Dr. Danny Takanishi’s career has come full circle. After years of saving and extending patients’ lives as a cancer surgeon, the University of Hawaiʻi at Mānoa and John A. Burns School of Medicine graduate returned home to JABSOM more than 10 years ago. This year, he takes on the role of Interim Associate Dean of Academic Affairs. In our sit-down interview, we look back on his JABSOM education and learn how it helped him throughout his career. He shares his passion for academic medicine and how it blossomed after a mentor spotted the opportunity for greatness.
Q: Like many other doctors I’ve interviewed, a career in medicine was not your childhood dream. What did you want to do?
A: I actually started out as a child wanting to be a farmer, then a zookeeper. In hindsight, I was very fascinated with science. My father was an elementary school teacher, and I’d love to read some of the zoology textbooks. Through middle and high school, I gravitated towards STEM (Science, Technology, Engineering, Mathematics.) I was also a band geek in middle and high school. I was the concertmaster for the clarinet section at McKinley, so I always enjoyed working with my hands, whether it was playing a musical instrument or building things as a child. The time came when I had to decide what to select for my undergraduate degree. My older sister went through the medical technology program here, and I saw myself enjoying laboratory work and felt it was a great stepping stone to go into medical school, so that’s what I did.
Q: Did you know what field you wanted to practice when you entered JABSOM?
A: I wanted to go into internal medicine because people would always say that the internists understood physiology and how the whole body worked. You also had an opportunity to develop these longitudinal relationships. You get to know not only the individual, but also their families and their support group. The whole ʻohana perspective really fits with the sense of growing up in Hawaiʻi.
Q: What made you pivot to surgery?
A: It happened during my core clerkships. I had wanted to go anywhere but Queen’s for my third year surgery clerkship, because it was notorious for being grueling. The lottery didn’t have it that way, and I ended up at Queen’s. I was disappointed, but JABSOM, in its own way, tried to instill this sense of resiliency, discovery, and adventure. I was encouraged to keep my mind open and not let my biases get in the way of what may be potential opportunities. I decided to make the best of it and immersed myself. I would notice things that most people might not find too intriguing, like seeing the bowel undergo peristalsis, just moving and pumping and flowing intraoperatively, and seeing the pulsation of the blood vessels that feed the bowel. It was really beautiful to see the living body in action. I was surprised when I ended up really, really liking it.
As it turned out, when I was going into my fourth year and had to start deciding what kind of residencies to apply to, I was stuck between surgery and pediatrics.
Q: You couldn’t be further apart in specialties. How did you choose between the two?
A: I think it was the challenge of the breadth of physiology, the disease processes, that enamored me. I always liked the challenges that diagnostic dilemmas posed. I did sub-internships in both specialties and came to the realization that I truly enjoyed learning the craft inherent in a surgical specialty. When it came time to apply for residency training, I decided that my goal was to work in the community, so I thought it would make sense to go through residency training here. I applied, and fate was on my side. I landed a categorical position and then finished five years of general surgery training. After that, I decided that I wanted to do a fellowship. I was interested in surgical oncology. However, as I was completing my Chief Resident year in general surgery, the Surgical Critical Care Fellowship opened up in Hawaiʻi, and for that year, I got more training and built up my skills in critical care. I got board certified in both specialties and then went on to The University of Chicago to do my three years of surgical oncology training. I always thought I would return to Hawaiʻi and work in the community, but I was offered a faculty position there. What was supposed to be three years in Chicago ended up closer to 10. It unexpectedly opened a lot of doors.
Q: One of those doors was a career in academic medicine. How did you end up going down this path? It seems like such a stark contrast to cancer surgery.
A: My section chief, who’s now the Chair of Surgery at Cornell in Manhattan, wanted me to think about leadership roles in academic medicine. Before that, it never crossed my mind. Slowly they started sticking me into positions, like medical director of the Surgical ICU at one of the affiliates. I was also appointed director of the university’s Comprehensive Breast Cancer Center. That required a lot of philanthropic activity. I was also on a CBS 2 News Women’s Health advisory panel. At that point, I thought this was a really intriguing career path. In a physician’s lifetime, if we’re blessed with longevity, we can care for many patients. That number tends to be finite within the constraints of our professional lifespan. On the other hand, in the context of academics, where you help to create systems or you help to mentor or assist with policies that can reach a much broader group of individuals who then are going to go forward to extend what you do, there’s merit and value to this. Having been raised in a family where my father was a school teacher, there was this imprinting of the value of education. The payback you get is not necessarily what you see right away, because it is an investment. Education has some profound consequences, and it has a significant reach. As time went on, I realized that much of what I was doing was within that realm, so it was just a natural progression.
