Barrow magazine Volume 17, Issue 2, 2005

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

EPILEPSY CENTER

Bedside-to-bench research improving patients’ quality of life

Barrow Patient Tower New tower to open in April

THE 103RD CARDIAC STANDSTILL PATIENT

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Volume 17, Issue 2, 2005

Opening thoughts ur move into the new Barrow Patient Tower is fewer than six months away. As this impressive new building rises on the St. Joseph's campus, our excitement grows.

All of us at Barrow and St. Joseph's—physicians, nurses, staff and patients—are extremely grateful for the support of our donors in helping make this long-held dream a reality. The next spread gives you a glimpse of Barrow's new home. I think you'll be impressed.

As always, this Barrow celebrates accomplishments made possible by your continued support:

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• The dramatic growth of Barrow's Epilepsy Center. Our epilepsy specialists—neurologists, surgeons, nurses and researchers—are continually improving patient care through bench-to-bedside research.

You’ll read about a few of the patients who have been helped by the Epilepsy Center and about some of the center’s fascinating research projects.

• The continued success of the cardiac standstill procedure for the treatment of otherwise inoperable brain aneurysms. This summer, the Discovery Health Channel followed Brett Kehrer, our 103rd cardiac standstill patient.

• The establishment of the Karsten Solheim Dementia Research Chair. Our thanks go to the Karsten Solheim family for making possible this chair. With it, Barrow has successfully recruited Patricio Reyes, MD, a leading dementia expert and researcher.

We also celebrate the enormous contributions of the Barrow Women's Board. This group of dynamic, community-spirited women reached a major milestone in 2005—40 years of serving Barrow. Please join me in recognizing the vital role the Barrow Women’s Board plays in the life of our institute.

And once again, I would like to thank each of you for your contribution to Barrow.

Sincerely,

Robert F. Spetzler, MD Director, Barrow Neurological Institute

Like to be added to the Barrow mailing list?

If you don’t receive Barrow but would like to, just send your name, mailing address, phone number and email address to Catherine.Menor@chw.edu or call 602-406-1041. We’ll be glad to send you the magazine twice a year at no charge.

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2: New Barrow Patient Tower The new 430,000square-foot building is on track to open this spring.

4: Epilepsy Research: Bedside to Bench and Back Barrow researchers and epileptologists join forces to improve health care for people with epilepsy.

16: Cardiac Standstill A Pennsylvania man becomes Dr. Spetzler's 103rd cardiac standstill patient, and the Discovery Health Channel records the drama.

18: Women’s Board’s 40th Birthday These creative and energetic women celebrate four decades of raising funds and awareness for Barrow.

Contents

22: Karsten Solheim Dementia Research Chair New endowed chair attracts leading Alzheimer’s expert.

25: The Unlonely Life of a Neurosurgery Resident 28: Sister Mary Placida, Barrow’s Unsung Hero 30: Nurturing Future Researchers Will Hendricks graduates from ASU and Barrow’s Scientific Enrichment Program to a PhD research program at Johns Hopkins.

32: ResourceLink Your connection to Barrow 36: Research News 40: ‘I Give’ Versus ‘I Leave’

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

Philip Barnett, Sally Clasen, Debra Gelbart, 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

Steve Woods Printing • 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 and www.PushingBoundaries.org.

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Were you born at St. Joseph’s? Have you been a patient here? Help us celebrate our past and future by sharing your story at www.BornatStJosephs.org.

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Pushing BOUNDARIES

he new Barrow Patient Tower is rising on St. Joseph’s campus. The seven-story building is scheduled to open in the spring of 2006.

Meanwhile, volunteer leaders of the Pushing Boundaries Capital Campaign are on target to reach their $31-million goal by the end of 2006.

In the next few months, St. Joseph’s will celebrate 111 years of serving Arizona and the opening

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of the new Barrow Patient Tower. Were you born at St. Joseph’s? Do you have a St. Joseph’s/Barrow story to share? If you do, you are invited to help us capture our history by sharing your information at www.BornatStJosephs.org.

All people who share their stories will be invited to the grand opening of the new Barrow Patient Tower. ■

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the barrow epilepsy program From bedside to bench and back

ithout the epilepsy care available at Barrow Neurological Institute, Joshua Alderson might not be a happy four-year-old going to school for the first time this year.

Nine-year-old Dylan Gregg might not have recent-

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ly enjoyed a Diamondbacks game with his parents.

Donna Johnson might not be driving again.

And Briley Nelson might not be sleeping peacefully through the night.

These Barrow patients and many more have

• More than 53,000 Arizonans and two million Americans have epilepsy. It is the second most common neurological disorder (after stroke).

• Epilepsy is a neurological condition that makes people susceptible to seizures. A seizure is a change in sensation, awareness or behavior brought about by a brief electrical disturbance in one or more areas of the brain.

• Epilepsy can begin at any time of life. Most often, it begins in the first year of life or after age 60.

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Barrow Neurological Foundation has allocated more than $1 million for epilepsy research in Fiscal Year 2006. The epilepsy research areas profiled here are three of the areas that have received funding from the Foundation. received relief and, in some cases, a complete cure from debilitating seizures that ruled their lives and threatened their futures.

Today, people with epilepsy have more treatment options than ever before—a dozen antiseizure medications with several more being tested, several types of surgery, the vagas nerve stimulator and even a special diet that reduces seizures in children. And clinical trials are testing deep-brain stimulation as another treatment option.

Despite these advances in epilepsy care, many patients continue to struggle with their condition.

Experts estimate that about 30 percent of people with epilepsy have difficulty controlling their

seizures with medications alone, and about 15 percent have seizures that are truly refractory—resistant to all treatments.

To help them, Barrow epilepsy specialists, surgeons and researchers are working to develop a better understanding of epilepsy and new ways of treating and curing it.

On the pages that follow, you will meet some of the patients who have been helped by the Barrow epilepsy team. And you will learn how physicianresearchers at Barrow hope to improve epilepsy care through translational research—research that goes from the bedside to the laboratory bench and back to the bedside. ■

• Seizures vary from a momentary disruption of the senses, to short periods of unconsciousness or staring spells, to convulsions. Some people have just one type of seizure. Others have more than one type.

• Epilepsy is not a mental disorder. It can be caused by anything that affects the brain, including tumors, head injuries, infections and strokes. Sometimes epilepsy is inherited. Often, no cause can be found.

Information from the Epilepsy Foundation and Barrow Neurological Institute

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So Long, Seizures Barrow Epilepsy Center offers help to many Dylan Gregg

om and Sherry Gregg were worried about their six-yearold son, Dylan.

Dylan had had plenty of health problems in his short life—an under-

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Dylan Gregg and his parents recently enjoyed a Diamondbacks baseball game and a surprise visit from Dylan’s hero, Luis Gonzalez.

developed right brain that caused ed to take another look at the surweakness on the left side of his body gery option. and difficult-to-control seizures Dylan underwent an intracobeginning at age three. But now, the ratid spike suppression test while in child could keep nothing down and a coma. First one side of the brain was losing weight rapidly. was put to sleep and then the other.

Still, they were unprepared for “If you put one side of the brain what they learned at St. Joseph’s to sleep and all the spiking goes Hospital. away, and then you put the other Dylan was in status epilepticus, side to sleep and the spiking conthe worst form of epilepsy. His brain tinues, you know everything is was being wracked by one seizure being driven by the one side,” says after another with no recovery Dr. Kerrigan. between seizures. The seizures were The test showed that the seizures subtle, difficult to detect until Dylan were originating from the right, was connected to an EEG. The spikes on the EEG Seizure after seizure wracked screen were clear—with- Dylan’s brain. Only a radical out immediate help, surgery—the removal of half Dylan would suffer brain of his brain— could save the damage or even death.

St. Joseph’s Children’s child’s life.

Health Center team—led

by Jack Kerrigan, MD, and Yu-Tze underdeveloped side of Dylan’s Ng, MD, two of four pediatric brain. The doctors recommended epileptologists in the state—acted that Dylan undergo a hemiquickly. They moved Dylan to the spherectomy—the removal of the Pediatric Intensive Care Unit and right side of his brain. put him into a pentobarbital coma “I prayed for my son in a way I to save his brain from further dam- had never done before,” says Tom. age. Twice during the next 10 days, “I felt such a peace come over me the team gradually reduced the that I was not worried about the coma-inducing medicine in hopes surgery.” that the seizures would cease. They did not.

Earlier testing had shown that Dylan’s seizures were coming from both hemispheres of his brain. At that time, his doctors had concluded that he was not a good candidate for surgery. But in the crisis Dylan faced, Drs. Kerrigan and Ng decidYu-Tze Ng, MD

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“At Barrow, we try to determine where the seizures are coming from and address that issue.”

Steve Chung, MD Harold Rekate, MD, performed the operation in October 2002.

“After his surgery, Dr. Ng said, ‘I can’t tell you how he will be.’ He said he would probably be paralyzed on his left side for at least six month,” Tom recalls.

Dylan beat all the odds. With his parents’ encouragement, he was standing two weeks after the operation. His voice, initially very soft and hoarse because of the pro-

Donna Johnson

thorough evaluation is the key to good results for patients with epilepsy, says Steve Chung, MD, an epileptologist at Barrow.

“Many patients are first seen by a general neurologist, and the patient’s seizure focus is not identified. Instead, the doctor tries a variety of medications, which may or may not be effective,” says Dr. Chung.

“At Barrow, we try to determine where the seizures are coming from and address that issue.”

Donna Johnson of Paradise Va l l e y Steve Chung, MD, in the Epilepsy Monitoring Unit learned firsthand the value of this approach. longed use of the breathing tube, Donna became seriously ill with also returned. Dylan is now a third meningo-encephalitis when she was grader in Prescott Valley. He is gain- a baby. Sixteen years later, she began ing strength in his left hand and having seizures. Donna learned to has had no more seizures. live with the seizures—and the fact Drs. Ng and Kerrigan co- that none of the medications she authored an article about Dylan’s tried stopped them. treatment. It was published in a She noticed that her seizures professional peer-reviewed journal seemed to cluster around her mento help other neurologists facing a strual cycle and mentioned this to similar set of circumstances. her long-time neurologist. “He said Dylan was doing great at his last that had nothing to do with it,” she visit, very talkative and outgoing, says.

Dr. Kerrigan reports. The pediatric Finally, Donna decided to see neurologist hopes to take Dylan off another neurologist, and that neuhis last anti-seizure medication rologist referred her to Dr. Chung. sometime in the near future.

Donna told Dr. Chung about the

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cyclical nature of her seizures. To her relief, the Barrow epileptologist confirmed that seizures can be related to the menstrual cycle.

“He explained all the different possibilities,” Donna says. “I wanted to hug him because he verified that everything I had been going through was feasible.”

Dr. Chung told her that surgery might be an option, given her medical history.

