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VOL. 43 | NO. 47 | Friday, November 22, 2019

Childhood episode inspires new TMA president

By Nancy Henderson

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Dr. Elise Denneny, an otolaryngologist, is the third woman to serve as TMA president.

-- Photograph Provided

One snowy Christmas Eve in New York, when Elise Denneny was a little girl, her mother pulled her father aside to share the bad news that their next-door neighbor’s wife had just died from breast cancer and that the widower could use some company.

“Dad was not a real touchy-feely kind of guy, so this was kind of unusual,” recalls Denneny, 63, an otolaryngologist at Greater Knoxville Ear Nose & Throat. “They talked across the picket fence in our backyard when they were doing the yard work.”

When her father knocked on the neighbor’s door, he found the man “inconsolable,” Denneny says. “I remember sitting in the living room and watching my dad minister to him, and I thought to myself, ‘This is wrong. Nobody should suffer like this.’ And I said, ‘We’re going to fix this. Nobody’s going to die from cancer anymore.’ That was my motivation to go into medicine.”

In addition to her fast-paced day job – she specializes in dizziness, balance issues and voice disorders – Denneny also is serving a one-year term as president of the Tennessee Medical Association. She is the third woman of 165 physicians elected to the post in the history of the 9,500-member organization.

Despite the serious nature of her work, Denneny comes across as easygoing and fun.

“My brothers would say not,” she says with a laugh. “They would say that I’m like Lucy in ‘Charlie Brown,’ and that’s probably because I always had to boss them. But I’m a happy person.”

Randal Dabbs, M.D., a family physician and president of practice development at TeamHealth in Knoxville, has known Denneny for more than 20 years and serves with her on the board of the Knoxville Academy of Medicine.

“Her time, energy and positive attitude are always uplifting, even after a full day of office and three hours of meetings,” he says. “She has always been a strong advocate for the patients as well as for the physicians, has always been even-keeled, listened to all sides of the issue, and speaks with a purpose.

“Her patients love her because she is so down-to-earth and is very approachable and certainly makes people feel very comfortable,” Dabbs adds. “She doesn’t act arrogant or haughty, ever. She doesn’t mind acting silly if the need arises. She has an adorable personality, but she stands up for what she believes in and doesn’t take any crap from anyone.”

Growing up in New York, Michigan and Chicago, Denneny and her three siblings understood that their mom, a nurse, and dad, an engineering professor, expected them to do their best in four areas: academics, exercise, the arts and spirituality.

“My mom did motivate all of us to go into a profession that was autonomous, something where you would really apply yourself, never stop, never stop growing, have that kind of intellectual curiosity,” Denneny says.

Her love of science came from her dad, whom she sometimes accompanied to the lab where he worked.

After earning a dual undergraduate degree in biology and art history – she has always been enamored with the Renaissance – from Northwestern University, she did her medical studies at Rush Medical College and her residency at the University of Illinois before starting a head and neck reconstructive surgery fellowship at the University of Michigan. She’d originally leaned toward neurosurgery but changed her mind when she saw how often patients struggled after their procedures.

“We had just started using lasers in medicine,” she explains. “Prior to that, when an individual developed an intracranial hematoma, we would drain it and they would wake up, but with less of the faculties that they had prior to developing the hematoma.

“I watched the surgeons going out to the recovery room over and over again, saying, ‘Your mom or your dad is going to be OK, but I’m sorry, it’s going to take a slow recovery.’ … So it was pretty unsatisfactory, emotionally, having to back out and chronically having to say to families, ‘Your mom and dad will never be the same.’”

The last thing she wanted to do, she admits, was perform sinus and ear operations. But the outcomes were much better than those for brain surgery.

“It was delicate. It was precise. It appealed to the cancer aspect, because we were doing a very good job of curing head and neck cancer,” Denneny adds.

Eugene Tardy, M.D., her mentor at the University of Illinois and a legend in his field, greatly influenced her decision to concentrate on the ENT side with his logical, well-thought-out approach. Repairing facial injuries for battered women helped solidify the direction she would take.

“It appealed to me, being able to reconstruct them in a way where we gave them some semblance of self-respect again,” Denneny says. “It was very rewarding.”

She chose to concentrate on challenging ENT issues such as dizziness, she adds, “because my mom raised me to champion underdogs. When you see somebody get marginalized, somebody’s gotta [help] and nobody wants to. Dizzy is a multicausative disease, and it’s a puzzle. So it appeals to people who want to figure out what’s going on. It’s fascinating.”

Modern medicine is less about curing and more about enhancing quality of life, Denneny points out.

“I may not be able to give you a new balance mechanism in your ear without possibly making you deaf. But I certainly can improve your life so that you can go play and get on the floor with your grandchildren. That’s really important.”

