Ross Ungerleider, MD, MBA, is a national leader and pioneer in pediatric cardiothoracic surgery programs. He has joined the Department of Surgery as a Professor in our Cardiothoracic Division.
Dr. Ungerleider attended Wesleyan University in Middletown, CT where he graduated with Highest Honors in Biology and a major in English. He then completed medical school at Rush Medical College in Chicago, IL. He received his surgical training at Duke University Medical Center where he remained on the faculty for 15 years, rising to the level of tenured professor.
He is the author of over 300 peer-reviewed scientific papers and book chapters as well as an editor of two major textbooks on cardiac surgery. He has been named to America’s Best Doctors, Cambridge’s Who’s Who, Castle Connolly’s Top Doctors (receiving their distinction as being among the top 1% nationally in his field), and by Good Housekeeping as one of the best pediatric surgeons in the U.S. Throughout his 40-year career, he has repaired the hearts of more than 8,000 children. He is an expert in all congenital heart surgery procedures and has special expertise in aortic valve surgery and the Ross procedure. He is well recognized for his work in developing safe techniques to perform complete repairs of cardiac defects in tiny infants while protecting their neurologic outcomes.
He joins UNC Surgery after consulting for the Driscoll Children’s Hospital pediatric heart surgery program in Corpus Christi, TX. Previously he was a professor and chief of the pediatric cardiac surgery program at Brenner Children’s Hospital at Wake Forest University Baptist Medical Center. He also served as chief of pediatric cardiac surgery and vice chairman for education for the Department of Surgery at Rainbow Babies and Children’s Hospital in Cleveland. His previous positions also include chief of pediatric cardiac surgery, surgical director of the pediatric intensive care unit, and medical director of the ECMO program at Duke University Medical Center.
In addition to his work in Cleveland and at Duke, Ungerleider has served as professor and chief of pediatric cardiac surgery at Doernbecher Children’s Hospital in Portland, a part of Oregon Health and Sciences University (OHSU), the John C. Hursh Chair of Pediatric Cardiac Surgery at OHSU and the chief of the Division of Cardiothoracic Surgery at OHSU. While at Duke and OHSU, he helped develop two of the most outstanding academic cardiac programs in the country, both in terms of patient outcomes and contributions to the field of cardiac surgery
Why do you do what you do?
I remember clearly the day I figured out my “why.” It happened in the Museum of Science and Industry in Chicago during a trip with my mom and sisters. I was around seven years old, and traveling from our northern suburb to the museum, which was located on Chicago’s South Side, was a big trip back in the mid-1950s, but the museum was a special place. The entire first floor was an enormous electric train set that you could view from a mezzanine above. Cities, mountains, towns, and rural areas were all traversed by a network of train tracks for numerous electric trains. It was enthralling. In another exhibit, visitors could watch chicks hatch from dozens of eggs in a glass incubator, and in another exhibit, they could walk through a captured German submarine. There was a coal mine that enabled visitors to experience the dangerous underground life of coal miners.
But most special of all to me was an exhibit on an upper floor, one that unfortunately no longer exists. It was an exhibit about the heart. The heart-lung machine was invented around 1953, and by the mid-1950s, it was becoming a clinical reality–enough to spark the imagination of surgeons. What if surgeons could actually safely open a child’s heart and repair holes and other defects?
Part of this exhibit showed what it might look like to do these repairs; this was the cusp of innovation. But what I remember most was the enormous heart you could walk through from chamber to chamber in what was likely an anatomically correct pathway while from speakers hidden in the walls of the heart came the constant lub-dub of the heartbeat. I was enraptured. That day, I decided I wanted to become a heart surgeon. My parents were getting divorced at the time, and I thought that maybe I could fix the broken hearts of other children.
What are your contributions to your specialty?
I came into the field at a time we used to call the era of wonderment. I started performing Pediatric heart surgery in 1986 at Duke, where I had done my training. We didn’t have some of the external restrictions in place today that, while intended to be helpful, can impose limits on imagination and people’s willingness to try new things, particularly when trying new things can produce a fear of failure in young people. We were in an era when we did stuff because it made sense. We would go to the research lab, try something, and then figure out the best way to apply some of the science from the lab into the operating room.
