Episode 86: 2026 WIR Champion Award winner Sue Hanks, MD, FSIR

The following transcript was generated with AI. There may be errors or typos.

M. Victoria Marx, MD, FSIR: I'm Vicki Marks.
Shellie C. Josephs, MD, FSIR: I'm Shelly Josephs.
Alda L. Tam, MD, MBA, FSIR: I'm Alda Tam.

Sue E. Hanks, MD, FSIR: I'm Sue Hanks.
Dr. Josephs: So, I will start by asking some of the questions. So first off, congratulations, Sue, for being our Women in IR champion this year. We have all worked with you on multiple different fronts for a long time and know that you absolutely deserve it. And I am so very excited that you have this opportunity and honor. So, I think kind of just delving into your career and kind of differences in your career and doing what you've done so well for so long as a woman.

So, you're the chief of radiology at one of the largest level one trauma centers in the country. So that's kind of one of those, you know, kind of the old boy’s kind of sport is what I think of our trauma group as frequently.

How has that been for you as a woman in leadership? And has it made a difference at all?
Dr. Hanks: I never really noticed being a woman in this sphere. Let's put it that way. I started as the chief pretty early in my career, about six years after I finished training. And it was, I
think, more related to me being able to interact with people on an equal level to engage with other departments and see what radiology can do, what we can do better. And an ability to say no if there were unreasonable requests being made. So, you can do that without a confrontational edge, and I think it really helped over the years.

I actually stepped down from that position a couple of years ago. It was always a challenge but never felt overwhelming all those years. And I totally respect and love my trauma colleagues. And not only them, but it’s also a really high acuity facility. So, you get really close with the ICU, the ED, lots of different departments. And to help them function better was really what I was interested in. In a lot of ways, it was very challenging to move from an ancient hospital, which Alda knows well because she trained there, and Vicki knows well because she worked there. We moved into an entirely new hospital, which was awesome and a challenge, but really improved the care even more. Our department went from one of the most ancient departments in the country trying to do high level care to an actual modern facility. So that was a huge improvement, and I was really proud of how the department turned out, and it worked so much better.

Dr. Marx: I’ve had the gift of working with Sue for over 25 years and watched her in leadership roles and her many attempts to hand it off to somebody else—unsuccessfully. But one of the key aspects of her leadership is her ability to strategize. So, she would be going into a meeting where she knew what outcome she wanted, and she knew what somebody else’s preferred outcome would be, and she did a great job of strategizing how to make the conversation work and how to sway people and get to the most positive endpoint. And it was a very—I would say low key style of leadership that is incredibly effective. And it was effective over and over again.
Dr. Hanks: I kind of think my gift is marketing, in that you have to take what you would like an outcome to be and make others think that’s what they think it should be as well. And so, if I wasn’t a physician, I definitely should have gone into marketing or advertising.

Dr. Tam: So, along those lines, Sue, you have served as the only IR on the American College of Surgeon’s Trauma Guidelines Group for a while, and I think it would be great for listeners to understand your strategies around being the sole representative and how you made yourself heard. We face this in IR on the NCCN Guidelines where it’s a panel of 36 and you have five surgeons, medical oncologists, radiation oncologists, but often just one of you. So, what are some practical tips on how to get over that? Because inclusion is not necessarily representation, and what have you used to strategize your way around that?

Dr. Hanks: Interestingly enough, working with trauma surgeons, what you find out is that their big strength is in data. They’re not just doing stuff by the seat of their pants because they can. They have massive amounts of data, and they pay attention to it. And they’re very quality oriented. They’re very outcomes orient. I think that’s not well known in our community honestly, and we think it’s just a fly by the seat of your pants type field. But in fact, the trauma databank is absolutely humongous. They track outcomes, individual patients, the number of transfusions, the timing of imaging, the timing of operations, everything. So that’s something I learned working with them. And if we have any sort of sway in how things are done, you have to come with data backing your argument up, because they certainly rely and depend on data to influence and change how they practice. So, I learned that the trauma databank is massive and the amount they track is so impressive. And I don’t think our everyday IR realizes how much they really try to improve their outcomes. So that was something that working in this situation taught me. So, if I ever want to interface with trauma surgeons and change and influence what they do, I have to be able to back it up.

