river rock. The stairs led up to the second level. I ascended the stairs to the second floor. I was extremely tired but I could not but help feel a sense of calmness within the courtyard. The experience brought back memories of being in church as a child. There was an overwhelming sense of peacefulness.

I entered the office and was seated by the receptionist. While I waited for Dr. Berger, I read through several of the photo albums in the waiting room. There were pictures of many tubal reversal babies and letters of thanks and encouragement. These photo albums seemed like the fruit of a fulfilling and successful career.

Dr. Berger came out to meet me and we went into his office and talked for about 45 minutes. I explained my desire to become a tubal ligation reversal specialist. He told me about his background and how he had come to specialize in tubal ligation reversal. His training, history, and career development were very interesting. I was especially interested in how he had evolved to solely provide such a specialized service. Although we were very different people, it became clear to me that we shared many common fundamental beliefs. Overall, I thought our meeting was very productive. At the conclusion, I shook his hand and thanked him for meeting with me. Since I knew he was busy (and I was tired) I expected to make a quick exit. As I was about to leave, Dr. Berger said, “Let me show you around.”

A strange feeling came over me. I quickly dismissed my strange feeling but readily took him up on the offer. He showed me the top office and waiting room. We then went outside, down the stairs, and past the fountain and decorative rocks. Again another strange feeling went through me- a sense of deja vu. He then showed me the break room with tables for eating, the operative rooms and the recovery room.

I was extremely impressed by two things. First, the entire place was absolutely the cleanest health care facility I had ever been in – I literally felt I could eat off the floor. Second, it was the quietest health care facility I had ever been in. I am used to noise, commotion, screaming, and yelling. I had never been in such a calm health care setting before.

At the conclusion of our tour, I shook his hand again and thanked him again for his time. I left and went to my car. As I started to put the keys into the ignition, I had to pause. I began to process what had happened. I began to investigate my sense of deja vu. I had been here before. I had seen this. I had done this before. It all began to come to me. This was the dream I had several weeks prior!

Then it all began to make sense. The two levels. The water and the fountain. The boulders. The table. The sense of happiness and calm……….these things never happen to me. I quickly suppressed these feelings. Why? I don’t know. I think I was afraid I was building this up to be more than it was or would ever be. I started the car and drove away.

Posted by Charles Monteith, MD