Connor J. Maly, MD, Edward O. Rojas, MD, Sarah E. Ryan, MD
Cassim Igram, MD
The editors of the Iowa Orthopedic Journal (IOJ) dedicate the 2024 edition of this storied publication to Dr. Cassim M. Igram. It is these young “docs” pleasure to help compose this tribute to Dr. Igram, who has been a model leader, outstanding educator, and valued mentor to both faculty and residents alike throughout his career and tenure at Iowa.
Dr. Cassim M. Igram was born in Iowa City, IA at Mercy Hospital and spent his formative childhood years in Cedar Rapids, IA. He attended Washington high school, where he actively participated in track, wrestling, and marching band. His journey as a Hawkeye began when he enrolled at the University of Iowa for his undergraduate studies, and he remained a spirited Hawkeye by participating in the University of Iowa marching band throughout college. He subsequently stayed in Iowa City to pursue his medical education at the University of Iowa Carver College of Medicine. Staying in Iowa City for his medical education proved one of the best decisions he ever made for several reasons. First and foremost, during his 3rd year of medical school he met his wife Julie on a blind date at the Iowa River Power Company. They were married one week before he started residency, and have three wonderful children together, Alex (32), Sarah (31), and Taylor (26). It was also during medical school that he met several faculty members and lifelong mentors James Nepola, Stu Weinstein, Larry Marsh, and John Albright. Inspired by their guidance and support, he decided to pursue a career in orthopedics and matched for residency at the University of Illinois Chicago. After completing his residency training in the Windy City, he relocated to New Orleans, LA to complete a spine fellowship at LSU. Dr. Igram then returned to the Hawkeye state and settled in Des Moines, IA where he worked as a spine surgeon at Mercy Hospital for over 20 years. He was then recruited back to the University of Iowa by our very own Dr. Nepola, who initially offered him the job on the back of a McDonalds French fry box. As such, when discussing writing this year’s dedication with faculty, Dr. Nepola had countless thoughts to share. Fortunately, we were able to review, select and approve them before publication to ensure there was still room for actual manuscripts in this year’s edition. The following captures only some of Dr. Nepola’s accolades about Dr. Igram.
“It is well-deserved and fitting that the Iowa Orthopedic Journal is dedicated to Dr. Igram this year, as he truly embodies what it means to be an Iowa Hawkeye. I have known Dr. Igram since he was a medical student, and what was clear to me then and remains true of him to date is how much he cares about patients, residents, and colleagues. Every medical student says they get into medicine to help people, but only a special few outwardly embody this sentiment and are born doctors. Let me tell you what, Cass Igram was born a doctor. In Latin, the word doctor means teacher, and that is a large part of who Dr. Igram has been for students, residents, and faculty alike throughout his career. I have seen his entire career unfold in front of me, and since mentoring him through his residency application process, it always struck me how his mindset was always about helping patients. This never wavered, and I will never forget the look on his face when he told me he matched at the University of Illinois Chicago for orthopedic surgery, and how happy I was for him to carry out the vocation he was born to do. Residency took him off to Chicago, and fellowship took him away to New Orleans, but as I suspected his path brought him back to the Hawkeye state, and I was thrilled he could serve the people of Iowa because Iowa is where he belongs.
Dr. Igram and company at his eldest son Alex’s wedding.
Left to Right: Dr. Olinger, Dr. Lindsay, Dr. Weinstein, Dr. Pugely, Dr. Kesler, Dr. Igram, Dr. Eisenberg, and Dr. Found at Senior Resident’s Dinner 2022.
Dr. Igram showing one of his senior residents, Dr. Rojas, relevant anatomy intraoperatively as always.
Dr. Igram with the Iowa orthopedic resident representatives Dr. O’Reilly, Dr. Wilkinson, and Dr. Swenson in Washington D.C. at the National OrthoPac meeting.
Dr. Igram and his wife Julie with Dr. Nepola and his wife Cathy on Capitol Hill during the National Orthopaedic Leadership Council Meeting 2023.
Beyond his clinical practice, Dr. Igram has remained an active leader in the orthopedic community for over twenty years. He has served on the American Academy of Orthopaedic Surgeons (AAOS) board of counselors, is a member of the AAOS Now Editorial Board, sits on the AAOS committee on Professionalism, remains an active member of the Iowa Orthopedic Society (IOS), and serves as the treasurer of the OrthoPac. Throughout the nation, he is recognized as Iowa’s representative for the orthopedic community. His involvement, reputation, and status within the political community have even caught me by surprise. Most recently at a National Orthopedic Leadership Council meeting this past fall, where all my political friends not only know him by name but know him well. He is a doctor first, colleague, outstanding professional, and orthopedic leader in my eyes, whom we are lucky to have in this department. It is wonderful to see how well-regarded and respected he has become throughout his career. His reputation and influence with government leaders through his advocacy work for the orthopedic community now extend from Capitol Hill in Washington D.C. to the Governor’s Mansion on Terrace Hill in Des Moines. Everyone knows and makes sure to listen when Dr. Igram is speaking.
