It was the mid-1980s, and they bonded over grits, eggs and sausages. Onye Akwari, M.D., Department of Surgery at Duke University in Durham, North Carolina, and Kamal Itani, M.D., a research fellow in Dr. Akwari’s lab.

Dr. Akwari took Dr. Itani, who had completed medical school at the American University of Beirut in his native Lebanon, under his wing. Dr. Itani says Dr. Akwari treated him like a younger brother—always looking out for him. The relationship between the two men started when Dr. Itani wrote to Dr. Akwari, seeking a position as a research fellow.

“I was completing surgical electives at the Massachusetts General Hospital in Boston and considering staying in the U.S.,” says Dr. Itani. “A civil war was raging in Lebanon, and I knew there would be no opportunities at home. It wasn’t easy for international medical graduates to find training positions in the U.S. I thought it would be smart to secure a research position.”

Serendipity

Dr. Itani had completed an elective rotation with Andrew Warshaw, M.D., at Mass General.

“He performed pancreas resection using a modified Whipple procedure that involved leaving the pylorus and stomach in place,” he says. “Those patients experienced a lot of delay in gastric emptying. I was interested in learning more about this problem and ran across Dr. Akwari’s name as a leader in gastrointestinal surgery and physiology. I contacted him along with five others, inquiring about research positions. As luck would have it, Dr. Akwari was the only one who responded. I didn’t know him when I wrote to him, but he was looking for a research fellow and was interested in my observations. It was a lucky coincidence.”

After a phone call and in-person visit at Duke, Dr. Akwari called Dr. Itani to say he’d arranged for the latter’s visa and salary for a two-year fellowship at Mayo Clinic. It was the start of a lifelong relationship. Dr. Akwari died in 2019, his surgical career tragically cut short in 1995 as the result of a stroke. Until his death, Dr. Akwari stayed informed about Dr. Itani’s career and successes and never hesitated to pass along praise.

Go-to person

“Dr. Akwari was my go-to person,” says Dr. Itani. “I called him when I got my first job offer, when I had challenges as a faculty member, when I was offered new positions and when I needed a letter of recommendation. He was always there to advise and totally selfless in giving of himself to my education and career.”

Today, Dr. Itani is chief of surgery at the VA Boston Health Care System, a professor of surgery at Boston University School of Medicine, and a faculty member at Harvard University School of Medicine and Brigham and Women’s Hospital.

“Dr. Akwari wanted me to grow as an academic surgeon,” says Dr. Itani. “Most research mentors met with their fellows
once a week or so. I met with Dr. Akwari every day. We had breakfast together before his clinic time. It was a ritual, and he introduced me to grits, eggs and sausage and to many aspects of American culture—how to collaborate and interact with other researchers, colleagues, lab personnel and senior faculty. Despite the fact that I was a research
fellow and had no clinical role, he took the time to train me clinically and asked me to go on rounds with him. He expected me to attend Grand Rounds and other clinical conferences. He taught me how to develop a research idea and write IRB protocols. And he offered me to stay in his lab for a third year, which I happily grabbed.”

Similar struggles

Dr. Itani says he’s not sure why Dr. Akwari took such an interest in helping him succeed; the two men never discussed it. Dr. Itani speculates that Dr. Akwari, who had come to the U.S. in 1962 from Nigeria for college and medical school, identified with the difficulties his trainee would have faced training in surgery during Lebanon’s civil war. Dr. Akwari was undaunted by Dr. Itani’s international medical degree.

When Dr. Akwari studied medicine at the University of Southern California, a civil war in Nigeria destroyed his family’s home and businesses. As that war ended, Dr. Akwari started surgical training at Mayo Clinic, initially with Martin Adson, M.D. Dr. Adson lent Dr. Akwari the funds to replace the roof on his family’s home in Nigeria and remained a lifelong friend, serving in Dr. Akwari’s wedding to Anne Micheaux Akwari, M.D. In addition to repaying the loan, Dr. Akwari helped six of his seven siblings emigrate to the U.S. for their education.

“Through my time and many meals with Dr. Akwari, I realized the struggle he went through as an African American surgeon,” says Dr. Itani. “Dr. Akwari was a pioneer—the first African American faculty member in Duke’s Department of Surgery. During my time there, I don’t recall any surgical residents of color. I had the assumption that if you were a professor at Duke University, you had it all and no one could do you harm. I naively felt the same way about myself that even if I were an international medical graduate, I would be well regarded for my hard work and strong performance. Little did I know that was not always the case. We were going through similar struggles—him because of race and me because I was from another country and a non-U.S. medical school. I had great difficulty matching in surgery residency. If not for my research work and Dr. Akwari’s help, I probably wouldn’t have made it to a surgical training program.

“Because of my unique relationship with Dr. Akwari, my years at Duke were some of the best of my life. He was a
tremendous example of honesty, integrity, calm, generosity, selflessness and so much more. I’m very proud of what I’ve
accomplished in my life but wouldn’t be where I am without his mentorship.”

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