Growing up in New Jersey as the son of Greek immigrants, Dr. Steven Stylianos never imagined he would become a doctor. But the seed was planted after his high school guidance counselor told him — much to his surprise — that he would make a great physician one day.
“My vision for myself didn’t go beyond what I was doing over the next weekend,” says Dr. Stylianos, Chief of the Division of Pediatric Surgery at NewYork-Presbyterian/Columbia and Surgeon-in-Chief at NewYork-Presbyterian Morgan Stanley Children’s Hospital. “I had no professional role models, so what she said to me really sent me on the pathway to medicine. I’m so grateful this journey has led me to where I’m supposed to be — operating on children and trying to give them a fruitful life ahead.”
The father of three has done just that over a nearly four-decade career. Dr. Stylianos’ goal has always been simple: to help kids. His mentors were the ones who recognized he had the traits of a successful surgeon, like an analytical mind and the ability to focus under pressure. Over time, those skills helped him build an expertise in pediatric trauma care and complex surgeries like the Kasai procedure, a treatment for infants with biliary atresia that slows the progression of liver failure. He’s also helped separate five sets of conjoined twins, most recently in 2020 as part of the team that separated 5-month-old twins from Sierra Leone.
Dr. Stylianos spoke to NYP Advances about the lessons he’s learned over the course of his career, the power of mentorship, and the legacy he hopes to leave behind.
How do you prepare yourself before taking on high-risk, complex surgeries, like the separation of conjoined twins?
Just as important as the technical skills is the mental planning behind making sure you’re prepared for different scenarios and outcomes. When you’re dealing with conjoined twins there are so many anatomical issues that need to be sorted out with a larger multidisciplinary team, as many twins share too many vital organs to survive apart. So first we need to decide if we can even move forward with a separation. With our most recent case, the Jalloh twins, we determined we could separate the twins because even though they shared significant portions of their liver and abdominal wall, they had separate strong hearts. Then we have multiple discussions to map out the different parts to the surgery to make sure everyone’s prepared for their role. The more talented the surgical team the better the outcome is going to be, and I’m lucky to work with such talented teams.
For me personally, whenever I’m working on any kind of complex surgery, I like to break it down into its manageable parts so that it feels less overwhelming. I work through a best-case scenario and a worst-case scenario, and I have a plan for abnormalities that might not be visible on an X-ray. I think of it using a baseball analogy: a surgeon is like a batter who must be ready to hit any one of four pitches. So going through this preparation gives me both the comfort and confidence that I’m giving a patient my best before I walk into the OR.
Whenever I’m working on any kind of complex surgery, I like to break it down into its manageable parts so that it feels less overwhelming .