Pauline Raymond-Martimbeau, MD, FACPh
A colleague had this to say: “One of the most dedicated women in phlebology – she meticulously examines and investigates each case because of her amazing work ethic and her earnest efforts to help those who call upon her.”
Where do you see the specialty of phlebology in 5 years? 10 years?
Despite recent breakthroughs, such as chemical and thermal ablation, the best treatment for varicose veins has not yet been identified. Therefore, more advances in the next 5 years are certain. Surgical techniques will have to be reinvented, and ‘hybrid’ treatments will emerge. The boundaries between specialties will become blurred, resulting in the need for cross training. Additionally, phlebology academic programs will be implemented. The desire for safer, more predictable treatments will instigate prospective randomized studies. Further into the future, we may see a host of innovations, such as the following: more non-invasive techniques, catheter-based procedures, and the use of robotics and new assisted devices; percutaneous valve repair; cellular therapy, gene medicine, and tissue-engineering; biomarkers for diagnosis; more sophisticated imaging modalities; and the use of nanotechnology to dissolve thrombi.
What technological advances are contributing to the quality of vein treatment that most excite you?
The most exciting advances are rooted in the wave of the 1980s technology boom on duplex ultrasound followed by thermal ablation and foam sclerotherapy, which allowed the treatment of different vein diameters and categories.
What is the biggest challenge in your work?
Recently, there have been exciting innovations in the treatment of varicose veins; however, avoiding complications and recurrence are still significant challenges.
With all the talk about "going green", where do you think modern medicine will contribute the most? Where do you think it will fall short?
Yes, protecting our environment by changing our ways of thinking and by reducing medical waste should be a consideration in every medical facility. Simply by being more conscious of the environment in our daily decisions, whether purchasing office and medical supplies or establishing new procedures, even private practices can have an impact. The impact of each individual office may seem trivial, but the accumulative effect of thousands of medical offices around the country would be significant. It may fall short if hospitals and private practices exaggerate resulting in compromising patient care.
Is there a particular case that stands out in your mind?
One case that stands out as a personal challenge was listening to a patient, a mother of 3 children who had no significant medical history prior to treatment, describe her neurological symptoms after foam sclerotherapy. In this case, the symptoms were transient and resolved without any sequelae.
If you could share one bit of advice with a rookie, what would it be?
Phlebology has a long learning curve. The rewards of its practice well compensate the effort you invest into mastering the trade. As a bonus, you get to meet a great range of wonderful people through out the journey.
What question did we not ask that we should? Now, answer it!!
What is the biggest risk you ever took? After performing as a gymnast for several years, I beg my parents to let me walk along a wire at a great height. I wanted to fulfill my dream to become a highwire walker.(“funambule”). In retrospect, it was more so a risk my parents took in letting me try. Without the fundamentals and training I could not succeed. I learned a lesson that to develop a sense of confidence, independence and trust in your abilities you have to learn from others. That is what Phlebology is all about!
