One Practice, Three Generations

Donn Fassero (M'74), Todd Smith (M'91), and Richard Han (M'09)
Richard Han (M'09), right, says that the sense of community and a strong support system at Georgetown School of Medicine sets the school apart. Today he's in an orthopedic practice in Modesto, California, with two other Georgetown medical alumni, Donn Fassero (M'74), center, and Todd Smith (M'91) and says that those values live on in their practice. Photo credit: Norbert von der Groeben.

By Patti North

As students at Georgetown School of Medicine, Donn Fassero (M'74), Todd Smith (M'91) and Richard Han (M'09) all chose to pursue a career in orthopedic surgery. But these three successive generations of Hoya doctors share far more than a medical specialty—remarkably, they all practice under the same roof at Sutter Health in Modesto, California.

And while they received their medical education years apart, the trio has discovered that they also share a common philosophy of treatment, instilled by their professors at Georgetown. Above all, that means putting the patient first.

"It permeated everything—the tests you order should confirm what you thought after examining the patient, not the other way around," Smith says. "I recognize that quality in both Donn and Rich."

Han concurs, explaining that the Jesuit principle of cura personalis guided his medical education and now his practice. "I met with a patient the other day who had been referred by her primary physician for her shoulder. She said, 'You're the only doctor who listened to me.'

"You have to listen to the patient. It's not just a limb or an isolated problem—there's a bigger picture."

'Maybe You Should Consider Surgery'
For all three orthopedists, the path to Georgetown and a medical career was long and not always straightforward. Fassero, in fact, was working in a pharmacy in Alaska when he applied to medical school, and flew all the way from Kodiak to Washington for his Georgetown interview.

A Seattle native, Fassero had earned his degree in pharmacy from the University of Washington and became an officer in the U.S. Army during the height of the Vietnam War. Assigned to the burn unit at Brooke Army Medical Center in San Antonio, Fassero became fascinated with new burn therapies being developed to treat wounded soldiers. His commanding officer encouraged him to consider a career in medicine.

“When I have a tough case, Donn and Todd are always down the hall from me.”

Fassero began his medical studies at Georgetown in the fall of 1970. "Two weeks after I started, I got a call from Yale where I had been waitlisted," he says. "They said there was an opening if I wanted to come. I said 'I don't think so.' I just liked everything about Georgetown and I'd only been there two weeks. It was a great opportunity and a great education."

Despite the rigors of his academic schedule, Fassero was determined to take advantage of all that Georgetown had to offer, attending as many events on campus as he could and listening to speakers from all walks of public life. It was an era of great ferment in the United States and abroad, with the Watergate scandal and anti-war and civil rights movements playing out in Georgetown's backyard.

In his fourth year, Fassero had an opportunity to intern in Johannesburg, South Africa, at a so-called "non-European hospital," offering him the opportunity to see the impact of apartheid firsthand. "The 'whites only' atmosphere was appalling, but it was a beautiful country," he recalls. "At the time it was peaceful, but you could see something was going to change soon."

Ironically, it was a psychiatry rotation that first brought Fassero to surgery. Working at the P Street Clinic in Washington, he found himself treating a child with paranoid schizophrenia. "After six weeks I went to the professor and said, 'I worked as hard as I could, but this poor soul is no better—in fact I think he is getting worse!'

"It was so frustrating. I was resigned to failing the course, but the professor said, 'Son, you have to have patience—and by the way, maybe you should consider surgery.'"

Fassero found his calling in surgery and a mentor in Professor George Hyatt, whose course in orthopedic surgery was instrumental in honing Fassero's interest in the field. After graduating from Georgetown, he completed his internship and residency in orthopedics at the Mayo Clinic, and began his practice in Modesto in 1979.

'The Guys With Plaster on Their Scrubs'
Although they attended Georgetown nearly 20 years apart, Todd Smith and Donn Fassero were taught by many of the same legendary teachers, including cardiology professor Proctor Harvey. "He was such a wonderful clinician," Smith says. "He would get so much from talking to the patient before he ever put on a stethoscope."

