Barrow Magazine - Volume 19, Issue 1, 2007 by Barrow Neurological Foundation

A magazine for the friends of Barrow Neurological Institute of St. Joseph’s Hospital and Medical Center

LUCKY IN LAS VEGAS

Aneurysm patient still going strong 14 years later The 5,000th aneurysm

RAISING THE BAR IN SPINE CARE

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Volume 19, Issue 1, 2007

Opening thoughts he card arrived, as always, right before Christmas. Robert and Donna Frazier wrote to thank my colleagues and me for the care Bob received at Barrow 14 years ago. Bob came to us with an enormous aneurysm on his basilar artery, an aneurysm so large and complex and in such a difficult location that he had been told it was inoperable. Thankfully, the team assembled at Barrow was able to give this kind and gregarioius man another chance. Four operations and weeks of rehabilitation later, Bob and Donna returned to Las Vegas. I am grateful to be able to help patients like Bob and pleased that we are able to share his story with you on pages 21-22 of this issue of Barrow. Our ability to take on challenging cases like Bob’s is a direct result of Barrow’s continued focus on medical research and education, and for that, we have you, our donors, to thank. This issue of Barrow presents many examples of the fruits your gifts are bearing: • Linda Browning is walking again because of the quick and effective care she received from our Neurotrauma team. • Lee Lakes has escaped the disabling pains of lumbar spinal stenosis, thanks to the new X STOP procedure. • Larry Mora is living a full, productive life despite being born with spina bifida—with the help of Barrow, Children’s Rehabilitative Services and the Children’s Health Center. And physicians and scientists throughout Barrow are at work right now on new therapies to help many other patients like Linda, Lee and Larry. Benefactors have built Barrow, and in this Barrow you’ll read about a few of them—Grace Welton, whose gift is making possible a new, exciting project in vision research; Bruce and Deborah Downey, whose generosity is enabling more patients to receive neuro rehabilitation at Barrow; and the Women’s Board, whose Barrow Grand Ball once again set the bar for fundraising galas. Thank you for all you do for Barrow.

Sincerely,

Robert F. Spetzler, MD Director, Barrow Neurological Institute

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2: When time is of the essence Barrow, trauma docs work quickly to reduce damage of spinal-cord injuries. 5: X STOP Pain of lumbar spinal stenosis stopped short by new, less invasive procedure. 7: Spinal-cord research Barrow scientists and physicians investigate new ways to repair spinal injuries. 10: Bridging the care gap Specialists at Barrow and St. Joseph’s provide life-long care for birth defects. 14: The Legacy Circle Our Founding Members. 15: Health & Wealth Raffle MYTHBUSTERS! 16: Helping Joshua Family comes to Barrow Epilepsy Center for unusual treatment of difficult-to-control seizures. 18: The 2007 Barrow Grand Ball

Contents

21: Then and now Fourteen years ago, Barrow commuted Las Vegas man’s death sentence. 23: The 5,000th aneurysm Robert Spetzler, MD, clips his 5,000th aneurysm. 24: Deborah and Bruce Downey Neuro Rehabilitation Center New facility offers more space, improved features. 27: Why I give Long-time Arizona businesswoman supports research into macular degeneration. 30: Research update 34: What’s happening around Barrow 36: When silence is anything but golden

Catherine Menor Editor/Writer Catherine.Menor@chw.edu

Sally Clasen, Melissa Morrison, Sarah Padilla Contributing Writers

Robert F. Spetzler, MD Director Barrow Neurological Institute®

Justin Detwiler Art Director/Designer

Jeff Noble, Jackie Mercandetti Photography

Mary Jane Crist, CFRE CEO, Barrow Neurological Foundation

Panoramic Press • How to Reach Us • Barrow is published twice a year. We welcome your comments, suggestions and requests to be added to or deleted from our mailing list. Call 602-406-1041 or send mail to Barrow, Office of Philanthropy, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013. Please include your name, address and daytime telephone number in all correspondence. Visit us online at www.StJosephs-Phx.com.

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“As soon as I hit the emergency room, I thought, ‘I’m where I need to be. They’ll take care of me.’” Linda Browning

Linda Browning, center, with her friends, coworkers and support system: Trudy Finch, George Reitmeier, Cynthia Quihuis and Greg Bower.

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when time is of the essence Barrow and trauma doctors work quickly to reduce the damage of spinal-cord injuries by Melissa Morrison

inda Browning, 57, was driving home from her what I’m going to say to you: Hell no, I refuse to go to job as an RN case manager for the any other facility!” Oncology/Medical Surgical Unit at St. Joseph’s The paramedics listened. Once she reached the Del Hospital when her van suddenly stalled in the middle E. Webb Emergency Room and Trauma Center at St. of Highway 51. A nurse for 30 years, Linda was accus- Joseph’s, the trauma team kicked into action. With 24 tomed to taking charge during life-and-death emer- neurosurgery residents, two of whom are always gencies. It was no different now that her own life was inhouse, Barrow’s residency training program is the the one in peril. largest in the world. That evening, residents Steve Calmly, she turned on her hazard lights, called 911, Chang, MD, and Giac Consiglieri, MD, were on call. made sure her seat belt was fastened and said a prayer. Then she waited. “She came in essentially quadriplegic. The truck struck her from behind at full With that type of injury, I will tell you the speed. The impact shoved the van’s rear seats into the front ones and sent the van overwhelming majority will have permanent spinning 100 feet down the freeway, where neurological dysfunction—in other words, the retaining wall stopped it. a spinal-cord injury that never gets better.” “After I was hit, I noticed my breathing was shallower, and there were really deep Nicholas Theodore, MD waves of tingling that went from my diaphragm all the way to the tips of my toes,” Linda Nicholas Theodore, MD, director of Barrow’s says. “I realized my legs weren’t moving. Then I felt Neurotrauma Program, was readying to go home my neck. I knew I had a spinal-cord injury as soon as after finishing a case when he got the call. my breathing got shallower. But I didn’t put everything together until I realized that my neck was Quick action was critical locked. I thought, ‘Oh no.’” The team stabilized Linda’s spine with a metal ring

The nurse in Linda didn’t desert her now that she was the patient. When the ambulance arrived, she demanded it take her to St. Joseph’s emergency room where Barrow Neurological Institute doctors would be primed to deal with her injury. “I knew the most important thing I had on my side was time,” she says. “I had been taught all these years, the quicker you get to the emergency room after a spinal-cord injury, the better your outcome.” The ambulance crew initially refused Linda’s request because another trauma facility was closer. Despite the fact that she was gravely injured, Linda held fast. She told the crew member, “I want you to look me straight in the eye, and I want you to listen to

‘I refuse to go to any other facility’

attached by screws to her skull, inserted a tube to breathe for her, gave her medication to relax her muscles and then x-rayed her spine. The whiplash caused by the truck’s impact had fractured Linda’s fifth cervical vertebra, locking the sixth and seventh together, which severely compressed the spinal cord. “She came in essentially quadriplegic,” Dr. Theodore says. “With that type of injury, I will tell you the overwhelming majority will have permanent neurological dysfunction—in other words, a spinal-cord injury that never gets better.” The longer the spinal cord is denied blood supply, the more damage it sustains. “What happens is, part of the spinal cord dies,” Dr. Theodore says. That’s why acting quickly is crucial. One of the residents, gripping Linda’s head, forced the jammed verB A R R O W

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“We have a great set of trauma surgeons who are acutely attuned to spinal injuries and are very good at making the diagnosis quickly.” Nicholas Theodore, MD

Linda awoke the next morning in the Neurological Intensive Care Unit. “I like to dance,” says Linda, who before the accident could be found with friends at Scottsdale nightclubs. “I was lying there moving my legs like I was dancing. I could move everything.” Linda was released from the hospital one month later—walking. She continues to recover at home, with the help of physical therapy, swimming and, of course, dancing. She took leave of her job to concentrate on her recovery, but plans to resume at St. Joseph’s when she is able. She sometimes suffers severe pain in her arms, a byproduct of the spinal injury. But she expects that to recede within two years. She is also working with a cognitive therapist to sharpen her executive functioning skills in preparation for her return to work. Dr. Theodore deems her prognosis for a full recovery as “excellent.” So does Linda, as she did from the minute the ambulance arrived at St. Joseph’s. “It never crossed my mind I would never walk again,” she says. “As soon as I hit the emergency room, I thought, ‘I’m where I need to be. They’ll take care of me.’” ■

‘I could move everything’

tebrae to unlock, releasing the pressure on the spinal cord. The entire diagnosis and treatment took a mere 30 minutes from the time Linda’s stretcher came through the trauma-room doors. “We have a great set of trauma surgeons who are acutely attuned to spinal injuries and are very good at making the diagnosis quickly,” Dr. Theodore says. “That’s what we’re set up to do, and that’s what we do here.” Dr. Theodore operated immediately to permanently fuse the two damaged vertebrae into a normal position. The shattered cartilage disc that had separated them was replaced with a piece of bone and a metal plate.

