Respected Suffolk surgeon takes prestigious position

Dr. L.D. Britt strides down a hospital hallway in black leather clogs and green scrubs, an entourage of medical students fanning out behind him.

He is long, lean, intense.

The 59-year-old surgeon peppers students from Eastern Virginia Medical School with questions. Chastises them for presenting a case without a key diagnostic test. Presents hypothetical situations and looks intently at them, waiting for a correct answer.

Excruciating seconds pass.

Then he dismisses one wrong answer after another until someone finally ventures, "Intracranial pressure monitor?"

"That's what I wanted to hear," he says.

He scrubs in outside the operating room of his first case, making no apology for his assertive style.

"I want them to be well-trained. I want them to leave here with a swagger - not because they're arrogant, but because they are ready to deal with anything."

It's a discipline he himself honed in one of the last segregated classes to graduate from Booker T. Washington High School in Suffolk.

He describes his teachers there as "relentless, just relentless. They did not accept any excuses. They prepared you for the toughest environment. And they were right to do so. They were aggressive about teaching."

That beginning will serve him well come October, when he'll become president of the American College of Surgeons. The post will have him dining with the country's surgeon general, traveling to Japan, England, Australia, Israel and West

Africa, and serving as the voice of America's surgeons.

It's a prestigious position that's taken hard work, long hours and a scalpel-sharp focus in a field where less than 2 percent of academic surgeons are black. He's earned respect from colleagues, some of whom question why he chose Hampton Roads over bigger cities.

"I can tell you without question he has been a candidate for some of the leading surgical posts in North America, for chairs of major academic centers of surgery," says Dr. Gerald Healy, a Boston surgeon who was ACS president in 2008.

"He has uniformly turned them down to serve the people in his community and state. He is not in it for himself; he's not thumping his chest. He's a simple surgeon from rural Virginia who's become one of the most respected surgeons in North America."

There's a slide showing railroad tracks that Britt will no doubt use in presentations overseas.

Maybe the speech will be on health care reform, or the latest surgical techniques, or the future of medical research.

Whatever the topic, the slide will fit.

"We're at a crossroads," Britt will begin, or "It's been a long journey," or "We're on the horizon of a new day."

Britt leans back on a sofa in his office and smiles: "What they don't know is I am looking at that slide to ground myself before I give a presentation."

The railroad tracks run through Suffolk. That's where Lunzy Delano Britt grew up, one of three sons of Vandious and Claretta Britt. His father was a shipyard foreman. His mother taught third grade, which explains, in part, why L.D. skipped that grade.

His mother would quiz him at the kitchen table, asking questions, presenting scenarios, engaging him in conversations that made him think.

Even as a young child, he wanted to be a doctor. A high school football injury led to an interest in surgery. Dr. Oswald W. Hoffler Sr. operated on his knee and became Britt's mentor. As a black surgeon, Hoffler broke down barriers, joining medical societies that at first wouldn't admit him but later relented.

Excellence, he told Britt, is the best weapon against prejudice.

Britt heeded the advice. He graduated at the top of his class when he was 16 and earned a scholarship to the University of Virginia. He was one of a dozen blacks enrolled when he started in 1968, just a few months after Martin Luther King Jr. was assassinated.

He buried himself in study there, making the dean's list every semester. Classmate Lemuel Lewis, who was a few years ahead of him, remembers finding Britt in a dorm study room one Saturday afternoon, the day of a big football game. He was piecing together spheres and sticks to simulate molecules for a chemistry class. "There wasn't anyone else in the dorm," says Lewis, one of the few other blacks attending U.Va. at the time.

At some point, Britt went to his guidance counselor with a question: "Where is the best medical school?"

The answer led him to Harvard, where he simultaneously earned degrees in medicine and public health before going to Washington University School of Medicine in St. Louis. Residencies and fellowships followed at two of the most respected trauma units in the country, the University of Maryland and Cook County Hospital in Chicago. The latter - where he faced a manic pace treating the uninsured and seriously injured - is best known as the setting for the television series "ER."

There, he was known as the barefoot surgeon. He liked operating without shoes.

