Dr. Thomas Kosasa turned his back on a comfortable life inthe family business — ABCStores — to pursue the life ofa Renaissance man, and for years the life of a playboy.

By Susan K. Sunderland

Ever meet an “overachiever”? They take out the garbage without being asked and pay bills before the due date. For most of us, these little triumphs in life count.

Then there’s Dr. Thomas S. Kosasa, who pioneered infertility treatment in Hawaii, flies Air Ambulance missions on the weekends, directed the architectural design of his home in Nuuanu, is a champion race car driver, consults with the federal Food and Drug Administration, and lectures on the latest advancements on reproductive endocrinology at the University of Hawaii School of Medicine.

Is he an overachiever or a modern Renaissance man?

A Renaissance man is someone who is skilled, sometimes to greatness, in several areas. The Renaissance man constantly learns and masters new skills. It is this quality that allowed Leonardo Da Vinci and Benjamin Franklin to excel in scientific and artistic endeavors.

Kosasa is a local Renaissance man and a likeable, regular guy with many skills. He is soft-spoken, kindly, and comfortable in any situation. What you see is what you get. On the ground or in the air, his high-level achievements are just different dimensions of who he is and nothing he flaunts to get headlines.

Dr. Kosasa (right) with brother Paul and father Sidney,who run the family’s ABCStores

As a matter of fact, one rarely hears about this talented scion of the famed Kosasa family of Oahu, founder of the ABC Stores. His father, Sidney Kosasa (a past MidWeek cover subject), and younger brother Paul Kosasa are usually at the forefront of local publicity.

But, clearly, more people should know about 59-year-old Dr. Kosasa because he is doing remarkable things in the field of reproductive endocrinology — making babies, helping women get pregnant. That’s an oversimplification of his medical specialty, but now that we have your attention …

Kosasa has always been curious about the world around him. His early education at Aina Haina Elementary and Punahou School (class of 1963) set the standard for his professional aspirations. At Punahou, he was a member of the National Honor Society and the state champion rifle team.

Kosasa graduated with distinction and a degree in architecture from Dartmouth College (1967). He earned his medical degree at the McGill University School of Medicine in Montreal (1971) and completed his residency in obstetrics and gynecology and fellowship in reproductive endocrinology at Harvard Medical School as well as Brigham and Women’s Medical Center in Boston. After graduation, he served in the U.S. Army, attaining the rank of major.

Flying has always interested him, and he has been an avid aviator since 1963.

He believes “pilots are genetically destined.” Kosasa has an airline transport pilot’s license, highest aeronautics rating, and has logged over 4,000 hours of flight time. He has flown as a pilot for Air Hawaii, Air Molokai, and Air Ambulance (1990 to present). Each Friday and Sunday, Kosasa pilots a twin-engine Cessna for Air Ambulance, bringing Neighbor Island patients to crucial medical services on Oahu.

On the ground, he’s into fast cars. Racing honors include 11 first-place finishes in National Hot Road Association New England series, driving a 1965 Corvette, and 10 first-place finishes for the Sport Car Club of America North Atlantic Championship Series, with a 1975 Porsche. He also has participated in Ferrari Club of America racing events.

The youthful-looking, very fit Kosasa is an expert skier, scuba diver and shooter. What do all these interests have in common?

“Precision and technology,” says Kosasa, who is drawn to exciting and challenging pursuits.

That also applies to the medical field where Kosasa is a nationally recognized authority on artificial reproductive technology. He is a professor and chief of reproductive endocrinology at the University of Hawaii School of Medicine and publisher of more than 50 scientific articles.

“My main interest is delivering babies, because it’s a happy field,” Kosasa says modestly. “It’s one of the few fields where you leave the hospital with something extra.”

He has delivered thousands of babies, and there’s proof at his Kapiolani Medical Center office where the walls are covered with family photos from patients. Most couples conceive and deliver babies through the normal process. But there are more than a few “miracle babies” conceived through in vitro fertilization. It is in this highly advanced and sometimes controversial field that Kosasa has his greatest moments.

While pursuing advanced studies in obstetrics-gynecology, a professor got Kosasa interested in infertility research and solutions. Infertility is the inability to become pregnant, which can be caused by many factors including infections, disease, tubal blockage and abnormal tissue.

Infertility affects more than 6 million people in America, or 10 percent of the people of reproductive age. An estimated 39,000 couples in Hawaii experience infertility. Most cases can be treated, according to Kosasa.

Kosasa with photos of a few of the babies he’s brought into the world

In vitro fertilization (IVF) literally means “fertilization in glass.” Actually plastic dishes are used today in a process that involves collecting eggs and sperm from a couple with a non-surgical technique and fertilizing the egg outside of the body. The fertilized eggs (embryos) are then transferred into the woman’s uterus.

As medical director of the Pacific In Vitro Fertilization Institute, Kosasa leads a team of highly qualified specialists who use modern technology to help infertile women achieve a successful pregnancy. The institute, located at Kapiolani Medical Center, is the first and most experienced IVF clinic in Hawaii, established in 1985.

More than 1,600 babies have been born with Pacific IVF’s help. The Institute made front-page headlines 20 years ago with the birth of Jacquelyn Low, Hawaii’s first test tube baby. That was only seven years after the world’s first IVF baby was born and four years after the first IVF baby in the United States.

Kosasa’s colleagues at Pacific IVF Institute are Philip I. McNamee, M.D., Carl Morton, M.D., and Thomas T.F. Huang Jr., Ph.D. The Institute is affiliated with the internationally respected Galileo Research Center in San Francisco, providing real-time, ready access to scientists involved in cutting edge research. Thanks to this connection, Hawaii now has access to pre-implantation genetic diagnosis that helps couples minimize the risk of miscarriage and genetic defects.

