I am honored to receive the John W. Duckett, Jr, MD, Pediatric Urology Research Excellence Award from the Urology Care Foundation. To be nominated by my colleagues and friends from the Societies for Pediatric Urology and to be in the company of this award’s distinguished past recipients is a humbling experience. I realize how fortunate I was at the beginning of my career to have the opportunity provided by the Urology Foundation Scholarship to help train me in the methodologies needed to develop basic science and clinical research endeavors, training that taught me to be prepared for what happens when fate steps in.

My career is based on a saying by Allen Sanders that was turned into a song by John Lennon, “Life is what happens when you are making other plans.” In 1987, I was approached by Dr Harry Spence, a pioneer in the field of pediatric urology, to take over and manage 94 of the adult patients he had reconstructed for their congenital defects. Dr Spence expressed that these individuals needed someone with expertise in pediatric urology to watch over them upon his retirement. Although trained as a pediatric urologist, with the intent that I would never again see a patient over 18 years of age, I acquiesced to this request. I absolutely had no concept of how this would impact my life and theirs.

I was soon caught up in managing the long-term complications of ureterosigmoidostomies, bladder augmentation, and the complications of penile reconstruction in individuals who had failed multiple epispadias and hypospadias repairs. Upon relocating my practice from the University of Texas Southwestern to the Mayo Clinic in 1991, I thought I had left this endeavor behind. To my surprise, several patients followed me to the frozen tundra. Once in this new location, a few of my physical medicine and rehabilitation colleagues saw I was taking care of adult patients with congenital disabilities and asked if I would mind seeing a few adults with complications arising from their cerebral palsy and spina bifida defects. Thinking it would not be much different than my adult patients from Texas, I agreed, and with a simple response of “Sure, no problem,” the sky fell in. Suddenly, I was knee-deep in the world of adult cerebral palsy and spina bifida patients. I looked for a mentor in the field regarding how to manage these patients. Surprisingly, I found only 1: Christopher Woodhouse, from University College in London. For years, I latched onto and avidly read anything he published; although I was only privileged to ever share a few glasses of wine with him over the years, his impact on my career runs deep.

Realizing, by 1990, that my clinical and surgical practice was rapidly becoming unique, I began to keep prospective databanks on various subjects. Overwhelmed and needing help for the complex surgical reconstructions we were involved with, I was fortunate to attract 2 nurses to my surgical practice, Deb Shandley and Deb Heys. These individuals became my right and left hands in the operating room, practicing with me in the operative theater for 25-30 years. I loved their expertise in offering subtle suggestions from the operative table that greatly aided in the care of our patients and the outcome of our complex surgical procedures. To them, I am forever grateful. They are the unsung heroes of the operative theater.

In the clinic, I found an individual who would become a “mother to our patients and a dedicated work wife.” For over 20 years, she not only watched over my patients, but every day took her time to help me fill in our prospective databases. Undoubtedly, without her efforts, the clinical work would have overwhelmed our scientific endeavors.

We have been too clinically busy for decades to publish all the data we accumulated over 30 years. Indeed, only now can we devote time to tapping these data. We are analyzing databases regarding long-term renal function outcomes in patients with congenital solitary kidneys. We are evaluating the impact, if any, that we had by monitoring children with a solitary congenital kidney for the development of Müllerian and Wolffian duct abnormalities. We are assessing the impact of pregnancy and pregnancy complications in women with a congenital solitary kidney, reviewing the urological manifestations and sequelae in adults with Down syndrome and cerebral palsy. We are appraising the long-term impact of the surgical management of the upper pole in patients with ectopic ureters, determining long-term patient outcomes in individuals with persistent severe hydronephrosis following a successful ureteropelvic junction repair. In addition, we are evaluating our databanks to see if we can determine the risk factors and tests necessary for the successful long-term management of patients with neurogenic bladders arising in childhood.

I readily acknowledge that we can only fulfill our responsibility to society through the effort, inspiration, and commitment of working together as a team. Success is never an individual endeavor. I recognize the significant impact of my mentors, Drs Terry Allen, Paul Peters, Bernard Churchill, Gordon McLorie, Gene Wilson, Mike McPhaul, and numerous friends, coworkers, and family who have helped and supported me throughout my 30-year career. I need to thank Drs Brad Leibovitch and Steve Boorjian, the last 2 chairs I have worked with, for allowing me to continue pursuing my research efforts during my retirement.