Chairman's Corner Blog

Future Leaders

This Summer will mark the 45th anniversary since the founding of Stanford’s resident alumni organization, the John W. Hanbery Neurosurgical Society. The society was named in honor of Dr. Hanbery, who was best known for his devotion and loyalty to Stanford’s neurosurgery residents. His legacy lives on in the more than 90 Stanford-trained neurosurgeons - myself included - who are treating patients, making discoveries at the bench, and advancing our field in ways Dr. Hanbery  never could have imagined.

The program, which is seven years long, is quite rigorous and demanding but our residents also have unique opportunities to learn from some of the world’s leading neurosurgeons and scientists, to tackle some of neurosurgery’s most complex cases, and to work in a variety of clinical settings across the Bay Area. In addition, the kind of work young neurosurgeons are doing now makes entering the field that much more compelling – it is not only growing in diversity and depth of knowledge, but there are technological advances in the field that have made training in this profession simply very cool - our residents now use 3D virtual reality, advanced imaging including vivid color displays of neural tracts, and sophisticated robots, as part of their daily work routines.

My own passion for teaching and the joy I experience from watching our residents master the skills necessary to become great neurosurgeons only continues to grow, and I am one of many Stanford faculty members who value their time training residents, as much as all the other aspects of our work. Dr. Gerald Grant, our Residency Program’s director, is an oustanding pediatric neurosurgeon-scientist who is able to expertly guide our residents through the tough balancing act of focusing on both clinical and research commitments. Dr. Michel Kliot, a nationally recognized senior peripheral nerve surgeon brings the necessary attention on physician wellness to the program, emphasizing the importance of self-care and team bonding - elements of a neurosurgery career which haven’t always been at the forefront of training, but ones we hope our residents will carry with them beyond their time at Stanford. We have built a culture where our entire faculty and staff are all dedicated to the success of our residents, and to ensuring their time here is valuable, unique, and fulfilling.

We are lucky that Stanford’s reputation and location attracts some of the top medical students in the country and our program continues to be enhanced by the talented new residents who enter the program. While we’ve consistently matched our top 5 candidates (of more than 250 applicants), this year we were particularly pleased to match our top 3! We are very excited for our new interns, Silvia Vaca, MD, Rukayat Taiwo, MD, and Daniel Lee, MD,  to begin their training and officially join our Stanford Neurosurgery family.

As a new group of residents enter, our graduating residents are moving on to the next steps in their careers. Yi-Ren Chen, MD, will be an attending neurosurgeon at Sacramento’s Dignity Health and will also stay on as an adjunct assistant professor of neurosurgery here at Stanford. Adrienne Moraff, MD, is joining the University of Missouri’s Saint Luke’s Marion Bloch Neuroscience Institute as a clinical assistant professor of open & endovascular cerebrovascular surgery. And Laura Prolo, MD, a second generation Stanford-trained neurosurgeon is going to Seattle Children’s Hospital and the University of Washington for a pediatric neurosurgery fellowship. I wish them all the very best in their future careers, they are all not just outstanding neurosurgeons but also outstanding individuals. I fully trust they are going to represent their training and our institution well in their clinical and research work, and will each become a future leader of neurosurgery in their own right.

Concussion

It’s been two years since I last wrote about concussion, and with Brain Injury Awareness Month quickly approaching, it’s a good time to reflect again about the progress we’ve been making. We understand now, better than ever before, the long-term impacts that brain injury can have on brain function, and the importance of proper detection and treatment.

We were particularly excited, when this past Fall, the CDC released a major new guideline for diagnosis and management of brain injury in children. The guideline, which is the culmination of years of work by a group of experts from several disciplines - including neurosurgery, emergency medicine, sports medicine, and neurology – busts some of the myths about treatment for concussion. Most notably, in the past, it was common for doctors to prescribe long periods of isolation in a dark room as part of the recovery regiment for people with mild traumatic brain injury. We now know that is not how concussion should be treated. The new guideline also points out that imaging studies really aren’t necessary when diagnosing concussion, and emphasizes the importance of keeping athletes off the field after suffering a concussion. The goal of the guidelines is to standardize diagnosis and treatment, something we haven’t had before. In light of the new evidence, the American Academy of Pediatrics also recently updated its guidelines for treating mild brain trauma.