Dr. Josephs: And again, just getting off onto the clinical for a minute, I think that’s really important because again, with your representation on that seat and across the country, people talking about arterial puncture within one hour of trauma and they have numbers to back up patient outcomes based on that. So, I think one of the other things that I know you’ve been involved with is establishing and helping to write some of our guidelines, including our most recent trauma position statement and some of the guidelines through SIR. With your experience of sitting on the other side, it seems to me that we do these guidelines, they take a lot of work, and they’re slow to get out. But we have a group that’s really accumulating a lot of data on our procedures. So how would you say for IR? What’s the best way that we disseminate the information that they’re gathering—because everybody doesn’t read the Journal of Surgical Trauma, but we all take care of trauma. And because it’s scientific and you’re exactly right, they think we’re cowboys because of lot of times that’s what we are kind of, that we’re not doing it based on the data, we’re doing it based on what we were taught years ago.

Dr. Hanks: Right. Well, the most recent guidelines that we worked on were a collaborative effort. I really enjoyed working with that group. Each of us took a certain organ system and focused on that. I feel like I’m the spleen queen. But it’s important for us to realize that resources aren’t uniform everywhere.
And that's one of the things that makes it a little bit more challenging to establish algorithms and for us to standardize care when resources aren’t standardized. And the ability to practice uniformity in every hospital is really challenging. So that’s the part that I don’t know exactly how to overcome, because the number of interventionalists is small compared to the number of surgeons.  And I think our field has a great impact. It's just that there's not enough of us and it’s not a resource that’s available as widely as I feel like it should be. So, to me that’s the challenge for us, is having the great things that we can do available to all patients who can use it.

Dr. Marx: Now one thing that sue led with our trauma service a few years ago was to develop a standardized approach to splenic trauma in our institution. So, we all worked together, we met with an interdisciplinary group to say well, when do we embolize? When do they go to surgery? So at least within our institution, with the resources we have, we were able to develop a standardized algorithm. And I think you almost have to disseminate information to other hospitals saying, look at other groups, other IRs and say, work with your surgeons to figure out what you, with your resources and algorithm, should be. So at least there is some standardization.
Dr. Hanks: That makes a huge difference, honestly, it really does, to be able to make certain that there’s uniformity in practice, because it really doesn’t help a patient to have treatment be different on Saturday than Monday. You really do need to be able to standardize your algorithms to improve your outcomes.

Dr. Josephs: And I think one great opportunity that you have had is that you’ve been able to have a number of trainees that go all over the country so that when you show them this way of doing things and model that effort to your trainees, it is hugely valuable. Because when they see the battles between IR and trauma that's what they expect it to be like everywhere. And then they see an example of a really congenial relationship that is well-designed to work together to provide optimal care.
So, I know your residents all love and adore you—how do you get your residents involved in these things? What’s your philosophy on residents?
Dr. Hanks: When our residents rotate on our service, they know that they are not observers. They are active participants on day one. It doesn’t matter if you’re IR/DR, you’re working. It’s not optional. And I think even our DR residents appreciate feeling like they’re part of a group effort. So that’s number one. We include our trainees in everything. They’re scrubbed in every procedure. They’re not at the tip of somebody’s elbow watching them do stuff—that’s not a good way to learn. And I think the more hands on you allow them to be, the more engaged they become and the more they really appreciate the field for what it is. It’s so fun and you create a fun atmosphere that’s engaging for everybody, and it makes them feel more productive, and like they’ve accomplished something. Even if it’s a DR resident doing their first HermCAF by themselves. For them to feel like they can confidently do this creates an amount of buy-in into our field. Even people who aren’t going to do it for the rest of their lives feel engaged with it. And our IR residents, they’re doing everything from the get-go, they’re involved in every case. We as a group are more likely to talk them through stuff rather than have them watch us.

That’s actually a skill to be able to watch somebody do something and tell them through a procedure because it’s anxiety-provoking for the person watching and you know what you’d be doing at any one moment, but to just—I’m getting anxious sitting here honestly.

Dr. Marx: But Sue, you are the best at talking residents through procedures. You are the best. You may be anxious on the inside, but you deliver the words you’re saying to them in a very calm tone, so you’re not making them anxious. I have always admired your ability to teach with words, not by demonstration.

So, I have a question. What made you go into IR?

Dr. Hanks: Oh, so a few things. When I was in my residency, one of the female originators of IR—there were three founding members who were female, and Ethel Fink was one of them, and she was one of the attendings at USC. So, meeting Ethel, she was an awesome person and made IR super interesting. I liked the more interactive, patient-centered part of it as well. And I’m a little on the hyper side, so being active and busy during the day was more appealing to me than the diagnostic side. So those things all made a big difference. And my husband was a surgeon, and he saw the future of IR, to tell you the truth. When I started talking to him about how awesome I thought it was, he was like if I had a do over, that would be something I would be interested in. its going to be ag rowing field and you should do it. So, it was having ethel, having supportive family and just being at a place where being a woman in that position wasn’t weird or odd, it was normal.

