Bariatric Times

MAY 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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11 In Memoriam Bariatric Times • May 2017 I t is with abundant sadness that we commemorate the loss of our c olleague and dear friend, Ronald "Ronnie" H. Clements, MD. He died January 19, 2017, at home, surrounded by his family, after a courageous battle with cancer. He was 50 years old. It was a privilege to know him and an honor to work alongside him. We are certainly not alone in saying that he inspired, motivated, and elevated our lives professionally and personally. We, and countless others, are better from having known him. Ronnie was born in Greensboro, Alabama, on March 23, 1966. He received an undergraduate degree from the University of Alabama in 1988 and medical degree from the University of Alabama School of Medicine in 1992. He subsequently completed a general surgical residency at Carraway Methodist Medical Center in Birmingham, Alabama. He first came to Vanderbilt University as a Fellow in the Minimally Invasive Surgery (MIS) Fellowship program in 1997, where he developed adept skills as a laparoscopic and bariatric surgeon. During his fellowship, he proudly performed the first laparoscopic repair of a perforated duodenal ulcer at Vanderbilt University Medical Center (VUMC). Ronnie then returned to the University of Alabama-Birmingham (UAB) and quickly became Associate Professor of Surgery, Director of Bariatric Surgery, and Co-Director of the MIS Fellowship. He would later return to Vanderbilt as Professor of Surgery, Director of the Center for Surgical Weight Loss, and Program Director of the MIS/Bariatric Fellowship. Ronnie's constant quest for personal growth and knowledge led him to enhance his business and finance acumen by obtaining a Master's Degree in Management of Healthcare from the Vanderbilt Owen Graduate School of Management. "Dr. Clements dedicated his life to the service of his patients and those around him," said Seth Karp, MD, H. William Scott Jr. Professor and Chair of the Department of Surgery, Vanderbilt University Medical Center. "Even as he dealt with his terminal illness, he gave of h is time and energy to support the department and its patients. Memories of his warm personality, clinical excellence, and indomitable spirit will continue as an inspiration to all of us." Ronnie had a strong influence in his field and was highly regarded as an expert, both regionally and nationally. He was a Fellow of the American College of Surgeons (ACS), the Southern Surgical Association, and the Southeastern Surgical Congress. He was an active member of the American Society for Metabolic and Bariatric Surgery (ASMBS), the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and the Society for Surgery of the Alimentary Tract (SSAT). He diligently served on a number of committees in these organizations. Always striving for perfection in patient care, Ronnie passionately worked to develop national standards and guidelines promoting and improving the safety of metabolic and bariatric surgery. He was a lead author on the SAGES Guidelines Committee publication regarding optimal credentialing for laparoscopic bariatric surgeons. He served as a committee member of the ACS Bariatric Surgery Center Network and became instrumental in the development of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). He was the Co- Chair of the MBSAQIP Standards Committee, which produced the standards manual, "Resources of Optimal Care of the Metabolic and Bariatric Surgery Patient." He eventually became the Chair of the combined ACS/ASMBS Committee for Metabolic and Bariatric Surgery. As a result of his efforts, the overall quality of care significantly improved at every metabolic and bariatric surgery center in the United States. In 2015, the ASMBS Foundation honored Dr. Clements for his accomplishments in metabolic and bariatric surgery by naming its annual Patient Safety & Quality Award after him. His research interests included nonalcoholic fatty liver disease, metabolic changes associated with bariatric surgery, and clinical outcomes of bariatric surgery. In 2009, he courageously challenged surgical dogma by publishing his results from almost 1,000 patients who underwent bariatric surgery without pharmacological venous thromboembolism (VTE) prophylaxis, demonstrating no difference in VTE rates compared to published reports in patients receiving pharmacologic anticoagulation. He concluded that chemoprophylaxis was not mandatory in patients with no prior history of VTE when pneumatic compression devices, early ambulation, and short operative times were utilized. In addition to performing laparoscopic metabolic and bariatric procedures, he felt extremely comfortable performing thoracoscopic truncal vagotomy for treating intractable marginal ulceration after Roux-en-Y gastric bypass, and he co-authored an article describing the technique. Dr. Clements was described as a "truly gifted surgeon" by everyone that ever had the pleasure of observing him in the operating room. He was an artist, painting a masterpiece with every operation. To better illustrate the true essence of Ronnie, one of his sons shared a wonderful story about him. Immediately following the movie "Spiderman," his young son, overcome with excitement about superheroes and wishing he could be one, asked Ronnie what superhero he would like to be. Rather than naming a character, Ronnie provided a characteristic and simply answered "wisdom." Indeed, Ronnie was blessed with outstanding wisdom, exemplified by his keen insight, sage advice, and prioritization of what mattered most: his faith and his family. Ronnie demonstrated to all of us that keeping these priorities straight allowed him to excel personally as a man of integrity, a devoted and loving husband, exemplary father, and to excel professionally as master educator, astute clinician, and expert surgeon. Ronnie was a member of Judson Baptist Church in Nashville, where he served as a deacon and volunteered on numerous committees. He is survived by wife, Kim Clements; sons, R.J. Clements and Austin Clements; parents, Spencer and Patricia Clements; and brothers, Jimmy Clements and Roger Clements. His family, VUMC and UAB colleagues, and the ACS and ASMBS metabolic and bariatric surgery community will truly miss Ronnie dearly. Many colleagues have expressed interest in developing a fund by providing contributions in Dr. Clements' honor for a lectureship and research stipend to help students, residents, and fellows interested in advancing research in quality and safety outcomes related to metabolic and bariatric surgery. Please contact Beth Boord at 615-322- 7341 or beth.boord@vanderbilt.edu if you are interested in contributing. AUTHOR AFFILIATIONS: Wayne J. English, MD, FACS, is Associate Professor of Surgery and Director, Vanderbilt Center for Surgical Weight Loss, Nashville, Tennessee. D. Brandon Williams, MD, FACS, is Assistant Professor of Surgery, Division of General Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee. Matthew D. Spann, MD, FACS, is from the Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. Chetan V. Aher, MD, is Assistant Professor of Surgery, Division of General Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee. ADDRESS FOR CORRESPONDENCE: Wayne J. English, MD, FACS; E-mail: wayne.english@vanderbilt.edu IN MEMORIAM: Ronald "Ronnie" H. Clements, MD by WAYNE J. ENGLISH, MD, FACS; D. BRANDON WILLIAMS, MD, FACS; MATTHEW D. SPANN, MD, FACS; and CHETAN V. AHER, MD Bariatric Times. 2017;14(5):11. Even as he dealt with his terminal illness, he gave of his time and energy to support the department and its patients. Memories of his warm personality, clinical excellence, and indomitable spirit will continue as an inspiration to all of us.

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