“About 50 to 60 percent of patients can control seizures with the first medication,” Dr. Chung says. “If the first one fails, though, the chance of a second medication working is less than 20 percent and of a third one working, less than five percent. It’s time to try something else.” In fact, experts estimate that 30 percent of patients with epilepsy respond poorly to antiepileptic drugs.

To determine if surgery would work, Donna spent several days and nights in Barrow’s Epilepsy Monitoring Unit. In the EMU, an EEG recorded her brain waves 24 hours a day, while a video camera recorded her physical behavior. The tests confirmed that the seizures were caused by scar tissue from the childhood brain infection.

Before surgery, Donna underwent functional brain mapping to determine whether removing the scar tissue would result in any deficits. Donna was told she could lose some peripheral vision and short-term memory.

Andrew Shetter, MD, a Barrow neurosurgeon, operated on Donna in June 2003. Her peripheral vision and memory remained intact, and she has been seizure-free ever since.

In June 2005, Donna began driving for the first time in five years.

“I wish I’d come to Dr. Chung 10 years earlier,” she says.

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Joshua Alderson was the tenth person to undergo a new surgical approach for treating hypothalamic hamartomas. Barrow was the first center in the US to offer the surgery.

Joshua Alderson

hen he was born, Joshua Alderson of Winter Springs, Florida, seemed normal in every way—except for a strange little sound he made. Sometimes, it sounded like a laugh and sometimes like a cry.

His mother, Lisa, worried about the strange spells and, as he grew older, other troubling behaviors— pulling his sister’s hair, hitting people and flying into rages.

“We couldn’t have anything breakable on any of the tables in our house because it was too dangerous for all of us,” she says.

Lisa mentioned these problems at Joshua’s one-year check and at his 18-month check. His pediatricians didn’t seem worried.

But then Lisa and her husband, Timothy, watched a Dateline seg-

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ment about a little boy named CJ Soeby who acted a lot like Joshua.

“Our jaws dropped as we realized that some of Joshua’s behaviors and tics were exactly what we were seeing on TV,” Lisa says.

The Dateline show described CJ’s saga—how he had been born with a hypothalamic hamartoma (HH), a rare tumor found on the hypothalamus at the bottom of the brain.

How the tumor had caused gelastic, or “laughing,” seizures in infancy and more severe symptoms later—increasingly severe seizures, aggression, rages and mental impairment. And how CJ’s parents, at great personal expense, had flown him from Phoenix to Australia for a promising new surgery for HH not available in the United States.

After the surgery, CJ was greatly improved.

Over the next three months, Lisa took Joshua from one doctor to another, and Joshua underwent EEG testing, an MRI and then another MRI. Finally, in early 2003,

removing the HH through what seemed the best and shortest route—from the bottom of the brain.

Frustrated that the surgery was not successful in many cases, Dr. Rosenfeld went to the laboratory to study the anatomy of the brain. He discovered that by entering the brain from the top of the skull and following a plane between the right and left hemispheres, the surgeon could reach the HH with less risk to adjacent structures of the brain.

“The approach that he developed allowed the two halves of the brain to separate like opening a book at the middle. The HH is then seen to lie exposed at the binding of the book,” says Harold Rekate, MD, pediatric neurosurgeon at Barrow.

“This was a major advance and allows surgery to be performed with much more success and lower complication rates.”

During Dr. Rosenfeld’s stay at Barrow in February 2003, six children underwent the new surgery.

Dr. Rosenfeld, Dr. Rekate and other

“The team at Barrow is recognized worldwide for a reason. It is not due to large egos and arrogance, but to their research efforts and willingness to accept that no one has all the answers.”

Lisa Alderson he was diagnosed as having a hypothalamic hamartoma.

“I told my husband we would do whatever it took—mortgage the house, whatever—to take Joshua to Australia,” says Lisa.

Then, the couple learned that Dr. Jeffrey Rosenfeld, the Australian neurosurgeon who had developed the new surgery for HH, was going to Barrow Neurological Institute in Phoenix to teach his technique to the neurosurgeons there.

Dr. Rosenfeld, like the neurosurgeons at Barrow, had first tried

Barrow neurosurgeons worked together on these operations.

Joshua Alderson traveled to Phoenix four months later for the life-changing surgery. On June 3, 2003, Joshua, then 2 1/2 years old, became the tenth patient to receive the surgery at Barrow. Dr. Rekate did the surgery.

“Joshua woke up a different child, a healthy child,” says his mother. “He’s had no seizures, no memory problems, no endocrine issues. He’s very bright and very funny.”

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“This diet has been a miracle. Briley’s a new kid. She’s a happy little girl.”

Amy Nelson

Joshua has begun pre-kindergarten classes. His future looks rosy.

“The team at Barrow is recognized worldwide for a reason. It is not due to large egos and arrogance, but to their research efforts and willingness to accept that no one has all of the answers,” says Lisa.

“Thank God for Dr. Rekate and the wonderful HH team at Barrow.”

Briley Nelson

ix-year-old Briley Nelson eats lots of whipped cream, butter, cheese and mayonnaise—all the high-fat foods dietitians tell us to avoid.

But in Briley’s case, the high-fat regimen—called the ketogenic diet—was prescribed by her doctor as a remedy for the seizures that plagued the child for nearly three years.

Briley was born with a mitochondrial disease that affects the ability of cells throughout her body to make energy. Because of the disease, Briley cannot sit, walk or talk, and she is prone to seizures.

Briley had her first seizure when she was nine months old. By the time she was three, the seizures were striking several days a month and nearly always as the toddler was falling asleep.

“She would wake up and scream and scream,” say her mother, Amy. “This would continue for hours before she was finally able to sleep.”

The seizures were sometimes so bad that Amy and her husband, Greg, took Briley to the hospital.

Once, Briley was given an anti-

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seizure medication—and suffered an allergic reaction.

When Briley was four, Martha Dolenc, a registered dietitian at St. Joseph’s, suggested that she go on the ketogenic diet as an alternative to medications.

For many years, people had observed that fasting seems to control seizures, says Jong Rho, MD, a pediatric epileptologist who conducts research into the diet at St. Joseph’s. In 1921, a group of doctors at Johns Hopkins University developed a diet that mimics fasting—the ketogenic diet.

“I’d heard about the ketogenic diet,” says Amy. “And I thought, ‘I’d rather try this than another antiseizure medicine.’”

Within two days of starting the diet, Briley’s seizures stopped.

“It was a lot of work at first,” says Amy. “But she’s been on the diet for over two years, so now I have all the proportions memorized. It takes me about 15 minutes in the morning to make all three of Briley’s meals.”

Amy works hard to make the diet—which consists of high-fat, low-carbohydrate, low-protein foods—as interesting as possible.

The results are well worth the effort, she says.

“This diet has been a miracle.

Briley’s a new kid. She’s a happy little girl.” ■

Briley Nelson eats a diet rich in whipped cream, butter and other high-fat foods. The diet, called the ketogenic diet, has been a godsend, says her mother, Amy.

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status epilepticus Using translational research to stop a killer avid M. Treiman, MD, is an epilepsy specialist with his feet planted firmly in two worlds—that of the physician treating patients in the clinic and that of the researcher studying disease in the laboratory.

“We identify our problems, our questions in the clinic. We find the solutions to these problems in the lab. Then we can go back into the clinic with solutions to make patients better,” says Dr. Treiman.

Dr. Treiman is the director of the Epilepsy Center at Barrow and holds the Newsome Chair in Epileptology. He has devoted his 30-year career to studying and treating status epilepticus (SE), the most serious type of seizure activity.

During SE, the patient has one seizure after another without fully recovering between them. About 150,000 people in the US have an episode of SE each year, and more than 25 percent do not survive.

Through his research, Dr. Treiman has learned that the longer SE continues, the harder it is to stop, the more damage it inflicts on the brain, and the more subtle its convulsions are. “The patient may appear to be getting better, but may actually be getting worse,” he says.

Dr. Treiman is currently working on several research questions that may result in better care for patients with SE:

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David M. Treiman, MD

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“We identify our problems, our questions in the clinic. We find the solutions to these problems in the lab. Then we go back into the clinic with solutions to make patients better.”

David M. Treiman, MD

• Can Keppra, an anti-seizure medication, prevent the long-term consequences of SE—loss of mental functioning, tissue damage and chronic seizures?

Can it protect brain cells?

• Is more medication needed to stop the second convulsion than the first convulsion?

• What mechanisms underlie the fact that the longer SE lasts, the more severe the seizures are?

What is the relationship between the EEG changes in SE that Dr. Treiman has described and the mechanisms of SE? Dr. Treiman is also using his laboratory models of SE to study an innovative treatment for chronic epilepsy that would prevent seizures by predicting a seizure and then stimulating the brain with electrodes.

Dr. Treiman is particularly excited about this last area of research. He, Leon Iasemidis, PhD, Associate Professor of Bioengineering at ASU, and Kostas Tsakalis, PhD, Professor of Electrical Epileptology at ASU, have received a grant from the Epilepsy Research Foundation to explore and test the new concept.

In this method, EEG monitoring would detect the changes in brain waves that occur before a seizure. This would trigger the delivery of electrical stimulation to the brain to actually prevent the seizure.

Lucy Treiman, PhD, is examining the changes in genes during status epilepticus.

“If you wait until a seizure starts, your chance of stopping it is much worse than if you detect it’s going to happen, stimulate the brain and prevent the seizure,” says Dr. Treiman. “Better yet, what if we were able to use this method to deliver more frequent little stimulations and prevent even the beginnings of a seizure?

“A new method like this could be a godsend for the thousands of people with epilepsy that can’t be controlled by drugs or surgery.”

Other scientists working with Dr. Treiman on research into status epilepticus are Jie Wu, PhD, who is looking at GABA-receptor function and modulation at the molecular level; Lucy Treiman, PhD, who is examining gene expression and the changes in genes during SE; and Norman Wang, MD, who is studying how the amount of medication needed to stop seizures increases with each successive seizure.

The ultimate goal of all the epilepsy research at Barrow is to improve treatments for patients, says Dr. Treiman.

“We are trying to be triple hitters—superb clinicians providing excellent patient care, productive investigators on the forefront of learning new things about caring for patients, and excellent teachers training residents, fellows and other doctors about how to take better care of patients with epilepsy.” ■

Jie Wu, PhD, is researching the role of GABA receptors in epilepsy.

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hypothalamic hamartoma What we’re learning about this rare tumor may help in treating other causes of epilepsy

arrow research into a rare but debilitating brain tumor could shed light on treating other, more common causes of epilepsy.

That tumor is the hypothalamic hamartoma (HH), a benign tumor that causes increasingly severe seizures, rages and mental deterioration, often beginning in infancy. Children with HH who do not receive effective treatment often face a grim future—daily seizures and mental retardation.

Unfortunately, medications are rarely effective in treating HH. Since early 2003, Barrow surgeons have removed 85 hypothalamic hamartomas, more than any other single center in the U.S. Most of these patients have experienced a dramatic reduction or complete cessation of seizures.