We were the first group in this country to begin using echocardiography in the operating room. We started generating images of the anatomy both before and then after repair to see if we’d done a good job repairing the heart defect. We published some of the first papers on the use of intraoperative echocardiography to evaluate congenital heart repairs. That’s evolved to where it’s a standard of care today.
Around the same time, we were also getting involved with brain protection for babies undergoing heart surgery. In the 1980s, it was pretty common for infants who underwent heart operations to have a successful heart operation but to come out of the procedure with various neurological impairments—everything from seizures to bad movement disorders, to strokes to severe incapacitation of their intellectual abilities. A lot of that had to do with the strategies we were using for performing cardiopulmonary bypass back then.
So, we began researching in our laboratory concomitantly with research in our clinical setting, and we were able to study the characteristics of how the brain gets blood flow during surgical operations. We created some of the initial strategies for brain protection for children having heart surgery, which changed the entire field of cardiopulmonary bypass and how it’s applied in the sense of protecting the brain and preventing brain injury. I would say we made considerable contributions to the cardiopulmonary bypass field that have probably impacted thousands of lives around the world.
The other contribution my team and I made was to improve overall strategies for cardiopulmonary bypass for infants and children. Cardiopulmonary bypass circuits used for adults were being made a little bit smaller for kids. We began to experience tremendous mismatches in how babies were affected by these big circuits. That led to a movement to create miniaturization of cardiopulmonary bypass circuits to reduce the baby’s inflammatory response when suddenly exposed to this great big foreign circuit. We worked on the correct sizing of the cardiopulmonary bypass machine so that it matched up with the neonates and young infants that we were operating on to create less of a downstream effect of inflammation and other systemic influences.
And then there were a lot of contributions along the lines of various surgical techniques. I have one of the most extensive experiences in the country of Ross operations. The Ross operation was named for Donald Ross, and I’ve done about 264 Ross procedures over the course of my 40-year career, which is one of the larger experiences in this country.
Over the years, we’ve modified the technique so it could be better applied to adults like Bill Wild, whom I helped alongside Dr. Sharma, to protect older patients from having some of the consequences of a Ross operation that sometimes occur in young adults. This has been a very effective modification that is now being used by surgeons all over the country.
What work are you doing outside of pediatric cardiac surgery?
The work I am most invested in now is the work I’ve done with teams and leadership and what some people call work-life balance or rather work-life integration. My wife, Jamie Dickey Ungerleider MSW / LCSW, Ph.D., and I speak and conduct workshops nationally and internationally on leadership, teamwork, conflict management, and stress management for health care professionals. We try to help them find ways to make choices that contribute to more fulfillment, joy, and authenticity in their life. I’ve written and published many articles on leadership, especially what we call our whole brain leadership, which is both left brain “operational” leadership and right brain “relational” leadership. To be an effective leader today the science, research and experience demonstrate that you need to integrate both sides of your brain.
We’ve published on wellness or occupational wellness for the surgical workforce and as well as on teamwork. We often get asked to speak on our seven practices of highly resonant teams. Those conversations usually revolve around creating teams of people, bringing out the best in them, where they feel safe and feel seen. In essence, they feel “gotten” and understood, and they feel like they can speak up and have a role on this team. That’s an area that I am contributing to more and more.
Why did you decide to become a professor?
I didn’t give it much thought at the time. I want to tell you that I had a strategy and a plan, but I didn’t. I found my tribe when I was training at Duke. I had some outstanding teachers and mentors. It was a natural connection with the people who were what I wanted to become. They were not just technically excellent surgeons, but they were innovators through research and imagination, and they were teachers. They tried to give to those who followed. I wouldn’t be where I am if there weren’t people who spent time giving of themselves to me. I think it just made sense to try and become one of those people.
Now, I didn’t set out to be a professor. A professor is a title. I gave the commencement address at the University of Missouri medical school some years back entitled, “What if there were no diplomas?” What if the only thing you knew about yourself wasn’t something you hung on a wall that validated you, but it was something you could take with you wherever you went? And I think that’s not being a professor, but a professorship is what you get if you do that.
What brought you to the Department of Surgery at UNC?