Dr. Tam: I think that’s great. You and Vicki are my Ethels. I mean, it's pretty much my story from training at LAC/USC.
Dr. Hanks: It's not. It wasn't strange or odd. It felt normal. And it's just, again, so much fun and just knowing how important what we do is, it feels so good. So, all of those things were factors. It’s just the sense of accomplishment it always gave me. And it’s a field that from the beginning you knew was going to grow, change and evolve into something really big. And that’s what happened.

Dr. Josephs: I do think it’s really nice to hear. I don’t think id ever heard that you had a woman there that influenced you to go into IR. So again, I had Helen Redmond. So, I think it’s, again, it really shows that who you have there with you that’s training you, it influences you no matter how long ago it was. Because again, I also never thought it was any big deal to be a woman in IR, and because there’s nothing about being a woman that makes you unable to do the procedure. You know, again, I went into medicine thinking I wanted to be an orthopedic surgeon because I had knee surgery early. And I went to the OR and watched the hammer and nail and I was like, that is just not even the slightest bit interesting to be. I have no interest in that. And again, having seen IR—having Helen Redmond, its not necessarily even a question that that was a field that wasn’t perfect for anybody. It didn’t matter who you were, male or female.

Dr. Hanks: Yeah, I love my male trainees as well as my females. Anybody who can do it, who has the right attitude, aptitude and determination has a spot in IR. It’s not for the faint of heart, that’s for sure. You definitely need to have some ability to think on your feet, be flexible, change plan. I tell my trainees all the time, you better have plan A, B, C, and D at the ready. Don’t go into any procedure with plan A and think that’s going to get you through. You had better options. And so, it isn’t for everybody, but for those who have the right makeup it’s awesome.

Dr. Josephs: So, I think the next question would be on that plan A, B, and C. Again, one of the things that we all know you really well for is Western Angio. You have such a great way of putting together saves and disasters. And again, I’d love to hear a little bit about how you get these cases and how you come up with these great matching videos and titles to go with them. What goes through your head what kind of processes do you use? I mean, I would be overwhelmed with the crazy cases that you get sent in. how do you deal with those? I swear it takes me a whole year to put something together like that.

Dr. Tam: Isn’t it all just about your love of hockey?

Dr. Hanks: It’s more general. It started because the very first year I did it was when Western Angio was in Vancouver. So back to the beginning, I don’t know. Well, you guys know Larry Stewart Deutch. Larry was one of the people involved with Western Angio when I was a younger attending, and he was so good to me. He invited me to speak at an M&M session that he did. I had some crazy case I presented, and then whoever the program director had asked me to do the session in Vancouver. I thought, oh, it’d be cool to do a little intro for everyone’s cases. So, I did a hockey video for everyone’s cases. If it’s a good case, you’d match it with a fantastic goal or winning the Stanley cup or some achievement. If it was something that didn’t go well, you show an embarrassing moment for a professional athlete and match the moment with the case. So, it was super fun to do. And I was surprised because it got a really good reception. And I’ve done it for years and years in a row now.

Dr. Tam: Vancouver was in 2015, so you will be on your 22nd year of this.

Dr. Hanks: Maybe. It might have gone before that, I can’t remember for sure. But it’s fun, I really enjoy it and I appreciate the bravery of a lot of people who showcase that didn’t go well. It’s a nice atmosphere because there’s no judgement within the group, and the amount of education that can come from audience discussion, which is an important aspect of it as well. When someone shows something that didn’t go to plan and they find out when you get to the audience discussion part that they’re not a lone—similar things have happened to others, and they talk about how to prevent it or how to deal with whatever the complication was. And other people in the audience are just absorbing this information like a sponge because it’s a great way to learn. Learning from what others have done, whether it’s the great things or the not-so-great things. I think the audience interaction part of it is also really super important and makes it one of the most educational and enjoyable sessions.

Dr. Marx: And the leadership sets the tone, Sue. The reason there’s no judgement and people feel safe is because of your leadership. So, congratulations.