In 1986, he accepted a position at EVMS, where he became the first black person in America to have an endowed chair in surgery.

"A visiting professor a few months ago asked why I came back," Britt says. "My colleagues still ask me that. I came back because, No. 1, I like Hampton Roads. My parents were alive. And I knew I could stake out my career anywhere."

It's 7:30 a.m., and Britt is already four hours into his day.

His alarm went off at 3:15, after which he did floor exercises and checked e-mail. He worked out at a Norfolk yacht club, then gathered medical students in the hallway of Sentara Norfolk General Hospital to go over the slate of surgeries that day.

Now he's settled into a chair and is posing questions to students, much like his mother used to with him at the kitchen table.

"If I had a telescope and could see liver transplants done all across America, if I asked you what is the most common reason for a liver transplant today in America, what would be the reason?"

"Alcohol?" one student says.

"Cirrhosis?" another ventures.

"Hepatitis or cirrhosis," a third says.

"You like to hedge your bets," Britt says, in a way that suggests he doesn't approve.

"Hepatitis?" medical resident Troy Shell suggests.

"A, B, C?" Britt queries.

"Hepatitis C?" she says.

"I agree with you," Britt says. "Ten, 15 years ago it was alcohol, but now the most common reason is hepatitis C."

There's a palpable sense of relief that lasts mere seconds before Britt is on to the next question:

"What predisposes you to hepatitis C?"

His first operation today is a gallbladder surgery he's performing with Dr. Nicholas Schaub, a resident who soon will begin a job at the National Cancer Institute in Washington, D.C.

Classical music is playing. Britt is in his socks. Students look over his shoulder.

"You can see how you can make a mistake if you cut the wrong duct," he says, looking intently at the screen on which the patient's internal organs are viewed. "If you cut the major duct, you have given him a malignancy. No case is without complications, no case is devoid of risk," he says, a point he made to a CNN reporter who called earlier this year about the death of Rep. John Murtha of Pennsylvania after the same kind of surgery.

It's a high-profile role Britt has played this year as president-elect of the ACS, and one that will expand after he's in his new post. He's been on national TV talking about the surgeon shortage and made last year's Ebony magazine's "Power 150" list of the most influential blacks in America.

The music changes according to where they are in the operation. "Dr. Schaub feels we're ready for jazz, but I'm not so sure yet," Britt says.

Once Britt and Schaub get to a point in the surgery where they feel they have a good handle on the case, they switch to jazz, then close to rhythm and blues. Britt goes to talk with the patient's wife before swinging back for a session in which medical students present cases to him.

Dr. Don Alves, who attended EVMS in the mid-1990s, remembers Britt's direct style of questioning. He says it was not done in a berating fashion, but in a way that "made you appreciate your knowledge deficits."

Britt expects much from medical students and residents, down to their appearance.

"You dress like a professional. I do not accept exposed tattoos, weird hairdos. The patients are frightened enough. I do not want them thinking, 'Who is this taking care of me?' "

He also confesses a disdain for shorter workday policies for medical residents, preferring the trial-by-fire training he had.

"Will there have to be someone with a clipboard checking off whether someone had a nap? I don't want them to have any slack at all. I'm old school. I miss the 120-hour work week."

One of the conditions Britt made before accepting a position at EVMS was office space in Suffolk and time to practice there once a week.

One day this summer, he settles in at a desk in a suite of exam rooms in Greater Suffolk Medical Center, where Dr. Michael Williams has an internal medicine practice. Britt joined the practice in 1986, three years after Williams, a native of Chicago, came to Suffolk.

"He took all comers, whether they could pay or not," Britt says.

Williams says many of his older patients know the surgeon as "Claretta Britt's son." From the medical center, Britt can walk to the house where he grew up. It's on the same street, down about half a mile, and now is a rental. Britt's mother died in 2003, more than a decade after his father.

He remembers sitting as a child with his aunt and mother all day long in a doctor's office waiting to be seen, back when this area was more rural, with fewer physicians to go around: "I knew there was something wrong with that."

Today one of his patients is Annie Land, who'd rather not say her age. Britt removed a mass - thankfully noncancerous - in her colon several weeks ago.

