Heather Gulish-Melton, MD, FAAOS, with her brother Jesse (left) and father (center) in the Baptist Memorial Hospital, Carroll County operating room
Courtesy of Heather Gulish-Melton, MD, FAAOS

AAOS Now

Published 12/31/2019
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Kerri Fitzgerald

Health Care Is the Family Business

Heather Gulish-Melton, MD, FAAOS, grew up with a father who was an orthopaedic surgeon and a mother who was a nurse. Dr. Gulish-Melton went on to become an orthopaedic surgeon herself. Even more interestingly, each of her four siblings also made a career in health care—her two brothers are physician assistants, one sister is a therapist, and another sister works with autistic children.

Dr. Gulish-Melton’s father, Eugene Gulish, MD, FAAOS, established Henry County Orthopaedic Surgery and Sports Medicine in Paris, Tenn., in 1994, and Dr. Gulish-Melton joined the practice in 2003, where they practiced together for 13 years before she went into a private solo practice in July 2019 called Twin Rivers Ortho in Paris, Tenn.

During an interview with AAOS Now, Dr. Gulish; Dr. Gulish-Melton; and her mother, Chris Gulish, discussed the family’s lifelong commitment to health care.

AAOS Now: Dr. and Mrs. Gulish, did you have a feeling that any of your children would go into health care?

Mrs. Gulish: I think they felt they had to.

Dr. Gulish: When we had children, my feeling was that education is key. I didn’t tell them they had to be in health care. I felt like they needed to love what they’re doing, because if you love what you’re doing, you’re not working. For me, it was a dream come true that they all went into health care.

When Dr. Gulish-Melton decided to go to medical school, I was excited, and when she decided to become an orthopaedic surgeon, it was out of this world. Then when she decided to come work with me, it was incredible.

Did you ever have concerns with everyone going into health care, or was it always a source of pride?

Dr. Gulish: My concern was that I was so enthusiastic about orthopaedics that I thought many of them felt like they needed to follow that same path. I didn’t want them to go into it unless they wanted to. But I think they all wound up where they wanted to be.

Dr. Gulish-Melton, how did your family influence your career choices?

Dr. Gulish-Melton: I’m the oldest of five children, so I think I had the most exposure to orthopaedics. I remember going with my dad to the hospital when I was little, and I even remember watching him do an arthroscopy when he just started and they couldn’t even really do anything through the arthroscope. Later in life, I had some really influential experiences working with him in Africa on mission trips. It had an impact on my decision.

I always knew I liked sciences, and we grew up on a farm, so at one point I thought I wanted to be a veterinarian. When I got into medical school, I knew I wanted to be a surgeon, but as soon as I did the orthopaedics surgical rotation, I knew it was in my DNA.

My dad was a great role model. I admired how he conducted his practice and cared for his patients. I knew that’s what I wanted to emulate.

Dr. Gulish: We had a parallel journey, because I wanted to be a surgeon, but I had no clue I wanted to be an orthopaedic surgeon until that rotation. Then I knew that was where I wanted to be.

Dr. Gulish-Melton, did you feel pressure going into orthopaedics after watching your father’s career?

Dr. Gulish-Melton: Yes; I don’t know that it was necessarily applied by him, more so self-induced. Any child wants to make their parents happy.

Dr. Gulish-Melton, was there ever a sense of competition among you and your siblings?

Dr. Gulish-Melton: Yes, I think there is always some of that. I think there were probably multiple areas of competition, maybe not in career choice.

Dr. Gulish: As Dr. Gulish-Melton mentioned, we lived on a farm in California, and all the kids showed cattle. Among the girls, there was this tense competition—they all wanted to be the winner.

What was it like working together?

Dr. Gulish-Melton: My parents moved from California to Tennessee when I was in medical school. Medical care in Tennessee is a lot different than what it is in California. We live in a really small town here. It’s a simpler way of life than California. I think we have less restrictions here. We have a different relationship with our patients. It’s a very trusting, mutually respectful relationship, and you’re really part of the community. Because we’re in an underserved area, we do have some more freedom.

My dad and I had a great working relationship. It was really a family practice because both of my brothers worked with us, and my sister-in-law was a medical assistant in the office. My dad loved joint arthroplasty, and I love sports medicine; a lot of times we would refer patients to each other. It was a really good balance.

