Ever to excel: Colleagues and family reflect on Dr. Constantine Karakousis’ legacy

Many associate the Greek words “αἰὲν ἀριστεύειν” (translation: “Ever to excel”) with Homer’s “Iliad.” These are the words Glaucus’ father imparted to Glaucus before his battle with the Trojans.

To Constantine Karakousis, MD, PhD ’86, these words were an axiom to live by, and words he regularly imparted to his sons just as Glaucus’ father had.

Karakousis dedicated his life to his work. A professor of surgery at the University at Buffalo, and surgical oncologist at Millard Fillmore Suburban Hospital, Roswell Park and Buffalo General Medical Center, Karakousis was no stranger to long days in the operating room.

Still, he never stopped dedicating time to his family, and instilled his humanitarian virtues in his sons.

“From a young age, I remember him telling me that if I did not cultivate a love for philosophy, literature and the arts, I would grow up to be only ‘half a man,’” his son Petros Karakousis, MD, said.

Karakousis, 81, died on March 31, and he is remembered by colleagues, students and family for his enigmatic duality.

Both a “Renaissance man” and “giant in his field,” Karakousis’ impact extends past the bounds of surgical procedures, and beyond the borders of Buffalo, NY. Karakousis was born in Galatista, Greece, and went to medical school at the University of Athens. He moved to the United States and completed his residency in Boston and Syracuse before earning his PhD at UB in 1986, and pursuing his fellowship in surgical oncology at Roswell Park. His work revolutionized the field of surgical oncology. And his love for the arts led him to publish a poetry book, “Poems of the Mind.”

Colleagues say Karakousis “was like an atlas” of surgical anatomy. He was an “innovative technician” and an “innovative mind,” a poet and lover of the arts. They tell stories of Karakousis’ calm and patient teaching style, and of his frequent travels to Greece where he would visit family and perform surgeries.

Karakousis’ sons, Petros and Giorgos Karakousis, MD, remember these travels well. Their childhoods were intertwined with their father’s work. They grew up in “a tiny apartment” across the street from Roswell Park, in the same building as their father’s office. They remember playing soccer with their dad in the field outside Roswell’s research center. When patients would travel from Greece to Buffalo seeking Karakousis’ expertise, Petros and Giorgos say their mother would take the patients sightseeing, and often invited them home for dinner.

While some would feel stifled being surrounded by their parent’s work, Giorgos and Petros were inspired by it.

“He basically was his work and his family. I really appreciated that, it seemed like he did everything for my brother and me, and for my mom,” Giorgos said. “Even though I could tell, in retrospect when I got a little bit older, that he could have probably had trying days at work with complicated cases, he never really showed that.”

Karakousis knew what it was like to grow up with a father in medicine, his own father was a pediatrician, so he “never pushed” his sons to pursue the field.

Still, Petros, a professor of medicine at Johns Hopkins Bloomberg School of Public Health, and Giorgos, a surgical endocrinologist and oncologist at the University of Pennsylvania, both followed in their father’s footsteps.

“We both kind of naturally gravitated toward it,” Giorgos said. “It was really by example. And I think the only thing he would tell my brother and I was, ‘Whatever you choose to do, just really make sure you like what you do, because you’re never really going to be good at something if you don’t like what you do.’”

Karakousis’ dedication to his work was evident to his colleagues, too.

John Gibbs, MD, a surgical oncologist at Hackensack Meridian Health, says this dedication is the memory that sticks with him most. He remembers asking Karakousis why he stayed in the apartments across from the hospital when he could live anywhere else.

“It was a matter of staying close to his patients and being able to concentrate on his research,” Gibbs recalled.

He was “the go-to individual” for knowledge in his field, but he never stopped learning. Nicholas Petrelli, MD, medical director of the Graham Cancer Center at ChristianaCare Health System, said Karakousis would often review his surgical anatomy atlas before his procedures, even the ones he “had done hundreds of times.” Sometimes he would bring the atlas into the operating room.

“This is an individual who had a tremendous amount of experience but still was reviewing the anatomy of cases prior to every surgery,” Petrelli said. “And that was just a great

precedent and example set for fellows, residents, medical students. And I had never really seen anybody do that.”

James Hassett, MD, an emeritus professor of surgery, said Karakousis was more knowledgeable about surgical anatomy than anyone he’s ever met.

“If he said he wouldn’t do something that way, you wouldn’t do it,” Hassett laughed.

But greater than his procedural knowledge, Hassett said, was the impact Karakousis had on his patients.

“There are a whole bunch of people who got more time in life largely because of the way Dr. K worked,” Hassett said.

These weren’t only his patients, but surgical patients across the world and those yet to come.

“He was innovative in developing for extremity sarcomas a limb perfusion procedure,” Petrelli said. “And that spread across the country, he was respected for that. I mean he was really a real giant in the field of melanoma and sarcoma during his era.”

Every avenue of thought Karakousis pursued inspired those around him.

His “Poems of the Mind” and his interest in determinism versus free will inspired Petros to complete a work of fiction on the topic. Giorgos credits his father as his inspiration “to become what I became.” And although Karakousis’ sons “miss him tremendously,” Giorgos knows he “would be happy with what we’re trying to do.”

“He always believed that you should strive for excellence in what you do at work. But more importantly, strive for excellence as a person,” Giorgos said. “He was always extremely kind, generous to people. He would really go out of the way to take care of patients as people, not as a surgical specimen.”

Dr. Karakousis left behind an extraordinary surgical and personal legacy that will always be remembered in the Department of Surgery.