Alum of the Month

Hotchkiss Alum of the Month | January 2021 | Dr. Kate Gray '92

Dr. Kate Gray '92 is an orthopedic surgeon with specialized training in the care of the hand and upper extremity. She is also one of the team physicians for the National Hockey League's San Jose Sharks®.

Born in Carmel, CA, Gray explains her path to Lakeville and Hotchkiss. "My parents were divorced, and my mom married again when I was eight. We moved to the Bay Area at that time. My stepfather had gone to Harvard Business School and had always been under the impression that an East Coast education was better than those offered on the West Coast; he had sent his sons to Deerfield Academy. My mom did not want to send me to boarding school, and I wanted to stay at the Menlo School, a well-regarded local private school, where I had completed my first two years of high school. But my stepdad thought I needed to be challenged and pushed the idea of boarding school. Since Deerfield, at that time, had only recently gone coeducational, we thought that might not be the best option.

"As my stepfather was familiar with Hotchkiss, I ended up applying there - actually the only boarding school to which I applied. Since I was not very excited about the prospect of leaving home, we compromised - if I went to summer school there and liked it, then I would consider enrolling. If I hated it, I could stay at the Menlo School. I was already strong in academics, so I chose to participate in the Hotchkiss drama summer program. I found the School itself to be amazing, and I loved the lake, the campus, and the people whom I met. There were many international students, and I spent a lot of time with my new German friends. I enjoyed many new experiences and the exposure to so many different things. I returned to Hotchkiss in the fall as a new upper mid."

Gray was one of only three or four incoming upper mids that year and found Hotchkiss during the regular school year to be much different. "My roommate was also a new upper mid; she was a star tennis player from Puerto Rico. While there were a few international students, I was surrounded mostly by New Englanders. There was no dress code at Menlo School, and wearing boys' boxer shorts and t-shirts was the fashion. When I showed up at Hotchkiss with a brand-new wardrobe of skirts that hit way above the knee, within just a few days I heard a group of boys singing 'She wears short skirts!' I quickly learned that to fit in, I needed to start shopping at L.L. Bean! Making friends as a new incoming upper mid was not easy. It really wasn't until my senior year that I found my crowd and felt comfortable socially."

Overall, Gray found the faculty to be kind and helpful. "When I arrived, Joe Merrill was assigned to be my advisor and was very supportive. He suggested that I try out for the ice hockey team even though I couldn't skate. He lent me all of his daughter's pads and gear, as I was very good at falling. As you can imagine, I did not make the team! Walter Crain always looked out for me. He always had a big smile, and you could count on him. Senior year, I lived on the fourth floor of Bissell, and I liked the fact that our floor faculty member, math teacher Becky Perotti, treated us as equals."

Drawn to the science program, Gray particularly enjoyed biology with Jim Morrill. "He was a kind, soft-spoken man. I took an elective called Evolutionary Biology as an upper mid and AP Bio as a senior. Evolutionary Biology had only eight or so students. We killed our own frogs, dissolved them in acid just long enough until all the soft tissue was gone, and reassembled and reattached the bones into complete skeletons. I think that was where I found my love of bones. I also took physics and calculus at Hotchkiss. I was the only girl in my physics class, and that turned out to be a long-term theme for me, being the only female. I loved physics, and it came very easily. Calculus was more of a challenge, but I really liked my teacher, Dave Coughlin, and he prepared me so well that I never had to take calculus in college, which was fabulous!"

Yet, few experiences of value come without their challenges, and Gray found one with a history teacher. "We just didn't get along. If I used the word 'like,' he would make me start each sentence over again until I could say it without using the word. He was only supposed to be our teacher for the first semester, but when we got back from winter break, there he was, and I remember how difficult it was to keep from crying during that first class back! I do credit him, however, for ridding 'like' from my vocabulary!"

Gray had played water polo in California, but since Hotchkiss did not have a girls' team, she, along with three other girls, joined the boys' JV team. "We had a great time together. As a senior, I was the only girl to make the varsity team, and it was awkward. I was not great and did not play very often." She also participated in track and field.

