Medicine's prodigies: Careers on fast forward

Every so often there is a blitz of news about the 12-year-old headed off to college and the newly graduated physician who is barely old enough to vote.

But what happens to these youngsters who at a young age achieve things that most people will never accomplish in a lifetime?

Some of the world's greatest achievements sprang from prodigies' minds. But translating early success into an equally impressive career takes more than just a bright mind. Education experts say highly gifted individuals commit suicide, divorce and become alcoholics at the same rate as the general population.

Prodigies who carry their achievements into adulthood are the ones who develop maturity and political savvy while sustaining their creativity and technical expertise.

The number who fall into this highly gifted category is extremely small. Only 2.3% of the population has an IQ of 131 points or higher, the threshold at which a standard education, even with a few tweaks, isn't enough to keep these individuals engaged, according to the Reno, Nev.-based Davidson Institute for Talent Development, a nonprofit group that supports profoundly gifted children.

Surgeons Milissa McKee, MD, MPH, Balamurali Ambati, MD, and Valluvan Jeevanandam, MD, are among those who know what it is like to get the media's attention after entering medical school as teens. Despite obstacles that prodigies sometimes face, these three who are now into their physician careers show no signs of losing their early luster.

Here are their stories.

Milissa McKee, MD, MPH

Current age: 34
Age graduated medical school: 19

She arrived late on purpose. Milissa McKee, MD, MPH, didn't like getting up for the 7 a.m. start of her surgical program's exam.

"I'd show up at 9:30," Dr. McKee said, who was in her early 20s in the early 1990s when she was taking the test. "It was a five-hour test, but it only took me two hours. My director, he'd ask me, 'You stop in for breakfast?' I'd say, 'I'm thinking about it.' "

The oldest of seven children, she and two siblings whizzed through college to start medical school early. Family games were ones like Risk, where players sought world domination.

Dr. McKee was 15 when she left her Minnesota home for medical school in North Dakota. When patients questioned her age, she would respond: "Do you want an older doctor or the best?"

While others in her field were still training, Dr. McKee at age 28 joined the faculty of Yale-New Haven Children's Hospital in Connecticut as director of pediatric trauma services and director of minimally invasive pediatric surgery.

An assistant professor at Yale University School of Medicine, she's known for being the first to bring minimally invasive surgery for infants and children to her region, and her hospital is in the process of building an operating room to better accommodate the surgeries.

Paul M. Colombani, MD, chief of pediatric surgery at the Johns Hopkins Children's Center in Baltimore, knew Dr. McKee during her research fellowship from 1995-97 and clinical fellowship in 1999-2001. "Technically, she was one of the best surgeons, and we get the best of the best here," Dr. Colombani said. "Because of her young age, people would not realize who they were dealing with. A lot of times nurses would think she was a medical student when she was the responsible surgeon on the service."

In her 20s she was functioning at the level of a seasoned attending, Dr. Colombani said. "Sometimes she was showing me what to do."

Dr. McKee laughs as she describes herself as "compulsive almost to the point of sickness."

But she considers this a good thing. She makes the smallest incision possible in surgery, and every closing stitch must be exact. She does not leave residents unattended during a procedure, no matter how routine, and she makes no excuses for micromanaging patient care. She's developed tiny surgical instruments the size of straws to slip through the telescoping instrument she navigates into newborns' chests.

Robert J. Touloukian, MD, chair of pediatric surgery at Yale-New Haven, adds "undaunted" to Dr. McKee's traits. "She's always the first person to want to try something new," he said.

Balamurali Ambati, MD

Current age: 29
Age graduated medical school: 17

As a child, Balamurali Ambati, MD, never thought twice about jumping ahead in school. His brother, Jayakrishna Ambati, MD, seven years older, had raced through high school in two years, won multiple science competitions and became a National Merit scholar, and Dr. Balamurali Ambati did the same. In a form of friendly competition, he topped his brother in 1995 when he became the youngest physician in the world at 17, according to the Guinness Book of Records. It's a record that holds today.

Their relationship remains close, and both are ophthalmologists who often collaborate on research. "We took it for granted," said their father, Ambati Rao, PhD, of his boys' exceptional intelligence.

When Dr. Balamurali Ambati was 2, Dr. Rao found the boy carrying buckets of water. The future doctor had been told water made plants grow, and the toddler was bent on speeding their development. As an adult, his curiosity continues to shape his work. In October 2006, his research on inhibiting the growth of unwanted blood vessels in the cornea was published in Nature.

Dr. Ambati might have been published even sooner if he hadn't completed an internal medicine residency before training in ophthalmology. He was 24 when he finished training and became assistant professor and director of the cornea service at the Medical College of Georgia School of Medicine in Augusta.

These early accomplishments could have left Dr. Ambati bookish and geeky as he entered training. But that wasn't the case, said Adrienne Fleckman, MD, associate chair of medicine at Beth Israel Medical Center in New York City, who was Dr. Ambati's first program director.

"If someone said I was going to meet the youngest graduate from medical school, I would not picture Bala," Dr. Fleckman said. "He is entirely too normal."

He is personable and kind, as well as a physician with exceptional judgment, she said. When a colleague with corneal ulcerations continued to have problems under the care of nationally recognized experts, Dr. Fleckman sought out her former resident. Dr. Ambati suggested an experimental medical therapy instead of surgery others had recommended. It did the trick.

"People in a busy practice can sweep through things, but Bala, he stands out," she said, taking the time to thoroughly consider each patient and explain the pluses and minuses of treatments.

Valluvan Jeevanandam, MD

Current age: 46
Age graduated medical school: 23

An accelerated education is not without its social consequences. Valluvan Jeevanandam, MD, said he was short and fat when he graduated high school at 15 in 1976. The only reason he wasn't valedictorian was because he barely passed gym.

But during college he shot up 7 inches. He topped 6 feet by the time he graduated in 1980.

"I lost the stigma I had in high school," he said. "It was like a burden was lifted off my back."

His height helped him blend in, but while he had been an ace in public school, college introduced him to the prep school crowd. He started out at the back of his class, struggled with liberal arts but managed to finish No. 3 in his class.

Medical school was easy, he said, and he's been in his element ever since. A cardiothoracic surgeon, he's a doctor to whom heart specialists often refer their inoperable patients.

"I like to buck the books," said Dr. Jeevanandam, who became chief of cardiac and thoracic surgery at the University of Chicago Medical Center when he was 38. "It's intoxicating, and it's a sickness, too. Sometimes I challenge myself so much, I wonder, 'What did I get myself into?' Remarkably, the patients do well."

He finds new ways to do things and has the patents to prove it. In 1994 he started working with lasers inside the heart, which became the basis for the CardioGenesis company. Later he developed a new type of organ transplant technology that keeps hearts in better shape outside the body, an idea that spawned the TransMedics company. Now he is working with a company on CardioVad, a device that boosts heart function in patients with severe heart failure who are not candidates for transplant.

Besides being an inventor, he has earned a reputation as a charismatic leader. At age 31, his first job out of training was head of the transplant program at Temple University in Philadelphia. A month after he arrived, a competing organization lured away the entire transplant team.

"He called me when he learned of this," said his former boss, Eric Rose, MD, chief of surgery at New York-Presbyterian Hospital/Columbia University Medical Center in New York City. "I said, 'You know more about cardiac transplant organization than anyone in the city.' Val single-handedly not just retained the program that was there but made it one of the busiest transplant centers in the country."