I was getting ready to come back to North Carolina to retire, and Dr. Mahesh Sharma called and asked me if I’d be willing to come and support him in some way. So, I did. In January of 2020, Dr. Kibbe asked if I would consider staying on as a member of the faculty, but I was diagnosed with throat cancer and chose to leave to focus on treatment and getting healthy.
They were very nice to call me just recently and ask if I’d be willing to come back. I’ve got a lot of other things that drive my life, and I’m passionate about, including writing and teaching, but if I can be valuable for a while in sharing what I’ve learned about heart surgery, and in helping the outstanding faculty at UNC, that’d be great.
What’s your one piece of advice for people who want to become a surgeon or a pediatric heart surgeon?
We see a lot of people today who get very down on how medicine has changed. And yet, the field of congenital heart surgery, pediatric heart surgery, is a discipline that is constantly new. Every patient is like a snowflake. We can’t categorize them, and they’re all different. They all bring their unique challenges. It’s a field that has a tremendous capacity for learning, innovating, and contributing. It never gets old. Otherwise, people like me wouldn’t be inclined to come back. It’s a great field to go into.
What is one thing you wish your patients or coworkers knew about you before they meet you?
I think I’m authentic and genuinely care about the people I work with and my patients. People who work with me can see that this is a genuine passion of mine, being able to give back to the field of pediatric cardiac surgery as a form of “payback” for all that it gave to me. I’m all in when I’m there. I’m not somebody who’s just punching a clock and doing my time. I think that the people who work with me get that.
If you could pick the brain of someone alive or dead, who would it be? Why?
I pick my wife’s brain all the time. We’ve been married for 20 years. She’s a great partner and colleague, and we constantly challenge and encourage one another. I never get tired of picking her brain. She has a tremendous perspective on things that sometimes I get stuck seeing only in one way, and she sees it differently in a way that sometimes it’s very awakening. I mean, that’s probably as good a person as any I could give you.
If you give your younger self one piece of advice, what would it be?
Don’t let the down times get you too down. Don’t let the up times get you too up. When we are younger, in particular, we tend to begin to think that the events of that day define us, and it’s really the events of life that define us. The best thing I can tell people is to hang on to your heart. Always have compassion for yourself as a learner. Treat yourself like you’re your own best friend. If you can’t treat yourself like you’re your own best friend, why would you expect others to?
It is important for people to have compassion for themselves when times are difficult (and see themselves as having experiences that all humans have). During those times they are most in need of compassion for themselves and it is their own compassionate heart that will fuel their resilience. Likewise, it is helpful to enjoy some of the really exhilarating experiences in life for what they are—an exhilarating experience that might thrill them, but doesn’t necessarily define them.
There’s a story of a mandarin farmer who had a horse, a son, and a wife. One day his horse ran away. And all the people in the town said, “Oh you poor person, your horse ran away. Such bad luck.“ He said, ”Well, it’s neither good nor bad. It just is.“ And then, a few days later, the horse came back with two other wild horses. And the people in the town said, “Oh my goodness, your wealth has just tripled. Such good luck.“ He said, “It’s neither good nor bad. It just is. One day his son was out helping in the fields, and he broke his leg falling off a horse. The people in town said, “Such bad luck.“ And again, the farmer responded, “It is neither good nor bad. It just is.“ The next day, the Army recruited all the able-bodied boys in the town to fight in a battle. All the boys that went were killed. Of course, the people in town said, “What good luck your son couldn’t go to battle.“ The farmer responded, “It’s neither good nor bad. It just is.“ The point is life just is. It’s full of all the ups and down, but we have to find a way to accept it and enjoy it for what it is as just part of life. I think that would be the advice I’d give a young person. It’s not about the stuff out there that validates us. It’s not living on that rim. It’s trying to find something central and core within ourselves that we can always take with us wherever we go. I’d have people try to connect to what’s inside them, what we call the mindful heart.
How would you describe yourself in one word?
If you could have one superpower, what would it be? Why?
The superpower I would choose would be to have an extraordinary capacity for empathy. Not the kind of empathy that gets emotionally destructive where you get so caught up in what’s happening. But to be able to have an objective empathy, to be able to understand the impact of events on others so I could help find ways to make things different for people. To truly appreciate the experiences of another as if you are them to the point that it helps you understand ways you can make things better for others.
For more information check out Dr. Ungerleider’s professional profile.