For all the great things Dr. Igram has accomplished, he does have his vices. As a former member of the Des Moines Golf Club and an avid duffer, he rarely turns down a Sunday morning break of dawn tee time with me. Well, unless his children are in town, or he’s committed to another family activity with his lovely wife Julie. Family duties have always trumped my attempts to pull him away for a good game of golf, unlike myself. Cass is and will always be a dedicated family man who has successfully balanced his career and commitment to his family. Even while successfully establishing this work-life balance, I saw how Dr. Igram’s commitment to his patients and for Iowa never faltered, which is why I recruited him when we had the opportunity to add a new spine staff a decade ago. All it took was one fancy, impromptu lunch at McDonald's for me to confirm that he would be an excellent fit in Iowa City. He was still the same patient-centered doctor whom I met as a medical student. On top of it all, it was obvious that he could not resist the opportunity to return to his alma mater in Iowa City and finish out his career as a faculty member for The University of Iowa, again exemplifying how he is a Hawkeye through and through.
Bringing Dr. Igram into the department has been a fantastic addition on multiple levels. He has brought a wealth of experience and knowledge that he has constantly shared with faculty and residents. He has remained true to our shared core value of helping patients, which is what we are here to do. We may fix bones, fuse spines, and replace joints, but if we haven’t made the patient better, then we’ve failed, and Cass does not allow for failure. I have heard it from residents and for myself; he will only operate if he thinks it will help make the patient better. He doesn’t operate on imaging studies; he operates on people. He continues to teach residents how to understand patients and their problems, in the context of their imaging, and put it all into perspective for the patient to make the right decision. Now wouldn’t it be excellent if all of us could gain such wisdom from the time we spend with him? He always does the right thing, as all of us should. Iowa is better thanks to people like him being here. He cares about everyone; he is a giver, he is a doctor, and he personifies my vision for where I hope to leave this department in the future. Thank you, Cass; we are fortunate to have you here, and honored to dedicate the IOJ to a true Hawkeye!”
Similarly, when speaking with residents, both past and present, two words always come up when describing Dr. Igram: support and mentorship. He embodies these qualities to the fullest, not just for residents, but for faculty as well. Any resident who has rotated through the spine service has heard the other faculty say, “I have to run this by Igram,” when they have a challenging case, and he has always answered the call to help his fellow faculty with his extensive experience and intuition. This type of supportive presence is one every young faculty member hopes to have when starting their career and should aspire to become. Likewise, Dr. Igram’s innate drive to mentor residents and help them succeed in any way he can is exemplary. Even if you don’t aspire to become a "lowly spine surgeon," Dr. Igram always has your back and will support you without you even realizing it. One such example was shared by one of the IOJ editors, Dr. Rojas:
“From my time as a medical student to this day as a senior resident, Dr. Igram has been a constant support and mentor in my career. As a medical student, he helped set me up for success with an away rotation at the University of Illinois, Chicago, where he did his residency. He reached out to their residency director to put in a good word for me before I ever stepped foot in Chicago, and thanks to that, I had an excellent experience there. During the residency application process, he was a huge advocate for me to match at Iowa. Now as a resident, it brings me so much joy to hear him tell me how proud he feels that he supported my application, especially with how he has seen me grow as a resident. Even during the fellowship interview trail, he was always interested to know how things were going for me. I had several instances during interviews where I would show up and find out during the interview day that he had already reached out to a program to put in a good word for me, without me ever knowing. This type of constant, unwavering support is who he is and how he just always cares. Now I just hope to keep making him proud of what he has invested in me by paying it forward to others throughout my career.”
However, Dr. Igram’s impact has always stretched beyond our interactions with him in the hospital. As graduates like Dr. Kyle Kesler and Dr. Josh Eisenberg share—He was more than a mentor; he was a guiding presence, caring about our well-being both personally and professionally. His fireside chats during journal club sessions at his home were cherished moments where discussions about orthopedic spine articles seamlessly blended with conversations about life and medicine. It was always heartwarming to see how all the residents would show up regardless of their interest in spine because we always ended up talking about so much more than that. Gathered around his fire pit, we found ourselves immersed in discussions ranging from spine surgical techniques to advice on how to survive a career in medicine. Through these gatherings, Dr. Igram taught us the significance of excelling in our field while maintaining a balanced personal life. He instilled in us the belief that being a skilled surgeon also meant being a compassionate and well-rounded individual, leaving an enduring impact on our journey through training.
No number of words can do justice to Dr. Igram’s impact on countless residents and faculty through multiple avenues of education, support, and mentorship, his contributions to the orthopedic community through political advocacy, and his conscientious care for the people of Iowa through his clinical practice. However, we hope the 2024 Iowa Orthopedic Journal Dedication serves as a start. Finally, Dr. Nepola insisted on being the one to close out this tribute, and if you know Dr. Nepola, there is no changing his mind. So here is his year’s IOJ dedication closing thoughts.
“Every medical school applicant knows to recite the necessary phrase that they are going into medicine because they want to help people, and they may all mean it at that time. Yet, unlike many who lose that drive through the trials and tribulations of their career, Dr. Igram meant it then and continues to live it to this day. We, his students, are grateful to him for reminding and teaching us through his actions every day, not only to talk the talk, but ALWAYS walk the walk. There have been many notable orthopedic surgeons who have come through the University of Iowa in our storied history, and you stand among them as the consummate Iowa Hawkeye, whose career has never been about yourself, and instead always about those you could help in any way possible along the way. Thank you, Doctor Igram.”
We couldn’t say it any better ourselves and are honored to dedicate this edition of the Iowa Orthopedic Journal to you Dr. Igram.
-The IOJ Editors