Q: You’ve been back at JABSOM for more than a decade. How did you find your way home?
A: When I was invited home to be a visiting professor, JABSOM’s then-interim Chair of Surgery met with me, and said they were looking for a department chair. I was still pretty junior on the ladder, but after meeting with Dean Cadman, I applied. I did that for 11 years and was the General Surgery Residency program director for about 13 years.
Q: So that opportunity brought you home to JABSOM. How did your time as department chair and program director prepare you for this role as Interim Associate Dean of Academic Affairs?
A: As the door opened, I was invited to serve on more national committees, many of which had bearing on the role. I served on residency review committees for the ACGME, in addition to invited service on multiple Milestones workgroups. Then, more opportunities began opening up. I was invited or appointed to serve in roles for the American Board of Surgery, the American College of Surgeons, my specialty oncology organizations, the NBME, USMLE, Federation of State Medical Boards, and the LCME. Notably, there are some aspects of leadership roles that one is never quite prepared for initially. This is what we also call opportunity. It is the opportunity to grow and to tackle different frontiers, to gain experience, and to bring that back home and apply that knowledge here. There is a pioneering aspect to it all, perhaps, but at the same time, this is attended by the establishment of a firm foundation that provides valuable insights into the broad domain of a medical education program. Moreover, as a prior department chair and residency program director, I think an additional unifying theme gained was respect and acknowledgement for the vital role of good communication and collaboration. When we look back at what we have achieved in many instances, it was because we were able to build a team where everyone shared the same vision, worked together, and brought different skill sets to meet the challenges of tackling oftentimes difficult issues. I think that this is also one foundational aspect that we all gain as we go through our evolution as leaders, the nuanced insights that one possesses of the home institution, aside. These invaluable experiences collectively assist us in tactically carrying out our fiduciary duty, in the realm of strategic planning, budgetary processes, guidance and mentorship, evaluation and assessment, and programmatic development.
Q: Do you still practice surgery?
A: Yes, although I had pretty much limited myself over the past several years to just managing melanoma, which is more outpatient based, and covering the surgical critical care unit, because of time constraints based on what I was doing administratively and nationally. Now, with this transition, my primary clinical focus is in surgical critical care, where I also teach in that fellowship program at The Queen’s Medical Center.
Q: Being a JABSOM graduate and working here for more than a decade, you know the intricacies of our school. How does that perspective reflect your vision for the Associate Dean for Academic Affairs?
A: Anyone who has truly taken to heart what their alma mater has instilled in them and gifted upon them will carry forth a strong sense of commitment to that institution and to the ideals of that institution. I think having gone through both the undergraduate and graduate educational processes in medicine, not only do I come away with this sense of pride and understanding of the underpinnings of the culture here, but more so, it is a sense of really wanting others to be able to share and to enjoy the same opportunities that, that I’ve had. I went through the public school system in Hawai’i and grew up in a middle-class family. It wasn’t a situation where private schools or private universities were even on the radar. I only applied to one undergraduate school. I only applied to one medical school. I really appreciate the benefits that were given to me. I think coming with this sense of gratitude, of wanting to do this here, I think to a degree it has to do with a sense of pride and place. You know, this institution is very committed to the local population, to the “sons and daughters of Hawaiʻi.” This institution, like any elsewhere, has gone through its trials and tribulations in a state where a significant chunk of its economic portfolio is tourism dependent. Whenever that is affected, it affects the finances across the entire state, but the University of Hawaiʻi has persevered. There are lessons we learn when looking at how the University has conducted itself during times of exigency. The University of Hawai’i has been a role model in resiliency and stewardship. The Hawaiian values that are so steeped within the institution are values that I think every culture actually would love to embrace. Whether it’s simply helping others or doing things at the right time for the right reason or for the right purpose in the right way, kīnāʻole, those are things that I think every culture would like to embrace, but it is not always easy. Here, I believe this institution has really embraced that, and I hope to embody these values and ideals in the discharge of the duties of the role, and I excitedly look forward to the opportunity to do so!