First author of the new CDC guideline, Dr. Angela Lumba-Brown, is also co-director of our Concussion and Brain Performance Center, where she works closely with the Center’s director, neurosurgeon Dr. Jamshid Ghajar, and director of the Stanford Children’s Health Concussion Program, and chief of pediatric neurosurgery, Dr. Gerald Grant. The three have combined forces in an effort to build one of the most cohesive concussion care programs in the country. The team is working with Vaden, Stanford’s student health center, and with Stanford Athletics, to ensure that all Stanford students are well supported and are receiving the right concussion diagnosis and treatment. In learning from successful diagnostics and treatments at Stanford’s sports medicine clinic, the team has also refined care protocols at Stanford’s Neurosciences Health Center and the Stanford Pediatrics Concussion Clinic, by adding concussion subtype evaluations, part of landmark research the team will soon publish in Neurosurgery.

In addition, the team is working closely with local high school athletes using a variety of new technologies, including CrashCourse, a novel virtual reality concussion education program, to continue to learn and enhance our understanding of concussion. And this Spring, we will be hosting our first ever Stanford Sports Concussion Summit, where our experts will present the latest advances in concussion prevention, diagnosis, and rehabilitation to physicians and the general public. If you show up early, you can catch me and former 49er Steve Young, as we discuss the transformation of concussion care in professional football over the last couple of decades.

It’s exciting to see all of the attention that concussion science and medicine are receiving, and how quickly advances in the field are moving. I’m hopeful that as we move forward we can help more people get the correct diagnosis and the appropriate treatments needed to reduce or eliminate the long-term risks associated with concussion, and to continue to improve brain health for all.

Happy New Year

The Holidays are one of my favorite times of year. Despite the added commitments and stress, people are happy and friendly, and for a short time we can all temporarily forget our problems and those confronting the rest of the world. This is also a time of year to give thanks and celebrate all that we have. In that spirit, I give thanks to the many talented and extraordinary people I work with for their dedication, exceptional expertise, hard work and fortitude!

At Stanford Neurosurgery, 2018 was a year marked by an unusually high number of personal celebrations as many of our staff got engaged or married, and welcomed new children and grandchildren to their families. I too celebrated becoming a grandfather for the first time with the birth of my beautiful granddaughter, Emma.

Our team was thrilled with the grand-opening of the new Lucile Packard Children’s Hospital this past year, which includes one-of-a-kind neuro hybrid cath lab/operating room suites and intraoperative MRIs. We were also excited to open the new Neurosurgery Anatomy Lab and to launch the Brain Metastases Consortium. Our clinicians and researchers continued to be recognized for their excellence and leadership; including the Leibrock Lifetime Achievement Award presented to alumnus Dr. Donald J. Prolo and the Cushing Award presented to neurosurgeon and innovator John R. Adler at this year’s AANS Annual Meeting. Dr. Melanie Hayden Gephart was honored by her Alma Mater with a 40 under 40 Healer Award, Dr. Odette Harris was named to Ebony’s Power 100 List, the Stanford School of Medicine recognized Theo Palmer, PhD with the School’s Award for Excellence in Mentoring and Service, and the McKnight Foundation awarded its annual Scholar Award to researcher Brad Zuchero, PhD. In addition, The American Association of South Asian Neurosurgeons elected Dr. Anand Veeravagu as Member-at-Large and Co-Chair of their Education Committee, and Dr. Harminder Singh as the Association’s new president.

Furthermore, several of our faculty received significant grants this past year, including a major gift by Tad and Diane Taube to advance concussion research led by Dr. Gerald Grant, and an award by the National Science Foundation to E.J. Chichilnisky to support his training of young scientists in neurotech. We were also proud to host the West Coast’s first Facial Pain Conference, and the prestigious International Sunderland Society biennial meeting at Stanford this year. We welcomed two wonderful new neurosurgeons to our team, Dr. Tene Cage and Dr. Juan C. Fernandez-Miranda, and are looking forward to welcoming neurosurgeon Corinna Zygourakis who will join us in the new year. I’m incredibly proud of our faculty’s accomplishments, and am looking forward to seeing what they achieve in the coming year. 

On behalf of the Stanford Department of Neurosurgery, I wish you all a healthy, prosperous and happy 2019!