Medicine
7:00 am
Mon June 17, 2013

Florida’s First Liver Transplant Recipient Among FIU Med School's First Graduates

Dr. Trine Engebretsen bristles at the mere hint of anyone expressing sympathy for her – something she makes clear when strangers ask about her story.

Engebretsen shares a proud moment with mother Mary Ann Lunde and husband Ryan Labbe.
Engebretsen shares a proud moment with mother Mary Ann Lunde and husband Ryan Labbe.

  After all, Engebretsen’s entire life has been one display after another of fortitude.

“Scar tissue is stronger than regular tissue,” she states, calling upon a quote. “Realize the strength, move on.”

A recent graduate of the Florida International University Herbert Wertheim College of Medicine – she is one of 33 newly minted doctors who cast their fate with the school as part of its historic first class – Engebretsen came into this world with a failing liver and beat the odds.

Experts at a dozen institutions promised her desperate parents no more than the means to make their infant girl comfortable. Recalls Engebretsen’s mother, Mary Ann Lunde, “It took me time to realize that what the hospitals were offering was palliative care until what they viewed as my daughter’s inevitable death. Perhaps because I was so young and naive, this simply was not acceptable.

Lunde continued her search for hope and eventually found a Pittsburgh physician doing what in the early 1980s was considered the stuff of Frankenstein. “How can you even consider making a monster out of your daughter?” was the typical response – from family and close friends, no less – to the mother’s decision to seek a liver transplant for her daughter. At age two, Trine underwent the surgery. Predictions for success back then: 30 percent chance of surviving six months.

All of this might have remained little more than an old news story – Engebretsen, now 32, made huge headlines as Florida’s first liver transplant recipient – were it not for her decision to enter FIU’s fledgling medical school.

A New Medical School

Just over four years ago, before welcoming to campus their first students in the fall of 2009, a small cadre of recently hired faculty began the process of accepting applications and grinding out a curriculum.

“Nobody was sure we could pull this off,” says Dr. J. Patrick O’Leary, who heads FIU’s department of clinical affairs. “All of us had come to this project after very successful careers. We adopted a saying, ‘I didn’t come this far to fail.’”

The admissions committee sifted through 3,606 applications to fill 40-some spots. Those who accepted the invitation to attend FIU’s untested program were pioneers, O’Leary says, “who had embraced adventure as a part of their lives.”

And those pioneers worked hard. They had no upperclassmen to ask questions of and continually helped the administration re-evaluate courses and procedures. (Missteps in how certain rotations were set up and how histology was taught, to cite two examples, were brought forward by students and quickly addressed.) Some even harbored worries about whether they were receiving the type of education that would fully prepare them to enter the medical profession.

Those fears melted away earlier this year, in March, when medical students across the country learned where they would spend the next few years as residents, the doctors lowest on the totem pole but for whom every moment is a learning opportunity. All 33 FIU students matched to one of their chosen residencies, besting the national rate of 93 percent. That success came on the heels, in February, of news that the medical school had earned full accreditation – in the shortest time frame possible – thereby allowing it to confer medical degrees.

Paying It Forward

Engebretsen, who will complete a residency at Medical Center of Central Georgia, hardly grew up thinking about becoming a doctor. She did, however, early on exhibit a knack for fearlessly teaching others about transplantation.

In the third grade, little Trine and her classmates found themselves discussing one of the feature stories in the Weekly Reader. It focused on transplants, and the kids were not buying the far-fetched idea. “Impossible,” they claimed, even as Trine interrupted, “I have a transplant.”

Despite her insistence, nobody believed her. And so she picked up her pretty dress and held it high over her head. “See,” she pointed to her scar.

Engebretsen loves that story. She tells it mostly as an appreciation of her mom “who created an environment where I felt precisely that normal.” (Engebretsen’s beloved father, a ship’s captain, was lost at sea when she was 13.) She goes on to talk about teenage years filled with gymnastics and cheerleading and even water polo.

Less expected, during that same time Engebretsen agreed to enroll in a controversial study that aimed to help transplant recipients permanently get off of medications, including those that prevent organ rejection. Her doctor approached her with the idea and, defying well-established medical wisdom, Engebretsen took the chance. Again she beat the odds and has been free of medication ever since.

And all through those years Engebretsen kept up what she calls “paying it forward,” giving something to others out of consideration for what she received so many years earlier. In high school she won a Silver Knight award for a program she created that educates students about organ donation, work she continued into her adult years. Next came an opportunity to join a friend in Sydney, Australia, for a summer adventure that led to a public relations job with that country’s national organ transplant organization. Returning home to South Florida, she went back to a local organ recovery agency where she had previously been employed.

This history of service, in part, is what helped Engebretsen earn a spot in FIU’s medical school in the first place. “Trine is the kind of student we had been hoping to attract as we developed a program so committed to addressing social need in the community,” says Dr. John Rock, the founding dean.

A Life Worth Living

At the time working and going to school to earn an MS in biomedical science, Engebretsen was also facilitating an online chat room for those living with liver disease and their families. She connected with a certain young man online who as an infant underwent surgery to correct a birth defect in his bile ducts. One thing led to another, and the young man – Ryan Labbe – made a trip to South Florida to meet the woman who, eventually, would become his wife. Life together looked so promising – until, that is, Labbe’s liver showed signs of chronic damage.

After 25 years of excellent health, Labbe would require a life-saving transplant. The operation was complex and difficult. Success was hardly assured. “I was all yellow in our engagement photos,” he laughs now, six years later.

Having seen her husband through the worst, Engebretsen in turn relied on his support as she started at FIU’s medical school. Before long, she would rack up yet another first. Hardly making life easy on herself, she became the program’s first pregnant student – and half of the world’s only known dual-liver transplant couple to achieve a successful pregnancy together.

“Of course we worried,” says O’Leary, who at the time was concerned for her health. “But Trine more or less demanded that we treat her as we would any other student.” She kept up her rotations deep into her ninth month, and soon afterward Andersen, a healthy baby boy, arrived.

A Surgeon It Is

The last thing Engebretsen wanted was to be a surgeon. She had seen her share as a child. None, as far as she could tell, had the time or energy for a family. A young mother as well as (almost) a doctor, she had committed herself to emergency medicine – a specialty that has a set schedule of hours – and had already dismissed taking up surgery, which was the only rotation she had yet to complete as part of her studies.

Soon after she started, doctors at Miami’s Baptist Hospital, where she was taking the surgery rotation, began talking about the student with “good hands,” medical speak for the manual dexterity needed to handle surgical instruments with precision. And then one night she came home to her husband still grinning and excited after participating in several transplant surgeries over the course of 21 hours. Could these signs mean something?

Engebretsen consulted O’Leary, a surgeon himself, and initiated a conversation about the possibility of a change of direction. She believes that her mentor was responsible for opening both her eyes and important doors. He helped her understand that a surgeon can have a personal life, and he wrote letters of strong recommendation to the physicians that run the rigorous residency program that was her first choice. She starts this summer.

But O’Leary takes no credit for setting Engebretsen on her new path. “When a doctor is as gifted as Trine,” he says, “there is an inner voice whispering about a direction she needs to take.” Over time, he adds, “that voice gets louder and louder.”

This item was reprinted with permission from FIU Magazine