“Eighty-five HH cases is a jawdropping number,” says Jack Kerrigan, MD, pediatric epileptologist. “The surgery makes a big difference for a lot of these families.

It has also given us the opportunity to study the HH tissue that is removed. Virtually nothing is known about this condition because it is rare.”

Several studies into HH tissue are now underway at Barrow: • Team members, including John Stone, PhD, of the DNA Diagnostics Laboratory at Barrow, and David Craig, PhD, at TGen in downtown Phoenix, are investigating possible mutations in HH tis-

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Jack Kerrigan, MD, and Harold Rekate, MD, with Mikayla Krueger, one of the first children to undergo HH surgery at Barrow.

Barrow has removed more hypothalamic hamartomas (HH) than any other center in the US. Patients from throughout the US and three countries—Italy, the United Kingdom and Costa Rica—have come here for treatment of HH.

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“Our theory is that if you make an early intervention in epilepsy, you make a big difference in the patient’s cognitive and behavioral functioning. The HH population could prove this.”

Jack Kerrigan, MD

sue in an effort to identify the gene (or genes) responsible for the disease.

• Barrow researchers Jie Wu, PhD, DoYoung Kim, DVM, PhD, and Jong Rho, MD, are studying the electrical activity in HH tissue. They have recorded HH cells firing spontaneously—the first discovery of this in HH tissue. Their findings have been published in the Annals of Neurology.

• Steve Coons, MD, and John Beggs, PhD, in the Neuropathology Laboratory at Barrow are making new observations about the micro-architecture of HH tissue that may help explain why this tissue causes seizures.

• Jim Pipe, PhD, a scientist in the Neuroradiology Division at Barrow, is using diffusion tensor imaging to determine if an HH affects the wiring of the brain.

Dr. Kerrigan believes the most important research being done in the area of HH may be that of neuropsychologists George Prigatano, PhD, and Jennifer Wethe, PhD. Drs. Prigatano and Wethe conduct preoperative evaluations on all HH patients to determine their cognitive function before surgery.

In these sessions, the neuropsychologists look at short- and long-term memory, language, visual-spatial skills, problem-solving skills and other measures of cognitive function. They are currently compiling their findings into a paper that will be submitted to a professional journal.

In the next phase of their research, Drs. Prigatano and Wethe hope to conduct similar evaluations on patients after surgery. The biggest obstacle to this research is getting patients to return to Barrow a year or more after surgery, since most live in other states.

Dr. Kerrigan hopes that Barrow Neurological Foundation or the Women’s Board may help families with the expenses of a trip back to Phoenix.

This research is important not only because it will help improve care for HH patients but also because it may serve as a model for treating other types of epilepsy, Dr. Kerrigan says.

“Our theory is that if you make an early intervention in epilepsy, you make a big difference in the patient’s cognitive and behavioral functioning,” says Dr. Kerrigan. “The HH population could prove this.”

Dr. Kerrigan will present Barrow’s experience with HH at the annual American Epilepsy Society Conference to be held in December in Washington, DC. “Most advances in medicine are baby steps, but this has truly been a big step forward,” Dr. Kerrigan says of the HH clinical and research program. “Barrow’s work has made a big difference for children with HH, and we hope to make some really significant scientific discoveries as well.” ■

Pediatric neurosurgeon Harold Rekate, MD, has developed new endoscopic approaches to removing hypothalamic hamartomas since Barrow’s HH program opened in February 2003. Unlike open surgery, endoscopic surgery requires just a small incision in the brain. Patients recover much more quickly. Today, endoscopic surgery is used for most cases of HH at Barrow.

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ketogenic diet Novel epilepsy treatment proves ‘You are what you eat’ Neuropharmacology Research at the National Institutes of Health.

“I soon realized that drugs are not a panacea. Many children don’t respond well to drugs, many experience difficult side effects, and there are concerns about chronic drug use over a long period,” Dr. Rho says.

For centuries, fasting has been recognized as a way to reduce seizure activity. Dr. Rho says that fasting, or caloric restriction, seems to lead to chemical changes that allow cells to live longer. Studies have shown that a low-calorie diet rich in omega-3 fats reduces the risk of heart attack and stroke.

But no one knows why the KD works in epilepsy.

“The general hypothesis of our laboratory is that the KD or any diet that mimics fasting “It’s fascinating to think that epilepsy could may protect brain cells and reduce seizure activity by reducing free radibe fixed with simple dietary intervention.” cals and oxidative stress in the brain,” Jong Rho, MD Dr. Rho says.

In Dr. Rho’s laboratory, Timothy Dr. Rho. “These are children who do not respond to Simeone, PhD; DoYoung Kim, DVM, PhD; and Marantiepileptic drugs. The fact that the diet works in the wan Maalouf, MD, PhD, are using a variety of research most difficult cases tells you something important is methods to study the genetics, electrical activity and anatomy of epileptic brain tissue exposed to the KD. going on—something worth looking into.”

Ketone bodies—chemicals that the body makes There are problems with the diet. Children on the KD may experience constipation, diarrhea, kidney when it must break down fat instead of sugar for enerstones, vitamin and mineral deficiencies, and growth gy—are thought to play some role in the diet’s abiliretardation. Compliance is another issue—parents ty to reduce seizures.

Dr. Rho dreams of a day when new treatments for sometimes find it difficult to keep their child on the diet.

Because of the results he has seen, Dr. Rho is build- epilepsy offer the benefits of the KD without its side ing the first program in the country that offers the effects. “What if you were to take a ketone pill or a diet as a therapeutic option for children with epilep- ketone milkshake?” he says.

And, if the KD proves to be neuroprotective, as Dr. sy and that also conducts translational research into the diet. He hopes to increase the number of children who Rho suspects, his research could lead to treatments for other neurodegenerative disease. can be treated with this non-drug option.

“It’s fascinating to think that epilepsy could be Dr. Rho became interested in non-drug epilepsy treatments after completing a two-year fellowship in fixed with simple dietary intervention,” he says. ■ ou are what you eat.’ This familiar adage seems particularly true for the ketogenic diet, a novel approach to controlling seizures in children with difficultto-treat epilepsy.

The diet stresses high-fat, low-carbohydrate, lowprotein foods and includes ample quantities of butter, cream, mayonnaise and whipped cream—all those foods you’ve been told to avoid.

Jong Rho, MD, a pediatric epileptologist and researcher, has seen remarkable results with the ketogenic diet (KD). He has seen children with 100 seizures a week become seizure-free after a few days on the diet.

“Two-thirds of children who go on the diet respond with a more than 50 percent reduction in seizures,” says

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“I soon realized that drugs are not a panacea. Many children don’t respond well to drugs, many experience difficult side effects, and there are concerns about chronic drug use over a long period.”

Jong Rho, MD

Jong Rho, MD, and DoYoung Kim, DVM, PhD, are conducting research to learn why the ketogenic diet reduces seizure activity in some children with epilepsy.

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S T A N D S T I L L

The 103rd cardiac standstill Surgeons stop Pennsylvania man’s heart to save his life In 2005, throbbing headaches became a daily occurrence, so in May, Brett consulted a physician. The doctor ordered an MRI. That’s when Brett learned that he had a basilar tip aneurysm. The giant aneurysm was located on a major artery at the base of his skull. If it ruptured, odds were high that Brett would die.

The size and location of the aneurysm made it very difficult to treat, Brett was told. Aneurysms in difficultto-reach areas of the brain are often treated with an endovascular procedure. The neurosurgeon threads a catheter into an artery in the groin and up through the vascular system to the vessel where the aneurysm is located. The neurosurgeon then maneuvers tiny platinum coils—shaped much like miniature slinkies— through the catheter up into the aneurysm, blocking off the blood flow into the aneurysm.

But, the neck of this particular aneurysm was too big to be sealed off with coils. The only way to correct the aneurysm was to open up the skull and use a clip to seal off its neck. But reaching the aneurysm and operating on it without causing a rupture would be next to impossible, his neurosurgeon said.

Brett felt like a time bomb was ticking inside his head and he had no way to disarm it. He decided to get a second opinion.

A local neurosurgeon recommended three neurosurgeons. One was Robert Spetzler, MD, at Barrow. Brett sent copies of his MRI to the three neurosurgeons.

The first to respond was Dr. Spetzler.

A time bomb ticking inside his head

Brett and Ann Kehrer

ho knows how long it had been there. Perhaps since Brett Kehrer was born 28 years ago.

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It probably began as a weak spot on a blood vessel in Brett’s brain. As blood pulsed against the weak spot, the vessel walls grew thinner and thinner. Over the years, the weak spot became a blood-filled, balloonshaped bulge on the vessel wall.

Brett didn’t know about the bulge deep in his brain.

He didn’t know that his frequent headaches were the calling card of a dangerous cerebral aneurysm.

“I’ve had headaches as long as I can remember,” the Pennsylvania man says. “My mom gets them, so I just figured it was genetic.”

Funding from Barrow Neurological Foundation supports ongoing research into the cardiac standstill procedure.

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“It remains wondrous to me that we can actually turn off the blood flow, pulse and respiration in order to perform an incredibly complex neurosurgical procedure, reverse the process and have a viable patient.”

Robert Spetzler, MD

“I was amazed,” says Brett. “I thought, This guy is world famous and he’s calling me.”

On July 4, Brett flew to Phoenix for a consultation with Dr. Spetzler. “He told me he took one look at the films and knew what he needed to do,” Brett says. What he needed to do was a hypothermic circulatory arrest, often called a cardiac standstill.

A cardiac standstill is a complex surgery involving three teams of physicians—neurosurgery, cardiovascular and anesthesiology teams. The procedure enables neurosurgeons to operate on otherwise inoperable aneurysms by eliminating blood flow in the body.

This is accomplished by gradually cooling the blood—and thus the body—to 15 degrees centigrade or lower and then stopping the heart and draining the blood from the body. At such low temperatures, the brain and other organs can survive without harm for as long as 60 minutes—enough time to clip the aneurysm. The patient is in a kind of suspended animation—without heartbeat, breath or brain waves.

Once the blood is drained from the body, the aneurysm deflates like a pricked balloon, and the neurosurgeon can safely place a titanium clip across the neck of the aneurysm. The clip stops blood flow into the aneurysm while leaving the blood vessel intact.

Brett was scared, but Dr. Spetzler’s confidence and experience reassured him. “Dr. Spetzler helped to pioneer the cardiac standstill,” Brett says. “Nobody wants to go through that, but I knew I had to do it.”

Brett remembers the time leading up to surgery. He

What the doctor ordered—a cardiac standstill

remembers saying goodbye to his family, repeating a Bible verse and “getting real tired.”

A contingent of neurosurgeons from around the world watched the nine-hour surgery. The aneurysm’s size and complexity made it a challenging case.

“His youth and general good health contributed to the excellent result,” says Dr. Spetzler. “Having operated on thousands of aneurysms, I am still awed by the living brain and what it contains—the life, the values, the loves, the being of an individual.