Medicine was always in the back of Gray's mind, as her father was an ophthalmologist. She had thoughts of becoming a doctor, and her time at Hotchkiss helped solidify this idea. "Hotchkiss was academically a step up from my local high school, and it provided me with an excellent foundation in the sciences, one that I needed to make it through all of the pre-med requirements once at Stanford. Stanford pre-med courses were notoriously 'weeder' classes, and while I found some of them quite difficult, I was very well prepared and had great study skills. Additionally, in boarding school, you learn to take care of yourself, in terms of studying, but also in basic living skills like eating well and doing your own laundry. Most of my classmates at Stanford were still trying to figure this out during their first semester."

During her five-year orthopedic residency, Gray discovered her future specialty. "Throughout that time, you rotate through the variety of orthopedic subspecialties. I found that I enjoyed taking care of patients with hand injuries and hand problems. While every body part is important, the hands are invaluable - necessary for work, sport, hobbies, and for expressing yourself. As a physician, I not only address the orthopedic issues in the hand - the bones, joints, ligaments, and tendons - but also the nerves, vessels, tumors, etc. I am never bored and am always seeing new problems and learning new techniques in caring for the hand's intricate anatomy. There is no room for complacency in the mastery of this subject, and the specialty of hand surgery is an ever-evolving practice. Surgeons try out new techniques or do a new variation on a surgery frequently, and given the breadth of hand surgery vs. other orthopedic subspecialties, this happens more often in hand surgery than in other areas."

In what has become a reoccurring life challenge for Gray, as a female she is a minority in her professional field. "Only seven percent of practicing orthopedic surgeons are women, the lowest of any medical or surgical specialty, and this is not changing quickly. When I started my orthopedic residency, I was the only woman out of 32 residents, and there hadn't been a woman in the program for seven years prior to my arrival. It was three years before the residency director asked me where I slept when I was on call and offered to find me a room that I didn't have to share with the men. I declined the offer, as I wanted to 'have a seat at the table,' so to speak, or in this case, the bunk beds, learning from my peers. I had my first child at the end of my fellowship, and though most of the attending surgeons were supportive, one commented that I needed to decide if I wanted to be a mother or a surgeon. Awareness around gender bias is slowly changing, but it is certainly still present. I am lucky enough now to work in a department where half of our surgeons are women. This was not by design. This happened by hiring the best candidates."

Gray's days vary, with time spent in the office seeing patients and operating. "We have several venues for operating. I am typically in our ambulatory surgery center, where I do the majority of my surgeries. We also have a procedure room, where the patient is wide-awake with just local anesthesia, and there I do smaller surgeries like carpal tunnel releases and trigger finger releases. When I am on call, I cover general orthopedics, where I see patients in the Emergency Room, often fixing hip fractures in the elderly.

"When the coronavirus hit its first peak in the Bay Area in the spring, we stopped doing all but emergency surgery in order to preserve our supply of personal protective equipment (PPE). Our ambulatory surgery center was turned into a 50-bed ICU. All doctors who were not already working in the ICU or emergency department were trained to work in those departments. That was quite intimidating, since I have not had to care for someone with a heart attack or other serious medical condition for decades. Fortunately, I was never needed in those venues, and I remained busy in orthopedics because people continued to injure themselves. Often out of boredom in lockdown, patients would find new risky behaviors, like using their kids' hoverboards or trying roller skating again for the first time in years. So I continued to do a lot of surgery for fractures and soft-tissue injuries."

Surgery is not always the best option, and doctors do not always have a quick fix. "I am a surgeon, but sometimes, just behavioral modification and self-care are the best options. When surgery is the right treatment choice, it is never the end of the healing process. Patients need to be invested in their care, and often have to work hard with a therapist and be willing to push outside their comfort zone in order to achieve their best outcome. Motivation and adherence to post-operative therapy are key. Unfortunately, those who don't cooperate with post-op recommendations will fall out in both directions - meaning some patients go back to activities too quickly and can reinjure themselves or do not allow things to heal appropriately. Others remain too cautious and pain-avoidant and may never achieve optimal range of motion or strength."

"I am fortunate to work at Kaiser, which is not available in all parts of the country. We are an integrated health care system, and the doctors are salaried. Though no patient wants to think that their doctors' choices are influenced by finances, we have plenty of evidence to show that, unfortunately, they are. In most systems, including private practice and academics, surgeons, as we say, 'eat what they kill,' meaning they only make money if they operate. In our system, surgeons make their salary regardless of how many surgeries they do. Meaning, we have no financial incentive to operate unless we believe it is the best option for the patient. This is a powerful difference. I do not mean to say that Kaiser is perfect, but our system has been recognized nationally, for quality and as one of the solutions for sky-rocketing healthcare costs."

