Dr. Jeffrey Marsh takes the Chinese proverb, Teach a man to fish… a step further. He believes in “teaching men to fish, so they can teach others to fish.”
The director of pediatric plastic surgery at Mercy Hospital and head of Mercy’s Cleft Lip/Palate and Craniofacial Deformities Center travels around the world to Southeast Asia each year to teach life-changing surgical skills to physicians—who can then teach other health care professionals those skills. “As a surgeon, I work with my hands, and I can only help a small number of people,” Marsh notes. “But if you can train other people to do that same thing, then you can expand your impact exponentially.”
Throughout a 35-year career in medicine, Marsh has helped some 5,000 patients—and tens of thousands more by training resident and fellow physicians in St. Louis, as well as international health professionals. “The work for me is not just the people who I have operated on myself—it’s by training others to do that same kind of work to allow them to provide services to individuals who need the care.”
In Marsh’s case, those patients are among some of the smallest and most vulnerable. And his care of kids with facial birth defects can start as early as the mother’s womb. Through ultrasound technology, Marsh and his interdisciplinary team—from neurosurgeons to dentists—can begin to examine pediatric patients they haven’t even met yet. Once patients become young children, Marsh says he is able to build a rapport that aids in discussing the sensitive issues related to facial reconstructive surgery, including treatment of cleft lips and palates, and Beckwith-Wiedemann Syndrome, a rare condition that involves an enlarged tongue. “As the children age, they get used to seeing me once every year or two for routine evaluations, or more intensely during an operation, so a relationship develops over time.” When children become older, Marsh strongly believes in their involvement during the treatment process, in addition to their parents’ input and permission. “As kids get old enough to be aware of any facial difference they might have and having questions or concerns about it, I think they should become actively involved in the process,” he continues. “If we’re going to do something to change the appearance of the face, and the child is not having any psychosocial issues, I listen to what the child says to see if they think it is important to change something.”
In Bhutan, the Himalayan country in Southeast Asia where most of Marsh’s medical missions abroad take place, his relationship with the parent and child is reversed. “Because English is part of the education system, kids usually can converse moderately well in English and their parents can’t at all,” Marsh explains. “So the kids become the interpreters for their parents.” And most health care professionals can at least read and communicate some in English, he adds.
Those physicians’ communication skills have been invaluable to Marsh as he trains them in reconstructive facial surgery. While Marsh has treated hundreds of patients with cleft lip and palate surgeries in Bhutan, he finds his educational work with the country’s health care professionals to be the most crucial. “The objective is not for us to be permanent care providers, but to help build up and mature their program so the local care providers can carry on the work,” he notes. The international work is what Marsh hopes to do more as he winds down his practice in St. Louis within the next three years.
Marsh also treats patients from throughout the world from right here at home in St. Louis. Through the inception of parent-patient support groups and the heightened use of social media, a growing number of national and international patients’ families have discovered Marsh’s expertise in the treatment of cleft lip and palate and the rare Beckwith-Wiedemann Syndrome.
As Marsh approaches the finish line of his everyday practice, the Johns Hopkins graduate recalls realizing early on where his love was—dealing with kids and their facial birth defects. And through serving those patients in St. Louis and abroad during a 35-year career, Marsh says he has developed a large extended family. “I get graduation photos, marriage photos, and even the babies of the babies’ photos…there is always a huge wall of cards at the hospital.”