“It remains wondrous to me that we can actually turn off the blood flow, pulse and respiration in order to perform an incredibly complex neurosurgical procedure, reverse the process and have a viable patient.

Brett is fortunate that the technology has matured to such a level, giving him a new lease on life.”

Brett was Dr. Spetzler’s 103rd cardiac standstill patient. Dr. Spetzler has performed more cardiac standstills than any other neurosurgeon in the world. Barrow scientists and surgeons began conducting research to refine the operation in the 1980s and continue to improve the procedure today.

Brett has returned home to Montoursville, Pennsylvania. A month after the operation, he was still experiencing some double vision and headaches but feeling better every day. He and his fiancee, Ann Gaida, were planning an October 1 wedding.

“I’m looking forward to getting married, maybe having some children, going back to work,” he says. “The simple things in life—that’s what’s important.” ■

Brett’s new lease on life

A film crew from the Discovery Health Channel covered Brett Kehrer's odyssey, including his surgery at Barrow and his wedding in early October. The network is producing a show about hypothermia that is scheduled to air in the United Kingdom this spring and possibly in the US this summer. The show will include interviews with Robert Spetzler, MD. Stay tuned for more information in a future Barrow.

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B O A R D

board gains Barrow Women’s Board continues to make history

By Debra Gelbart

Above, gifts from the Barrow family helped make Barrow Neurological Institute possible. Right, an early Women’s Board meeting. ompassionate. Determined. Innovative. Visionary. These words can describe many philanthropists, scientists, statesmen and corporate executives, but they also characterize a group of single-minded, goal-oriented women in Phoenix.

Decades ago, these women established a tradition that today is a cornerstone of the biomedical community— raising money for the neurosciences.

When the Barrow Women’s Board was established, the first Super Bowl had yet to be played. Gasoline sold for 31 cents a gallon. “Bonanza” and “Bewitched” were two of the top television shows. The median price of a home was under $20,000.

Have you guessed the year? It was 1965.

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Gay Firestone Wray, one of the original members of the Women’s Board, was a young mother then, pregnant with her second child. She got a call one day from someone who knew of her background in New York and Philadelphia as an effective fundraiser.

“We’re forming a board to raise money for Barrow Neurological Institute,” said the caller. “And we definitely need some young blood on the board.” Gay

‘You simply didn’t say no’

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remembers not even mulling over the invitation before saying yes.

“You simply didn’t say no to these ladies,” she says.

“When they asked you to become part of something, you just did it. It was a great honor.”

Kathy Barrow, then the daughter-in-law of Barrow Neurological Institute benefactor Charles Barrow, got involved with the Women’s Board at the beginning and has remained a member for 40 years.

“I was at the groundbreaking for the first Barrow building,” says Kathy, referring to the year 1962. “I toured the shell of the building with Charles, and I remember thinking how amazing it was that it was going to be devoted to the neurosciences. I was struck by the thickness of the walls, particularly in one room that was going to be made completely soundproof for research on memory disorders.”

Gay remembers the first meeting she attended at a Women’s Board member’s home. “From the very beginning,” she says, “it was clear that these women would never take ‘no’ for an answer—especially when they were fundraising.”

She was struck by the enormity of the task before them: producing a formal social event designed to

W O M E N ’ S

1960–Ginger Moore, Jane Thorne, Genevieve Brecheisen and Kathy Barrow.

B O A R D

1970–Betty Rosenzweig, Marilyn Martin, Evelyn Higgins, Lois Mayer, Pat Goldman, Anna Lochhead, Glenna Shapiro, Patty Simmons, Pat Hester, Marianna Korte, Linda Kite, Connie Rodie, Bess Basham and Loretta White.

1980–Beth Matthews, Mary Helen Clancy, Vim Phillips, Stevie Eller, Patty James, Karen Meyer, Mary Hudak, Phyllis Taber, Harriet Friedland, Peggy Crayton and Sue Ellen Edens.

1990–Barbara Henward, Barbara Dow, Penny Gunning, Janis Lyon, Mary Ellen McKee, Marilyn Parke, Kim Loyd, Mary Leonard, Mary Ward, Diana Balich, Ginny Beardsley, Vicki Budinger, Muffie Churchill, Jane Norris and Debi Rosenzweig.

Four Decades of Barrow Women’s Board Members shown by decade they joined 2000–Bonnie Martin, Sandy Magruder, Judy Hewson, Ruth Lavinia, Nancy Hanley, Jane Edmunds, Jean Spangler and Nancy Walker.

secure contributions in the thousands of dollars for Barrow Neurological Institute.

The women’s drive and dedication resulted in net proceeds from the first Barrow Grand Ball of $26,000— the equivalent of $155,000 today. “We were very pleased with the outcome,” says Gay. “At $200 a couple, it was the most expensive ball in town,” says Kathy. Today, a couple can attend for $1,500.

Every year since then, the Ball has been a greater success than the year before. The 2005 Ball netted an amazing $1,953,709. Through the years, the Barrow Women’s Board has raised nearly $24 million from the Ball, which is held every January. The money funds projects and programs at Barrow.

In 1985, for example, the Women’s Board funded the Memorial Waiting Room for families of patients.

The Board continues to maintain the waiting room and will open a new one in the new Barrow Patient Tower now under construction and due to open in 2006. The group also furnished the Women’s Board Room, which has been used for meetings and teaching in the Neu-

Having a ball for Barrow

roscience Research Center and is currently set up for teleconferencing throughout the world.

In addition to raising funds, says Women’s Board Chair Victoria “Vicki” Budinger, the Women’s Board fosters community education about current research conducted at Barrow. About seven years ago, a board member, Harriet Friedland, established the first Education Day. This forum presents scientists, doctors and patients who discuss the miracles that are performed at Barrow on a daily basis.

Women’s Board member Julie Hopper of Phoenix chairs Education Day now. “We hold the event every February,” she says. “Each year we establish a neuroscience theme. This year the theme was stroke, and there were more than 125 people in attendance to hear the latest scientific information about research, treatment and recovery after a stroke.”

Education Day always includes tours of Barrow after the presentations. “We invite friends of Barrow and ask the Women’s Board members to invite their friends,” Julie says. “Their friends invite friends and soon, hundreds of people are there to learn.”

Education is of particular interest and a top priority for Vicki. She’s pleased that in 2000 the Women’s B A R R O W

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Barrow Grand Ball Through the Years

Board recognized the importance and contribution of nursing at Barrow by providing seed money annually for nursing projects, conferences and conventions.

Women’s Board member Jean Meenaghan of Paradise Valley developed and has chaired the nurse education project for the last five years.

“One of the objectives of the project is to help nurses obtain neuroscience specialty certification through the American Nurses Credentialing Center, the largest and most prestigious nurse credentialing organization in the US,” Jean says. “Our program already has paid for 50 nurses to complete their certification.”

The Women’s Board also has paid for 54 nurses to attend the American Association of Neurosciences Nurses annual meetings.

“These nurses have become active in the association, have presented papers at the annual meetings, and some serve on the association’s executive committee,” Jean says. “Their involvement with such an important organization brings additional prestige to Barrow Neurological Institute.” The Women’s Board also has paid for Barrow to host a meeting of local neu-

Supporting nurse education

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roscience nurses. “That, too, was very successful,” Jean says.

Education helps the members of the Women’s Board understand the clinical projects designated each year as recipients of the Ball proceeds, and they, in turn, educate the community. Every year, Robert Spetzler, MD, the director of Barrow, “contacts all of the principal investigators of research projects and asks them to supply him with a project list,” says Jo Anne Gill, the director of Donor Relations for Barrow Neurological Foundation and St. Joseph’s Foundation.

“Every year between 26 and 32 projects in neurosurgery, neurology, neurobiology, neuropathology and other neuroscience specialties are identified as the recipients of the proceeds from the Ball,” she says.

“It becomes the job of the Women’s Board members to let the community know about the importance of supporting those projects.”

Women’s Board members not only provide funding for new studies, they also follow the progress of the projects. Members of the Women’s Board have long understood that sometimes seed money for a new concept can lead to eventual multi-year funding from the National Institutes of Health.

W O M E N ’ S

B O A R D

Barrow Grand Ball 2005

Clockwise from top: 2005 Ball Chairs Judy Hewson and Jane Edmunds with Linda Hunt, Robert Spetzler, MD, and Past Board Chair Karen Meyer; Michelle Robson and Diane Halle; Robert Spetzler, MD, Chip and Daryl Weil, and Nancy Spetzler; Sandy and Mac Magruder; Ira Jackson, Julie Wrigley, and Lyle and Missy Anderson; Jane Edmunds, Stevie Eller and Judy Hewson.

“I’m always amazed by the extraordinary research that we fund and by how far we’ve come with research,” Kathy says. She adds that she intends to remain a Women’s Board member for the rest of her life. “There is a wonderful combination of talent and skill on this board, and I’m so impressed by how much gets accomplished.”

Although the Barrow Grand Ball is the Women’s Board’s largest fundraiser of the year, other opportunities abound for raising money. The Women’s Board of Barrow Neurological Foundation Memorial Fund, for example, provides a means for members, their families and their friends to make contributions as a memorial or in celebration of birthdays, weddings, anniversaries or special individual accomplishments.

“On behalf of the entire Barrow family,” says Dr. Spetzler, “I am very grateful to the Women’s Board for all of the members’ efforts.”

Vicki notes that individual members have made personal donations to the construction of the new patient tower. “These are energetic and creative women who

‘Energetic and creative women’

have an intense need-to-know spirit and often make great things happen because they are enlightened.”

“I like the purpose of this board,” says Jean. “There is a tremendous spirit of cooperation that the women show. I also love how everyone works together.”

“This is a very special group of people working on behalf of a very special part of St. Joseph’s,” says Julie, who has been a member since 1976.

“As chair,” Vicki says, “my goal is to provide monthly education to the Women’s Board. This incredible group of dedicated women is passionate about the caliber of research at Barrow, and news of scientist and physician progress is not only important but in many cases pertinent to their families’ health-care needs.”

In addition to being described as visionary and dedicated, the Women’s Board members have been called angels. Now, they’re also known as “honorary Sisters of Mercy.”