In her role as a Team Physician for the San Jose Sharks®, she is part of a team of specialists. "My colleague, Dr. Mark Davies, has been Head Team Physician for the Sharks since 2014. The NHL requires that there be an Orthopedic Sports Surgeon, an Emergency Room physician, and a Family Practice physician present at every game. Therefore the core team of physicians is made up of two Orthopedic Sports Surgeons, two Emergency Department physicians, and two Family Practice physicians, who share coverage of all the games. Mark also wanted to build a team of specialists who are experts in their field, so he asked me if I would be the hand surgery consultant. There are also a team dentist and consultants in Spine Surgery, Physical Medicine and Rehabilitation, and Ophthalmology. I do not cover the games, but am available as needed. I will often see injured players in the locker room before or after games."

Surely, the most challenging part of Gray's job is the occasional bad outcome. "No matter how hard you try or how diligent you are, sometimes things don't go as planned. Whether it is a bone that doesn't heal, a wound that becomes infected, or a patient who isn't perfectly satisfied with their care, bad outcomes weigh very heavily on me. I am lucky to have amazing partners with whom I share and discuss cases, and we support each other when outcomes aren't ideal. We remind each other to practice self-kindness."

In contrast, knowing that she has helped someone gives her great satisfaction. "I recently got a note from a 73-year-old patient expressing her gratitude. I operated on her broken wrist, and she wrote to let me know that she is back to doing 50 pushups per day and lifting 50-pound bales of hay! I can't take credit for how amazing she is, but it definitely gives me a sense of satisfaction knowing that I helped her get back to her pre-injury level of functioning. And while I can only impact the lives of a small number of patients at a time, I thrive on the visible benefits of my work."

Gray feels fortunate that she found her calling. "I considered public health, but ultimately chose to become a surgeon. It fits my personality and skill set better. I love using my hands and being creative, fixing and rebuilding things. One of my favorite procedures is treating a condition called Dupuytren's disease. This disease of the connective tissue in the hand causes one's fingers to contract down into a bent position, preventing them from straightening. One treatment option is to use a simple needle as a tiny scalpel to blindly break up the abnormal tissue through small poke holes in the skin. Within a few minutes, a patient who hasn't been able to shake hands with someone in years has a fully functional hand!"

Hotchkiss remains relevant for Gray, though she last visited in 2003. "My future husband and I were in the area for a wedding. We walked around, and I marveled at all the changes that had taken place since I was a student. Regretfully, I have not been to any of my Hotchkiss reunions, but I do plan on going at some point to catch up with old friends. I keep in touch with two classmates. Emmett Berg and I reunited in Santa Monica, CA, in the early 2000s, when coincidentally we both moved to the Bay Area. I also remain close to Jen Davies. Jen had been abroad in France when I was an upper mid and returned to campus that spring a day or two before graduation, and we became instant friends. She attended the University of California, Santa Cruz, while I was at Stanford, so we were able to see each other during college. She had grown up in Idaho and was a rafting guide and whitewater kayaker, and taught me how to do those things on the rivers in Northern California. Rafting and whitewater kayaking continue to be two of my favorite hobbies, activities I enjoy with my husband and three kids. Jen now lives in Montana, and I was fortunate enough to visit her there last year."

Gray's experiences and challenges as a woman have led to her involvement as a volunteer for The Perry Initiative. "This fabulous organization was started by a female orthopedic surgeon and a female biomechanical engineer. It is committed to inspiring young women's interest in these two fields, in which women are drastically underrepresented. They host outreach programs for young women in high school, using local female surgeons and engineers as the teachers. I have had the honor of teaching young women how to suture on pigs' feet, perform 'surgery' on artificial bones and ligaments, and speaking with them about my career and pathway to becoming a surgeon. While the workshops are currently on hold or have gone virtual, I encourage anyone who might be interested in volunteering or attending a workshop to get in touch at www.perryinitiative.org."

Gray is not on social media, but if you'd like to connect, you can reach her at: graykate@gmail.com.


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