Dr. Noel Berger – 2023 Kumar Patel Prize Recipient

Dr. Berger presenting at the 2019 Symposium.

Sometime in 1996, something big was coming that would forever change the practice of veterinary medicine. I wasn’t sure what it was, but I knew I wanted to find out more. Just as if it was yesterday, I remember two gentlemen that visited my practice on a cold call. One was John Huether, a former veterinary practice management software salesman, and the other was Anthony Petroni, a salesman from the human dentistry field. They knew of surgical laser applications on the human side of medicine and surgery, but they weren’t sure if there were any practical applications in veterinary surgery where a laser would be useful. They invited me to a lecture given by Drs. Ken Bartels and Geoff Clark, two well-known surgeons that used lasers in specialty surgery practice. The rest is history, and as you read this, you will learn of the people, events, and activities that formed my love affair with lasers.

From my student days to the present, I was always interested in all things related to animals, physics, healing, and good business practices. Of course, it would make perfect sense that while listening to a lecture about lasers in surgery that I must have one. Immediately I recognized that this is something I was born for; this is why God created me; this is my destiny. This would be the first step of my laser surgery journey. At the time, my practice was in Sutton, MA, less than an hour’s drive from the Luxar HQ in Norwood, MA. Here I met Daniel Fields, Carl Bennet, and Steve Nielsen. These men delivered my first 12W CO₂ laser within a couple of days. No matter what cases came to me for a surgical solution, the laser was going to be my tool of choice. Up until that time, the literature and clinical experiences were only covering elongated soft palate correction, certain feline surgeries, and tumor management. My priority was to find a way for this new technology to be used every day for any reason so that a scalpel or scissors would no longer be necessary. My excitement and enthusiasm were unbridled and contagious. The purpose of my journey became clear: I would need to tell everyone about the many benefits of veterinary laser surgery.

There was no one to interact with regarding how to best use this surgical device except John and Tony in those early days. They suggested that I scientifically document my procedures and results. For the first few weeks, we were on the phone every day. After a few months, I had a portfolio of images, videos, and tables of data from which to draw information. After reviewing this they asked me if I would consider making a presentation to my peers at the local University, Tufts NESVM, in Grafton MA. Boldly, I accepted the invitation and worked on assembling a presentation. As soon as I began speaking about CO₂ lasers in surgery, I could not stop. The images and video that I shared, combined with my enthusiasm and passion sparked interest in other followers. Before I knew it, I was asked to give another presentation, then another, and another. This was either a self-fulfilling prophecy, or there truly was something marvelous going on. To me, it felt academically affirming and professionally satisfying.

A year passed and I felt that a change in my message was needed, so I began researching the physics of laser-tissue interaction and upgraded to a 20W CO₂ laser with zeal. With new knowledge, more experience, a deeper commitment, and the same passion, I presented my successes and failures to other interested veterinarians. It was hard to believe that I was actually speaking, teaching, and leading others. Four hours of lecture and 3 hours of wet lab were offered at many prestigious veterinary schools, national meetings, large practices, and even at veterinary universities in other countries. My peers were listening, watching, and adopting my successful techniques.

It was the year 2000 when I met up with Dr. Peter Eeg in Washington DC at a meeting of the Veterinary Surgical Laser Society. This was the first attempt at an organized professional association for the understanding and utilization of lasers in veterinary medicine. In 2002 I served as the VSLS president and organized wet labs at the AVMA annual meeting and at several large practices. Peter and I talked about writing a comprehensive laser surgery text using our shared knowledge and experience. This required a few years to edit and was published in 2006. The illustrated book is what our veterinary colleagues were demanding at every venue, and a prominent publisher approached us to perform the work. It was simultaneously humbling and uplifting to be considered an author, especially when it was also translated into Spanish and Japanese. The message of the text remains the same as my speech: lasers can assist veterinarians to perform surgical procedures better than using traditional techniques. It will not make you a good surgeon, but if you are a good surgeon, lasers will make you a better surgeon.

Dr. Berger presenting at the 2018 ALSC Symposium

The notoriety I received for this academic work was exhilarating. I enjoyed traveling and meeting other laser surgeons, as well as key opinion leaders and the people in laser device production that make it all happen. I was able to upgrade to a 40W CO₂ laser and then my laser surgery journey really took off. The 2005 UC Davis symposium on veterinary laser surgery featured Drs. George Peavy, Bert Shelley, and me. It was three full days of lecture and lab hosted by the second most prestigious veterinary school in the world. My alma mater, Cornell University, is foremost, and I previously enjoyed rubbing elbows with my former professors when visiting there as well. I found myself lecturing with other innovators in video otoscopy, like Dr. Louis Gotthelf, combining CO₂ laser surgery with the management of ear diseases. Dr. Gotthelf prepared me to speak at an ASLMS meeting and asked me to contribute a chapter in the second edition of his Small Animal Ear Diseases text. Because of the enhanced response of oral tissue healing after CO₂ laser surgery, I worked with veterinary dentist Dr. Jan Bellows to create a presentation covering veterinary oral laser surgery. He was an early influencer in my career and he provided my first exposure to veterinary medicine during my high school years. This interaction was a proud moment for us both.

