Strittmatter Award: Recipients create impact

PCMS honorees

Award recipients spend years making impacts in their fields

By Susan L. Peña, Contributing Writer

Dr. Robert H. Rosenwasser, 2020 Strittmatter Award recipient, with his wife, Dr. Deborah August.

Dr. N. Scott Adzick is surgeon-in-chief, founder (in 1995) and director of the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment at the Children’s Hospital of Philadelphia. Adzick has not only become the pre-eminent pediatric general and thoracic surgeon of his generation, but for 30 years has led groundbreaking research on fetal surgery, a field that was in its infancy when he earned his medical degree. Editor’s note: The Philadelphia County Medical Society presented the 2020 and 2021 Strittmatter Awards on June 25, 2021 during the installation of its 160th president, Dr. Stephen R. Permut, MD, JD. We interviewed the winners, Dr. Robert H. Rosenwasser, MD, MBA, FACS, FAHA (2020), and Dr. N. Scott Adzick, MD, MMM, FACS, FAAP (2021), to find out why they chose their specialties and to explain their achievements in research and clinical practice.

Dr. Robert H. Rosenwasser

When Rosenwasser was growing up in the 1960s in Shreveport, La., no one would have suspected that he would later become a neurological surgeon and researcher of note.

Rosenwasser was already making his mark locally as a musician, having studied piano and violin as a child and playing guitar in rock bands.

“I wanted to be a professional musician,” he said, chuckling. “Medicine was my fallback.”

While attending Nicholls State University in Thibodaux, La., where he earned a bachelor’s degree in music and philosophy, Rosenwasser would study until 10 p.m. and then go out to paid gigs in New Orleans’ French Quarter.

While he took courses in science, he was not a pre-med student, although many of his fraternity brothers were.

As graduation approached, he began to consider what to do next, as the Vietnam War was winding down, but the draft was still active (his lottery number was 3).

When his friends suggested he go to medical school, he took the MCATS almost on a whim, and did well. Still undecided about his next step, he applied to the Louisiana State University medical school in his hometown, and was accepted.

Completed internship, residency

Rosenwasser turned out to be a brilliant student; he completed his medical doctorate in 1979, and then completed his internship in general surgery at Temple University Hospital, where he also completed

his residency in neurological surgery.

“I started in cardiac surgery, and found it really boring,” he said. “I had liked neural anatomy in med school, so I started neurological surgery and liked it.”

His musical background actually helped him become a good surgeon, he said, “because if you’re a musician, your brain is connected to your hands. I’ve been training residents for years, and our best technical students have been those who played instruments.”

By 1984, Rosenwasser had found his passion. That year he received a fellowship in open microsurgery with Dr. Charles Drake at the University of Western Ontario, “the epicenter of neurological surgery in the world.” He also completed a fellowship in endovascular surgery with Dr. Alex Berenstein, one of the founders of endovascular neurosurgery, at New York University in 1993.

The following year, Rosenwasser was recruited by Thomas Jefferson University Hospital and became a professor of neurosurgery at the university’s medical school. He is the Jewell L. Osterholm MD Professor and Endowed Chairman in the Department of Neurological Surgery, president and CEO of the Faber Institute for Neuroscience, medical director of the Jefferson Neuroscience Network and senior vice president of Jefferson Enterprise Neuroscience.

While Rosenwasser still practices non-emergency neurological surgery and continues to preside over the training of residents and fellowship recipients, he is most passionate about his research projects.

“When you’re a good doctor, you help individuals, but when you do research and make a discovery, you can help millions of people,” he said.

His earliest taste of that thrill came early in his career, when his lab helped define the role of the white blood cell in brain ischemia. Later, Rosenwasser co-authored a paper on the timing of interventions for vasospasms (secondary strokes) published in Neurosurgery, May 1999, that “changed the standard of care around the world.”

Stem cells

For the past 18 years, Rosenwasser has been working on the use of stem cells in stroke recovery, and has received a $10 million grant to begin trials on humans.

Additionally, he and other researchers at Jefferson are working on creating a brain/computer interface for paralysis in stroke victims, in which electrodes implanted in the brain can allow a patient to move a limb with an external skeleton in a natural way. These new treatments will be game-changers for stroke victims, who number about 750,000 each year, Rosenwasser said.

Asked if he still plays music, he revealed that he is a member of the popular Buzzer Band, a country/rock band founded and led by drummer Vinnie Stix, that plays throughout the region. Rosenwasser enjoys playing rhythm guitar for the band on a part-time basis. They have even played at the Jefferson Gala, and at Villanova University, where he earned an MBA in 2017.

“When I play with these talented musicians,” he said, “what’s nice is that I’m just one of the guys.”

Rosenwasser resides in Villanova with his wife of 37 years, Deborah August, a neuroanesthesiologist.

Dr. N. Scott Adzick, 2021 Strittmatter Award recipient, is a pioneer in fetal surgery at Children’s Hospital of Philadelphia.

Dr. N. Scott Adzick

A few minutes into an interview with Adzick, a pioneer in fetal surgery at Children’s Hospital of Philadelphia (CHOP) since 1995, two things become obvious: He is a person with a huge heart, and he has an irrepressible zest for the history of this venerable, beloved hospital in his adopted city.