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x stop Pain of lumbar spinal stenosis stopped short by new, less invasive procedure by Catherine Menor

ee Lakes has accomplished much and survived much in his 82 years. He served as a Marine in World War II, founded a manufacturing company in Ohio and ran it until 1980, and then “retired” and worked part-time as a consultant until four years ago. He and his wife, Edith, enjoyed a “55-year romance” until 2002—a year that claimed both Edith and their eldest of four children. But by 2006, 20 years of back problems had nearly brought Lee’s life to a standstill. “I had shooting pains up my legs and back,” the Ahwatukee resident says. “I fell a couple of times because the pain would shoot up my back and practically knock me out.” Lee’s problem—lumbar spinal stenosis—is the most common reason for back surgery in people over the age of 50 in the United States. In lumbar spinal stenosis, the lower spinal canal can become so nar- Lumbar spinal stenosis is rowed that the nerves traveling the most common reason through it to the for back surgery in people legs are pinched, over 50. causing lower back pain and shooting pains down the legs. Some people are born with this narrowing, but most acquire spinal stenosis gradually from the normal wear and tear of everyday activities on the spine. For decades, the standard treatment for severe lumbar spinal stenosis was decompressive lumbar laminectomy, a major open surgery that requires general anesthesia and involves removing the parts of the bone and tissue that are compressing the spinal canal. Now, there is a less invasive option for many patients—the X STOP Interspinous Process Decompression System, developed by St. Francis Medical Technologies, Inc. The X STOP procedure was first performed at Barrow Neurological Institute in April 2006 by Volker Sonntag, MD. “The X STOP procedure provides a low-risk alternative to current treatments for severe lumbar spinal stenosis,” says Dr. Sonntag. “Because it is a less inva-

Lee Lakes underwent the new X STOP procedure for lumbar spinal stenosis at Barrow.

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Lumbar spinal stenosis

Treated with X STOP Volker Sonntag, MD, performed the first X STOP procedure at Barrow in April 2006. The new procedure offers several benefits, including faster recovery times and fewer complications. It is also a fully reversible procedure that does not limit future treatment options. sive procedure, patients typically recover faster and have fewer complications.” Dr. Sonntag explains that the X STOP is a titanium implant that fits between two bones called the “spinous processes” in the lower back. “This creates forced flexion—a permanent bend forward,” the neurosurgeon says. “In fact, if a patient’s symptoms are relieved by bending forward, there’s a good chance that the patient is a candidate for the X STOP.” The one-hour procedure is usually performed under local anesthesia in an operating room. Using xray guidance, the neurosurgeon inserts the X STOP implant through a small incision in the skin of the back. Once positioned, the implant keeps the space between the spinous processes open so that the nerves in the spinal canal are not pinched when the patient stands upright. Another benefit of the X STOP procedure is that it is a fully reversible procedure that does not limit any future non-surgical or surgical treatment options. The X STOP procedure received FDA approval in late 2005. Lee had the procedure in September 2006. “The shooting pains were gone when I woke up from the operation,” Lee says. “That was a marvelous feeling.” ■

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“The shooting pains were gone when I woke up from the operation. That was a marvelous feeling.” Lee Lakes

Is it lumbar spinal stenosis?

Symptoms of lumbar spinal stenosis include: • Dull or aching back pain spreading to your legs. • Numbness and “pins and needles” in your legs, calves or buttocks. • Weakness or a loss of balance. • A decreased endurance for physical activities. • An increase in symptoms when you walk a distance or stand for a time. • A decrease in symptoms when you sit, lie down, put your foot on a raised rest, or bend or lean forward. To learn more, call the Resource Link toll-free, 1-800-BARROW-1 (1-800-227-7691).

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spinal-cord research Barrow scientists and physicians investigate new ways to repair spine injuries by Sally J. Clasen

Neil Crawford, PhD, and Andy Baek, MS, examine a computerized model of a patientâ&#x20AC;&#x2122;s spine created by technology at Barrow. The three-dimensional replica helps surgeons detect complexities and subtleties of the spine not revealed through traditional imaging.

hat if there were a drug that could reduce or even reverse the damage caused by spinal-cord injuries? Or technology that enabled a neurosurgeon to study a replica of a patientâ&#x20AC;&#x2122;s spine in exact detail before ever entering the operating room? While such ideas might sound like elements of science fiction, they and other investigative theories are closer to medical reality, thanks to research that Barrow scientists and physicians are conducting to improve spine-injury outcomes.

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“Rapid prototyping is the springboard into the future of spinal surgery. It will allow us to make spine surgery safer.” Nicholas Theodore, MD

The use of computer technology to see inside the Little is available to reduce the serious effects from body is not new, but its application in spine surgery spinal-cord injury, but Cethrin, a new drug currently is somewhat limited. Now, a three-year, $500,000 grant in clinical trials at Barrow and other select institutions from the National Institutes of Health is helping Bar- in North America, is showing significant promise in row scientists develop a computerized planning tool restoring functional movement. A recombinant protein, that creates a three-dimensional model of a patient’s engineered by BioAxone and recently licensed to spine before surgery takes place. Boston Life Sciences, Cethrin is applied directly to the “While rapid-prototyping technology is used in spine during surgery. It appears to stimulate regenthe industrial and engineering field, it’s relatively new eration and repair of nerves. in the medical field,” says Neil Crawford, PhD, a prinNicholas Theodore, MD, principal investigator of cipal investigator of the study. the study, was the first in the world to administer the The technique involves computer software that therapy and has the most experience using the theragenerates a virtual model of the injured spine based py. “Cethrin provides an opportunity to set up a local on a patient’s CT scan. With the model, surgeons can environment in an injured spinal cord and maximize perform virtual surgery and create anatomical drilling the healing potential,” explains Dr. Theodore, who guides to improve precision during actual surgery. The three-dimensional repli- “Of the 36 patients who’ve participated in the ca helps surgeons detect complexities study worldwide, one-third have shown some and subtleties of the spine that traditional neurological improvement. From where I sit, imaging procedures cannot reveal. “There’s so much we don’t know this is amazing.” about the bio-mechanics of the spine and how the spine responds to external forces Nicholas Theodore, MD and injury,” explains neurosurgeon Nicholas Theodore, first treated a patient at Barrow with Cethrin in March MD, director of the Neurotrauma Program and a co- 2005. investigator in the study. “Rapid prototyping is the One trial participant from Yuma was paralyzed in springboard into the future of spinal surgery. It will a car accident in December 2005. Dr. Theodore adminallow us to make spine surgery safer.” istered Cethrin to his injury while performing surBarrow Neurological Foundation has provided gery to reduce pressure on the 18-year-old's spine. funding for this project. “He showed demonstrated function within several

Modeling the problem

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Undoing spinal-cord injuries

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“What we are trying to do is help the natural healing response, nudge it along, so to speak, along a pathway that maximizes recovery of function.” Nicholas Bambakidis, MD weeks and through rehabilitation, is now able to walk with the help of therapists,” Dr. Theodore says. According to Dr. Theodore, the study has completed dosing at four levels and interim results for patients completing a six-week assessment were released in November 2006. “ One-third of the patients who've participated in the study have shown some neurological improvement. From where I sit, this is amazing.” Some experimental studies at Barrow have helped steer researchers to investigate alternative methods to reduce the effects of spinal-cord injuries. Eric Horn, MD, PhD, chief resident in Neurosurgery, recently examined the effectiveness of draining fluid in severe spinal-cord injuries. “When you decrease pressure, you have a greater chance of increasing blood flow and providing nutrients to the spinal cord,” Dr. Horn says. Though the results of the study indicated the technique is not effective for acute injury, the results showed promise for less severe spine injuries, says Dr. Horn. “While most treatments don’t work in complete paralysis, we learned that positive results do occur in moderate cases. Sometimes you discover that something doesn’t work. That’s the hallmark of scientific investigation.” Dr. Horn will continue to examine the role of spinalcord drainage in moderate cases and says the beauty of the application is that it would be a “very simple way to restore function, and is a procedure that could be done at any hospital.”

Process of elimination

In the Neural Regeneration Laboratory (NRL), researchers are examining ways the body can help heal itself naturally from damage caused by stroke, traumatic brain injury and spinal-cord injury. “What we are trying to do is help the natural healing response, nudge it along, so to speak, along a pathway that maximizes recovery of function,” says the lab’s principal investigator, Nicholas Bambakidis, MD. “There are many ways scientists around the country are doing this. At Barrow we are trying to use growth factors and small protein molecules. These molecules can stimulate the growth of stem cells, which can develop into any kind of cell and which all adults have. By stimulating these cells to grow and respond to injury, we hope we can get them to replace the cells that are damaged,” Dr. Bambakidis explains. Researchers are furthest along in studying the responses of the spine to injury, according to Dr. Bambakidis, who anticipates their efforts will lead to therapeutic trials in humans in five to 10 years. Initial results show that certain agents, when placed in the injured spinal cord shortly after injury, stimulate stem cells to grow and replace some damaged tissue. Because agents have to be directly injected into the spinal cord, the NRL scientists are attempting to develop newer molecules that can be given intravenously or even orally. “We have a long way to go, but with time there is great promise in such methods to improve recovery and restore function,” Dr. Bambakidis says. ■

Injury, heal thyself

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Harold Rekate, MD, talks to Carli Talbot-McInnis during the childâ&#x20AC;&#x2122;s appointment at Childrenâ&#x20AC;&#x2122;s Rehabilitative Services.