IVF has created plenty of buzz in the medical field because of its breakthroughs in dealing with the human biological clock. All the stories these days about miraculous high-tech fertility treatments and 50- or 60-year-old women giving birth might make one wonder, has the biological clock been reset?

The truth is the clock is just about where it’s always been. The average woman’s ability to get pregnant begins to slow down as early as 30, according to research. By 40, fertility drops steeply, and even with the most advanced medical techniques, very few women over the age of 44 are able to have a baby using their own eggs. Among this group, childlessness really is a huge problem, a national survey points out. Infertility can be due to male factors as often as female factors or a combination of both.

With embryologist Tracy Inouye as she removes a frozen embryo

Women aren’t the only ones with a ticking biological clock. Men’s fertility declines with age, too. Since 1980, there has been an almost 25 percent increase in men aged 35 to 54 fathering children in the United States, according to the National Center for Health Statistics. Men are waiting later than ever to start a family.

IVF was originally designed to help women whose tubes were blocked. Now this technology is helping men, which Kosasa says is a “real turn of events.” Among the latest advances in IVF is a process called intracytoplasmic sperm injection. This allows men with extremely low sperm count or who are sterile to have children, Kosasa explains. The technique involves the injection of a single sperm into an egg to fertilize it. It does not harm the egg, and pregnancy success rates are approaching 50 percent.

Other advances in IVF, according to Kosasa, are assisted hatching and blastocyst embryo transfer. Assisted hatching increases the chances for embryo implantation for women over the age of 35. New laser technology allows the hardened shell of a fertilized egg to be weakened prior to transfer into the uterus.

Advances in laboratory techniques now allow embryos to be cultured an additional two-three days to an advanced stage of development before it is transferred to the womb. This allows for identification of the healthiest and most robust embryos, which have the highest potential for implantation. Fewer embryos (one or two) are transferred to the womb, thus reducing the risk of multiple births.

What this means is “nearly everyone can have a baby,” heralds Kosasa. “Women can go through menopause and still have a baby with the use of donated eggs. As long as the menopausal woman has a uterus, we can give her medication to allow the embryo to implant, with pregnancy rates as high as 80 percent. Embryos can be created using eggs from a young relative or donor.”

What’s more, extra embryos can now be frozen and stored for an indefinite time. Frozen embryos can be thawed and used for future pregnancy attempts. Pacific IVF Institute has frozen embryos in storage that are more than 9 years old. The longest time an embryo has been stored at Pacific IVF before being thawed and producing a successful pregnancy is eight years, six months — one of the longest terms in the country.

What does this mean to the layman? The development of IVF marks the point in history when human beings seize control of their own reproductive and evolutionary destiny. In a literal sense, experts tell us, IVF allows us to hold the future of our species in our own hands.

It boggles the mind that this is happening in our lifetime. Kosasa and his colleagues at Pacific IVF Institute are at the forefront of this medical and scientific breakthrough.

Patients such as Pam and Mike Chun of Haleiwa can attest to the genius and care of physicians like Kosasa. Pam went through IVF at age 40, having previously tried other infertility treatments, without success. With IVF, the couple was successful on their first try with two eggs retrieved, two fertilized and two embryos transferred. Pam delivered Noah, a healthy baby boy, in August 2002.

Pam, a teacher at Salt Lake Elementary School, lauds Kosasa for “his compassion, his heart and positive outlook at all times. This was uncharted ground for us, and this was a high-risk pregnancy. But Dr. Kosasa worked with us for over a year and earned my trust every step of the way.”

With the advent of high technology in the medical field, have doctor-patient relationships changed? We ask Kosasa how much of his field is high tech (scientific) and how much of it is high touch (humanism)?

“High touch is more important,” is his reply. “Being kind is important, as is knowing that you are doing everything you can to help a patient. A good doctor is someone with a good heart who wants to help. I see this in all of my colleagues. When it comes to patients, giving the very best care is the bottom line.”

Kosasa, who serves on the UH med school admissions committee, says, “If we have a hint that someone is going into medicine for monetary reasons, we encourage them to consider a different field.

“Medicine is still a noble profession. It’s a business that takes care of itself. If you’re kind to your patients and give them good care, they’ll give you their business.”

Kosasa’s sisters, Susan Kosasa and Gloria Gainsley, also are in the medical profession. Susan is office manager for Dr. Kosasa’s private practice. Gainsley is a pharmacist at Kapiolani Medical Center neo-natal care unit. She follows in the footsteps of her father, Sidney Kosasa, who was a pharmacist and started a chain of drug stores before branching out into the ABCs of convenience-store retailing.

The sisters praise their older brother’s achievements and noble character. “He’s a great employer and manages many things at the one time,” says Susan. “People marvel at how much he’s accomplished at a young age. They ask if he’s the original Doogie Howser, M.D.,” referring to the boy-genius TV character.

“He’s very even-tempered and never gets upset,” adds Gainsley. “Like our younger brother, Paul, he has excellent memory and recall for people and dates.”

One date Kosasa recalls well is Dec. 16, 1992. That’s when he married Myrah “Mi” Higa, a former Cherry Blossom queen. After a long stretch of bachelorhood and being one of the town’s most eligible guys, he married at age 47. Acquaintances say the couple has a lot in common, including aviation interests. Mi is vice president of Bradley Pacific Aviation, which services corporate and commercial private jets.

They do not, ironically, have children.

Personal attainment and professional success. Accomplished outside interests. Worldwide respect for one’s knowledge. What is the true measure of a man? Is there a defining moment for a Renaissance man?

You’ll get no exalted response from this talented and modest physician-educator-innovator.

Perhaps the truth lies in Kosasa’s senior yearbook for Punahou’s class of ’63. The caption next to his photo reads:

“I have never met anyone who was not better than me in something.”


 

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