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Focus on Brooke Winner, MD

Brooke Winner, MDBrooke Winner, MD, uses her passion and expertise in the field of minimally invasive surgery to treat women with fibroids, endometriosis, prolapse and other gynecologic conditions.

Dr. Winner sees patients at the Center for Outpatient Health, 4901 Forest Park Ave., Suite 710, St. Louis, MO 63108 .





What happened in the course of schooling to make you choose your specialty?

As a child, I was very squeamish and didn’t like the sight of blood. However, in college at Stanford University, I found my human biology classes fascinating, and eventually decided to go to medical school. Turns out, it is amazing what you can get used to if you do it all the time.

I am from Anchorage, Alaska, which does not have a medical school, so I went to the University of Washington (UW) in Seattle that has a focus on rural medicine.



As a medical student, I did my family medicine rotation in Wrangell, Alaska, a remote fishing village accessible only by small plane or boat. The three family practice physicians there are the only doctors in town. There was no CT scanner and no surgeons. Women even had to leave town to deliver their babies in case they needed a C-section -- it was a real eye-opening experience.

I knew I liked women’s health, so obstetrics/gynecology (ob-gyn) was a natural choice, but I was still fairly squeamish and not sure if I would like surgery. My general surgery rotation was in Fairbanks, Alaska, which is in the interior of the state. I remember my cold morning commutes to the hospital, after scraping ice off my windshield, and driving by the bank signs that read minus 30 degrees.

The day I performed my first surgery, I was standing in the operating room and the surgeon was describing to me how to hold the knife. I thought, “Why is he telling me this?” He then proceeded to let me do the appendectomy - it was amazing. Surgery was so controlled and not the bloodbath that I had imagined.

I talked to my boyfriend (now husband) on the phone that night. He was on a rotation at the academic hospital in Seattle and had spent the day in the operating room on two risers, craning his neck just to be able to see over the residents and fellows, and he certainly didn’t get to do anything. He was jealous that I had gotten to actually operate.

So, now my choice was clear – I liked women’s health, and I liked surgery – obstetrics/gynecology it was. I initially wanted to be able to do some surgery, deliver babies and practice primary care. However, as I went further along in my training, I realized that to be good at something, especially something as complicated as surgery, you have to do it all the time, not just occasionally. That is why I decided to give up obstetrics, and become a specialist in minimally invasive gynecologic surgery.

What brought you to Washington University?

Brooke Winner and her husband after a day of skiing and snowshoeing in Vail, ColoradoIt’s funny how seemingly random events in life can often lead to something good. I came to Washington University for my ob-gyn residency. When you apply to residency, it is called “the match” -- you rank programs, and they rank you, and a computer decides where you will be moving and spending the next three to seven years of your life.

To make matters even more stressful, my fiancé, Drew (now my husband), was going into orthopedic surgery. Luckily, there was a “couples match” program, so the computer couldn’t split us up. But as a result, we had to find a single location that wanted both of us.

We were really impressed that Washington University was strong in ob-gyn and orthopedics, so we both applied.

Also, I specifically remember writing pro/con lists for each program, and put the Contraceptive CHOICE Project (a study designed to promote the use of long-acting, reversible contraceptive methods to reduce unintended pregnancy in the St. Louis region) as a pro for Washington University. As a resident I ended up doing research with the CHOICE Project, which was published in the New England Journal of Medicine.

Which aspect of your practice is most interesting?

Surgery -- there is never a dull moment.

What new developments in your field are you most excited about?

Minimally invasive gynecologic surgery is an evolving field, and with advanced training and newer techniques. Minimally invasive specialists are now able to offer a minimally invasive approach to almost all women. Often, we are removing a very large uterus or fibroids and in order to do this through tiny incisions, the large fibroids often have to be removed in pieces (morcellated).

We have perfected a new technique, in which fibroids are morcellated while contained within a bag inside the uterus, which minimizes the risks. The technique requires advanced technical skills, and is not offered at very many institutions. However, the benefits to patients are immense: tiny incisions, less blood loss, less pain, faster recovery and fewer complications.

Perfecting new techniques to make minimally invasive surgery safer and available to more women, and using surgical simulation to more safely and effectively train the next generation of surgeons are the things I am most excited about.

Where are you from originally?

I am originally from Anchorage, Alaska, which is a very special place. A lot of people I have met in St. Louis say they have never even met someone from Alaska. No, I did not live in an igloo or take a dog sled to school. However, it is true that it stays light all night in the summer, and is dark all day in the winter. And in the winter when it’s dark, the northern lights are beautiful.

Anchorage is a fairly large city of 300,000 with six high schools, restaurants, bars, a performing arts center, a symphony, and much more. However, in 15 minutes you can be out on a remote hike in the mountains, wishing you had remembered to bring your bear bell! My parents and brother live there, and I make a point of visiting every year.




Dr. Brooke Winner and her husband silver salmon fishing in Alaska



Which particular award or achievement is the most gratifying to you?

I am very proud of a medical school teaching award I received as a resident. Washington University is one of the best medical schools in the country, and if the students here think you are a good teacher, that is an honor.

Even more of an honor was the teaching award I won as a minimally invasive gynecologic surgery fellow here. In fact, that fellowship did not exist, but I wanted advanced training, so I asked that they create it – and they did.

However, some of the residents and faculty were worried that the fellowship I had created for myself would hurt resident education, since residents and fellows are often in competition to gain experience in the operating room.

So, I worked extra hard – holding teaching sessions, making study guides and flash cards, developing a website with learning materials and teaching videos, spending hours one-on-one with the residents in the surgical simulation lab, pointing out anatomy in the operating room. My goal was to make sure they knew the steps of each operation, what could go wrong, and how to fix it if it did.

And it paid off – the residents named me “teaching fellow of the year.” After so many people told me they thought I would detract from resident education, earning this award, voted on by the residents themselves, is the achievement that is most gratifying.

What is the best advice you have ever received?

As my mentor, fellowship director, and now partner, Dr. Scott Biest says, “Don’t ask, don’t get.” We actually joke around and say this quite a bit. However, at this point, I can’t remember if that was his advice to me, or my advice to him. In any event, it is true -- that’s how I got my fellowship. If you want something, first prove that you deserve it, and then ask for it. The worst they can say is no.

If you weren’t a doctor, what would you like to be doing?

I would like to be teaching. I spent three years between college and medical school as a teacher and math tutor. I take pride in figuring out what level of understanding a student is coming from, starting there and then working forward. Watching the moment when it clicks in their brain -- that “ah-ha” moment - is so cool!

As a doctor, I now use those same teaching techniques to make sure my patients understand their diagnosis and full spectrum of options -- in order for them to make the best decisions for themselves.

If a patient elects to have surgery, I go through in detail what to expect before, during and after the procedure. Surgery is a big deal. Most people only have surgery once in their life – but as surgeons, we do it every day. I always remember to view things from the patient’s perspective, and start with explaining the basics.