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bridging the care gap Specialists at Barrow, Children’s Health Center and Children’s Rehabilitative Services provide lifelong care for people with birth defects by Melissa Morrison

arry Mora was born with spina bifida. He turned 40 in February 2007. Until recently, those two facts would not have coexisted, because few babies born with the neurological disease, in which the fetal spine fails to completely close, would have survived past childhood. Now, thanks to dramatic medical advances, spina bifida babies are able to have normal lifespans. But this outcome is possible only if, when they reach adulthood, they receive the same expert care they received as children, and this is far from assured. Most physicians who specialize in treating children with spina bifida and other neurological disorders are based at children’s hospitals. Relatively few nonpediatric specialists have experience treating those same patients, who, as adults with congenital diseases, have different needs than people who develop neurological problems later in life, says Dr. Harold Rekate, chief of Pediatric Neurosciences at Barrow. Bridging this care gap has become Dr. Rekate’s passion. “It’s something I think about all the time,” he says. “Now we have a huge and increasing population of people whose birth defects are still affecting them, even though they’re no longer children. Finding specialists with interest and expertise in treating these conditions is a significant challenge.” Children’s Rehabilitative Services, Barrow and St. Joseph’s are rare because they are structured to care for patients from infancy through adulthood.

“I’ve always said I was unlucky to be born with spina bifida, but lucky enough to be born in Arizona. CRS is a wonderful program. It’s kept me alive, just like the strong hands of Dr. Rekate.” Larry Mora

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Larry Mora recently retired from his job at CRS. Coworkers at his going-away party included Paulette Sawyer, Giff Loda, Martha Frisby, Deborah Leach, Lupita Nandin and Marybeth LeBoeuf. The state’s Children’s Rehabilitative Services (CRS) provides care for child residents who have a disability or chronic illness. Administered by a branch of the Arizona Department of Health Services, CRS makes sure kids have the specialty medical care they need so they can grow into thriving adults. In central Arizona, the program is administered at St. Joseph’s Children’s Health Center. “I’ve always said I was unlucky to be born with spina bifida, but lucky enough to be born in Arizona,” Larry says. “CRS is a wonderful program. It’s kept me alive, just like the strong hands of Dr. Rekate.” Young CRS patients grow up seeing a variety of specialists on a regular basis. “Up to 21, we get care and build up a relationship with physicians and surgeons. When we graduate from the program and go out to the real world, we see them on the outside,” says Larry, who is living proof of how spina-bifida patients can thrive in adulthood. He is self-sufficient, working until recently as a desk clerk and translator for CRS. He’s also active in politics, such as campaigning for Congressman Ed Pastor.

Children’s Rehabilitative Services

Care beyond childhood is crucial because adult patients face different issues than they did as children. For example, like many spina-bifida patients, Larry has a related condition called hydrocephalus (“water on the brain”), in which spinal fluid normally siphoned off by the body builds up inside the skull. If not released, it can cause severe headaches, blindness and, ultimately, brain death.

Transitioning to adulthood

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Kaitlyn Nerhood receives speech therapy from Kelli Bruns at Children’s Rehabilitative Services

Hydrocephalus is treated with a shunt implanted in the patient’s skull. The invention of the shunt is a key reason spina-bifida patients are now able to reach adulthood. Larry, who was born in Phoenix, received his first shunt when he was two weeks old. But shunts wear out or need adjustment. In one out of five child patients, a shunt’s failure is not reflected on a brain scan, a fact that pediatric specialists are aware of. The statistic still applies when the patients reach adulthood, but specialists in adult neurology don’t necessarily have the same awareness that a shunt’s failure may not show up on a CT or MRI scan. That’s one reason nonpediatric specialists are reluctant to take on such patients. “Very few general neurosurgeons are comfortable with management of shunts put in during childhood,” Dr. Rekate says.

Learning to manage life with spina bifida

Adult patients face other issues they didn’t as children. The spine, for instance, tends to wear out over time, Dr. Rekate says. It’s up to the physician to determine when surgery will help stave off further damage or repair the spine and when it won’t. Spina-bifida patients also have urological, orthopedic and other issues to contend with. Most spina-bifida patients lack bowel and bladder control and must learn to catheterize themselves every few hours to prevent urine from backing up into their kidneys. They also have varying degrees of mobility, with most using wheelchairs or leg braces. Larry walks with the

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Cara Wright, MD, associate director of Children’s Rehabilitative Services (CRS), with children at one of the CRS clinics. help of a cane but has very little feeling in his feet, which means he must be vigilant about protecting them. “When it’s hot, I could walk down the street on concrete in the middle of July in bare feet and not feel a thing,” says Larry, who has friends who have lost limbs to gangrene. Larry credits CRS’s weekly spina-bifida clinics for teaching him how to manage life with the disease. The clinics bring together many specialists in one place—neurosurgeon, pediatrician, social worker, nutritionist, psychologist, urologist, orthopedist, physical therapist, occupational therapist and so on. Patients generally visit the clinic at least once a year. By the time they reach adulthood, they’ve formed relationships with their specialists that continue, which Dr. Rekate says is key to patients’ continuing health. “They’ve been nurtured in this environment where they’ve been taken care of by this group of experts who still practice at St. Joseph’s,” he says. “When they graduate, they can still be taken care of in the same nurturing environment.” ■

“Now we have a huge and increasing population of people whose birth defects are still affecting them, even though they’re no longer children. Finding specialists with interest and expertise in treating these conditions is a significant challenge.” Harold Rekate, MD

Dr. Rekate to be honored guest at national conference

The medical-care transition that young neurological patients face when they reach adulthood will be the subject of a speech by Harold Rekate, MD, at the annual meeting of the American Association of Neurological Surgeons this April in Washington, DC. Dr. Rekate, chief of Pediatric Neurosciences at Barrow, is a national leader on the subject, which is of burgeoning importance as more patients with spina bifida and other neurological diseases survive into adulthood. He will deliver the Matson Memorial Lecture, which is an endowed award for someone who has distinguished himself or herself in the pediatric sciences. “I feel very honored—and very old,” Dr. Rekate says. “It’s for gray eminences.” Dr. Rekate will use the opportunity to galvanize pediatric neurosurgeons to action by discussing the dire need for experts who are willing to care for neurological patients once they leave the aegis of a children’s hospital. “I’m trying to get a little guilt in them,” he says.

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Introducing the Founding Members of

The Legacy Circle St. Josephâ&#x20AC;&#x2122;s Foundation and Barrow Neurological Foundation are proud to announce the Founding Members of the new Legacy Circle. The Legacy Circle is a special group of benefactors within the Heritage Society who are building a secure future for St. Josephâ&#x20AC;&#x2122;s and Barrow through planned giving. Those people who had included the hospital in their estate planning as of January 1, 2007, are welcomed into The Legacy Circle as Founding Members. Please join us in honoring the following Founding Members of the Legacy Circle: Mrs. Jamie C. Barrow Mr. Al Bond Dr. and Mrs. Richard K. Brooks Dr. and Mrs. Robert A. Brooks Mr. Sumner Brown Mr. and Mrs. Fred Cheshire Mr. and Mrs. Warren Crist Mr. and Mrs. Terry E. Dennis Ms. Bernadine A. Diehl Ms. Patricia Anne Eaton Dr. Lisa Wilkinson-Fannin and Mr. Robert Fannin Dr. and Mrs. Donald Fausel Ms. Loretta Haugen Mr. and Mrs. Philip Hawkins Dr. Raymond A. Huger Ms. Marion E. Johnston Dr. and Mrs. Merlin W. Kampfer Mr. and Mrs. Richard L. Kaplin

Mr. and Mrs. Robert Kenkel Dr. George B. Kent, Jr. Dr. and Mrs. Neal A. Klein Dr. and Mrs. David Krigbaum Mr. and Mrs. Howard W. Lanus Mr. and Mrs. William B. Long Ms. Patricia Malick Mr. and Mrs. James M. McDonald Ms. Joan P. Miller Mr. and Mrs. A. Lee Moore Mr. and Mrs. Thomas Munro Mr. and Mrs. Ardeshir Namvar Mr. and Mrs. Jerry L. Nichols Ms. Janice R. Nicholsen Mr. and Mrs. Harry A. Papp Ms. Vicki King and Mr. Roger Pearsall Mr. and Mrs. Jef Peters Mrs. Erdwin Pfuhl Mr. and Mrs. Wick Pilcher

Thank you for helping ensure a healthy future through your planned gift!