Dr. Hanks: Thank you. And everyone knows that not every case goes as planned and sometimes best intention doesn’t get you where you want to go. And I think that’s the attitude we take into that session.  And it’s really an important part of it is—the feeling of it, that makes the difference, because if it’s pounding your chest, or hey I did this cool thing, that’s not what we’re going for. Were going “in this situation, this worked” or in this situation, this happened, id recommend doing this instead. And it’s not about making yourself look great or beating yourself up over a mistake. It’s just everybody learning from everybody else.

Dr. Josephs: Yeah, I think those are always my favorite sessions. I think that almost everybody would agree with that. That's part of the great thing about going to that meeting.
Dr. Hanks: Thank you. I really enjoy doing it. It’s something I look forward to doing. It’s a really great session and I pride myself in making it good. And if people didn’t feel comfortable participating, it couldn’t be a yearly session.  And the fact that people have seen the session and feel comfortable presenting things really makes me feel good and think that it’s valuable.

Dr. Tam: So, what have been some of your career highlights or favorite being an IR for so long?

Dr. Hanks: Oh Gosh. I’m not just saying this. When I interview people, and some have asked me that, I always say the same thing. It’s knowing how many people have come through our program and Ive trained and have gone out and doing unbelievably amazing things. And of course, I’m proud of people like you, Alda, who have had an amazingly successful career in academics and in our professional association. But I’ve had trainees go out and be the only IR in a rural hospital, and what they’ve done for their community is really inspiring because I don’t know if I could do that. It’s hard. I’ve had trainees go to places where they’ve built an amazing practice from absolutely nothing, and those aren’t names that people know. They’re not on a panel at SIR but they’re out in their community working hard. And I’m really proud of the trainees for the variety of things they’ve done.

I’ve saved a few lives along the way too.

Dr. Josephs: I imagine that you’ve saved thousands of lives along the way. I think that’s something that we never really put it in perspective, but it’s actually pretty amazing.

Dr. Hanks: It is kind of amazing, that I’ll say. But honestly the point of pride is the trainees that have gone out and they’ve served their community soi admirably. That’s really the greatest thing about what has happened in my career.

Dr. Josephs: So, the number of lives you have saved has been exponential because of your influence across all of them. And I mean, that’s actually really cool. And we never really think of our careers that way and I think that’s a really amazing way to think of it.

Dr. Hanks: Yeah, it makes me really happy because I’ve run into people who say, for better or worse, I still hear your voice in my head. And good or bad, I’m not 100% sure. But I think it’s good and that the lessons they’ve learned have stuck, so I still think that is probably good.

Dr. Josephs: So, do you have any advice for young interventionalists coming up, whether they be male or female, or just sort of how to embrace this career and still enjoy it?

Dr. Hanks: Oh it’s hard to tell someone else how to have fun because fun means something different to everybody. But I go to work and I’m really lucky because I’ve been in a situation where my partners are fun, working with the trainees is fun for me. So I guess my biggest point of advice is to find a situation where you’re enjoying what you do. You’ll be so much better at it. If you find a place where what you do is enjoyable, what you do is something to look forward to so that’s my bit of advice. I’m not good at taking advice, so I don’t know how much of it I should be giving. But have fun. And if what you’re doing makes you miserable, you should probably be looking around.

Dr. Josephs: I think that’s great advice, I completely agree with that. I still love coming to work and I know there are a lot of people who get kind of stressed—and we have a stressful job. So it’s important to work with people who really become your comrade in arms, because you have to be a team. And you have had a great team with you for many many years, but you also have been very successful at building those teams around you. And I think that’s a really important part of that.

Dr. Hanks: Well thank you very much. I’ve had nothing but fun the entire time, and I mean IR has given me so much I can’t even express how fortunate I feel because I accidentally ended up in that situation. And my partners have always been great, and it gave me a sister in Vicki and I just can’t fathom how it could have been better in any way. I just feel super fortunate that the starts aligned and I ended up where I did.

Dr. Marx: And it was the stars aligning, especially with you and me, Sue, because I don’t think most people know this, but we grew up in Ohio, 25 miles apart. We both lived through the Ohio tornados back in what, ’74 or something?

Dr. Hanks: Yup.

Dr. Marx: But we didn’t know each other until I came out to LA.