"This is your last visit with me," he tells her. "I know you're glad.

"Do you want to get up on the table, or do you want me to come to you?"

She answers by staying put, and he pulls a chair up to check her incision.

"I have a feeling she enjoyed the surgery," he jokes with Land's niece.

Afterward, Land offers this about her medical experience with Britt: "I live on the same street he did. And I heard so much about him, that he's good."

It's a small comment but, many would say, a powerful testament to the need for more minority physicians. To overcome racial health disparities in America, it's critical to have a force of minority physicians like Williams and Britt. Not only are they more likely to return to their own communities, but their minority patients are more likely to listen to them.

Despite being 13 percent of the population, blacks make up only 3.3 percent of doctors. For highly specialized surgeons like Britt, the numbers are even smaller.

It's a dilemma Britt tries to address by reaching further into the community than an operating room and a medical school. He's a former rector at Norfolk State University, he's involved in the Boy Scouts of America, and he even participated in an Emmy-winning television documentary called "A Call to Disarm" about youth and violence.

William Russell, a deputy superintendent for the Chesapeake schools, saw the surgeon in so many different volunteer venues in the early 1990s that he asked whether Britt had a paying job. When Russell was diagnosed with advanced colon cancer, he called Britt. He didn't want a stranger operating on him.

It wasn't so much that they shared the same skin color. It was Britt's standard of excellence, his sense of values.

"I remember he used to take his mother out to lunch every Tuesday," Russell says.

The operation saved Russell's life, and in 1995, he and members of his church raised enough money to honor Britt in whatever way the surgeon wanted.

That's how the L.D. Britt Scholarship for minority students came into being. It became an endowed scholarship this year, meaning it will last into perpetuity. Danea Campbell, a fourth-year medical student, is at EVMS because of that scholarship.

"I can see in my own family and the patient population here that there are a lot of minorities who don't trust the system," Campbell says, "because they don't see people who look like themselves who are in charge. It's important for them to see people they relate to; it puts them at ease when they're sick."

And so, in the same fashion that Britt followed Hoffler, Campbell follows Britt, who she says can be intimidating, "but in a nice way."

"I want to do well for myself," Campbell says. "But I want to do well for Dr. Britt, too."

At the top of Britt's curriculum vitae, above 52 pages of education, experience and accolades, are three lines:

Birthplace: Suffolk, Virginia

Spouse: Charlene Britt, M.D.

Daughter: Avery Marie Britt

And that sums up where he is this evening.

At the end of a day, he comes home and loosens his tie. His wife makes fried green tomatoes for visitors, a Southern hospitality that goes back to her childhood in rural North Carolina.

They met at Norfolk General, when she was completing her residency in family practice.

Britt jokes that L.D. actually stands for Late Developing; he got married the day before his 50th birthday: "I woke up and I was 50 and married."

The other Dr. Britt works part time as a family practice doctor in Virginia Beach. Daughter Avery Marie is now 6 years old. When the family visited Disney World in February, it was a first for all three.

Even in that arena, Britt was comprehensive: "I made sure she had her picture with each princess."

He expects his daughter will be able to see a bit of the world when he is traveling next year. And he hopes they'll still have time for conversations like his mother had with him. Avery sometimes comes up to his study to sit on her father's lap.

Britt lives in Suffolk, but he keeps a residence in Norfolk for when he is on call for trauma surgery at Norfolk General. He admits to long hours on the job: "I don't apologize for that."

But "when I'm home, I'm home."

While his questions may raise the blood pressure of students, here he's on the other end of the directives.

"Daddy, pick your feet up," Avery says as Britt and his wife sit on a porch swing on the three-story house that overlooks the Nansemond River. It was designed for them by the same architect who refurbished the historic Attucks Theatre in Norfolk.

"Is that long enough?" Britt asks in a rare moment when his feet aren't pounding the ground.

He doesn't see coming back to Suffolk as paying off a debt to the community that raised him as much as coming full circle:

"I wanted to close the loop. I didn't want to come back and then not go to my hometown. I sit in the same pew that I sat in as an infant with my mother. My daughter sits there, too. It's closing the loop, it's a completeness. It keeps me grounded."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com