Planned gifts range from simple bequests in a will to charitable gift annuities and charitable remainder trusts. To learn more about planned giving and The Legacy Circle, please call 602-406-3041. Ms. Marsha E. Playman Ms. Lorraine P. Prater Mr. and Mrs. William J. Ratsch Mr. John D. Richardson Dr. and Mrs. William B. Robey Mr. and Mrs. Robert R. Russell Dr. Michael Sarullo and Dr. Doris Sarullo Ms. Eileen Schell Ms. Carolyn Sechler Dr. and Mrs. Volker K. Sonntag Dr. and Mrs. Robert F. Spetzler Mr. Clarke Thomas Mr. and Mrs. Webb Todd, Jr. Mr. Tary H. Truman Ms. Diane Watterson Ms. Carolyn Wickliff-Kroman Mr. Barron Wood

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health & wealth raffle

MYTHBUSTERS! T

he Health & Wealth Raffle has been raising money for Barrow Neurological Institute and St. Joseph’s Hospital since 2003. Yet, we continue to receive questions that show a lot of confusion about the Raffle. Here are some of our favorite myths about the Health & Wealth Raffle: Myth: You have to purchase a lot of tickets to win a prize.

Busted: The fact is that most of the top winners have purchased just one ticket. We notify the top 50 winners of each raffle by phone, and most have told us they bought one ticket—or at most, a pack of three. The bottom line is that each and every ticket has the same 1-in-18 odds of winning a prize. Myth: The prizes are donated to the Raffle.

Busted: It would be impossible to acquire 10,000 or more donated prizes for each Health & Wealth Raffle. Most charitable raffles that rely on donated prizes give away only a few prizes. Instead, the Health & Wealth Raffle manager negotiates good prices for our prizes and when possible, buys from Arizona businesses. That’s good for Arizona’s economy! Myth: The prizes aren’t all awarded.

Busted: The fact is we’ve awarded more than 60,000 prizes over the course of our first seven Health & Wealth Raffles. Every prize has been awarded. Myth: The Health & Wealth Raffle generates a lot of money for research, medical education and care for those in need at St. Joseph’s and Barrow.

This one is NOT a myth, and we hope it’s a message you’ve heard loud and clear. Raffle dollars are enabling St. Joseph’s Foundation and Barrow Neurological Foundation to invest as many as 10 million new dollars each year in projects that are critical to the hospital’s and our community’s health.

That’s why we like to think of the Health & Wealth Raffle as a win-winwin situation: prizewinners win, Arizona businesses win, but most importantly, patients win with the improved healthcare made possible by the Health & Wealth Raffle. The Final Deadline is right around the corner. Buy a ticket by April 4 to be included in the Final Draw for more than 10,000 great prizes on April 12. If tickets sell out early, the Final Draw will be held 10 days after sell-out. For more information or to purchase a ticket, call toll-free 1-866-390-9034 or visit www.HealthWealthRaffle.org. ■

Spring 2007 Health & Wealth Raffle

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helping joshua Family comes to Barrow Epilepsy Center for unusual treatment of child’s difficult-to-control seizures by Catherine Menor

Joshua Thursam has returned home. Here he is shown with his mother and father, Amy and Jeff, and his sister, Emily, and brother, Tyler.

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my Thursam sits beside her son, Joshua, in his room in the Pediatric Unit at St. Joseph’s Children’s Health Center. She and her husband, Jeff, remain hopeful for their youngest child—and determined to do whatever it takes to wrestle him from the seizures that are coming far too often on this January day. “He’s having a seizure right now,” says Jeff. “See how his arm comes up, his head turns to one side, he sticks his tongue out and just stares? I can tell he’s just not here right now.” Amy hugs Joshua tightly. “It’s okay, Buddy. We’re trying to make you all better,” she says.

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Just three months ago, the future ter, cheese and mayonnaise. looked brighter for the three-year“There is now a commercially old Goodyear child. For a year, his available formula for younger seizures came much less frequent- patients that has the same high-fat, ly than they had before. Amy and low-carb balance as the ketogenic Jeff can even remember a day in diet,” Dr. Kerrigan says. “That is October 2005 when Joshua had not what we are using for Joshua.” one seizure. But gradually, the medAmy tries to remain hopeful but ication that was such a godsend already she is concerned. She has stopped working, and the seizures heard of children whose seizures returned with a vengeance. stopped soon after beginning the “In November, he turned into a ketogenic diet. Joshua is still having pile of mush,” Amy says. “You up to 20 seizures a day. should see the photos we took at “If this doesn’t work, we’re lookChristmas. ing at a posThe Christsible hemimas before he “She said her dream is was so alert— to have her brother walk he looked with her someday.” right at the camera. This Amy Thursam year, he was just mush.” spherectomy,” she says, adding that Joshua’s seizures began shortly Dr. Kerrigan has told them Joshua after birth. Jack Kerrigan, MD, a is not an ideal candidate for the pediatric epilepsy specialist, says surgery—which involves removthat Joshua was born with clotting ing the side of the brain where the problems, likely caused by the in- seizures originate—because in his utero death of his twin brother. case, both sides are damaged. When Joshua was born, both Still, there is much to be thankarms were dark from blood clots ful for, the Thursams say—the that were impeding blood flow into thoughts and prayers that have his arms. Doctors were able to poured in, a swimming pool for remove the clots and restore normal Joshua’s therapy constructed free of blood flow to his arms, but they charge by White Water Pools, and were unable to prevent the strokes, two older children who care deeply also caused by clots, that damaged about their little brother. most of the right side of his brain Five-year-old Emily recently and part of the left side. learned about Martin Luther King “Medication controls seizures in her kindergarten class. When her for most children.” says Dr. Kerri- teacher asked the class if they had gan, “but about a third of the chil- any hopes and dreams, Emily was dren we see have epilepsy that is quick to respond. “She said her hard, if not impossible, to control dream is to have her brother walk with medication alone. That’s when with her someday,” says Amy. we turn to other treatments that As for Jeff and Amy, they just have proven successful for some want to help Joshua emerge from children—a special diet, surgery or the prison in which he is trapped. vagus-nerve stimulation.” During that year that now seems so Joshua has come to St. Joseph’s far away, “he interacted with us, to try one of those treatments—the he interacted with the kids,” Amy ketogenic diet. This unusual diet says. “You know he’s in there. He’s consists of high-fat, low-carbohy- just stuck.” drate foods, including cream, butEditor’s note: Barrow Neurological

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Foundation funds numerous research projects designed to increase our understanding of epilepsy and to develop new treatments for the disease. If you would like to support our efforts to help children like Joshua, please con-

B ar ro w ’s E pi l e p sy Ce n t e r

The Epilepsy Center at Barrow offers comprehensive diagnosis and treatment for children and adults with seizure disorders. The Center features: • The first and most active epilepsy monitoring unit (EMU) in the Southwest. The EMU in the new Barrow Neuroscience Tower has 15 beds, twice the capacity of the old unit, and is equipped with the latest brain monitoring equipment. • Four full-time pediatric and five fulltime adult epilepsy specialists. • A full range of diagnostic tests.

• A large and active research program investigating the causes of seizures and developing new treatments. To learn more about the Barrow Epilepsy Center, call 1-800-BARROW-1 (1-800-227-7691).

tact the Foundation at 602-406-3041

Kevin Chapman, MD, and Jack Kerrigan, MD, are two of four full-time pediatric epilepsy specialists at Barrow.

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The 2007 Barrow Grand Ball Women’s Board raises $2.1 million for Barrow

1 legant décor, cuisine and entertainment marked the 2007 Barrow Grand Ball, the 42nd Ball presented by the Women’s Board of Barrow Neurological Foundation. This year’s event, held January 20 at The Arizona Biltmore, raised $2.1 million for research and education at Barrow. Co-chairs for the black-tie fundraiser were Sandy Magruder and Nancy Walker. Muffie Churchill is the chairman of the Women’s Board this year. The Barbara C. and Herbert H. Dow Foundation generously underwrote the Ball in Barbara Dow’s memory. Barbara, who passed away in August 2006, was honored for her 12 years of dedicated service to the Women’s Board. Through the years, Barbara gave more than $600,000 to Alzheimer’s and stroke research at Barrow. To further honor Barbara, the Women’s Board established the Barbara Clarke Dow Neurological Research Fellowship to fund the studies and laboratory research of a Barrow physician-scientist investigating cuttingedge initiatives associated with Alzheimer’s and stroke.

3 Major contributors to the 2007 Barrow Grand Ball are listed below:

Chief of Staff Marguerite and Jack Clifford - Spinal Cord Research and Pain Management Research Joan and Jerry Colangelo - Bipolar Research Hanley Family Charitable Fund, Lee T. and Nancy Hobbs Hanley - Neurosurgery Research F. Francis Najafi Family Foundation - Neurosurgery Research Horace W. Steele Chair for Neurosurgical Education, Daniel and Pamela Cracchiolo Annual Neurosurgical Fellowship Award Barrow Dean John W. Dawson - Neuroimaging Research Stevie and Karl Eller - Neurosurgery Research Mr. and Mrs. Robert C. Hobbs, Sr. - Karen and Robert Hobbs and the Hobbs Family Fellowship for Multiple Sclerosis Research Continued page 20.

