Before he can remove Stein's liver, devastated by hepatitis B, Busuttil takes an urgent call. A doctor quickly explains that one of her patients, a 6-month-old boy, has taken a turn for the worse. Is there any chance the half designated for OR 17 could save this baby?
No way, Busuttil says into the phone. "It's humongous. The lateral segment is huge. It's too big. I'm not going to waste it."
Know the difference between God and a surgeon?
God never wanted to be a surgeon.
"We do play God," Ronald Wilfred Busuttil says matter-of-factly. "I mean, you don't think you're playing God, but you're making a decision that determines whether that person lives or dies. Oftentimes, we don't make the right decision. We put livers in people who are way too sick. We think we can do it--and they die, and the organ goes with them. Or else it could have gone into somebody else. So just deciding who an organ goes to, every time you do a transplant, you, in a sense, are playing God."
If Busuttil is not the world's most experienced liver transplant surgeon, he is close, fast on his way to his 3,000th transplant. In the 16 years since he stopped at a convenience store to buy a Styrofoam chest and ice for his first precious cargo, he has built UCLA's liver program into the nation's busiest. His influence extends far beyond Westwood. Busuttil launched a transplant satellite six years ago at UCI Medical Center and retains oversight duties there. He and proteges kept the transplant program alive a few years ago at Cedars-Sinai Medical Center, where Busuttil still holds the title of academic director. And as president of the American Society of Transplant Surgeons, this overachieving son of immigrants draws fire in the emotional debate over the nation's organ allocation system.
"He's a star. He's world-class," says Thomas E. Starzl, who performed the first successful liver transplant in 1967. How many other liver surgeons fit that description? "Not many. Two or three."
Busuttil stands about 5 feet, 8 inches tall and has the trim build of a man who twice finished the New York City marathon and runs three to four miles a day. He is 54, with graying hair combed back and a manner that is by turns brisk and friendly. He plays a serious game of tennis and collects high-performance sports cars. His office decor at the Dumont-UCLA Transplant Center features a photo of him racing one of his Ferraris at Laguna Seca, an image that inspires jokes about Busuttil himself wanting to be an organ donor.
By all other appearances, however, Busuttil is a model of stability, a man of both science and faith, a Catholic who used to serve as a lector, and a husband who surprised his wife on their 25th anniversary with a lavish party at the Hotel Bel-Air. That night, the Busuttils renewed their vows before daughters Amber and Ashley and more than 100 guests. "My husband," JoAnn Busuttil says, "never does anything halfway."
At UCLA, "Dr. B" is a known workaholic, "addicted" to surgery, as one colleague puts it. Though sometimes impatient and demanding, Busuttil also seems well liked. Surgeon R. Mark Ghobrial describes his mentor as at once gutsy and very kind. Nurse Fong Chuu says her boss has mellowed since the day he rebuked her for a forceps fumble. "He said, 'Fong, you do that one more time, I'll chop your hand off.' He claims he doesn't remember."
"Very intense," Dr. Goran B. Klintmalm says of Busuttil. Now chief of the liver transplant program at Baylor University Medical Center in Dallas, Klintmalm and Busuttil are part of the generation of liver surgeons who trained under Starzl. Klintmalm and Busuttil didn't write the book on liver transplantation. They edited it. The text, hefty as a family Bible and just $275 through amazon.com, contains 85 chapters written by more than 100 surgeons and hepatolgists from around the world.
"He's very fast and quick in seeing the situation, in seeing the questions as well as the answers," Klintmalm says of Busuttil. "He's always busy with something. He has all these plans and ideas and thoughts. He is a visionary." Which is not to suggest that Klintmalm and Busuttil always see eye-to-eye.
Transplant specialists work erratic hours, as many as it takes, responding as organs become available. Busuttil's stamina is the stuff of legend: He once performed five consecutive transplants over a 28-hour stretch. But, associates say, he knows his limits. "He's too much of a control freak to let his body get the better of him," one says.