After completing her fellowship in 1987, she followed her then-fiancé to Knoxville to teach at the University of Tennessee and join the staff at Greater Knoxville Ear, Nose & Throat. The culture shock was jolting, but she soon fell in love with the people, food and terrain.

“I was gung-ho to apply all these different things. I was your typical Yankee, just talking a mile a minute,” Denneny says, laughing out loud. “People would kind of look at me funny because one, I was Asian, and two, because I was a Yankee. And I realized really early on that you better slow down, just a hair.”

Denneny chokes up a bit as she talks about her role as physician.

“I think every caretaker, whether it is somebody who is helping keep the room clean in the hospital to the CEO, has that same goal in mind: to improve health for your community, for your neighbors. Yeah, it’s a job, but at the same time it’s a privilege to get up every day and do something that’s going to help somebody else.”

The best part, she says, is “when I go to a patient and I say, ‘Are you better?’ and they say, ‘Yes.’ That makes it worth everything.”

Practicing medicine, however, has become more and more challenging, she acknowledges.

“Doctors are under the microscope for delivering value-based care, and it’s really hard because so many things that create that ‘I’m better’ [response] are outside of my control. I don’t control the medication they get anymore. Somebody can substitute a generic [drug] without authorization.

“The authority to order a test is now in the insurance company’s space. The authority for some medications is also under the insurance space. The authority of where I can do surgery sometimes is not determined by myself.”

A TMA member since 1988, Denneny has served in numerous leadership roles, including a seat on the legislative committee. It’s all about giving back, she says, and “trying to improve the way a physician can get to that, ‘I’m better’ statement.”

About her status as one of only three female presidents since the group’s formation in 1830, Denneny says simply, “I think that’s a reflection of increasing percentages of females in the medical profession.”

In addition to serving as the organization’s spokesperson, tackling the state’s opioid crisis, which she’s been doing through the TMA since 2012, and partnering with other associations like the Tennessee Hospital Association and the Tennessee Pharmacy Association, Denneny is working on a dilemma that has stumped many doctors.

“The best models for value care are the ones that put the patient at the center,” she says. “That requires also the patient to buy into their health, and that is really hard. Health illiteracy is a huge problem.

“We are under huge pressures to generate revenue, get the patient in and out in 15 minutes. You can’t do that. Sometimes you’re trying to explain to Mrs. Jones how her pancreas works. You come into contact with people who are very sophisticated in their understanding, and then others who aren’t. So more time is now being required to educate people on why it’s important to select your foods, why it’s important to exercise. And learning how to be able to do that in two minutes is interesting.”

As both a physician and TMA president, Denneny would love to help the public understand that a pill is not always the best solution to a health problem.

“Americans love their drugs,” she says. “Tobacco, obesity, hypertension, diabetes – those are all things that can be managed well with diet and exercise.”

Despite the controversy surrounding Gov. Bill Lee’s proposed $7.9 billion Medicaid block grant, which could affect medical coverage for an estimated 1.4 million low-income children, mothers and other caregivers, seniors and people with disabilities, Denneny says, “The implications … are possible greater flexibility in fiscal resources, allowing for new, creative efficiencies in health care.”

Her current TMA responsibilities, along with her day job, don’t leave much time to spare, so she’s had to put some of her community volunteer work on hold, including giving free piano lessons at the Joy of Music School, which also provides musical instruments to disadvantaged youth. She is still active with Knoxville Area Project Access, a consortium of physicians, hospitals and Knoxville Academy of Medicine staff who offer health care to the underinsured.

“These are people who are above the 138% poverty level – they don’t quality for TennCare subsidies – but at the same time, have five kids. I don’t want them to go medically bankrupt,” she says. “That’s just horrible.”

When it comes to exercise, Denneny practices what she preaches. “We’re very lucky [as physicians],” she says. “We have jobs where we can actually move. I always feel so bad for somebody who has to sit at a cash register or do data entry at a desk. That just can’t be healthy. I need to move.”

For fun, she heads to the dance floor. “True ballroom dancing is physics,” she says. “You’ve got one mass on one side and one mass on another side, and you have to partner so that the masses work appropriately. It’s like skiing. If you ski, you have to generate enough potential energy when you come around that curve that it will then drive you into the next turn. You accelerate, and that’s the same thing with ballroom dancing.”

To satisfy other artistic urges, she throws pottery – not the abstract, esoteric kind but utilitarian items that can be used every day. She loves the feeling of restoration she derives from shaping raw clay.

When asked about her good-natured outlook on life, Denneny chuckles. “Basically, I got sprinkled with a little bit of laughter. I find the simplest things joyful. You can have a horrible day in the hospital and get out at 11 at night and come out and all of a sudden you hear an owl hooting and you go, ‘That’s so cool.’

“It helps to recognize that things are definitely beyond you, that things will survive even after you’re gone. You just plug away doing what you think is right and somewhere down the road, it’s going to all be fine.”

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