‘There’s a Physician-Patient Bond
That’s Sacred’

The emotion is still as genuine today as when he started his surgical career a quarter-century ago.

That dedication to patients and their families, combined with his passion for research, teaching and surgery, are among the many reasons Smith has been named the Walter and Carole Young Endowed Professor in Surgery.

Smith, who is also an associate professor of surgery at the Geisel School of Medicine at Dartmouth, specializes in the treatment of pancreatic and complex digestive health conditions. As a leading pancreatic surgeon, he’s been instrumental in advancing treatment options for patients with pancreatic disease in northern New England.

“This appointment is a wonderful recognition for Dr. Smith, who is an outstanding technical surgeon and also an incredibly kind human being who cares deeply about his patients,” says John T. Mullen, MD, FACS, the William N. and Bessie Allyn Professor and chair of the Department of Surgery at Geisel and DHMC.

The Walter and Carole Young Endowed Professorship in Surgery was established in August 2024 with a $4 million bequest from the estate of Walter Young, a previous patient of Smith’s. The professorship supports a faculty member whose teaching and research focuses on general surgery, with a preference for pancreatic disorders.

Walter and Carole Young’s connection to DHMC began in 2012, when Walter sought treatment for pancreatic duct stone disease. After treatment, Smith’s work drew the Youngs’ attention and support. Throughout more than a decade of friendship, they supported the work of Smith and colleague DHMC gastroenterologist Timothy Gardner, MD.

Smith says he was thrilled when he heard he would be the inaugural recipient of the Youngs’ professorship, noting that the honor is “very personal” because of his relationship with the couple.

“Walter was so appreciative of the care he received, and he and Carole always wanted to help both myself and Tim Gardner,” Smith says. “I think they both could see how passionate we were, and we could see how proud they were to be able to meet some of the patients who directly benefited from their generosity. I hope this professorship will honor their commitment to our program and support not only me as a surgeon but future surgeons who share the same passion and dedication to helping patients with pancreatic disease.”

Focusing on the “Hermit Organ”

Smith was raised in Hanover, where his father was a scientist at Dartmouth’s medical school, and his mother was chef-owner of Café la Fraise just off Main Street. “My brother and I grew up as restaurant kids, so we were always there, doing our homework at the restaurant, eating meals there,” he recalls.

It was a medical career, however, not a culinary one, that Smith was drawn to. But why focus on the pancreas—which Smith has called “an orphan organ”—as a specialty?

“Some people refer to it as the hermit, because it’s sort of hiding back there in the human body … it’s hard to get to; it’s hard to study from a scientific standpoint,” he explains.

That’s part of the draw: This oft-ignored digestive organ represents an area of study where innovations abound and where clinicians like Smith are making breakthroughs. One example is the Whipple procedure Smith performs. Traditionally considered one of the most complex major surgeries to remove tumors, it’s made less invasive through Smith’s robotic-assisted approach. Another example is being able to offer a total pancreatectomy with islet auto transplantation therapy to treat advanced pancreatic disease. This procedure removes a patient’s diseased pancreas, isolates its insulin-producing islet cells, and transplants them back into the patient’s liver—thereby treating pancreatic disease while also preventing the onset of diabetes that usually follows pancreas removal. “It’s a life-changing treatment that offers hope to patients who previously had limited options,” says Gardner.

The Patient-Physician Connection Runs Deep

It’s been 14 years since Walter and Carole Young—the namesakes of Smith’s professorship— first connected with DHMC, when Walter sought treatment for pancreatic duct stone disease. Smith soon removed multiple stones from his pancreatic duct, meaning Walter finally felt relief from debilitating symptoms that had prevented him from digesting food.

Smith’s attentiveness and unwavering commitment to Walter’s full recovery made a lasting impression on the patient. And the Youngs made an impression on Smith.

“Walter was interested in learning more about the pancreas, and we just connected,” says Smith. “He was very curious.” Smith eventually invited the couple to the medical center’s Pancreas Education Day, where they met Gardner and learned about the revolutionary islet cell transplant—and how, at the time, Gardner and Smith couldn’t easily or regularly perform the life-changing surgery because DHMC did not have the right equipment.

Impressed, the Youngs made a gift they knew would help Smith, Gardner, and their patients: $250,000 to purchase the equipment needed to create DHMC’s total pancreatectomy with islet auto transplantation program. No more sending patients hundreds of miles away or sending a patient’s pancreas on an odyssey to a Boston hospital to isolate insulin producing cells, then waiting for it to make the trek back.

Eventually, “Walter became like a father-figure to me,” says Smith, recalling the many times they would talk on the phone over the past several years—about growing up in rural New Hampshire, reminiscing about old restaurants that had long since closed in the area, and other everyday topics.

Life in New Hampshire was one of the Youngs’ favorite topics. Their legacy is deeply rooted in their humble beginnings in Claremont, N.H., and in their commitment to New Hampshire’s Woodsville-Wells River area, where they lived and operated Newman Lumber Company, Taylor Chevrolet (now Wells River Chevrolet), and Transit Milling in Wells River. Through their philanthropy, they support scholarships for local students, the building of the Haverhill Corner Fire Department, and other causes that benefit the residents of their beloved North Country.

Their professorship is part of their transformational $14 million estate gift that is revolutionizing digestive health at Dartmouth Health. The gift also created the Walter and Carole Young Pancreas Center at DHMC and the Walter and Carole Young Center for Digestive Health in 2024, which unites and expands clinical programs and research in gastroenterology, hepatology, gastrointestinal surgery, endoscopy, colorectal cancer care, and obesity medicine. Smith is a key member of both centers.

Mullen describes Smith as courageous—namely, for building the pancreatic program with Gardner from the ground up, and for taking on complicated cases.

“Dr. Smith has consistently shown strong ingenuity, confidence, and grit,” says Mullen. “That kind of perseverance advanced his field of work and ultimately benefits the patients he treats.”

Training a New Generation of ‘Old School’ Surgeons

A portion of the professorship funding, at Smith’s direction, will be used for resident and medical student professional development—specifically travel and attendance costs for those up-and-coming physicians to attend conferences and meetings.

And for all the modern treatments and innovation that drive his work, it’s something more traditional Smith hopes he’s passing on to the residents and fellows he teaches and mentors.

“I’m coming from a kind of old-school approach, where there’s this physician-patient bond that is sacred, and physicians honor that. So that even when there’s a whole team of people caring for a patient, that person is still your patient, you feel that responsibility,” says Smith. “That is one of my goals as a mentor, to instill that idea in the younger generation.”

Living Out That Patient Commitment

What Smith and the Youngs had in common is problem-solving: Smith with his patients as much as possible, helping them to live lives free of pancreatic pain and disease, and the Youngs wherever they saw a need they could address, or a gap they could fill, with their generosity.