This year, Sister Madonna Marie Bolton of St. Joseph’s and Barrow Neurological foundations declared that “the Women’s Board has become the hands and the hearts of the Sisters of Mercy” and urged the members to “continue your compassionate concern for humanity and your participation in miracles.” ■ B A R R O W

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D E M E N T I A

karsten solheim dementia research chair In the 20 years since his training, this Philippines-born neurologist-neuropathologist has dedicated his career to finding answers to AD and other dementias. hen Patricio Reyes, MD, was a Neurology res- serve dementia-diseased brains shortly after death in ident in the 1980s, doctors-in-training were near life-like condition for research into the mechanisms taught that nothing could be done for patients of AD and dementia. And he has been involved in the with Alzheimer’s disease and dementia. development of two of the five drugs now approved “Nobody wanted to put up with a patient who by the FDA for the treatment of AD. He was one of was inattentive, forgetful, unable to concentrate,” Dr. the first to report the combination Parkinsonism and Reyes says. “It was very disappointing to me as a stu- Alzheimer’s disease, and the presence of smell deficits dent of neurology and science.” in Alzheimer’s disease This attitude toward dementia deeply affected Dr. Dr. Reyes joined Barrow Neurological Institute Reyes and fueled a passion for improving quality of this year as the medical director of the Alzheimer’s life for the elderly. and Cognitive Disease Program and as the Karsten “When I was training Solheim Dementia in medical school, I was Research Chair. He has amazed by the amount of high goals for this new effort and resources we Barrow program. put into newborns and kids to preserve life at any Is It cost,” he says. “I was Alzheimer’s? always asking my colAt least 4.5 million leagues, ‘What happens Americans have Alzif you’re able to preserve heimer’s disease, and by life into old age? We don’t 2050, this number could know anything about swell to more than 14 milolder people.’” lion.

He also worried about In October 2004, John the financial and social Swartz and his son, Stan, impact of millions of feared that John had Americans living with joined these ranks. dementia. “We can’t At 91, John still led an afford to have a nursing active life.

“This is a man home on every street cor- The Karsten Solheim Dementia Research Chair enabled Barrow to who still spent hours ner of America. We have recruit Patricio Reyes, MD, a leading dementia specialist and every day managing comto develop more effective researcher. plicated property matand safer treatment.”

In the 20 years since his training, this Philippines- ters,” says Stan. But in a matter of months, John born neurologist-neuropathologist has dedicated his found he could not perform the simplest tasks, like career to finding answers to AD and other dementias. writing a check. “I lost my memory. I couldn’t rememDr. Reyes has established and headed several ber a thing,” he says.

At about that time, Stan met Patricio Reyes, MD, Alzheimer’s and dementia centers, including those at who’d just joined Barrow. Stan described his father’s the University of Texas in San Antonio, Jefferson Medsymptoms, and Dr. Reyes insisted on meeting John. ical College in Philadelphia and Creighton University.

Dr. Reyes did a complete assessment of John—not He has developed brain-banking systems that pre-

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“I think we have a great opportunity here at Barrow to make major progress in our fight against Alzheimer’s and other neurodegenerative diseases.”

Patricio Reyes, MD

just a physical exam but also a thorough look at his The ABCs of Dementia sleeping habits, exercise routine, nutrition, mental Dementia is a condition characterized by a set of health and social connections. symptoms that Dr. Reyes calls the ABCs of dementia: “When I first met Mr. Swartz, he had lost the • Activities of daily living—the patient experiences desire to live because he felt nothing could be done a decline in the ability to carry on the normal for his condition,” says Dr. Reyes. activities of daily living.

The neurologist determined that John has mild cog- • Behavior—the patient develops abnormal behavnitive impairment (MCI)—not Alzheimer’s disease. ior, such as depression, violence, hallucinations MCI is a condition characterized by a decline in menand agitation. tal performance that may affect memory, learning • Cognition—the patient experiences a decline in and concentration. Unlike people with Alzheimer’s, cognitive ability, such as a loss of memory or people with MCI are able high-level thinking. to handle everyday activThe most common ities reasonably well; cause of dementia is however, they have probAlzheimer’s disease; in lems remembering fact, at least 65 percent of details of conversations, the dementia among midevents and upcoming dle-aged and elderly peoappointments. About 17 ple in America is caused percent of people over 65

by AD. Other causes of have MCI. dementia are stroke, Dr. Reyes developed a Parkinson’s disease, head treatment plan for John trauma and normal-presthat included regular sure hydrocephalus. In physical exercise, some instances—such as improved nutrition, normal-pressure hydroactivities to stimulate the cephalus—the symptoms brain, and medication for of dementia can be depression and sleep relieved or even elimiproblems. nated by appropriate The changes worked The treatment plan that Dr. Reyes developed for John Swartz has treatment. wonders for John. Today, the Phoenix man exercising more, eating and sleeping better, and Dr. Reyes says that John is walking regularly, thinking more clearly. researchers have identimanaging his investfied two types of genes ments again, learning how to use a new computer involved in AD. A mutation in one group—chromoand sleeping six hours a night. “If it weren’t for Dr. some 1, 14 or 21—causes AD at a young age, usually Reyes, I wouldn’t be in the condition I am today,” he before 65. A mutation in the second group of genes— says. the E4 type—increases the risk of getting AD after 65.

Dr. Reyes will continue monitoring John closely “I think we’ll discover more genes that either because 10-15 percent of people with MCI progress to increase the risk or cause the development of the disAlzheimer’s disease each year. ease when there are mutations,” says Dr. Reyes.

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Dr. Reyes will be conducting both clinical research into promising new treatments and basic-science research into what happens in brains with AD and other dementias.

One clinical trial involves a skin patch used to deliver AD medicine to the brain. The patch appears to be safer and more effective than pills. Another trial will test the effectiveness and safety of neuroprotective drugs that protect brain cells from degeneration.

“We want to make sure that our patients have access to the latest treatments,” Dr. Reyes says.

A critical component of his research is a brain bank.

“In understanding human neurological diseases, we don’t have the luxury of opening up the brain and examining the brain during life,” Dr. Reyes explains.

“So, by using a rapid autopsy system and preserving the brain in a fresh-frozen stage right after death, we are able to study all kinds of proteins and chemicals that are of great value in understanding what happens as the disease progresses.”

He plans to study the link between Alzheimer’s and other diseases—stroke, diabetes, heart disease—and to work with physicians specializing in other neurodegenerative diseases, such as multiple sclerosis.

“I think we have a great opportunity here at Barrow to make major progress in our fight against Alzheimer’s and other neurodegenerative diseases.

Already, our scientists and physicians are collaborating with T-Gen, Mayo, Banner and Sun Health,” says Dr. Reyes. “We just have to put our brains and hearts together.” ■

Promising Research Projects

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Keeping Your Brain Healthy

Patricio Reyes, MD, medical director of the Alzheimer’s and Cognitive Disease Program at Barrow, says you can take steps to keep your brain healthy: • Be physically and mentally active. Exercise improves circulation, releases tension and promotes general well-being. When it comes to exercising your brain, do something new. If you’re used to doing crossword puzzles, learn a new language.

• Seek the company of interesting people.

Stimulating and enjoyable relationships with friends and family are good for your mental health.

• Eat plenty of fruits and vegetables, particularly those with dark skins, which have high antioxidant properties. In particular, Dr. Reyes recommends eating fresh blueberries and spinach.

• Keep your cholesterol, diabetes and blood pressure within recommended ranges, and maintain a healthy weight.

• Seek regular medical check ups.

The Alzheimer’s and Cognitive Disease Program will be offering educational programs about preserving brain function and knowing when to seek treatment for mental decline. For information, call Michelle Grigaitis, nurse practitioner, at 602406-3781.

N E U R O S U R G E R Y

R E S I D E N T

the very unlonely life of a neurosurgery resident

By Sarah Padilla

s a third-year med-

A

ical student, Ruth Bristol, MD, spent a

lot of time trying to talk her-

self out of becoming a sur-

geon. She worried about

the duration of the training

and the long hours that

would follow. She wondered

whether she was smart

enough and questioned the feasibility of having a

family. She thought that

“You have to be willing to take on risks and responsibilities, and to forge ahead on your own to be successful here.�

Ruth Bristol, MD Ruth Bristol, MD, is a sixth-year Neurosurgery resident at Barrow.

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R E S I D E N T

many surgical residents seemed lonely. Now a sixthyear Neurosurgery resident at Barrow, Ruth smiles when she thinks of those early concerns —especially the last one.

Barrow residents may have been described as many things, but lonely has never been one of them.

Originally an economics major, Dr. Bristol was turned on to the field of medicine when she took a genetics course to fulfill a general studies requirement. The course intrigued her, so she “threw caution to the wind” and changed her major to biology in pursuit of attending medical school. She was accepted to a handful of top-notch schools and chose Tulane University in New Orleans.

Once she had made the decision to pursue surgery, she had to decide on a subspecialty. She made that decision the first day of her Neurosurgery rotation.

“I observed the removal of a bifrontal meningioma and saw the patient’s brain pulsating and oozing,“ she says. “The next day, the patient was sitting up in bed complaining that he didn’t have any syrup for his pancakes. It was amazing to me.”

Dr. Bristol’s first experience with Barrow occurred during medical school, when she completed a monthlong rotation here under chief residents Paul Detwiler, MD, and Randall Porter, MD. “I never thought I would match here, but I guess I made a good impression.”

Not only did she make a good impression on Barrow, but Barrow made a remarkable impression on her.

The Road to Barrow

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As an only child, she considered her parents, who spend winters in Arizona, when applying to residency programs. While the location was a plus, Barrow offered a laundry list of attractions—a huge and diverse surgical case load, an opportunity to gain extensive operative experience, the autonomy of the residents and a camaraderie she hadn’t seen anywhere else.

In neurosurgery circles, Barrow’s residency program is as well known for its off-campus activities as it is for its academic and clinical expertise. Among these activities are frequent volleyball games and meals at Dr. Robert Spetzler’s home, weekly mountain bike rides, and annual events such as the Rim-to-Rim Hike, the Hike from Hell and the Barrow Olympics. The friendly competition and conversation help form relationships that are more familial than collegial.

It was through this Barrow family that Dr. Bristol met her husband, fellow Barrow neurosurgeon Felipe Albuquerque, MD. When the couple married in November 2003, every neurosurgeon—residents and attendings—came to the wedding.

Dr. Bristol believes the amount of respect and independence the residents are given—a level that she believes is unparalleled in other residency programs— further adds to the sense of camaraderie at Barrow.

“As residents, we have a huge amount of autonomy,” she says. “The attendings trust you to know your own proficiency level, and they know that you’ll call them once you reach your limit.”

A Match Made at Barrow

N E U R O S U R G E R Y

That autonomy extends beyond the walls of the OR. For example, the residents who will be the chief residents the following year are highly involved in the selection of the next crop of incoming residents. Since the residents work as closely with each other as they do with the attending physicians, it’s only natural that they should be involved in the selection process, too.

Barrow attracts the best of the best. The neurosurgery residency program receives about 200 applications a year and interviews about 50. Only three lucky men and women are selected each year. There are currently 19 residents in the program. As women, Dr. Bristol and the two other female residents are part of an even more exclusive group—there are only 150 certified female neurosurgeons in the US. Dr. Bristol admits that neurosurgery and Barrow aren’t for everyone. “You have to be willing to take on risks and responsibilities, and to forge ahead on your own to be successful here,” she says.