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7 8 9 1 - Muffie Churchill, Sandy Magruder and Nancy Walker. 2 - Dr. and Mrs. Robert Spetzler and Jimmy Walker. 3 - Linda and Bill Hunt. 4 - Amy Thurston, Sara Dial and Wick Pilcher. 5 - Mary Ellen McKee and Judy Hewson. 6 - Stevie and Karl Eller. 7 - Anne Robbs. 8 - Dr. and Mrs. Tim Vollmer and Dr. and Mrs. John Boyd. 9 - Monique Millon and Kay Long. 10 - Kathy Barrow and Volker Sonntag, MD.

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Dellora A. and Lester J. Norris Foundation, Mr. and Mrs. Robert C. Norris - Neurosurgery Spinal Research Dr. and Mrs. Volker K.H. Sonntag - Neurosurgery Spinal Research St. Josephâ&#x20AC;&#x2122;s Hospital and Medical Center and Barrow Neurological Institute - General Research Fund

2 1 - Dick Grey and Evelyn Higgins. 2 - Louise Sumner, Steven Shedd, MD, and Michael and Susan Erne. 3 - Nancy and Dennis Sage. 4 - C.A. Howlet, and Patty and Jim Simmons. 5 - Ann and David Glew. 6 - Sybil Francis and Michael Crow, and Nancy Hanley.

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White Coat Celebrity Fight Night Foundation - Neurology Research Herbert H. and Barbara C. Dow Foundation - Neurology Research Mr. and Mrs. Geoffrey H. Edmunds - Neuropsychology Research Mr. and Mrs. William A. Franke - Neurobiology Research Patricia Goldman - Professional Education Mr. and Mrs. James B. Hebets - Neurosurgery Research Mr. and Mrs. Gary J. Hewson - Neuro-imaging Research Mr. and Mrs. Robert J. Lavinia - Neurology Research Mr. and Mrs. Marion M. Magruder - Neurosurgery Research Mr. and Mrs. Robert H. McKee - Neurology Research Mrs. Newton Rosenzweig - Neurology Research Stardust Foundation, Mr. and Mrs. Gerald Bisgrove - Professional Education Mr. and Mrs. Thomas J. Stewart - Neurology Research Jane Wallace Thorne - Professional Education Valley Anesthesiology Consultants, Ltd. Neurosurgical Research US Airways - Community Outreach Mr. and Mrs. Robert L. Ward - Neurology Research Mr. and Mrs. Louis A. Weil III - Neurosurgery Research Julie Ann Wrigley Foundation - Neurosurgery Research Continuing Pledges Genevieve Allison-Bush - Research Laboratories for Neurobiology Research Paola and Mickey Schulhof - Development of a Surgically Implantable MRI Marker Shamrock Foods Company - Parkinsonâ&#x20AC;&#x2122;s Research Laboratory

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then and now Fourteen years ago, Barrow commuted Las Vegas man’s death sentence by Catherine Menor

1993 2007 obert Frazier was deteriorating daily because of a giant basilar artery aneurysm in his brain. The aneurysm was pressing against his brain stem and causing both physical and cognitive problems—a drooping eye, slurred speech, paralysis on his left side, confused thinking and terrifying nightmares. Doctors in Las Vegas—even after consulting several West Coast neurosurgeons—offered no hope. One advised Robert to “get your affairs in order.”

obert and his wife, Donna, have celebrated 14 Christmases and anniversaries since then. Robert has worked as a parking valet, as he did before his health scare, for 13 of those years. “Everything’s great,” says the 58-year-old man of his current health.

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Donna Frazier was not • On Oct. 8, Dr. Spetzler ready to give up on her husand his team used a piece of vein to build a bypass band of 20 years when, in around the aneurysm. By 1993, doctors told them giving the blood in the basal Bob’s aneurysm was inopartery a way around the erable. Instead the couple aneurysm, the surgeons drove to a nearby library, where they found a book on reduced blood flow into and “America’s best doctors.” pressure inside of the Inside, the Fraziers found aneurysm. listings for several neuro• Three days later, Phil surgeons who fit their criteDaspit, MD, created more ria—doctors with excellent room in which to operate on credentials and within drivthe aneurysm by drilling ing distance of Las Vegas— through the mastoid bone but the couple kept going behind Bob’s ear. After this back to one particular name: surgery, neuroradiologists Robert Spetzler, MD. Barrow neurosurgeons performed a series of operations to examined the aneurysm Bob and Donna were remove a huge aneurysm in Robert Frazier’s brain. Barrow more closely through cereimpressed with their first Neurological Foundation supports aneurysm research at bral angiography. They call to Barrow. “We were in Barrow. found no evidence of bleeda boat without an oar,” says ing from the aneurysm. In Donna. “When I called his office, they were so wonfact, the bypass had reduced blood flow enough that derful that I knew we’d made the right choice.” some clotting had occurred in the aneurysm, decreasThe Fraziers sent Bob’s X-rays to Dr. Spetzler. Then one afternoon, when Bob was feeling panicked about the aneurysm, the phone rang. It was Dr. Spetzler. “That call was so relaxing,” Bob says. “He had such a soothing voice. It was as if he said, ‘Just relax. Everything’s going to be okay. You’re coming to a good hospital.’ It was just an unbelievable, super call.” Dr. Spetzler explained that the operation, though difficult and complex, was doable. It would require a team of surgeons and multiple operations to eliminate the balloon-shaped, blood-filled aneurysm. There were huge risks, but the outcome without treatment was certain death as the aneurysm continued growing and pressing against vital brain structures—or ruptured, causing a massive stroke. The Fraziers’ insurance company was not convinced that Bob could be helped. After initially rejecting the surgery, the company agreed to hear the case at their review board. Donna appeared before the board, which she describes as “seven men in suits.” “I wore my power suit,” she says. “I had the confidence that there was someone out there who could help Bob and that was where we needed to go. I guess I did one heck of a sales job because they agreed to it.” Bob and Donna arrived at Barrow in September 1993. They would not go home again until December. Bob underwent a series of four surgeries:

‘An unbelieveable, super call’

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ing the risk of hemorrhage during the final operation.

• On Oct. 15, Dr. Spetzler and his team implanted a shunt in Bob’s brain to drain excess fluid.

• In the final surgery on Nov. 12, the neurosurgery team debulked the aneurysm—that is, they removed as much of the lesion as possible.

Bob spent many weeks in the Neuro Rehab Unit, both between procedures and after the final operation. He participated in physical and speech therapy. “I fought all the way,” says Bob of the effort he put into rehab. “I thought to myself, ‘I’ll drive a car again. I’ll be back in no time.’” His therapists were not so optimistic. Bob might never drive a car again, let alone go back to his job parking cars in Las Vegas. But Bob was determined. Back in Las Vegas, he began walking daily—using a cane at first and walking short distances. Gradually, he worked up to fivemile walks and, just a year after his surgery, he returned to his old job. Now, at age 58, Bob is still parking cars. His only deficit is a slight weakness in his left arm. Bob has not forgotten what Barrow did for him. “Every year I send Dr. Spetzler a birthday card and a Christmas card, thanking him, telling him everything is good, and thanking him.” ■

A remarkable recovery

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The 5,000th aneurysm Barrow neurosurgeon reaches milestone by Carmelle Malkovich

On Feb. 19, Robert Spetzler, MD, clipped his 5,000th aneurysm, believed to be the most of any neurosurgeon.

obert Spetzler, MD, the director of Barrow Neurological Institute, recently reached a milestone perhaps no other neurosurgeon can claim. Dr. Spetzler performed his 5,000th aneurysm procedure on Feb. 19â&#x20AC;&#x201D;the most any neurosurgeon is believed to have ever performed. Dr. Spetzler reached this special milestone when he operated on Valley resident Eva Jen, 70. During Eva's procedure, Dr. Spetzler successfully clipped four cerebral aneurysms. Cerebral aneurysms are balloon-like dilatations along normal arteries that most often develop at the base of the brain. They begin as weak spots in the wall of a blood vessel in the brain and can gradually enlarge, creating a thinwalled, blood-filled balloon that can burst. Many aneurysms remain undetected and produce no signs or symptoms until they rupture. Only 50 percent of people who have a ruptured aneurysm live. Of those who survive, 50 percent will live a normal life. Dr. Spetzler is internationally recognized for his treatment of cerebrovascular disorders and has treated patients of all ages from throughout the world at Barrow. He was instrumental in the development of the cardiac standstill, a procedure in which the patient's body is chilled and heart and blood flow stopped during surgery so the neurosurgeon can operate on vessels in the brain without the risk of bleeding. â&#x2013;

Images from the 5,000th aneurysm: Preparing for surgery, under the microscope and three members of the team, Robert Spetzler, MD; Ricardo Hanel, MD; and Iman Feiz-Erfan, MD. B A R R O W

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Deborah and Bruce Downey Neuro Rehabilitation Center New facility offers more space, improved features for patients, families and staff by Sarah Padilla

Above, Guests at the ribbon-cutting of the new Neuro Rehabilitation Center included Cody Unser, of the famed Unser racing family, and Deborah and Bruce Downey, whose $1.2-million gift made the new Center possible. Cody was a patient in the Center after she came down with transverse myelitis eight years ago. Right, the halls in the new Center illustrate the spaciousness of the new facility. In the photo are Pat Hassel, RN, and Dominique Sanders, RN.