Smith also recalls general surgery chair John Dillon as a tough but wise taskmaster. "With him you had to be prepared to sweat the small stuff. He broke down your assumptions—it's not about knowing, it's about understanding."

As a medical student, Smith was drawn to orthopedic surgery from the beginning. "They were the guys with plaster on their scrubs and scissors in their pockets. They looked like they were having fun—and it IS fun putting people back together again."

Fassero, Smith, and Han
While Fassero, Smith, and Han received their medical education years apart, they share not only an orthopedics practice but also a common philosophy of patient care, instilled by Georgetown.

And for Smith, it's highly rewarding as well. "By the time patients see you, they've usually put up with not only pain, but lack of function in their lives," Smith says, "When you can fix those two things, it's significant."

Raised in California, Smith grew up an only child after his father passed away when he was small. Early on, he learned the rewards of helping patients back on their feet by observing his mother's work as a physical therapist. His decision to apply to medical school came later, however; after graduating from the University of California at Berkeley, he married his childhood sweetheart and worked for several years while earning an MBA.

Although Georgetown was rigorous academically, it is the collegiality that Smith remembers best. "Georgetown was a family—everyone was there to try to help you succeed," he says. "They taught us up front that this is not about being better than the guy next to you. This is about working together to make the patient better."

Smith also recalls an emphasis on teamwork and leadership. "Being around Georgetown and in D.C., you were around leadership all the time—the concept of physicians as leaders and learning how to step up to that role," he says.

"You had to be a respected member of the team to lead it. Leadership is about removing the barriers for the people you are trying to lead. To this day, I think about that when I am training new partners or physician's assistants. It was the underpinning of how we were trained at Georgetown."

'Always Down the Hall'
As with other areas of medicine, orthopedics practice has changed over the generations — something Smith and Fassero both acknowledge. "We did everything—club foot deformities in children, all kinds of fractures, trauma, and knee replacements," Fassero says. "Now you have a more restricted practice—shoulder, neck or spine surgery, or joint reconstruction."

For Richard Han, who joined the Modesto practice a year ago, being able to call on the experience and knowledge of his two Georgetown colleagues is invaluable. "When I have a tough case, Donn and Todd are always down the hall from me," he says.

Han notes that his colleagues are role models as leaders as well: Fassero is past president of the California Orthopedics Association and Smith is chair of the Sutter Health board.

The son of Korean immigrants, Han has wanted to be a doctor for a long as he can remember. He acquired a strong work ethic from his parents, who woke up at 4 a.m. to open the deli and coffee shop they operated in the San Francisco Bay area.

“When I have a tough case, Donn and Todd are always down the hall from me.”

Han earned his undergraduate degree from UC Berkeley, and like both Fassero and Smith, spent time working before applying to medical school. He entered a one-year graduate program at Georgetown and while there, fell in love with the university and the city and applied to the medical school.

"It was a great community. No matter how competitive a field you wanted to go in, they would help you," he says. Han received his medical degree in 2009, going on to complete an internship and residency at Temple University and a fellowship at the University of California San Francisco Medical Center.

Han speaks fondly of the relationships he made while at Georgetown, forging some of his closest friendships there. "We would spend hours studying together at school and then spend many hours enjoying the nightlife D.C. had to offer. And I met my wife Aimee there when she was a graduate student—a real Georgetown romance story."

Early on in his medical studies, Han's interest shifted from cardiology to orthopedics. "You can fix problems immediately, as opposed to managing problems over the course of a lifetime," he says.

Like generations of Georgetown medical students before him, Han found timeless inspiration in the teaching of his professors. He calls Jack Delahay, his professor of orthopedic surgery, "easily the greatest teacher I ever had in my life—a character of characters. He was good at putting the pressure on and finding the humor in it, while making you want to step up and learn more," Han says.

Practicing with Fassero and Smith, Han has gained the best of both worlds: his older partners are not only colleagues who share his "patient first" approach, but also teachers eager to share their knowledge.

"And that's what medicine is," Hans says, "a constant learning experience."