A Legacy of Innovation, Compassion, and Leadership in Spine Surgery and Beyond

A chance phone call

Needing a part-time job after his second year of undergraduate studies, Garfin remembers pulling two opportunities from the school’s job board, one was in the lab of a cardiovascular surgeon and the other was at the university’s pharmacy school. While he was offered both jobs, Eugene Bernstein, M.D., the cardiovascular surgeon, called first and that set the wheels in motion for Garfin’s career in medicine.

“I loved what I did in the lab,” said Garfin. “But more importantly I loved Dr. Bernstein and his family. He and his wife mentored and befriended me and my wife, and sort of took us under their wings.”

That chance summer job not only began Garfin’s medical career, but it also brought him to San Diego. In 1969, Bernstein moved from the University of Minnesota to a brand new medical school at UC San Diego. It was the summer after Garfin’s first year of medical school, when Bernstein asked him to come out for the summer to help him set up his new lab. The rest, as they say is history, almost.

Garfin returned to Minnesota to finish medical school, but by then he had fallen in love with San Diego. He applied for and completed an internship at UC San Diego with Marshall J. Orloff, M.D., founding chair of the Department of Surgery and was ready to apply for a residency. Though the Vietnam War draft had ended, there were concerns that it may return and anyone who hadn’t served previously would be required to serve before being accepted into the surgical training program.

Trying to stay one step ahead of that potential, Garfin volunteered to serve two years in the Public Health Service assigned to the U.S. Coast Guard Training Center in Yorktown, VA. under the condition that he did not have to go overseas. The admiral who agreed to Garfin’s terms had a stroke, and the admiral’s replacement told Garfin to prepare to ship out for a six-month deployment in the Arctic on a Coast Guard icebreaker, a class of ships designed to break through ice to clear pathways for other ships.

With the help of some well-connected friends and relatives, a few presidential nominees and a congressional inquiry, Garfin was excused from the deployment, completed his two years of service then applied for residency programs at UC San Diego. He was accepted and completed a residency in orthopedic surgery between 1975-79. A fellowship in spine surgery in Philadelphia followed before Garfin came back to San Diego for good. He officially joined the faculty at UC San Diego in 1980, where he has served ever since.

Changing lives

When Garfin joined UC San Diego, he described himself as the "spine guy." Over time, he became an international leader in complex spine surgery, helping to develop and improve techniques including the cervical spine halo, modular screws for spinal fixation, procedures for spinal fusion, kyphoplasty for osteopathic and pathologic vertebral body fractures and minimally invasive sacroiliac fusion.

While known for his work in complex spine surgeries, he also treated a wide range of spine conditions, including adult scoliosis, herniated discs and spinal cord injuries. He is credited with advancing the design and evaluation of surgical techniques and tools to address a variety of spine disorders, most of which are mainstays in current spinal surgery.

“I am lucky to have known Dr. Garfin through my entire career as my boss, mentor and friend,” said Reid Abrams, M.D., chief for the Division of Hand and Microvascular Surgery and vice chair of academic affairs in the Department of Orthopaedic Surgery at UC San Diego. “He has disseminated his surgical, teaching and leadership acumen to his resident and fellow trainees, many of whom have become pioneers and leaders in their own right. He has transcended his early career trajectory as a clinician educator, blossoming into innovator and trailblazer, and transforming into a benevolent, caring and collaborative leader.”

For Haley Scott DeMaria, Garfin literally changed her life. A member of the University of Notre Dame swim team in 1992, Scott DeMaria was travelling on a bus with the team when the unthinkable happened. The bus hit a slippery spot in the road, tumbled down an embankment and rolled over. Tragically two of her teammates suffered fatal injuries. Scott DeMaria was left temporarily paralyzed with no feeling or movement from the waist down. She remembers being told by her nurse and doctor that she would never walk again.

After a couple of surgeries in another state, the rods placed in Scott DeMaria’s spine began to loosen and protrude through her skin. Scott DeMaria came to UC San Diego Health where Garfin removed the old metal and placed a bone graft with new metal to hold her spine together. The complicated surgery was performed through her abdomen and chest, as well as her back, adding to the complexity and recovery time.

“My spine was so damaged, it took Dr. Garfin three surgeries to successfully straighten and stabilize my spine,” said Scott DeMaria. “More than 30 years later, I stand straight and pain free! In 2019, I hiked Mt. Kilimanjaro. I can ski, I ran a marathon and completed a triathlon. I have two healthy children, which my body was able to carry because of Dr. Garfin. There are no words to adequately explain how grateful I am — everyday — for Dr. Garfin and the beautiful and healthy life he has allowed me to live.”

Becoming the dean

In 2018 when he was first approached to serve as the interim dean for the School of Medicine, Garfin wasn’t sure that he was the best person for the job, but he agreed to step in for one year and begin the work of creating an independent dean’s office for the School of Medicine.