“Our hope is that our gift allows more people to get the exceptional care I received.” Bruce Downey

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or many neurological patients, a successful surgery or treatment is often just the first step down a long road to recovery. Some patients may need only a few days to get back on track, while others require months of extensive rehabilitation. The opening of the Deborah and Bruce Downey Neuro Rehabilitation Center in mid-February not only enhanced Barrow’s ability to care for these patients, but also expanded its capacity.

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James Craig Brooke works out with the help of Kristen McGinley, OT, in Brent’s Gym, a new gym for patients with spinal-cord injuries funded by Stephanie and Guy Inzalaco.

To a unit with a multi-page waiting list, the move into the newly renovated space is significant. The new center offers 52 patient beds—up from 38 beds in the old unit—with 18 private and 17 semi-private rooms. Five private rooms, two more than in the old unit, are dedicated to pediatric patients, a population in dire need of more services. The new pediatric area also offers a dedicated pediatric gym and staff who subspecialize in pediatrics. Barrow is the only in-patient acute rehab licensed in Arizona to provide pediatric rehab. The new Neuro Rehabilitation Center also includes a secure five-bed area with special safety features and a gym dedicated to patients with traumatic brain injury (TBI), who tend to require closer supervision. “These dedicated areas will allow our TBI patients to receive one-on-one treatment in a less stimulating environment, which will help them concentrate better,” says Christina Kwasnica, MD, medical director of Neuro Rehabilitation. “The gym will also help keep these patients safer, offering them a space to move around in without the fear of getting disoriented.” The Neuro Rehabilitation Center is the only rehabilitation unit in the state with accreditation for its brain and spinal-cord injury programs from the Commission on Accreditation of Rehabilitation Facilities. The center admits more than 520 patients each year and has an average length of stay of 25 days. Its patients tend to have a higher-than-normal acuity level, meaning that their conditions are more severe than the national average.

A special area for children

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Carol Browner, RN, Spinal Cord Injury Program supervisor, assists Jean Oh.

New center boasts extras

In addition to more beds, the Deborah and Bruce Downey Neuro Rehabilitation Center features:

• Three gyms—one for patients with spinal-cord injuries and other neuro diagnoses, one for patients with traumatic brain injury, and one for pediatric patients. • A café area with computer and DVD access.

• A transitional apartment for patients and families preparing to leave the hospital.

• Ceiling lifts to assist in the movement of patients with spinal-cord injuries.

• Voice-activated environmental-control units in select rooms.

About a third of qualified patients are turned away from the Neuro Rehabilitation Center due to a lack of beds. While the expansion will be helpful, there are already tentative plans to add even more beds to the third floor of the building in the near future. There are several reasons why Barrow’s neurorehabilitation services are so coveted, says Meg Black, RN, BS, Neuro Rehabilitation admissions coordinator. She cites program-specific therapy and nursing staff, neuropsychology services, clinical supervisors who help with patient and family education, and a nurse case manager and medical social workers who help patients with all aspects of their care through discharge and beyond.

Easing the rehab-bed shortage

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The 240 Building is the home of the Deborah and Bruce Downey Neuro Rehabilitation Center.

William Snyder practices swallowing technniques with the guidance of Stacey Clark, MS, CCC-SLP, in the new kitchen.

“We use the team approach to help with continuity of care,” she says. “With rehabilitation, you see subtle changes on a daily basis. You won’t observe those changes with a revolving door of staff.” Deborah and Bruce Downey have their own opinion of what puts Barrow in a league of its own—exceptional care. Bruce was a Neuro Rehabilitation patient in early 2003, after coming down with transverse myelitis, an uncommon neurological syndrome caused by inflammation of the spinal cord. After five weeks of intensive physical, occupational and recreational therapy, Bruce was well on his way to a complete recovery. Two years later, Bruce and his wife, Deborah, expressed their gratitude by making a $1.2-million gift for construction of the new center. “Our hope is that our gift allows more people to get the exceptional care I received,” says Bruce. Their donation has helped make the new center the most comprehensive neuro rehabilitation unit in the state, staff say. “Now that our services are located in one area, we have one of the safest, most-accessible and userfriendly units for staff and patients,” says Jo LemonsCrawford, Neuro Rehabilitation pediatric coordinator. And that makes the road to recovery just a little bit smoother. ■

A $1.2-million thank you

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Thanking the Downeys

“Bruce, by your actions you have spoken volumes to this staff. It’s nice for us to be thanked and appreciated, but you have done so much more. You know that phrase ‘Pay it forward’? That’s what you have done. Somewhere along the line during your illness, a doctor, nurse, aide or therapist made a difference for you, and you decided in turn to pay it forward to make a difference for others. This rehab center named for you and Deborah is your legacy for others. And the dedication of the center today gives us a way to say ‘Thank you’ for this wonderful gift. We, in turn, rededicate ourselves to pay it forward with courteous, unhurried and respectful care to our future patients so that your legacy becomes our legacy as well, and your spirit lives on in the Deborah and Bruce Downey Neuro Rehabilitation Center at Barrow. On behalf of our staff, thank you very, very much.” — Carol Browner, RN, in remarks during the dedication of the Deborah and Bruce Downey Neuro Rehabilitation Center, March 5, 2007

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why i give Long-time Arizona businesswoman supports research into macular degeneration by Catherine Menor

The laser Grace Welton is funding will enable Barrow vision researchers to examine individual blood vessels in living tissue.

race Welton, whose career in land and apartment ownership in Phoenix and Prescott began more than 50 years ago,

has given $80,000 for the purchase of a highly specialized laser that will enable two Barrow vision researchers to explore blood flowâ&#x20AC;&#x2122;s role in macular degeneration at the microscopic level. Grace recently met with Stephen Macknik, PhD, and Susana Martinez-Conde, PhD, to discuss her gift and their research. B A R R O W

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Grace, can you tell us about your own experience with macular degeneration?

Grace: I’ve had macular degeneration for four or five years. It started out in the right eye. At the time, we had white tile with brown grout, and when I’d look at the floor, the lines were crooked, wavy. After I lost my husband in 2004, my sight got worse. Now, if I look at you straight in the face, you don’t have any eyes. But if I put my eyes a little to one side, you do have eyes.

sels tend to be very fragile and often leak blood and fluid, causing swelling within the macula and damaging it. That leads to the death of the neurons in the retina and to vision loss.

Grace, is your own disease what brought about your interest in vision research?

Grace: No, I decided to support research into blindness long before I developed this problem. I remember asking myself years ago, “What is the worst thing that could happen to me? Being in a wheelchair? No, I’d get by. Oh…to be blind. That was the worst.” I never thought of that until a few years ago when I thought I’d better set up a will. I wanted to give now while I can still see the results. I set it up then so that it went to general blind causes. When I met my husband, we delved further into research for the eye. It’s almost as if it [my ability to fund vision research] was planned. I don’t know how many times—I get goose Susana Martinez-Conde, PhD, and Stephen Macknik, PhD, discuss their research with Grace Welton. bumps just thinking Both Dr. Martinez-Conde and Dr. Macknik receive support from Barrow Neurological Foundation. about it—my husband and I would be looking at some property, but there Dr. Martinez-Conde, what is would be something wrong with the property, the macular degeneration? title, for instance, that would prevent us from moving Dr. Martinez-Conde: Macular degeneration is the forward. Shortly afterward, a better opportunity would most common cause of vision loss among people over come along and we would end up with a better deal. 60. Macular degeneration gradually destroys sharp, That happened again and again, as though my life was clear vision by affecting the macula, the part of the eye guided. that allows us to see fine detail. In its early stages, macular degeneration is characterized by yellow Doctors, tell us about the deposits in the back of the eye called drusen, which research you are planning into seem to have little effect on vision. In later stages of macular degeneration, a process macular degeneration. called neovascularization occurs—new abnormal blood Dr. Macknik: Our main goal is to find out if abnorvessels grow under the macula. These new blood ves- mal blood flow in new retinal blood vessels leads to

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vision loss in macular degeneration. Our hypothesis So this is a very high-tech is that the new blood vessels that grow during macupiece of equipment? lar degeneration are linked to blood flow problems in Dr. Macknik: This microscope in this particular the retina. These new vessels, which are fragile and configuration will truly be one of a kind. In the world bleed easily, may be killing neurons and causing vision there are fewer than 200 labs with this equipment and loss. maybe a few dozen in this country. I just can’t express What we’re going to do is measure how abnormal how important this donation is. the blood flow is. And if we find out it’s indeed abnorGrace: So in other words, this laser and micromal, we’re going to try to see if drugs that regulate blood scope can be used for a long time? I realize you have flow might ameliorate the problem. Medications now to keep getting new equipment. used in treating stroke, for instance, might help patients keep their vision longer by regulating their blood flow and preventing neovascularization. It’s a hypothesis and in a way we would never have studied this if it weren’t for Grace. Dr. Martinez-Conde and I both have different programs of research to study amblyopia and other disorders that impair vision. When we met with Grace, she asked if we could do research into macular degeneration. We thought about it and realized we are in a unique position to do research that isn’t being done by anybody else. It was really Grace’s idea to do Grace Welton presents a gift for vision research to Stephen Macknik, PhD, Susana Martinez-Conde, this type of work. PhD, and Xoana Troncoso, PhD.