Dr. Hanks: Yeah, the Xenia, Ohio, and Dayton, Ohio connection was not known to either of us and not until much later in our careers. Yeah, the stars aligned and we ended up in a place that IR was appreciated. And it took us a long time to build that street cred. You have to be reliable, you have to be willing to work with your clinical colleagues, and after all these years, we’ve built at our institution a good deal of street cred where people come to you with a problem and its like, is there a way that you can solve it? And it makes it a great mental challenge and is really rewarding when you can come up with a solution to a really challenging problem using devices that were meant for something else, but you find ways to make it work in unexpected ways so it’s super fun. And our colleagues, I think appreciate what we bring to the table. And it helps with the new model, where IR is meant to be more clinically oriented and to have your colleagues know if you’re saying that’s not a good idea, they listen and are like okay, thanks for your opinion, instead of just feeling like…what they think can be done should be do. So, I appreciate ethe way that our practice has developed over the years. It makes it feel like we’re part of a team and not just an individual person.

Dr. Marx: And I hope you notice that Sue keeps saying We, because one of the aspects of our IR practice has always been that none of us try to figure stuff out alone. We always were asking questions of our colleges in IR to figure out tough problems. And that’s a very powerful way to deliver good care and do the best thing because you’re not relying on one head when you’re coming to conclusions. Youree relying on an IR team. So it’s always we.

Dr. Hanks: And when we’re really confused, we call Shelly. It’s always good to have the phone a friend option.

Dr. Joseph: I do love the phone a friend network. And I do think that’s one of the things that, honestly I will say for me as woman early in my career one of the hardest things was networking and being able to go to a meeting where you don’t know anybody and trying to figure out who to meet, and who is you’re there, because at least early in my career, most of the women there were reps or nurses. So, I got to meet Sue at my first western Angio, and it’s just great to be able to find people that you network with that you feel comfortable calling and asking for advice.

So, I think for women, identifying other people who do the same job you dol and having people to reach out to has always been really helpful. And I’ve always been someone who is, well, I’m outspoken most of the time but I’m a slightly social introvert, and so having recognition and people that you relate to is really important, and so I think that’s one of the things that recognizing women who have done so well in their career and have do it for so long, who have been able to reach across those gender stereotypes and borders it’s really great for other people to hear how that has been accomplished over the years.  Like, I don’t go to the golf course to meet people. That’s not what I do. I want to go on a boat fishing around Hawaii with you.

Dr. Tam: Do you think it’s easier these days to network given all the different platforms or do you think it’s still better to be in person and walk up and say hello?

Dr. Hanks: I’m the most massive extrovert you’ll ever see and can work a room like nobody’s business. And platforms, I’m not even sure what you’re talking about when you say that. So, I am for sure a work the room kind of gal.  And for the younger generation I’m sure they have a lot of different ways that they feel comfortable connecting to others. But I can’t speak to that because I’m a work the room person.

Dr. Josephs: I do remember being at a meeting and my other program director I was with said he can just go sit at the bar and meet everyone who comes up. And I was like I can’t do that. That’s not what I do. So WIR helped me to recognize and meet and learn who people are and that was a really helpful way to network. And one of the things that you know is that in the business world, we know that networking is really important for your early career. And I think you’ve done a great job of helping your residents network because I always see you introducing them to everyone and I think that’s one of those extrovert strengths that you have, which is really helpful for them because becoming known is the way you get invited to do things. Do you think about doing that or is that just a natural part of your socializing?

Dr. Hanks: I actually have intentionally included early career people in my session every year because it’s a comfortable place to get your feet wet with public speaking. So, for early career academic people I have intentionally made sure that there’s a person or two included in my sessions. So that’s quiet conscious on my part. As far as my trainees when they’re with me at the SIR, Vicki’s the same, we make sure they’re meeting people they may have heard of or read about. It’s an exciting moment for them and it’s a good way for them to connect if they’re looking for a job in the future or may have a project they need insight into, they’ll feel more comfortable reaching out. I do consciously try to make sure our trainees have access to people who might in some way help them somewhere down the road.

Dr. Marx: Another piece of Sue’s talent is also that she is extroverted to everyone, all men and all women. She’s not encouraging residents to be in a silo. Theres a lot of men in our field, you’ve got to learn to be comfortable asking advice from a guy, not just a woman.

Dr. Hanks: I don’t notice, honestly. It wasn’t part of my consciousness in my everyday interaction with people.

Dr. Marx: Your gender didn’t influence what you were going to say.

Dr. Hanks: Never. I wish. It might have dialed me back a little.

Dr. Marx: I share that with you in that it never occurs to me when I walk into a room that I’m shorter than anyone. But that’s part of my own mental set. So just like being a woman isn’t part of your mental set how you interact with the world.

In conclusion, this has been a wonderful conversation, we’ve really enjoyed speaking with you and are so appreciative of you receiving the WIR Champion award for 2026. So Congratulations.

Dr. Hanks: Thank you very much.