The photograph of a little girl all dressed up and playing with her new doctor’s set makes Dr. Oluwafunmilola T. Okuyemi go down memory lane with a smile.
An assistant professor in the UNLV School of Medicine department of otolaryngology, Okuyemi, who was the first otolaryngology-trained microvascular reconstructive surgeon in Nevada (there are now two), noted that the family photo caught her earnestness.
“I was pretty young, 4 years old, when I started thinking about becoming a physician,” she said, smiling as she remembers the time in her native Nigeria when a birthday gift punctuated an already developed desire to help people with health problems. “You can see in the photo I’m serious about this doctoring.”
Today, Okuyemi and her UNLV colleagues in otolaryngology, which is better known as ENT or ear, nose and throat, couldn’t be more serious about their efforts in helping treat head and neck cancer and non-cancer patients as well as, most recently, UMC’s critically ill COVID-19 patients.
Adapting a long-used technique of creating a tracheostomy (a hole in the neck that helps patients get off a breathing machine) to the treatment of recent COVID-19 patients, the UNLV team sews the patient’s skin right up to the surgical cut hugging the breathing tube (Okuyemi says they’re the first group to adapt this technique uniquely to COVID-19 patients), making it more difficult for the virus to escape into the air — a procedure making it less likely for the virus to spread to the health care team.
JAMA Otolaryngology-Head and Neck Journal, a peer-reviewed publication of the American Medical Association, last month published the UNLV team’s research article on the procedure.
“These and other research opportunities or innovations are what attract me to academic medicine in Las Vegas — an opportunity to assess what is being done and develop strategies and interventions for improvement,” said Okuyemi, who was recruited in 2016 to Las Vegas to join the UNR Medical School. A year later she transitioned to UNLV’s new medical school.
On a day-to-day basis, Okuyemi essentially focuses on surgery to remove head and neck tumors (both non-cancerous and cancerous) involving the skin, oral cavity, pharynx, larynx, endocrine glands, salivary glands, and neck structures. “Often,” she said, “removal of these tumors leads to significant defects...that require repair...This is where the reconstruction comes in, as we use tissue from somewhere else in the body to repair the defect and improve functions of speech, swallowing and cosmesis.”
In a recent interview that dealt with her past, present, and future, Okuyemi, an adventurous sort who enjoys the adrenalin rush of skydiving, fencing, and traveling the world, shared her thoughts on matters that included childhood experiences, her Yoruba culture, watching an autopsy at age 4, the uniqueness of a physician’s life, Black History Month, and racism.
Early inspiration
Her goal of becoming a physician materialized very early, during her own childhood hospitalizations for malaria.
While her parents — her father is a chemical engineer and her mother is in banking and finance — had the means to pay for hospital treatment for their children, some other parents weren’t as fortunate.
To this day, Okuyemi sees in her mind’s eye families showing up at a hospital with children just as sick, if not more so, than she was, but without the funds to pay for treatment.
“My parents, God bless them, would do what they could to help others out at such times, but never for one moment tried to shield us from the reality that the world was not rosy and we needed to do our part to make it better. I recall always feeling so bad in those situations, and asking myself, ‘How can I help?’ I decided in those moments that I was going to be a doctor and do my part. This was at the age of 4 and it stayed with me.”
She grew up as the last of three children in Ibadan, a city in southwest Nigeria that at the time of Nigerian’s 1960 independence from Britain was the largest city in West Africa and the second largest in Africa after Cairo. She has an older brother who is a chemical engineer and an older sister who is also a physician. Of her parents, she says: “They always pushed us to accomplish the best. I remember an incident when I scored 18 out of 20 on a test in primary school, and I was hoping to brandish my result in front of my dad. And on his looking at it, his response was ‘Did the person who got 20 out of 20 have two heads?’ Wow, I was immediately humbled and worked harder the next time.”
It was in nursery school that she says she realized she’d love mathematics and science.
“My nursery school teacher had to take the day off. So the principal, who had taken a liking to me, said that I should teach my mates what had been planned for the day. So here I was, with a piece of chalk and blackboard taller than I ever could be at the time. I stood on a chair to teach the class. It was simple addition and subtraction, but goodness, I remember thinking this could be fun one day. It was an experience that made me want to learn more and be educated in the best way possible.”