A typical day in the life of a Barrow Neurosurgery resident is long, beginning at 6 a.m. when all of the residents meet to assign the day’s surgical cases. The cases are assigned by seniority, with the chiefs getting the first pick. Following a quick breakfast in the cafeteria, the team heads to the fourth-floor Neurosurgery OR where the first cases are scheduled for 7:30 a.m.

Depending on the complexity of the surgery, a resident may be assigned to as few as one or as many as four operations a day. Following surgery, which typ-

Not for the Faint of Heart

R E S I D E N T

ically lasts until late afternoon, the residents are expected to attend teaching rounds, in which Drs. Spetzler and Volker Sonntag present patient cases until as late as 7 p.m.

The training is long and intense, but residents do get breaks. They are allowed three weeks of vacation a year, and their on-call responsibilities decrease with seniority. Over the course of the seven-year program, they are granted two full years of off-service time to pursue other electives, such as research or a fellowship.

Dr. Bristol is currently in her sixth year, a year that the residents are guaranteed off to tailor to their own interests. She will spend the year researching pediatric brain-stem tumors. Other residents have spent this time exploring areas such as Gamma Knife or completing a fellowship in a subspecialty such as endovascular neurosurgery. While Barrow offers an unparalleled experience in the operating room, it also offers many other opportunities.

The future for these talented men and women also holds many possibilities. Dr. Bristol will become a chief resident next year just in time to move Neurosurgery into the new state-of-the-art Barrow Patient Tower. The following year, she has already secured a one-year fellowship in Pediatric Neurosurgery at the Children’s Hospital Los Angeles.

Beyond that, she’s still not sure. One thing is for certain, though—she will forever remember her experience at Barrow as anything but lonely. ■

What the Future Holds

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P L A C I D A

sister mary placida More than perhaps anyone else, she turned Barrow from a dream into reality

he unsung hero of Barrow Neurological Institute lives a quiet life in a retirement home nestled in the gently rolling hills of the Sisters of Mercy Motherhouse in Burlingame, California.

At 95 years of age, Mary Placida Conant, RSM, is a half a century away from the momentous years she spent at St. Joseph’s Hospital and Medical Center.

But her imprint on St. Joseph’s remains clearly visible. More than perhaps anyone else, Sr. Placida turned the dream of Barrow Neurological Institute into a reality.

Sr. Placida was assigned in 1953 to serve as assistant to the administrator at St. Joseph’s. The Sisters were completing their new hospital at Third Avenue and Thomas Road. Sr. Placida’s first job: To direct the move into the 350-bed facility.

T

Sr. Placida quickly impressed her colleagues with her resourcefulness, hard work and respect for others.

Respect and hard work

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“Sr. Placida had contact with every employee, and she called them by their first name,” says Frances Webster, RSM, who still volunteers at Barrow today.

“She went to every department days, afternoons and nights to meet employees.

She went to the boiler room, the kitchen and central supply as well as the nursing units. During the construction of one of the buildings, you would see her serving coffee to the construction workers.”

Within her first year at St. Joseph’s, Sr. Placida was promoted to administrator, the top job at the hospital.

It was during those early years that Sr. Placida met Charles Barrow, whose wife, Julia, had an incurable brain tumor. Julia was being cared for by John Green, MD, a neurosurgeon at St. Joseph’s.

Charles was so happy with the care his wife received that in 1954 he made the first of many gifts to St. Joseph’s.

Charles later said that he “kept a close eye on how they managed my money, and I liked what I saw. My dad always said

S I S T E R

P L A C I D A

Upper left, Sister Placida with John Green, MD, and Charles Barrow. Left, Sister Placida with Charles, Jamie Barrow and Dr. Green.

“I am grateful for the privilege of knowing Sr. Mary Placida. She is a leader, risktaker, mentor, Sister and friend.”

Sister Madonna Marie Bolton if you watch the pennies, the nickels take care of themselves, and that’s exactly what the Sisters did.”

He was equally impressed by the care his wife received—especially a birthday party the Sisters gave Julia.

“But we did this for everyone,” says Sr. Placida.” Every person is an individual and is to be treated with dignity and respect.”

Sr. Placida says she will never forget the day in 1958 that Charles offered her $500,000 to build a neuroscience center—if the hospital matched his funds.

Accepting the gift meant taking on the tremendous responsibility of raising a huge amount of money, but Sr. Placida proved up to the task.

She quickly started the process of obtaining federal funds and within a few months received word that her request had been approved.

A day she’ll never forget

In all, the Barrow family contributed $1.2 million, making possible the construction of the first neuroscience center in the Southwest.

In planning Barrow, Sr. Placida and Dr. Green agreed that to advance the neurosciences, Barrow must offer not only patient care, but also medical research and education.

The Sisters agreed to cover the cost of patient care and medical education. Barrow Neurolological Foundation was established to fund research.

The fact that research was being done in a private Catholic hospital made St. Joseph’s one of a kind. This visionary commitment to the academic model has enabled Barrow to become one of the finest neuroscience centers in the world.

During Sr. Placida’s watch, St. Joseph’s also constructed the School of Nursing, the intern apartments and the convalescent unit, and opened the Mercy Care Center.

Sr. Placida left St. Joseph’s in 1965 to take an assignment in San Diego as the administrator of Mercy Hospital, which was constructing a new facility. In 1976, she was named administrator of Mercy Hospital, Bakersfield, and in 1982, she retired from administration, taking a job in the admitting office of St. Mary’s Hospital in San Francisco.

Sr. Placida’s 63-year career as a nurse, supervisor and administrator in California and Arizona hospitals includes many impressive accomplishments. But none is more notable than the creation of Barrow.

Madonna Marie Bolton, RSM, St. Joseph’s and Barrow Neurological foundations, sums up the feelings of many when she says, “I am grateful for the privilege of knowing Sr. Mary Placida. She is a leader, risk-taker, mentor, Sister and friend.” ■

Life after St. Joseph’s

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C E L E B R A T E !

scientific expression The not-so-reclusive Will Hendricks stages a bright career in molecular biology

By Sally J. Clasen

ith his multiple piercings, leather bracelets and tattoos, Will Hendricks hardly fits the conventional profile of a bookish molecular biologist. The 25-year-old Phoenix native looks more like the edgy lead singer of a punk rock band than a researcher ready to embark on important scientific discoveries.

Yet despite his expressive style, Will is one serious—and promising—young scientist devoted to understanding cancer and disease progression at the most basic level.

For the past two years Will, who recently left Barrow for graduate work at Johns Hopkins University in Baltimore, guided a molecular biology research study that examined the development of meningiomas in the brain.

As part of his research, he published multiple papers as the lead author and presented at national cancer meetings under the direction of Adrienne Scheck, PhD, senior staff scientist, Neuro-oncology and Neurosurgery Research, and Mark Preul, MD, director of Neurosurgery Research.

“Barrow was a great fit for me,” Will says of the research he conducted to define the molecular difference of tumors in individuals with the same disease. “The encouragement and mentoring I received from Drs. Scheck and Preul, combined with my work at Barrow, set me up for a level of involvement that is unparalleled for an undergraduate student.

“The classroom is important but it can’t substitute for the learning experience in the lab,” he says.

W

“I’m excited about the ability to manipulate life at the fundamental level and to figure out how things work.”

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C E L E B R A T E !

Dr. Scheck says of Will’s work, “It’s not unusual for students to have their own projects, but one of relative importance such as Will’s meningioma project is rare.”

Will worked at Barrow through the Scientific Enrichment Program for Students (see sidebar) and graduated magma cum laude with a bachelor’s in molecular biosciences and biotechnology from ASU in May 2005.

Science was not Will’s first academic choice—he also holds an honors degree in English literature from Grand Canyon University but became emotionally dissatisfied with the lack of facts and figures available in the arts.

“I found there were more questions than answers in literature,” Will says of the switch to molecular biology. “Science is more concrete.”

The standout student wasn’t immediately accepted into Dr. Scheck’s lab. “He had no training, and his schedule did not permit him to commit to 20 hours a week for a full year,” Dr. Scheck says.

A semester later, Will made some adjustments—-moved in with his parents, quit his job at a Christian bookstore and convinced Dr. Scheck of his dedication to molecular biology research. “It’s the smartest thing I’ve ever done,” she says of hiring the budding scientist.

Dr. Scheck’s decision turned out to be an academic resume-builder for Will . He turned down Harvard and other leading research programs, opting to pursue a PhD at

Scientific Impression

Johns Hopkins, where he is currently studying under worldrenowned colon cancer biologist Dr. Bert Volgestein. “I’m excited to manipulate life at the fundamental level and to figure out how things work,” Will says.

“Will is special,” says Dr. Scheck, who believes Will demonstrates a scientific maturity that sets him apart from other molecular biology students his age. “He’s incredibly intelligent and intense, but not in a reclusive, abnormal way,” she says. “He’s also willing to do the work, which makes him a great molecular biologist.”

While he is no longer immersed in unraveling the mysteries of literature and theory, ironically, Will sees an intellectual parallel between his first and second career choice. ”What’s frustrating about science is that often the one thing you want to see the most you can’t.”

However, his training in the creative arts does inspire Will’s research approach at times.

“My background in literature comes in handy. It allows me to understand and think in ways that my training in science doesn’t.”

In a world of genetic absolutes, the probability of Will ever resembling a conservative researcher is low, but Dr. Scheck is confident his scientific star will rise high before the decade ends.

“He will make important contributions in the molecular biology field over the next 10 years. He’ll rise to the top of the heap.” ■

Shining Star

Got Science?

The Scientific Enrichment Program for Students

Valley high school and college students who have completed their freshman year of study and are interested in pursuing science careers can get a taste of the biomedical research world through the Scientific Enrichment Program for Students (SEPS). SEPS, coordinated by Adrienne Scheck, PhD, and Natasha Dennis, was developed 10 years ago by Joan Shapiro, PhD, and Dr. Scheck. The program helps aspiring scientists enhance their knowledge of basic biological principles, evaluate scientific literature, develop communication skills and use advanced techniques to develop projects presented at local and national scientific competitions and in scientific journals.

As SEPS participants, high school students can work as volunteers in a number of laboratories at Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, the Mayo ClinicScottsdale, Arizona State University and T-Gen. Undergraduates also can participate in SEPS as full-time summer research interns under the direction and supervision of a staff research scientist at Barrow.

Barrow Neurological Foundation provides funding for SEPS. For more information about the program or to learn how you can contribute to SEPS, please call (602) 406-4092 or send an e-mail to seps@chw.edu.

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R E S O U R C E L I N K

ResourceLink Barrow call center improves customer service emand for physicians at Barrow Neurological Institute is great, and without a specific referral from a physician in the past, you often had to navigate a system of multiple telephone transfers to schedule an appointment.

All that changed in January with the launch of ResourceLink, Barrow’s new call center that offers accurate call routing for physician referrals and general information about the world-renowned neurological center.

D

“ResourceLink offers comprehensive access to Barrow staff and services that wasn’t available before,” says Sharon Hughart, call center manager. “It eliminates a lot of investigative work for the caller.”