Heather Gulish-Melton, MD, FAAOS, with her brother Jesse (left) and father (center) in the Baptist Memorial Hospital, Carroll County operating room
Courtesy of Heather Gulish-Melton, MD, FAAOS
Heather Gulish-Melton, MD, FAAOS, also worked with her husband, James “Sonny” Melton, prior to his death during the Oct. 1, 2017, shooting at the Route 91 Harvest festival in Las Vegas.
Courtesy of Heather Gulish-Melton, MD, FAAOS

We always bounce ideas off each other—even to this day.

Dr. Gulish: It couldn’t have worked out better: We were both interested in orthopaedics, but we have different subspecialties. We had a few other orthopaedic partners along the way, but most of the time it was just she and I.

Do you ever talk about work outside of your practices, or do you try to keep work and family separate?

Dr. Gulish-Melton: I think it’s almost impossible for us not to talk about work once we’re together. It’s just part of our everyday life.

How does it feel knowing that your family dynamics are incredibly unique?

Dr. Gulish-Melton: I’m immensely proud of my family and the kind of health care we provide our patients. One basic philosophy that has been consistent in our family is putting the patient first and providing compassionate and state-of-the-art care. That’s what we’re known for in this area. I have a little bit of hope that one of my daughters will go into orthopaedics so we can be a mother-daughter duo, but I don’t know if that will happen.

Dr. Gulish: I’m so proud of Dr. Gulish-Melton and her siblings and how we’re all together. This has been such a great time in my life. Sometimes you don’t realize how good things are until they’re over, but I realized from the time she and my two sons came into the practice what a wonderful time that was.

On Oct. 1, 2017, a shooter opened fire during the Route 91 Harvest festival in Las Vegas. Dr. Gulish-Melton and her husband, James “Sonny” Melton, were in attendance. When the shooting began, Mr. Melton shielded Dr. Gulish-Melton, saving her life but ending his own.

Dr. Gulish-Melton, your late husband, Mr. Melton, also worked in health care. What was your working relationship like?

Dr. Gulish-Melton: When I met Sonny, he was not a nurse, but he decided to go to nursing school about a year later. He got his BSN on an accelerated track and initially started working in the intensive care unit at another hospital. Later, he got a job at the hospital I worked at and worked in the emergency room, so I saw him sometimes. In the last few months of his life, he was assisting me in the operating room, and that was great. We always enjoyed each other’s company and had a great working relationship.

Dr. Gulish: He fit right into the family. He was like our third son.

How did the family come together after the tragedy?

Dr. Gulish: You can’t get over it. Even now, it doesn’t get better. I wake up in the morning and think about Sonny; I go to bed at night and think about Sonny. We all handle it differently. Even after more than two years, it’s hard.

Mrs. Gulish: As her mother, I have to say, Dr. Gulish-Melton is an amazing, strong person. She gave interviews right away because she didn’t want people dwelling on the horrible person who caused death and destruction. She wanted people to realize that he disrupted people’s whole lives and wanted to tell everyone how wonderful Sonny was.

Dr. Gulish: She was stronger than I could have been. I would have been curled up in a ball, but she was out there telling her story.

Dr. Gulish-Melton: Sonny was the kind of person that if you met him, you never forgot him. I received dozens of letters from patients he cared for as a nurse, saying what an impact he had on them. That is what motivated me to talk about him. These kinds of tragedies have ripple effects—it’s not just one person, but a whole family, a community.

He saved my life that day. He wanted me to live. So that’s what gets me out of bed every day—knowing he sacrificed so much for me.

How did the orthopaedic community support you after the shooting, and how can the orthopaedic community better respond to these events?

Dr. Gulish-Melton: We are kind of isolated from the orthopaedic community in Paris, but a lot of people reached out—attendings and my chairman and other staff from the University of Connecticut, where I trained. Even to this day, other coresidents still message me to see how I’m doing. As a group, they donated to Sonny’s scholarship fund. That was such an amazing gesture to me.

This is such a multifaceted problem. I think just being a support system to people is most important, as well as understanding that this isn’t something that ever goes away or gets better.

Dr. Gulish: The medical community as a whole was very supportive. But the people who were most supportive were the patients and people of our community. To this day, patients will come up to us and talk about Sonny—about how much they loved him and think about us. Maybe this is unique to our small southern community, but that’s a real help.

Mrs. Gulish: People still ask me how Dr. Gulish-Melton is doing. It’s still on people’s minds. We live in a special place; it makes you feel supported.

Kerri Fitzgerald is the managing editor of AAOS Now. She can be reached at kefitzgerald@aaos.org.