Medicine in
general and surgery
in particular
matched Nelson’s
lifelong desire to
do things that were
hands-on, making
ideas tangible
CR | Page No. 26 | Winter 2009
At the same time, the Mayo
Clinic has been a place for
Nelson to test her wings. Nelson,
who grew up with her brothers
and cousins on the West Coast,
migrated to the Midwest after
completing medical school and
her residency. Drawn to cancer
because of the complex problems
it posed, Nelson arrived at Mayo in
1987 on a fellowship that focused
on colon and rectal cancer surgery.
She became the first female
surgeon on staff when she was
hired in 1990 and, in 1996, was the
first woman to chair the surgical
division. She also became the
head of a research lab focused on
cancer immunology.
From the time she first set
foot in the operating room,
Nelson says, she found surgery
“captivating.” Medicine in general
and surgery in particular matched
her lifelong desire to do things
that were hands-on, making ideas
tangible. “It became clear to me
that this was a fit, a perfect fit,”
she says, speaking with controlled
passion. “I’d found my calling. I’d
found what was natural to me and
I fell in love with the profession.”
Just three years after she was
hired at Mayo, Nelson received
a federal grant to study a new,
less-invasive surgical technique for
treating colon cancer. In the early
1990s, she explains, it seemed like
the field of gallbladder surgery
had been turned on its head by
the technique, called laparoscopy,
which required only very small
incisions. Surgeons were beginning
to look at using laparoscopy for
colon cancer, but some early
reports led doctors to fear that
operating in such a small space
might accidentally spread cancer
cells throughout the abdomen or
to the incisions.
Because of those concerns, the
clinical trial Nelson spearheaded
to examine laparoscopy for colon
cancer was controversial from the
start. Eventually, 872 patients at
48 institutions joined the Clinical
Outcomes of Surgical Therapy
(COST) study, which was funded by
the National Cancer Institute. Each
surgeon who participated followed
a defined protocol and had to
submit videos of their operations
to Nelson’s team so they could
ensure that the procedures met
specified standards. On top of
her surgical schedule, which often
kept her in the hospital from
7 in the morning until 9 at night,
Nelson found herself reviewing
these surgical videos at night and
traveling frequently to talk about
the study and recruit institutions
to participate.
The COST study became “a day
and night job,” Nelson says. “I
loved the work I did … [but] when
you are wrapped up in surgery, it
can take over your life. I don’t feel
that is necessarily wrong, but it
was maybe a little more consuming