When customers—patients, physicians, providers—who were unfamiliar with Barrow experts called St. Joseph’s before January, operators had to make their best guess, within seconds, about where to transfer the call. Unfortunately,

The missing link

that usually led to a frustrating and time-consuming game of telephone tag before customers were connected to the right department.

“Part of the problem was that hospital operators cannot legally refer customers to a particular physician,” Sharon explains. “They did their best to figure out what Barrow clinic or office callers were trying to reach. It was challenging for everyone.”

Now, customers who contact ResourceLink can be quickly linked to the right person or department.

ResourceLink associates ask a series of questions to assess a caller’s needs so the caller can be matched with the correct Barrow professional.

“We screen, or triage, calls by asking specific questions, such as ‘What is your diagnosis?’ and use our database to cross-reference specialties, diagnoses and symptoms and link the customer with the appropriate physician’s office,” Sharon explains.

Referring physicians can call a separate ResourceLink line to sched-

Hazel Alexis, Sharon Whitlock, Victor Carrasco and Sharon Hughart in Barrow’s new call center

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By Sally J. Clasen

ule appointments and do consultations (see sidebar).

Making the right connection

Since ResourceLink started, the staff has answered and handled more than 6,000 calls, according to Sharon. “On average, we take 35 to 45 calls per day. And most days, 100

R E S O U R C E L I N K

“ResourceLink offers comprehensive access to Barrow staff and services that wasn’t available before.”

Sharon Hughart

percent of calls are answered within one minute,” she says.

While many callers request physician referrals, ResourceLink associates also provide information about Barrow programs and services and help schedule registrants for community-education classes and screenings. “The line was not created to generate new business but to

facilitate the volume of calls Barrow already receives,” Sharon says.

“ResourceLink is a central reference.

If we can’t help you at Barrow, we’ll try to refer you to other community specialists who can. We’re all about linking customers to the services they need.”

In addition, the referral service has become a valuable internal

resource for Barrow and hospital staff to respond to non-telephone inquiries. For example, e-mail messages from international customers interested in details about Barrow are directed to the ResourceLink staff and then referred to the appropriate neurospecialist.

Open Monday-Friday 7 a.m.-6 p.m.

ResourceLink associates take calls from 7 a.m. to 6 p.m., Monday through Friday. Voice messages can be left at other times. Messages are returned the next business day. Customers don’t have to worry that their calls will be lost or forgotten because a follow-up software tool reminds staff to respond promptly to inquiries. ■

Make the ResourceLink call

Consumers and patients: Call toll-free at 1-800-Barrow1 (1-800-227-7691).

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L E T T E R S

y name is Jonna Preciado. My husband (Carl A. Preciado) was a patient of Dr. Nicholas Theodore back in January of 2003.

When we came to him we had been told. because of his worsening back problems, that my husband's 15 year military career was done. That he would never fly again and that he would be more than likely medically discharged from the Army.

Dr. Theodore along with the others who helped in my husband's surgery and after care changed all that. My husband went from partial paralysis on one side and barely being able to walk without assistance, to walking on his own that very night after surgery. He is a new man.

Dr. Theodore and Barrow changed my husband's future and our lives.

Today, my husband, Captain Carl A. Preciado, is company commander for the Alpha Company Spiders of the 4-3 Aviation Regiment, 3rd Infantry Division. They are on a 15-month tour to Iraq, and Carl has currently made Pilot in Command.

Serving his country is all my husband dreams of. It is our life and it wouldn't have been possible without you. I receive emails from him telling me all his stories and how proud he is to be a soldier. You gave my husband back his life.

M

E L

entered your first time Health and Wealth Raffle not expecting to win anything but I considered I would win just by donating to Barrow. I won a Sony digital camera which I gave to my daughter to use taking photos of my granddaughter. My daughter and I both enter your raffle twice a year. We believe it is a wonderful cause we support.

I will be indebted to Barrow for the rest of my life for their wonderful staffing: • Dr. Spetzler, who had agreed that if surgery was an option, he would operate on my son. This amazing surgeon came to us at almost midnight to tell us he would take our case.

• Dr. Andrew Shetter, who did the required exploratory surgery so we could know more specifically what we were fighting. He was the one who had to identify the monster— a very rare and highly invasive brain tumor.

• Dr. William Shapiro, who was with us all the way—even the 2nd time my son was admitted to Barrow when his cancerous tumor returned. I thought Dr. Shapiro was so sad and compassionate and wanted to cry with me when he gave us the news that Patrick's chances of survival just went down to 50%. I’ll always remember this wonderful, gentle doctor.

• Dr. John Kresl, who treated him for two rounds of 6 weeks of special radiation oncology. He made the special masks Patrick had to wear each day in treatment. My son . . . as much as a dying soul can appreciate a doctor . . . felt a great rapport with Dr. Kresl and probably would not have been as willing to undergo the treatments if he did not so thoroughly respect and trust Dr. Kresl.

Alas, my son Patrick was not one that was to be saved or cured . . . God takes the best ones home early. . . but he did donate his eyes (cornea) so that a blind man could see his children for the first time. He taught me what true guts and courage really mean.

I have researched and learned so much more on brain tumors since my son's death. I believe now they have discovered so much more with research that if only my son did not get the tumor until now, he would have lived. Research must continue so that others do not suffer the same fate. We need to support Barrow— their research and staffing might save your life in the future.

Barrow did everything possible to treat and save my son, Patrick Michael Nicastro. He was originally brought into Barrow on Dec. 9, 1999. He died in my arms at home on March 19, 2000.

Together we gave it our all.

WE THANK YOU. We will continue to support Barrow.

I

S R E T T

Thank you. And God Bless you.

With my greatest Love, Jonna A. Preciado

P.S. I have attached a company photo taken of Carl with his company. He is all the way on the left.

GOD BLESS YOUR MIRACLE WORKERS, Sonja Nicastro

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CREATE INCOME FOR TODAY. LEAVE A LEGACY FOR TOMORROW.

“We earn interest rates far, far higher than we could get from any CD or money market fund, we get a very large tax deduction and most of our annual income is tax-free. And, ultimately, Barrow, which we feel so strongly about, will receive money to grow and assist others.”

— Bill and Jane Ratsch

When you establish a lifetime income gift, you ensure that Barrow Neurological Institute will continue to grow and thrive into the future, helping thousands of people every year. And, like Bill and Jane Ratsch, you’ll benefit with tax savings and a dependable fixed income for life.

Suggested Annuity Payments for a $10,000 Gift* Age Rate Annuity Tax Deduction _______________________________ 60 5.7% $570 $3,105 _______________________________ 70 6.5% $650 $3,952 _______________________________ 80 8.0% $800 $4,905 _______________________________ *These figures are for illustration purposes only. Minimum age: 50. Minimum gift: $10,000.

The deduction is variable and based on the available IRS Discount Rate.

Consult your adviser about such a gift.

For a personalized proposal, please contact Philip Barnett, director of Planned Giving, at Philip.Barnett@chw.edu. or 602-406-1046.

R E S E A R C H

N E W S

Research News

Three hundred of a projected 400 patients are now enrolled in the Marguerite Clark Hobbs Ruptured Aneurysm Trial, also known as the Barrow Ruptured Aneurysm Study.

This research trial is comparing the outcomes of two different approaches to correcting ruptured aneurysms—traditional neurosurgery, performed by cutting open

Ruptured aneurysms

Marla Pressler is one of the patients enrolled in the Marguerite Clark Hobbs Ruptured Aneurysm Trial. She is shown with Joseph Zabramski, MD

rupture rather than one caused by trauma or underlying disease.

Cerebrovascular neurosurgeons Robert Spetzler, MD, and Joseph Zabramski, MD, and endovascular neurosurgeons Felipe Albuquerque, MD, and Cameron McDougall, MD, are involved in the study.

Barrow Neurological Foundation supports this research.

The Epilepsy Research Foundation has awarded one of three New Therapy Grants to a BarrowArizona State University research collaboration. Grant recipients were chosen because they demonstrated a clear translational pathway to bring new therapies from the laboratory to patients with epilepsy.

David M. Treiman, MD, Newsome Chair in Epileptology and Director

Epilepsy

of the Epilepsy Center at Barrow, is collaborating with Leon Iasemidis, PhD, Associate Professor of Bioengineering at ASU, and Kostas Tsakalis, PhD, Professor of Electrical Epileptology at ASU, on the Barrow-ASU project.

The project will explore and test a closed-loop feedback control electrical stimulation method of treating epilepsy. The method relies on mathematical algorithms developed by Dr. Iasemidis that use EEG data to predict seizures.

This method could lead to a system that would predict a seizure before it occurs and then deliver electrical stimulation to the brain to prevent the seizure.

Dr. Treiman’s research receives Barrow Neurological Foundation funding.

Susana Martinez-Conde, PhD, principal investigator in the Laboratory of Visual Neuroscience, has received a $100,000 grant from the Dana Foundation to study the visual process called “filling-in.”

Filling-in enables patients who are blind in several spots of their

Vision

the brain, and endovascular neurosurgery, performed through a catheter inserted into an artery and threaded up to the aneurysm.

The study follows patients for six years and looks at such indicators as length of stay in the hospital, level of care required after surgery, return to work, quality of recovery and neuropsychological status.

To qualify for the trial, a patient must be under 80 years of age and must have suffered a spontaneous Susana Martinez-Conde, PhD

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R E S E A R C H

N E W S

Ron Lukas, PhD visual field to be unaware of the problem. It also occurs in people with normal vision, hiding the naturally occurring blind spot that is found in the part of the healthy retina that contains no photoreceptors.

Dr. Martinez-Conde’s study will seek to determine the brain level at which filling-in occurs in the visual hierarchy. Whole-brain scanning will be done using the hospital’s 3T MRI scanner.

This will be the first study to investigate texture filling-in in the human brain through imaging techniques and the first to conduct simultaneous measurements of physiological and perceptual filling-in in any species.

Dr. Martinez-Conde’s research receives support from Barrow Neurological Foundation.

The Human Specimen Procurement Service (HSPS)—also called the tissue bank—opened in May to collect, process and store human tissue for use in research.

The goal of the HSPS is to support St. Joseph’s/Barrow scientists, their collaborators and external

Tissue bank

investigators by providing human tissue, cells and fluids for research that may ultimately benefit patients.

The tissue bank is operating according to guidelines approved

by St. Joseph’s Institutional Review Board; tissue can be collected only from patients who give proper consent.

Proceeds from the Health & Wealth Raffle helped establish this important resource for medical research at the hospital.

The project will aid in the identification, design and development of drugs that selectively or specifically interact with nicotinic acetylcholine receptors in the brain. Such drugs could lead to the development of medicines to control or improve mood, treat emotional disorders and counteract drug dependency.

