Urology of Virginia
It may seem a far stretch from an undergraduate degree in statistics to a career in the operating room, but for Ed Robey, the route was less circuitous than it might appear. He’d always done well in math and science, and found the statistics curriculum at NC State “a real smorgasbord” – for the first two years, that is. “The courses included everything from economics to philosophy, from foreign language to genetics, from biology to chemistry – that all appealed to me,” he says. But in the third and fourth years, he remembers thinking, “What am I gonna do with this? I did OK in theoretical math, but I couldn’t see myself making a career of sitting around thinking about numbers all the time.”
One of the first things any student of statistics hears is a quote by the American mathematician John Tukey: “The best thing about statistics is that you get to play in everybody’s backyard.” Dr. Robey set about to find a new backyard.
A college dorm mate was in pre-med, and that inspired Dr. Robey to think about medicine. Fortunately, his statistics curriculum had prepared him well: all he had left to take to make the switch was organic chemistry and biochemistry.
He earned his doctor of medicine at Wake Forest University’s Bowman Gray School of Medicine in 1980, and served both his internship and residency in surgery at EVMS. He enjoyed his rotations in neurology and urology, but chose urology because he wanted to do surgery – and because he liked the urologists he worked with. “I was lucky enough to get a call from Dr. Paul Schellhammer regarding a urology residency,” he says, and thus began his career with what was then known as Devine-Tidewater Urology, now Urology of Virginia, in 1980. He was named Chief Resident in his last year at EVMS.
Following a three-year stint as a Major in the Air Force – Dr. Robey served as a staff urologist at the 31st T.F.W. Hospital at Homestead AFB in Florida – he began applying for positions. For several years, in addition to his regular caseload, he took care of the urological aspects of the kidney transplant program, removing kidneys from donors laparoscopically. “It was quite intense,” he remembers, “because removing a kidney from a healthy patient is a major procedure – but it was tremendously rewarding.”
In recent years, he has pursued his interest in stone disease, and has tailored his practice to caring for the most difficult cases, which he finds equally rewarding. Because obesity, hypertension, diabetes, chronic diarrhea and other diseases can increase the risk of stone formation, it’s not surprising that the incidence of stone disease is rising. Currently five percent of American women and 12 percent of American men are affected. “Heredity is another factor that plays a role in the formation of these stones,” Dr. Robey notes, “as do certain metabolic imbalances, such as too little or too much calcium or oxalate. Even some medications can increase the risk of stone formation.” Left untreated, these stones can lead to chronic kidney disease.
Over the course of his career, he has seen tremendous advances in the treatment of urological cases. “When I was a resident, we were doing mostly open surgery for stone disease, as well as for kidney cancer,” he recalls, “but then along came less invasive ways of dealing with stones: the shock wave machine, small telescopes and lasers, then laparascopic surgery. We performed our first nephrectomy laparascopically in 1991.” And of course, not long thereafter, was the introduction of robotic surgery.
“Our ability to treat patients with stone disease has improved dramatically,” Dr. Robey says. “We used to have to make big, open incisions to get the small stones out of the ureter, but now, with a small telescope – a ureteroscope – we can take care of them without any incision at all. We go up the bladder, and into the ureter toward the kidney, and using a monitor, use a laser to break up the stones.” The majority of these are out-patient procedures, which require far less recovery time and result in less pain for the patient.
There’s another advance that Dr. Robey believes has dramatically improved the practice of medicine: the introduction of electronic medical records. It’s especially helpful during off hours when he gets a call from a patient or family member. “Now we can access a patient’s records any time at all,” he says, and adds, “I remember the days of going down to radiology and standing in line waiting for films to be found, only to discover they’ve been checked out to someone else. All that is eliminated now.”
He spends his operating time these days at Sentara Princess Anne Hospital, where he finds real joy working with his surgical team. A self-described introvert, he says, “I really enjoy the interaction with colleagues in the operating room. But I also love building relationships with my patients.” He has several who have been with him for years, who first sought his care for prostate issues or urinary tract infections. And because stone disease can recur, he continues to see those patients as well.
Having seen so many advances in medicine, he’s excited about what lies ahead for his profession. If he has a concern for the future, it is that “as the pace quickens and we try to get more patients seen, there’s less time for interaction with them. That part I would hate to see become less personal. It’s very rewarding to build those relationships.”