Why is the laser being funded by Grace important to this research?

Dr. Martinez-Conde: The laser is essential to our research. It will provide a very special beam of light for a custom microscope that will allow us to view the individual blood vessels in living tissue. Most microscopes can view things at the surface. This one can magnify structures beneath the surface of the living brain.

Dr. Martinez-Conde: Yes, this equipment will be used for many, many years. Grace: That makes me feel really good. ■ Normal vision

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by Sarah Padilla

Vinodh Narayanan, MD

Researcher receives grant to study neurofibromatosis

The Department of Defense Neurofibromatosis Research Program has awarded Barrow a one-year exploratory and developmental grant worth $105,600. Researchers will use the grant to investigate

Research Update whether gene defects in neurofibromatosis 1 (NF1) disrupt the function of nerve cells and movement of molecules from the cell body to the terminals where they are needed. “This grant will help us study a new area of research in neurofibromatosis and might help us find new targets for treatment of NF1,” says Vinodh Narayanan, MD, senior staff investigator and pediatric neurogeneticist at Barrow. Neurofibromatosis is one of the most common genetic disorders. Usually diagnosed in childhood, it causes tumors to grow along nerves anywhere in the body. NF1 is a distinct type of the disease that causes tumors and developmental problems, including moderate to severe cognitive impairment. It is believed to be the most common neurological disorder caused by a single gene.

Pediatrician plays key role in new medication for autism

Ronald L. Lindsay, MD, a developmental and behavioral pediatrician at St. Joseph’s Arizona Child Study Center, played a key role in a pivotal research study that led to the recent FDA approval of the first medication for children with autism. Dr. Lindsay was the senior pediatrician in a multisite study into the benefits of using risperidone (Risperdal) for children with autism. The National Institutes of Mental Health-sponsored study took place between 1999 and 2001, during which time Dr. Lindsay was serving as the medical director of the Nisonger Center at Ohio State University. Initially used to treat adults with schizophrenia, risperidone had shown promise for treating the serious behavioral problems often associated with autism. The study found that the medication was, in fact, effective for reducing symptoms such as irritability, tantrums and aggression. Children who were considered responders to the medication showed at least a 25 percent decrease in parent-reported irritability. A child psychologist or psychiatrist also had to note significant improvement.

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The Barrow research will focus on the potential functions of neurofibromin, the protein encoded by the NF1 gene. Initial research has shown that neurofibromin may play a role in the transport of other molecules throughout different parts of the cell, which could have important implications on learning and memory. The team will study a mouse model to learn more about the specific cellular processes that are impaired as a result of NF1 gene mutation, potentially leading to new targets for drug development. Dr. Narayanan and his team at Barrow treat many children with neurofibromatosis at St. Joseph’s Children’s Rehabilitative Services. His research receives funding from Barrow Neurological Foundation.

The initial study results were published in the New England Journal of Medicine in 2002. More recent articles have appeared in the July 2005 issue of the American Journal of Psychiatry and the December 2006 issue of the Journal of Intellectual and Developmental Disability. Dr. Lindsay was the lead author of the latter, which examines weight gain in children taking the medication. While risperidone is not designed to eliminate the Ronald L. Lindsay, MD core symptoms or behaviors of autism, Dr. Lindsay and others believe that the medication’s approval is significant. “Risperidone is not a cure for autism by any stretch, but it does deal effectively with irritability, which is one of the main complicating issues confronted by children with autism and their families,” says Dr. Lindsay.

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Barrow receives $450,000 to study spinal-cord injuries, brain tumors

Adrienne Scheck, PhD

Scientist studying natural anti-cancer treatments

While the use of natural substances for anti-cancer treatment is not new, research into the field— and at Barrow—is increasing. Adrienne C. Scheck, PhD, senior staff scientist in Neuro-Oncology and Neurosurgery Research, is currently pursuing two such complementary treatments. One project involves studying the extract from a Chinese medicinal herb. Scutellaria baicalensis has long been used in oriental medicine for the treatment of a variety of conditions, including inflammation and allergies. Dr. Scheck’s study, however, marks the first time anyone has researched the herb’s effect on brain tumors. Initial results have been promising: Extracts from the herb have been found to kill cells from brain tumors, including some cells resistant to normal chemotherapy agents. Additionally, scutellaria baicalensis is historically nontoxic and is relatively easy to obtain. The team’s initial findings were published in a recent online issue of BioMed Central’s BMC Complementary and Alternative Medicine. Dr. Scheck is also working with Barrow pediatric neurologist Jong Rho, MD, to study the effects of a ketogenic—or high-fat, low-carb—diet as a complementary treatment for people with brain tumors. Dr. Rho is a clinician and scientist who specializes in studying the diet in children with epilepsy, particularly the biochemical and neurophysiologic effects of ketones. A talk he gave at Barrow stimulated Dr. Scheck’s interest, and the two rapidly found a sound scientific basis for collaboration. The duo has found that treating tumor cells with ketones—and treating others with a combination of ketones and a chemotherapy agent—inhibits cell growth. They have submitted several grant proposals for further research into the mechanism behind their findings. Barrow Neurological Foundation supports Dr. Scheck’s research.

The Arizona Biomedical Research Commission (ABRC) recently awarded Barrow and Arizona State University (ASU) two grants worth $450,000 each to study spinal-cord injuries and brain tumors. Researchers at Barrow and ASU will use one of the grants to develop new hydrogels, or liquids that gel, to stimulate the ends of damaged fiber on the spinal cord to grow and bypass injured or scarred areas. Barrow’s grant application for spinalcord injury research scored the highest of all submitted grants. Surgically placed at the site of spinal-cord damage, hydrogels form into scaffolds, which will hopefully enable the cells and the ends of damaged fiber to cross to the other side of the spinal cord, avoiding additional damage to the injured area. “This study uses the latest in bioengineering materials against one of our most pressing problems in neurosurgery,” says Mark Preul, MD, Barrow Newsome Endowed Chair of Neurosurgery Research, who heads the grant along with bioengineer, Alyssa Panitch, PhD. “Our team is composed of some of the best minds from Barrow and ASU in a practical attempt to help reconnect the damaged spinal cord. Those with spinalcord injuries are often young or in the prime of their lives. Helping to repair the damage is daunting.” The brain tumor immunotherapy grant, a partnership between Dr. Preul, Adrienne C. Scheck, PhD, and researchers at ASU, will be used to develop proteins that stimulate the immune system to attack malignant brain tumors. An additional grant from the Wallace Foundation will allow researchers to investigate if the proteins work with malignant melanoma, which has a high tendency to metastasize to the brain. “The fusion of expertise in neurosurgery research, neurooncology, and some really novel applications of peptides driving the immune system is the key to this work,” says Dr. Preul. “We’re focused on translating new ideas into therapies that will give brain-tumor patients some extra time—the most valuable commodity there is.”

Mark Preul, MD

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Barrow scientist contributes to new research into addiction

For nearly 30 years, A.D. “Bud” Craig, PhD, has been studying the pathways that carry sensations from the spinal cord to the brain. On Feb. 6, his work made national headlines as the New York Times reported on new findings that people with damage to a part of the brain called the insula were able to stop smoking instantly. Although Dr. Craig was not directly involved in the smoking research, his research paved the way for the scientists who were. In his research at Barrow, Dr. Craig has tracked sensations like itch, A.D. “Bud” Craig, PhD pain, cold, taste, hunger, thirst and muscle soreness from receptors in the skin and internal organs to the insula. What Dr. Craig has learned

is that the insula processes sensations from throughout the body and generates subjective feelings that bring about actions designed to keep the body in a state of internal balance, or homeostasis. “Let's say you're in a cold room, and it starts to feel uncomfortable,” Dr. Craig says. “You are motivated to do something about being cold because if you're cold too long, you die. So you put on a sweater or turn up the heat or go to a warm room. Those are all behavioral responses to the condition of your body.” In humans, information from the insula goes to other parts of the brain involved in making decisions, says Dr. Craig, and is the source of emotions. The insula may also interpret body states like hunger and craving, and motivate people to buy a candy bar or smoke a cigarette. Thus, research into the insula may lead to new strategies for treating addiction, anxiety and eating disorders. Dr. Craig holds the Atkinson Research Chair at Barrow, an endowed chair made possible by donors.

Barrow neurologist conducts Alzheimer’s research Wrapping up his second year as medical director of Barrow’s Alzheimer’s and Cognitive Disease Program, Patricio Reyes, MD, continues to work toward the goals he envisioned upon his arrival. Collaborations among neurology, neurosurgery, neuropsychology and neuropathology have helped initiate programs that benefit patients, caregivers and medical professionals alike. Most recently, Dr. Reyes instituted a bimonthly Clinico-Pathologic Conference. “We discuss interesting and challenging neurological and neurosurgical cases, including symptoms, diagnosis and outcome,” he says. This year, the Alzheimer’s program also hosted its second annual diversity and caregivers conferences, both of which drew record numbers of participants from across the country. On the research front, the program is involved in several cutting-edge projects. Clinicians recently completed a clinical trial using an acetylcholinesterase inhibitor to treat Hispanic patients. The trial marked the first time researchers studied the effects of an approved medication for Alzheimer’s on a specific ethnic group, which is significant because medications may be processed differently by different ethnicities.

