Anesthesia Spotlight: Following in Her Footsteps

For Kinza Berical, MD, and Shannon (Xiangwei) Zhang, MD, MS, anesthesiologists at Massachusetts General Hospital, a career in medicine is in their DNA.  

“As the daughter of a vascular surgeon, I was immersed in the culture of medicine from a very young age,” says Dr. Berical, a Mass General Brigham-trained attending. “I spent many weekend days rounding with her and waiting in the operating room staff lounge for a case to be done.”  

Similarly, Dr. Zhang’s own mother, an OB/GYN in her hometown in China, opened her eyes as a young child to the wonders of providing lifesaving care to people in need by example. 

“Patients used to come to our front door at all times of day asking for her help,” says Dr. Zhang, an attending at the Mass General/North Shore Center for Outpatient Care since its launch in 2009. “And she would go and help them, no questions asked.” 

Today, both women are following in their mothers’ footsteps by transforming medicine at Mass General. Dr. Berical is a cardiac anesthesiologist with an interest in blood product management in the cardiac surgical population. Dr. Zhang is the medical director and site chief for anesthesia at the Mass General Brigham Outpatient Surgery Center at Danvers. 

Q: What was your journey to a career in medicine?

Dr. Berical: My mother is a vascular surgeon, so I grew up in medicine. As a child, I saw firsthand the commitment and sacrifice it takes to be in the field and, truthfully, I wasn't sure at first if I wanted to pursue it myself. But as I reflected on my mother's success with building both a career and family, and as I connected with other women in medicine, I realized that with perseverance and thoughtfulness, I wouldn’t have to sacrifice one for the other. My mother was the one who suggested anesthesia. I enjoyed my anesthesia rotation in medical school, and loved how anesthesia integrates multiple areas of medicine into daily practice.   

Dr. Zhang: My journey to medicine started when I was a child. My mom was an OB/GYN doctor in China, a career that she fought for despite many barriers women at the time faced in accessing higher education let alone a career in medicine. I witnessed all the magical work she did, and it was a no-brainer for me to follow in her footsteps. Becoming an anesthesiologist was a different story. I began my journey wanting to become a cardiologist; however, I was told I would be a pathologist after I graduated from medical school in China. This was a very common practice back then—you did not have the choice what specialty or where you were going to be trained and practice. After negotiating with the human resources director at the Beijing hospital where I worked, I was granted a two-week trial in the anesthesia department. I became very attached to the discipline. 

Q: What has helped you achieve success in your career?

Dr. Berical: I think the most important thing has been support from my family, husband, and friends throughout the years, especially during training. Having a good peer support system, both within and outside of medicine, really helps to maintain perspective. I have also had some wonderful female mentors during my training. These women showed me how to excel both clinically and personally through example. Lastly, having excellent quality childcare as a working mom is key. 

Dr. Zhang: I would attribute my success to the excellent support systems from the department leadership, my colleagues, and, of course, my family. My mother also taught me to always count on myself, which has served me immensely. This is advice she followed herself, as it was extraordinary at the time for a woman to have an education beyond high school let alone become a physician.  

Q: What barriers have you faced?

Dr. Berical: The biggest challenge is trying to find balance as a working mother in medicine. You want to be everything to everyone, and you always feel like you are letting someone down. I think prioritizing what made me happy in my career and personal life versus others’ expectations was key. That often meant getting comfortable saying no to certain obligations that didn’t fill my cup. There is a lot of power in saying no. 

Dr. Zhang: For me, there is never enough time for all of the responsibilities and tasks that need to be fulfilled. I have had to learn how to juggle them and learn self-management.  

Q: How would you describe your approach to patient care?

Dr. Berical: I try to think about every patient as if they were my family member. What would I want someone to do for my parents or best friend? Small details are crucial and the human connection you make within the first few moments of meeting a patient can really shape the entire experience for them. We are meeting patients at their most vulnerable moments and asking for them to trust us. It's a very sacred responsibility.  

Dr. Zhang: I aim to fully know my patients’ history by thoroughly reviewing their chart before meeting them, and acknowledging their concerns and needs. Many patients have told me that they feel the anesthesiologist is the most important person in the room, as they are like guardians, watching over the vitals. When I meet a patient for the first time, I let them know that I have read about their personal concerns, and I share the specifics of how I plan to address the concerns. Also, I always make eye contact and sit in a chair next to them. I do not look at a computer or act like I am in a rush, even if I have other patients to attend to. 

Q: Is there anything coming up for you in your work that excites you? 

Dr. Berical: I am thrilled with the work we are doing in the department’s Mother’s Support group. We have been able to pass some important initiatives within the department, such as revised call requirements for pregnant providers in their third trimester, pregnancy scheduling guidelines, and the construction of a new lactation suite in the Lunder building. Looking ahead, we are hoping to host more events to foster in-person connection in the spring and summer.  

Dr. Zhang: At the end of January, the anesthesia team at Mass General/North Shore Center for Outpatient Care launched new quality metrics for “first case on time starts” and “turnover time.” Before launch, the “first case on time starts” metric was about 40% and now it’s at 85%. This ensures that the first surgical patients of the day are starting surgery at the time they were told. For the “turnover time” metric, we have improved from an average 20-minute turnover time to 18 minutes. Both of these results are important for the patient experience, and I’m looking forward to continuing to improve care through quality metrics.