Talking Real Science with Yelena Akelina

This episode of Share Science features Yelena Akelina, DVM, MS, a Research Scientist and a Co-Director/Instructor in Clinical Microsurgery at the Microsurgery Research and Training lab at Columbia University. Through a multitude of workshops and microsurgical training programs, Yelena has made a significant impact on the microsurgery community. Her passion for her students, the animals she works with, and her commitment to education shines through in this podcast, which has been transcribed below.

This interview has been edited slightly for clarity and conciseness.

My story starts from Moscow, Russia where I grew up. I’ve always loved animals since I was very little. My parents always complained because I’d bring every little kitten and dog I could find on the street, nurse them back to health, but then couldn’t keep them all, so I let them go. That love for animals and living creatures is what put me on my path to be a biologist. I applied for the Moscow State University in the late eighties, but because of the political situation in Russia I couldn’t make it to the university, but I was accepted to the Veterinary Academy of Moscow to become a veterinarian. This still applies my love of animals to science, and that’s how I became a vet somehow by accident. But many things in my life were by accident.

“Well I can tell you it was by accident. Sometimes you have an opportunity in your life which you have to grab onto and just go for it.”

In Russia, I also completed a Master of Science, which opened my eyes to research and to the possibility of being a scientist. When we came to the United States, I wanted to become a veterinarian again and started applying for the foreign veterinary program to become a licensed veterinarian. Unfortunately, my education credits were not enough, so I needed to get more and went to the veterinary technologist program at Mercy College in New York and started taking credits.

The microsurgery lab in the department of Orthopedics at Columbia University accepted interns at that time. So, I came here as an intern for three credits and during my internship, the director at the lab left and I was left hanging. Being a doctor and being exposed to the science and loving to teach made me eligible to get a position in the lab, again by pure accident. Plus, my personality was open to learning something new and apparently, I was good at teaching which I had never done before. So I was asked to stay as a senior technician in 1996 and grew from there to be a research scientist and director of the lab for the last 26 years. Hard work, self-teaching, and observing my students and learning with them on their mistakes and my own that made me quite a good instructor.

Well, there are a lot of people I’ve met on my way to become a microsurgeon. When I started working here, I was sent to a lot of microsurgical centers in the US. In 1998, I became very friendly with Dr. Brian Cooley, who was an instructor and microsurgeon in Milwaukee, Wisconsin. An amazing instructor and a very, very talented scientist and researcher and microsurgeon, we became good friends and he taught me a lot of tips and tricks of microsurgery. 

When I saw him working and admired him, I was thinking, “oh my God, I really want to be like you with your hands and your open mind”. He also introduced me to the Society of Microsurgery Specialists of the US and the World Society of Microsurgery. 

I went quickly from a small lab in NYC to a world of microsurgery, first inside the US and then a global level microsurgery education. Dr. Harold Dick, who was the chairman at that time, and the founder of this microsurgery lab offered me a job in 1996 as a tech and in a few years I became an officer and co-director of the lab. He believed in me and I worked hard to make him proud. There was another special person who turned my professional life around and became my mentor, advocate, friend, and a big supporter: Dr. Melvin Rosenwasser, who is my boss and my co-Director of the lab and an amazing microsurgeon. I was very fortunate to have those people in my life! Working with those doctors opened the door to a high professional level and taught me many important lessons that I would have never learned otherwise. There is a line of people I admire and many, many more to mention, but those are the main ones.

That’s a great arena to talk about, thank you for this question. As a microsurgery instructor I teach not only human surgeons but also many researchers and people from industry and pharma. And as you know we recently started a new teaching program designed specifically for that audience. That question always comes up: How do I start? What [do] I do?

“You do have to have a specific, very specific goal in your mind.”

You must know what species you’re going to be working with, what project, what procedures you’re going to start working on. And the first thing, of course, as a microsurgeon, is that you must have a stereo microscope, no matter what brand it is, with good optics and the right focal distance. Of course, you must have the right instruments, special surgical tables, specific chairs, the lighting, sutures that are specifically designed to do micro-procedures and of course, anesthesia.

It is always important to plan and not just jump in with closed eyes into the project. Now there are a lot of things you need to do and I’m open to help anybody who would have some questions, as I’ve done it before. I helped to design quite a few labs and I’ve been doing it for 26 years.

Well, all of that. You do need to know how to handle animals, how to set up the right surgical environment, what the right ergonomics are, what set of instruments and other equipment you do need, and of course how to correctly perform the procedures you need to do.  For example when you attend a course that I teach, one of the most important things that you learn is the ability to be comfortable with the microscope. This is a completely different kind of surgery. When you go under the microscope, everything feels different and strange, working so your hands can go in the direction that you expect them to go. It takes time to adjust and learn that skill.

Then you need to learn how to be comfortable working with the microscope, micro-instruments, micro-sutures. You need to learn how to gently dissect the tissues of rats and mice, as mice have very fragile vessels and tissues. You must be very careful with how to handle that. You must learn how to perform the basic surgical techniques, such as vessel ligations, cannulations and of course microvascular surgery. You will learn how to create a surgical plan, step-by-step procedures paying attention to little details. You really must sit down and make the plan, whatever it is you do. It’s also important that you learn troubleshooting in the course.

By doing the lab work during courses like this, you encounter all kinds of mistakes and all kinds of trouble, for example: the clamp came out, you ripped something, etc. You have to learn not to panic and what to do to fix it to save the animal’s life and to go on with your experiment, so you won’t lose the data, the animals or expensive drugs.

After taking such a course, people will be more sufficient, more confident, more comfortable in performing different difficult procedures with minimal number of animals used. Thus, students learn not only how to operate under a microscope, but the whole nine yards of the surgery. A whole world of microsurgery and animal surgery opens up for them when you take courses like that. They can also practice on their own to improve the skills we give them.

“It’s a skill, the more you do it, the better you become.”

I love the satisfaction I get from seeing the success of my students who came to me on Monday with no skills, or very limited ones, and leaving after 4-5 days being very competent and confident and able to perform very difficult surgeries on their own. Most of them are surprised at their own achievement in such a short period of time and it’s the best gift I can give them!  Sharing my skills and seeing them succeed is my favorite part of the job! Most of my students either are human surgeons or researchers from scientific institutions or pharma going back to the operating room, or back to their research bench to do their job much better – saving human lives or moving medical science and technology forward with much more proficiency and efficiency after successful completion of the microsurgery course with the skills that they’ve learned. 

When I give them certificates of completion and a hug goodbye – it is such a pleasure to get a huge thank you hug back! What else does the teacher need? I know that I do make a difference for those people and for their patients and for their scientific goals.