Drs. Lukas and Wu also receive funding from Barrow Neurological Foundation. ■

Nicotine and mood disorders

Ronald J. Lukas, PhD, senior staff scientist and director of the Laboratory of Neurochemistry, and Jie Wu, MD, senior staff scientist, have received a $965,860, three-year grant from Phillip Morris for their project, “Nicotinic Receptors Involved in Mood and Reward.”

The central hypothesis of the study is that nicotine acts upon areas of the brain associated with reward and emotion and thereby plays a key role in drug reinforcement, mood control and associated pathologies.

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U P D A T E

What’s Happening Around Barrow U.S. News & World Report ranked Barrow the seventh in the nation for neurology and neurosurgery in its 2005 “America’s Best Hospitals” edition. In determining the country’s best hospitals, U.S. News & World Report evaluated data from 6,007 medical centers; 17 specialties were listed, and 176 hospitals made the lists. St. Joseph’s was ranked 32 in treating respiratory disorders.

Barrow ranked seventh in U.S.

Hurry—Write a Will Seminar coming November 2

A seminar on the basics of writing or amending a will, along with an overview of estate planning, will be offered at St. Joseph’s as part of Leave a Legacy’s Write A Will Month in November.

The Write a Will Seminar will be offered on Wednesday, Nov. 2, in the Goldman Auditorium at three different times—7:30 a.m., 12 noon and 7:30 p.m. Each session will last about one hour with time afterward for questions. The presentations will be made by attorneys with expertise in estate planning and are sponsored by St. Joseph’s Foundation and Barrow Neurological Foundation.

The seminar and parking are free, but reservations are required. Please call Cindy Walland at 602-406-6333 to reserve your spot.

Hats off to Barrow’s Health Care Heroes

Barrow has two new Health Care Heroes. Thomas Hamm, PhD, was named the winner of the new Researcher/Scientist category in the 2005 Health Care Heroes Awards, presented by The Phoenix Business Journal. Harold Rekate, MD, a pediatric neurosurgeon at Barrow, was a finalist in the Innovator Category of the competition.

The winners and finalists were honored at a breakfast at the Arizona Biltmore on Aug. 25.

A special section of the Phoenix Business Journal said this about Dr. Hamm: “Through his neurobiology research at Barrow Neurological Institute’s Spinal Motor Systems Laboratory, Hamm is

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gleaning knowledge that could have a profound impact on development of treatments for patients with spinal cord injuries.”

PET/CT now available at St. Joseph’s

St. Joseph’s is now providing mobile Positron Emission Tomography (PET/CT) imaging.

PET/CT imaging can differentiate malignant from benign tumors, as well as determine the extent and stage of malignancies.

“Whole-body PET/CT imaging is advantageous for patient care and cost-effective patient management,” says Randy Boberg, manager of Ultrasound, Nuclear Medicine and PET/CT. “PET/CT offers a comprehensive assessment for both initial staging of newly diagnosed cancers, ranging from lymphoma to lung tumors, as well as for treatment.”

The service is available Monday through Friday from 8 a.m. to 4:30 p.m.

An Affair to Remember to benefit Parkinson Center

The An Affair to Remember committee has chosen the Muhammad Ali Parkinson Research Center to be the beneficiary of its third annual fundraising gala on Saturday, February 4, at Palmbrook Country Club in Sun City, Arizona. Rasheda Ali, the daughter of Muhammad Ali, is serving as Honorary Chair and is scheduled to attend.

“We had so many worthy non-profits apply to be our 2006 beneficiary, but this program really touched our hearts, and we’re proud to be able to contribute to their West Valley activities,” says Susan Dahlquist.

The An Affair to Remember committee is comprised of West Valley businesses and professionals committed to enhancing the lives of older adults in the community. For more information, contact co-chair Susan Dahlquist at (623) 977-6532 or Cindy Saverino at (623) 815-1100.

U P D A T E

When 10-year-old Kyle Niquette heard that his best friend’s mother had a brain tumor, he worried that some people with brain tumors could not afford the care they need. With the help of his parents, Cherie and Ed, Kyle visited the Barrow website and learned he could make a donation to Barrow Neurological Foundation.

“I don’t want any of the money in my savings,” he told his parents. “I would like it to go to research or whatever they really, really need.” Kyle’s parents matched his $20 and donated it to Barrow. Kyle is a fourth grader in Havasu City.

A budding philanthropist

Shawn and Lindsay Green support new Craniofacial Center

Diamondback Shawn Green and his wife, Lindsay, have made a $100,000 donation to St. Joseph’s for its new Craniofacial Center. The Craniofacial Center brings together the expertise of Barrow and the Children’s Health Center in caring for children and adults with complex congenital or acquired craniofacial disorders.

The center, which opened in September, provides comprehensive clinical, diagnostic, surgical, educational, genetic and support services. The Greens’ donation will accelerate the construction of three new dental operatories and a radiographic room, enabling the center to see more children and reduce wait time.

This student researcher plays the piano too!

Veronica Shi, a high school student working in Barrow’s Research Department, won first place in the piano division and the grand prize in a two-day competition for the Phoenix Symphony Guild Young Musician’s Competition. Veronica won a full scholarship to summer music camp. She works in Research as part of the Science Enrichment Program for Students.

Barrow adds neurointensivist, stroke specialist

Marc D. Malkoff, MD, a neurologist with extensive experience and training in critical care and stroke, has joined Barrow as the director of Neurocritical Care and the Neurovascular Program. Dr. Malkoff was formerly the Associate Professor of Neurology at the University of Texas-Houston Medical School. As a neurointensivist at Barrow, he will manage the care of critically ill patients at Barrow and direct the hospital's Stroke Program.

After receiving his medical degree at Northeastern Ohio Universities College of Medicine, Dr. Malkoff completed an internship in Internal Medicine at the Cleveland Clinic and a residency in Neurology at Emory University.

He was then chosen to be the Senior Clinical Fellow and the Charles A. Dana Foundation Fellow—both in the Neurosciences Critical Care Unit, Department of Neurology at Johns Hopkins University. Dr. Malkoff has also served on the faculties of the University of Texas-Houston Medical School, the Indiana University School of Medicine and the Saint Louis University School of Medicine.

Dr. Malkoff has been active in the Society of Critical Care Medicine, the American Society of Neuroimaging, the American Academy of Neurology, the American Board of Psychiatry and Neurology, and the International Society for Neuroemergencies. He has been named a Fellow by the American Heart Association and the American Academy of Neurology.

Dr. Malkoff has served on the editorial boards of several professional journals. He has written more than 120 refereed articles, abstracts and book chapters, and presented many lectures at professional conferences and meetings.

Day on the Lake offers rare opportunity

Participants at the Ninth Annual Hanger’s Day on the Lake soaked up the sun and some new skills May 13-14 at Bartlett Lake Marina. Day on the Lake provides a unique opportunity for people with neurological impairments to have access to water skiing, jet skiing, fishing and boat rides.

Barrow’s Recreation Therapy offers a special thanks to Fishing Captain Richard Komzelman for making sure that everyone on his boat caught fish and to Innovative Mobility for adapting their pontoon boat with a hoyer lift to help participants get into the boat after water or jet skiing.

The 10th annual event is scheduled for May 4-6, 2006, at Bartlett Lake Marina. For information, call the Recreation Therapy Department at 602-406-4329.

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P L A N N E D

G I V I N G

‘I give’ versus ‘I leave’

by Philip Barnett, director, Planned Giving

here have been a number of focus-group studies conducted about philanthropy. One of the most fascinating addressed the topic of “leaving” as opposed to “giving.”

An audience of 100 was assembled. The only requirement was that the participants be either employed or retired.

The first question they were asked was “How many of you could comfortably, right now, write a check for $10,000 to a charity whose mission statement you support?” Two people raised their hands.

The second question was almost the same with only one word changed: “How many of you could comfortably ‘leave’ $10,000 to a charity whose mission statement you support?”

This time 80 people had their hands in the air. And, when the amount was raised to $25,000, there were still 30 hands up. In fact, when that amount got up to $100,00, a full 10 percent of those in attendance were still voting in the affirmative.

T

My own personal circumstances probably mirror those of many of you reading this article. I am able to make several donations each year but not for nearly as much money as I’d like. However, when it comes to my estate, things change rather dramatically.

I’ve got a couple of insurance policies, an IRA account, a 401(k) plan, some investments and the equity in my home.

Naturally, my family comes first, and the bulk of my assets will go to them. However, after they are taken care of, there will still be a substantial amount left over.

When I realized that, I sat down with my attorney and worked out a plan—one that would work within tax laws to insure that the maximum amount possible went to family members and charity, and as little as possible to the government.

What I discovered was that although I’ve never made an enormous amount of money, I would be able to leave an organization I care deeply about (and that would be St. Joseph’s Hospital) a significant amount of money.

When you get a few minutes, please take a look at your estate and think about what you’d like to accomplish, beyond assisting those close to you. My guess is that you will be able to make a gift of substance and create a legacy in the process.

And by the way, this can also be done in your lifetime. We recently received a “lifetime income gift” (for a charitable gift annuity) from an 87-year-old woman. In return for her $100,000, she will be receiving $10,200 every year (that’s 10.2%) for as long as she lives. Most of this will be tax-free income, and she’s getting a large tax deduction as well.

For more information about these ideas or anything else related to estate planning, contact me at Philip.Barnett@chw.edu or 602-4061046. ■

“What I discovered was that although I’ve never made an enormous amount of money, I would be able to leave an organization I care deeply about (and that would be St. Joseph’s Hospital) a significant amount of money.”

Philip Barnett

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BARROW NEUROLOGICAL INSTITUTE Endowed Centers

A.B. & Anne-Merete Robbs Stroke Center Annette & Harold Noren Stroke Care Unit Golden Family Aneurysm Wing Ina Levine Brain Tumor Center Muhammad Ali Parkinson Center

Endowed Chairs

Alumni Spine Chair Volker K.H. Sonntag, MD

Chair for Pediatric Neurology John Bodensteiner, MD

Evelyn and Lou Grubb Neurovascular Research Chair Cameron G. McDougall, MD J.N. Harber Chair for Neurological Surgery Robert F. Spetzler, MD

John and Betty Van Denburgh Chair for Neurology Timothy L. Vollmer, MD Karsten Solheim Dementia Research Chair Patricio Reyes, MD

Kemper & Ethel Marley Chair for Neurology William R. Shapiro, MD Newsome Chair in Neurology David M. Treiman, MD

Newsome Chair in Neuropsychology George P. Prigatano, PhD

Newsome Chair in Neurosurgery Research Mark Preul, MD Spetzler Neuroscience Research Chair Robert F. Spetzler, MD

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D o y o u h av e a S t. J o s e p h ’ s S t o r y ?

St. Joseph’s Hospital and Medical Center will celebrate its 111th anniversary with the opening of the new Barrow Patient Care Tower. As we get ready to celebrate, we’re looking for people who were born at St. Joseph’s or who have a special story to share. Please submit your story at bornatstjosephs.org.

Participants will be invited to the opening of our new building in March 2006.

it’s about life.