Up until that point, the School of Medicine fell under the purview of the Vice Chancellor for Health Sciences who served as both vice chancellor and dean. As the health sciences were expanding to include the School of Medicine, the Skaggs School of Pharmacy and Pharmaceutical Sciences and the Herbert Wertheim School of Public Health and Human Longevity Science which was established in 2019, the role was becoming a bit too much for one person.

At the time Garfin was into his 22^nd year as the chair of the Department of Orthopaedic Surgery. He knew that it was probably time for a change for both the department and himself.

“What I learned as the department chair and what I’ve taught all the chairs that I have hired is that the first five years in the chair role is really hard,” said Garfin. “But then as you pass into the second five years, it gets a little easier. By the third five years, the role becomes much easier and you can start to relax a little bit. After 20 years as the chair, I had done about all I could.”

Throughout Garfin’s tenure as the chair, the department had grown into a world class orthopedics department with a reputation for top notch patient care, well respected and sought-after educational opportunities for trainees and national rankings for innovative research credited with advancing knowledge in the field of musculoskeletal injuries and diseases.

The department had grown from seven orthopedic surgery faculty members in 1996 to 47 in 2018 when he transitioned to the interim dean position. Part of that growth was due to a 2001 amalgamation agreement with Rady Children’s Hospital-San Diego to combine pediatric patient care, research, education and community service programs designed to better serve the San Diego region.

“Working with Dr. Garfin in the clinic, his compassion, caring, kindness and mentoring was unsurpassed,” said Liz Stimson, retired nurse practitioner who worked with Garfin for more than 30 years. “His talent moved the spine world ahead through his research and innovation. But beyond that he just has a way of making everyone feel comfortable and he always seems to know when to talk and when to just listen. He would end every patient visit with a hug or a handshake. He just showed so much compassion and caring for all of his patients.”

An enduring legacy

Garfin agreed to the one-year interim dean role. One year turned into two years, then three years. Now after more than six years in the position, Garfin is stepping aside to take a new role as associate vice chancellor within the Office of the Vice Chancellor for Health Sciences.

“I've received some very nice compliments, which I never expected,” said Garfin. “I mean I’ve just been doing my job the way that I do my job. And it has apparently impressed some people and helped some people. There were people who were concerned that I was the wrong person for the dean’s job, but now they seem pleased. I am glad that I have been able to accomplish what I have done.”

In addition to creating an independent School of Medicine dean’s office, Garfin was instrumental in improving the School of Medicine’s finances, enhancing education, growing the number of faculty members, increasing research awards and clinical activities, and increasing overall diversity among the students and faculty.

“I did not do all these things alone,” said Garfin. “I just happened to be the dean when a lot of good things happened with great colleagues and leaders. In hiring new chairs and other administrative positions, my goal was never to just hire the best researcher or the best clinician. I was always looking for great leaders who could implement positive changes.”

Additionally, under Garfin’s leadership the medical school curriculum was completely revamped, and the Atkinson Physician Assistant Education Program was created and welcomed its first class of students this past summer.

“Dr. Garfin’s exceptional leadership has left a lasting impact on UC San Diego School of Medicine,” said Chancellor Pradeep K. Khosla. “With his 22 years of distinguished leadership as chair of orthopedic surgery and a reputation for innovative ideas and improving lives, he has leveraged his expertise to create healthier communities through enhanced medical education and excellence in research and clinical care. I am deeply grateful for his commitment to transforming lives through medicine and his steadfast leadership, both of which have solidified the School of Medicine's position as a top-ranked institution."

Over the last 44 years, Garfin has been a member of, and served in leadership roles for, several national and international spine and orthopedic surgery societies, including the American Academy of Orthopaedic Surgeons, American Orthopaedic Association, International Society for the Study of the Lumbar Spine, Orthopaedic Research Society, Lumbar Spine Research Society, Society for Minimally Invasive Spine Surgery,  the Cervical Spine Research Society, the North American Spine Society and the International Society for the Advancement of Spine Surgery – the latter three he served as president.

Additionally, Garfin has edited 21 books, authored more than 145 book chapters and published more than 300 peer-reviewed articles.

“Dr. Garfin's leadership as interim dean has profoundly shaped the future of the School of Medicine, from hiring a diverse group of department chairs to fostering an environment where leaders are empowered to lead,” said John Carethers, M.D., vice chancellor for Health Sciences. “His leadership in launching the Atkinson Physician Assistant Education Program and integrating compassion into the updated medical school curriculum will leave a lasting legacy, impacting the next generation of medical professionals and the communities they serve. Dr. Garfin’s steady vision and commitment to both the school and the broader health care community have elevated UC San Diego’s place in the academic and health care landscape.”

Looking ahead

As Garfin prepares to step down from the dean role, he is adamant that he has no plans to retire or slow down.

“It is a bit of a nervous time for me,” said Garfin. “I don’t garden. I don’t fish. I don’t golf. The beauty of working in academics is that you can administrate. You can teach. You can do research. You can do patient care. There are so many options that I can get back into within orthopedics and/or the School of Medicine, some of the things that I gave up to serve as dean. I want to be able to serve and stay busy in whatever ways that I can.”