Given the opportunity, Adzick will recite all the details about the visionaries who created the first 12-bed CHOP in 1855, and particularly about one of the founders, Dr. George Bacon Wood, whose descendants have been involved in funding the hospital — now one of the largest children’s hospitals in the world — and its research division to the present day.

One of them, Richard D. Wood Jr. (chairman emeritus of Wawa), recently donated $25 million to the CHOP’s Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, of which Adzick is surgeon-in-chief, founder (in 1995) and director.

Words like “amazing” and “incredible” are sprinkled through his narrative, and it’s this kind of enthusiasm and passion that have driven him to keep finding ways to treat genetic illnesses in the womb, and to encourage others to do so. He credits those who came before him, such as former U.S. Surgeon General C. Everett Koop, who preceded him as surgeon-in-chief at CHOP, for their vision and inspiration. (Adzick is the C. Everett Koop Professor of Pediatric Surgery at CHOP.)

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Richard D. Wood Jr. (chairman emeritus of Wawa) recently donated $25 million to the Children’s Hospital of Philadelphia Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, of which Dr. N. Scott Adzick is surgeon-in-chief, founder (in 1995) and director.

Mentors he remembers

Adzick’s journey through long and arduous training at Harvard Medical School and beyond was full of mentors he remembers with admiration, including Dr. Judah Folkman, who was then surgeonin-chief at Boston Children’s Hospital; Dr. W. Hardy Hendren, chief of pediatric surgery at Massachusetts General Hospital; and Dr. Francis D. Moore, an iconic chief of surgery at then-Peter Brent Brigham Hospital.

All of them instilled in Adzick a passion not only for pediatric surgery, but for continuing the work of research to help eliminate or treat genetic disorders.

Adzick has not only become the pre-eminent pediatric general and thoracic surgeon of his generation, but for 30 years has led groundbreaking research on fetal surgery, a field that was in its infancy when he earned his medical degree.

One of his successes in this field was developing a method for repairing myelomeningocele, the most serious form of spina bifida, in utero at 23 to 25 weeks’ gestation. Once the technique was developed, a large study found that, while it was not a “miracle cure,” the surgery would give the baby a “much better chance to have a more normal leg function, a chance to walk, and no hydrocephaly,” Adzick said. (Infants that have spina bifida of this type repaired after birth are usually paralyzed.) Now this surgery is the standard of care for spina bifida in many centers around the world, led by physicians trained at CHOP.

Adzick has also presided over the development of techniques such as fetal surgery to correct twin transfusion syndrome, as well as corrective surgery in newborns for many congenital conditions.

Special delivery unit

In 2008, Adzick led the creation of CHOP’s renowned Garbose Family Special Delivery Unit, the first birth facility specifically designed for healthy mothers carrying babies with known birth defects. A three-part PBS documentary “Twice Born” (2015), directed by Monica Lange, was filmed during 15 months inside the unit, and followed three families, from their decision-making process through the outcomes of their prenatal treatments. It won an Emmy Award for outstanding science and technology programming.

Since that time, he said, there have been exciting developments in CHOP’s research division, in spite of interruptions caused by the COVID-19 shutdowns.

“Dr. Alan W. Flake (director of CHOP’s Center for Fetal Research) is close to doing the first in-utero bone marrow transplant to treat sickle-cell anemia at 12 to 14 weeks gestation (before the immune system kicks in),” he said. “We’re waiting for Food and Drug Administration approval, but we’re getting close.”

He said CHOP’s big initiative on cellular and gene therapy is being led by Dr. William Peranteau (who holds the Adzick-McCausland Distinguished Chair in Fetal and Pediatric Surgery, endowed by Richard D. Wood Jr.). One of these projects is developing in-utero gene editing, using CRISPR technology, to treat “a whole list of single-gene disorders,” including cystic fibrosis. Animal trials have already shown promise.

Artificial womb

Then there’s the artificial womb, a fluid-filled, temperature-controlled container supported by an external oxygenator to exchange oxygen and carbon dioxide, which Adzick said “may be a big breakthrough for our tiniest patients, at 23 to 25 months gestation. If you can have a bridge of four to five extra weeks for them to grow and develop, they may be able to survive.

“Dr. Flake has worked on fetal sheep of similar size and found the artificial womb can support the fetus for four to five weeks, with normal development.”

Under his leadership, CHOP has developed the Center for Birth Defect Outcomes, using data collected from about 28,000 referrals to create “an extremely powerful tool for counseling families and for the referring physicians to help us do things better and better,” Adzick said.

Another new development is the Birth Defects Biorepository, a collection of genetic information on parents and baby, “so we can shed light on the genetic causes of defects, and extract strategies for prenatal treatment.”

When he talks about such miraculous-sounding visions for the future, it’s clear Adzick is just as passionate about his chosen work as he was at the start of his career, and has no plans to stop anytime soon.

“Dr. Koop always said that if you operate and save a child, you save a lifetime,” Adzick said. “That’s really true.”

Adzick and his wife, Sandy, a former pediatric cardiac surgery nurse and world-class sailor, have a son, Mark, and daughter-in-law, Marguerite, and two grandchildren, Behr, 1, and Annie, 3 (who was born in CHOP’s Special Delivery Unit and is now “perfect”).

“Grandchildren are the best things in the world,” Adzick said. • Susan L. Peña is a contributing writer to Philadelphia Medicine.