I continued to write case reports for Veterinary Practice News, speak at various venues, and lead wet labs at private practices with the following message: using a surgical CO₂ laser is very easy to do, gives improved results, and is an affordable profit center for the hospital. Having a laser in the practice is good for the patients first, good for our clients’ confidence level in the practice second, and improves morale in the hospital knowing that the best care is being provided by the doctors and staff. This had to be backed up with academic knowledge, and not just clinical experience, so I took the time to become certified by the American Board of Laser Surgery, in laser physics, safety, and clinical applications. Also, I passed the requirements of the Laser Institute of America’s certificate in laser safety. These credentials attracted invitations for me to lecture on low-level laser therapy and stem cell therapy well before the techniques became popular. The multi-faceted approach to pain relief and better patient care was the foundation of my message of hope that, if a surgical procedure needed to be performed, it could be completed better with a CO₂ laser.

Memorable moments in my laser career have included receiving a phone call from a young Dr. John Godbold, who had similarly documented his case findings and wanted to share his knowledge as I had done previously. When Dr. Chris Winkler wanted to publish a second textbook on veterinary laser surgery, I was so excited and proud of him. When the American Laser Study Club was formed, I knew it would be a high-quality organization. Dr. Peter Vitruk’s vision for ALSC has the sole purpose of scientific laser surgery education. The ALSC created an opportunity to meet with fellow laser surgeons like Drs. David Duclos, William Schulz, Miguel Carreira, Ziemowit and Anna Kudla, Lorraine Corriveau, Jakub Kaczmarek, and many other luminaries in the field of human oral surgery too. At all of the ALSC meetings, I have met Dr. Kumar Patel, the inventor of the CO₂ laser, and one year I even introduced him as a speaker. My friends, the highlights of my laser surgery career have been getting bigger and better and this could not have been realized without you. No step in this educational journey compares to this latest achievement.

To be considered as a recipient of the Kumar Patel Prize in Laser Surgery from ALSC is the highest form of recognition for professionals that use this device. It is humbling, to say the least, that the basis of the award is from demonstrated innovation, commitment, and passion for education in this field. Using a CO₂ laser has defined my professional career. My work itself is its own reward, and I find it challenging to accept a prize based on performing professional activities that I enjoy so much! It is a reminder to me that receiving this award also requires great responsibility. Now that I possess this distinction, I believe my duty is to continue serving you and maintain the high level of excellence that our profession requires. Accepting this prize is not the end of the journey, just the continuation of the process of raising the standards in veterinary laser surgery by promoting quality education, superb patient care, and responsible case management. Thank you all so very much for your support and for honoring me as the recipient of the 2023 Kumar Patel Prize in Veterinary Laser Surgery.

Noel Berger, DVM, MS

Biographical Highlights

Noel Berger DVM, MS, DABLS is a 1988 graduate of the New York State College of Veterinary Medicine at Cornell. He also earned an MS degree in Veterinary Clinical Sciences in 1989 from Cornell University by studying Feline Leukemia testing and vaccination responses. Following a residency in pathology at Angell Memorial Animal Hospital in Boston, MA, he entered private small animal veterinary practice and has been a clinician for over 35 years.

He was certified in 2000 by the American Board of Laser Surgery in veterinary surgery, physics, and safety. He is the first author of several peer-reviewed papers in veterinary laser surgery, laboratory diagnostics, and stem cell therapy. These works were published in prestigious journals such as JAVMA, Cornell Vet, DVM News, and Vet Med SA Practice. He has co-authored several book chapters (Gotthelf LN, Small Animal Ear Diseases: An Illustrated Guide; BSAVA, Manual of Canine and Feline Surgical Principles; Winkler CJ, Laser Surgery in Veterinary Medicine) and published a textbook on small animal laser surgery in 2006 with his co-author, Dr. Peter Eeg.

Dr. Berger created Boston Road Animal Clinic in 1993 and highlighted laser surgery as a primary focus of the mission and purpose of the practice. He sold that entity in 2009 to an associate and then relocated to Charlotte, NC. There, he bought a coastal small animal practice, naming it the Animal Hospital and Laser Center of South Carolina. This practice was also sold several years later. Dr. Berger then took a sabbatical for a year as a Supervisory Public Health Veterinarian. This career move was unsatisfying since it did not include laser surgery at all! Returning to a general referral practice in 2019, Dr. Berger continues to advance his surgical skills, and now offers TPLO, MPL, BOAS correction, and other laser-assisted procedures at a specialty hospital in Tampa, FL.

Dr. Berger has completed the requirements of the Laser Institute of America for the safe and judicious use of lasers in surgery. He maintains membership in several laser surgical professional organizations. He holds Fellowship and Faculty status of the American Laser Study Club and delights in teaching the safe techniques required to minimize post-surgical pain and inflammation using lasers. Whatever is next in the world of veterinary laser surgery, you can be assured that Dr. Berger will want to be a part of it.

While his three children are grown and following their own professional quests, Noel and Gayle, his wife of over 31 years, enjoy many pursuits together. They enjoy kayaking, swimming, SCUBA, fishing, and eating food outdoors. Indoor wine tasting is also a newfound hobby that has proven fruitful and intriguing. Thanks for spending some time reading about Dr. Noel Berger, he appreciates your interest.