Barrow was one of the first sites to test a new skin patch for Alzheimer’s disease, and it is also participating in a study to verify the efficacy and safety of treating Alzheimer’s patients with a combination of two new drugs. In collaboration with neurosurgery, the team has received funding to develop diagnostic protocol and determine clinical and biomedical markers for normal-pressure hydrocephalus. In the lab, researchers are studying the metabolic and neuropathologic features of a genetically engineered mouse as an animal model for Alzheimer’s disease. Dr. Reyes receives support from Barrow Neu rological Foundation.

Patricio Reyes, MD

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Brain Proteomics Lab studies biological basis of disease

There’s an emerging field that has the potential to provide even more detailed knowledge about the human body than genomics. Proteomics, the study of proteins and how they interact, takes genomics to another level. To stay on the leading edge of brain disease, Barrow has established a Brain Proteomics Laboratory. While the human genome (the collective genes in the body) is static, the human proteome (the collective proteins in the body) changes in response to factors such as environmental stress and disease. The goal of proteomics is to analyze the more than 300,000 proteins in the body and use them as biomarkers for diagnosis, disease progression and treatment. “Proteomics holds the promise of unraveling the biological basis of disease and leading to the discovery of new diagnostic and prognostic markers and the development of new clinical tests,” says Richard S. Burns, MD, director of Barrow’s Movement Disorders Program and co-director of the Proteomics Laboratory. With generous support from Barrow Neurological Foundation, the lab was established in 2005 in the Parkinson’s research area. Additional donor support has provided more equipment, software and staffing, including co-director Peter L. Pingerelli, PhD. The primary equipment used in the lab includes two mass spectrometers. These instruments can measure the masses and relative concentrations of atoms and molecules. The lab also offers a molecular modeling program that produces high-quality, threedimensional images of proteins. “This type of sophisticated instrumentation is most often found in the chemistry department of a university,” says Dr. Burns. “But at Barrow, we’re driven by the clinical aspect—diagnosis and treatment—as opposed to the theoretical.” While the majority of research is currently focused on neurodegenerative diseases, the lab can support research on other brain diseases as well. The ultimate goal is to create a multi-disciplinary Brain Proteomics Research Center, which would help clinicians better understand and treat individuals with brain disease, develop clinical tests and educate the next generation of researchers in proteomics. ■

Richard S. Burns, MD

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what’s happening around barrow

Barrow Neurological Foundation and St. Joseph’s Foundation have installed a Donor Recognition Wall in St. Joseph’s renovated and expanded Stardust Foundation Lobby. The video wall presents information about philanthropy’s role at the hospital, the foundations’ governing boards, donors’ stories and the hospital’s mission. The wall also lists members of the Heritage Society’s Circles of Value and donors to the Pushing Boundaries Capital Campaign. Please be sure to take a look the next time you visit the hospital!

“The Spirit of Giving” Donor Recognition Wall installed

Barrow co-sponsors disabled sports event

Barrow teamed with the Mesa Association of Sports for the Disabled, the Paralympic Academy and Arizona State University (ASU) in presenting the 2006 Arizona Paralympic Academy & 9th Annual Disabled Sports Expo on Oct. 28 at ASU. The event included a paralympic academy clinic with sessions about paralympic sports, disability responsibility and equipment modification. The expo featured instruction and demonstration of such sports as quad rugby, tennis and wheelchair basketball.

Child Neurology and Pediatric Neurosurgery join forces

The physicians in Child Neurology and Pediatric Neurosurgery at St. Joseph’s have combined their practices to create the Pediatric Neurosciences Center, located in Suite 400 of the McAuley Office Building on the hospital campus. There are 12 pediatric neurologists, one pediatric neurosurgeon and one nurse practitioner in the new center. The physicians provide services to several areas on the St. Joseph’s campus, including Barrow Neurological Institute, the Children’s Health Center and Children’s Rehabilitative Services.

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New pediatric epilepsy specialist starts New-Onset Seizure Clinic

Kevin Chapman, MD, a new pediatric epileptologist at St. Joseph’s Children’s Health Center, has opened a clinic for patients with new-onset seizures. Patients at the New-onset Seizure Clinic undergo tests to determine if they are having seizures and what type of epilepsy they have. The clinic provides newly diagnosed patients and their parents with information, treatment and support to help them begin dealing with epilepsy. Dr. Chapman comes to St. Joseph’s from Baylor College of Medicine in Houston, Texas, where he served as an assistant professor in the Department of Pediatrics and the Section of Neurology and Neuroscience. He completed his residency in Pediatrics and Pediatric Neurology at Texas Children’s Hospital with special qualifications in Child Neurology and Neurophysiology. He is a member of the American Epilepsy Society and the American Academy of Neurology.

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Photos, left to right: Shahram Partovi, MD; Stevie Eller and Muffie Churchill; Eric vanSonnenberg, MD; and John Kresl, MD.

Education Day explores alternatives to surgery

“Life’s Not Always Black or White: Gray Matters!” was the theme of the Women’s Board 2007 Education Day on Feb. 8. Guest speakers Eric vanSonnenberg, MD, chairman and professor of Radiology at St. Joseph’s, and John Kresl, MD, PhD, Arizona Oncology Services at St. Joseph’s, discussed alternatives to surgery, including Gamma Knife, CyberKnife and tumor abla-

tion. Attendees enjoyed a continental breakfast in the Marley Lobby and took tours of the MedPresence Conference Room, presented by Shahram (Shez) Partovi, MD, director of Medical Informatics at St. Joseph’s and Barrow. Karen Meyer was chairman of this year’s event.

Center for Transitional Neurorehabilitation celebrates 20th anniversary

The Center for Transitional Neurorehabilitation (CTN) celebrated its 20th anniversary at a fundraising gala on Oct. 14 at the Caleo Resort in Scottsdale. Susan Goldstein, a former CTN patient, and Lauren Dawson, PhD, a neuropsychologist, co-chaired the event. About 300 staff, former patients and friends of the CTN attended the dinner. Special awards were presented to George Prigatano, PhD, the neuropsychologist who founded CTN, Kathern Plenge, MD, a neurologist who was medical director of the CTN until her

retirement in 2001, and Pam Klonoff, PhD, who helped launch the CTN and has been its clinical director since 1993. The Center for Transitional Neurorehabilitation was founded in 1986 to help people rebuild their lives after life-changing brain injuries. Since its beginning, it has grown significantly, caring for more patients and more types of neurological problems. The event raised more than $100,000 for the CTN. ■

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G I V I N G

when silence is anything but golden by Mike Birgen Director of Major Gifts

n our world—with the proliferation of technologically advanced gadgets that can fill waking hours with information, entertainment and mind-numbing stimuli—almost everyone has experienced that hour when a touch of pristine silence would be as good as gold. Silence seems almost impossible to come by. It is ironic that in an hour when communication could be so meaningful, if not critical, to family, friends and loved ones, many Americans impose an almost unnatural silence. It is the silence imposed by the absence of a valid and updated last will and testament. And this is one occasion when silence is far from golden.

As is often the case when someone chooses not to speak, another voice fills the void. This is what happens when someone dies without a valid will: the state government steps in with a kind of one-size-fitsall document that will be used to determine the final disposition of all issues related to your estate—without consideration of your wishes. In other words, a judge will name an individual to serve as executor and make every decision with respect to your estate. This person and the courts will decide who will serve as guardian of any minor children, how specific assets will be divided among family and the final distribution of all assets. Apart from the way we almost always think of a will—as a legal document outlining asset distribution—the last will and testament can carry a message of hope and specific wishes for those left behind. And the absence of this final communication may be the thing most devastating of all to family and loved ones.

Filling the silence

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In addition to articulating specific wishes for family, the will has always been a place for the charitable voice to be heard. Even a superficial glance around our communities testifies to the lasting impact of bequests to organizations like St. Joseph’s Hospital and its Barrow Neurological Institute. Actually creating a last will and testament need not be complicated or costly. In fact, in most states you can actually create a valid will in your own handwriting. Of course, the more detailed your actual will—the more you would like to tailor the document to deal with specific personal wishes and objectives—the more essential it becomes to consult a lawyer familiar with the creation of a will. Visiting with someone familiar with the best options and the basic stumbling blocks in the process can prove to be both emotionally efficient and cost effective. Professionals in our Office of Planned Giving can answer any questions you might have, help you identify options that will best fulfill your objectives and even provide you sample language to assist your own professional advisors. Of course, there is never any cost or obligation for the information and service we provide, and it is in no way designed to replace the counsel of your personal advisors. To learn more, call St. Joseph’s Foundation/Barrow Neurological Foundation at 602-406-3041. We’re open from 8 a.m. to 5 p.m. Monday through Friday. Or email me at Mike.Birgen@chw.edu. I would love to talk to you! ■

Your philanthropic intent

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