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UMC musculoskeletal oncologist providing care patients otherwise might not be able to obtain

JACKSON — Dr. Scott Porter, who is on the faculty at the University of Mississippi Medical Center, is one of a kind in Mississippi. The graduate of Yale Medical School is the state’s only musculoskeletal oncologist treating patients suffering from cancer of the extremities including muscles, bones, nerves and skin.

Strange as it may sound, Porter didn’t like school much during his elementary and high school years. This is despite the fact that the last time he got a grade lower than a “B” was in junior high.

“It was one of those deals that certain people just get certain things,” Porter said. “School was just something I got. I didn’t have this great love for it. I could just figure out a way to get good grades. Maybe it is a good memory. Or it may have been a way to keep from getting a whooping for bad grades. I had ‘spare the rod, spoil the child’ type of parents. It wasn’t anything more than that. I wish it were more grand. I wish my story was more a fairy tale, but it really isn’t.”

When he was in high school, despite his high scores the school counselor recommended that Porter attend a trade or junior college. Porter said it didn’t have that much impact on him, but his mom was very upset.

“If that counselor walked in right now, I would have no idea who she was,” Porter said. “I didn’t read anything into it. My mom certainly did. She gave the counselors a tongue lashing. I think a significant part of it was a small town mentality instead of any race issues.”

After graduating with all A’s with a degree in biology from Morehouse College in Atlanta, he was accepted by both the Yale School of Medicine and the Harvard Medical School. He chose Yale. After completing an orthopedic surgery residency, he felt challenged to do more. So he successfully completed a fellowship in musculoskeletal oncology at the University of Chicago.

“Orthopedics is not a profession that deals with sick or dying people, generally speaking,” Porter said. “Most patients are healthy and had some acute mishap befall them, and seek our help. We put them back together and they go about their way. As a resident, I kind of wanted more. It is life and death now. I like that. I wanted to touch people more.”
It is a tough, stressful climate. Porter is faced with life and death issues on a weekly basis. “You grow up kind of fast doing that,” he said.

By offering this specialty in Mississippi, people are able to get care who otherwise might not be able to get it. Mississippi is the poorest state in the union, and many people here are on Medicaid. Medicaid payment plans aren’t transferable across state lines.

“So it is difficult for Medicaid patients to cross stateliness and get care,” Porter said. “Yet Medicaid patients are a significant part of your population that has to seek medical care in Mississippi. They are out of luck unless they can figure out a way to receive care somehow at a neighboring institution in Memphis, Birmingham and Houston.”

Porter gets some patients from out of state. Since Hurricane Katrina, the only musculoskeletal oncologist in New Orleans left that area.

“There is somewhat of a void there, so I see a lot of people from southern and mid-Louisiana, as well,” Porter said.

Porter’s work involves surgical removal of tumors from patients who are likely also being treated by a radiation oncologist and a medical oncologist. He says “a knife is a knife” and the same kind of surgical knives are being used now that were used 20 years ago. But while the tool hasn’t changed, other things have.

“The biggest advance now is we don’t do amputations as much anymore,” Porter said. “The previous amputation rates were six to eight out of 10 people. Current amputations rates are more like one out of 10 or 1.5 out of 10. That number continues to shrink as we continue to push the envelope for surgery.”

In cases with patients who have advanced cancer, doctors can’t save everyone. Scott said it is depressing to lose a patient. But he remembers reading a philosopher in college who said the depth of depression defines the height of happiness. That has stuck with him.

“You rejoice for the patients you save, and grieve for the ones you lose,” Porter said. “While some people certainly get emotional when they realize what they are facing, people don’t fall apart. People are strong. It is all in the presentation. Even if there is only a two-in-10 chance of living, I tell my patient that only the people who fight have a chance of being that two.

“I give an objective spin. I don’t believe in sugar coating. I tell them what it is, what we have to deal with, but then I give them a pep talk, if you will. My favorite line is I tell people, ‘I’m not your friend. I’m your doctor. You brought the other person here to be your friend. It is their role to console. My job is to give objective information and the fighting chance you deserve.’

“The unfortunate thing is that many of the primary cancers that people like me see are extremely aggressive and oftentimes lethal cancers. The beauty of it is that over the last 20 to 30 years, our survival rate has increased significantly. It’s still not to the overall survival of the other cancers that are more commonly known, like lymphoma.”
Porter said he elected to take the job in Mississippi a year and a half ago partly because his parents are close in Alabama. But the main factor was he liked the people he met here.

“When I interviewed, it really clicked,” Porter said. “The residents I have are phenomenal. The people in the department are great. It was just a family fit. We have a class act of people here, so it makes it easy.”

Porter finds being an assistant professor equally if not more enjoyable than practicing his specialty. And in his spare time, he enjoys his hobbies of running, biking, golf and his “secret passion,” muscle cars.

Contact MBJ contributing writer Becky Gillette at bgillette@bellsouth.net.


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