An unusual opportunity
When she was 14, Okuyemi and a friend, whose mother was the head of surgical pathology at one of Nigeria’s teaching hospitals, both told the pathologist over lunch that they wanted to be doctors. “She looked at us curiously and then said, ‘OK, come with me.’ We had no idea where we were going until we got to the morgue. She opened the door and waved us in. She said, ‘Let’s find out if you really want to be doctors.’ And right there, we watched a post-mortem from start to finish, exploring all the organs. I loved every moment. I have always wondered if my friend’s mum wanted to see if we could stomach what was to come in medicine, or if she just wanted to watch two teenage girls squirm. Regardless, that experience most certainly was a major decision point for me. It confirmed my choice of medicine and got me thinking specifically about surgery.”
After attending a Nigerian boarding school, she emigrated to the U.S. for undergraduate studies at Rutgers University in New Jersey. “After secondary school, I knew I wanted to study medicine outside Nigeria. There were on-going faculty strikes in many universities in Nigeria at the time, which could amount to a delay in starting or continuing a medical education.”
After receiving her bachelor’s degree in biotechnology from Rutgers, she went on to obtain her MD at the Washington University School of Medicine in St. Louis. She also completed a residency in otolaryngology and a master of science in clinic investigation there. She then completed a Head and Neck Oncology and Microvascular Surgery Fellowship at the University of Iowa Hospital and Clinics.
Originally, Okuyemi thought she’d specialize in cardiothoracic surgery. But in her third year of medical school during her ENT rotation, she saw a lower jaw being cut out due to a cancer, while simultaneously being recreated from a bone in the leg. “It was literally a jaw-dropping moment for me. I remember saying to myself, ‘Wow, we do this in ENT? Sign me up!’ And that was how my journey into ENT began.”
Being a physician is a unique honor, Okuyemi said, because providing hope and relief to people through the practice of medicine is something few others can do. It is a partnership, she said, that is “enveloped in a relationship of trust.” To help people at their most vulnerable, she stressed, is a privilege, one she said she holds “most dear and will never take for granted.”
Okuyemi said the ability to combine the expertise of head and neck cancer removal with immediate highly complex reconstruction is the specialized level of tertiary care in otolaryngology unique to her and her group in all of Nevada. Her goal is to galvanize head and neck cancer care in Las Vegas, and throughout the state, through partnership with other physicians, including, but not limited to, otolaryngologists, medical oncologists, radiation oncologists, oral surgeons, plastic surgeons, and speech therapists. She’d also like interested citizens in the community to get involved, believing it would accelerate access to care for these patients and further improve outcomes.
“Las Vegas is unique in having an abundance of the risk factors of smoking, alcohol, and sunlight exposure that predispose to head and neck cancers,” she says. “ Any efforts to modify the abundance of these risk factors would be impactful.”
Black History Month
A naturalized U.S. citizen, Okuyemi's take on Black History Month speaks to people of all backgrounds. “When I think about the month, I think that at the foundation of all races or tribes or ethnicities is one important element — humanity. Our humanity underscores our essence, it underscores our being, and is the one thing that we all share. When we celebrate diversity, we are in essence celebrating humanity and that is such a powerful motivation for propelling humanity forward.”
Okuyemi said racism has been costly for society, and many lives have been painfully lost.
“I grew up in an African country where race was not a societally conscious issue. As other African immigrants might be able to identify with, coming to a country where all of a sudden race is a conscious issue in society impacts your awareness differently.
“Have I seen or experienced situations in relation to racism so far? I have, ranging from the overt where a patient did not want to see a Black doctor, to the subtle circumstance. You know, what is so interesting is when operating during surgery and the skin has been cut to gain access to the deeper tissues, looking at the structures before you look at the color of the outside skin ceases to be obvious and really does not translate to the internal structures. I could not tell apart the thyroid gland of one ethnic group from another by just looking at the gland while I am operating. The intricate color of the body organs and structures is the same in everyone no matter the race.
“So why then, should skin color which is only skin-deep, have so much stake in deciding fates or destinies? I believe that if we can really focus on the foundational element, the humanity that unites us all at the core, it allows us to respect and treat each other with dignity regardless of what we look like or where we come from, doing the best as we can, as God intended.
