Faces of Neurosurgery: Dr. Behnam Badie

kris 2Guest post from Kristopher T. Kimmell, MD
Neurosurgical Resident, University of Rochester Medical Center
Rochester, NY

For many people, encounters with physicians happen at times of crises in their lives. A grandmother is sick in the hospital. A cousin suffers serious injuries in a car accident. An aunt receives a devastating diagnosis. For many physicians, these encounters are the fuel that lights our professional fire. To meet people at their most vulnerable and to offer succor, and even hope, in their desperate hour, is one of the sacred honors of our profession. While some physicians may have had such a personal experience which inspired them to pursue medicine, fewer still have had such a personal crisis in the midst of their careers. Behnam Badie, MD, FAANS, FACS, is one of these few, and his experience serves as inspiration for his current clinical and research work.

Dr. Behnam Badie

Dr. Behnam Badie

Dr. Badie was born in Iran and immigrated to America in the late 1970’s. His initial plans to receive his education in America before returning to his homeland were altered by the Iranian revolution in 1979. After obtaining his undergraduate degree at UCLA, he went on to attend medical school there as well. During a rotation on neurosurgery as a third-year medical student, Dr. Badie knew he had found his calling. He was enchanted by the technical challenge of microsurgery. He pursued his neurosurgical residency at UCLA, and during his training, he became very interested in the treatment of brain tumors. Upon completing his training at UCLA, Dr. Badie moved to the University of Wisconsin, where he began a surgical neuro-oncology program and also continued his research efforts in neuro-oncology.

In May 2004, Dr. Badie’s life changed forever when his father came to visit him from Iran. His father did not appear well to Dr. Badie. Upon further probing, his father admitted that he had been experiencing arm numbness for several weeks. Dr. Badie implored his father to obtain an MRI; he could never have prepared himself for what was discovered. Dr. Badie’s father had an aggressive, invasive glioma located in the insula. A tumor in that area required the utmost technical prowess in a surgeon. Dr. Badie brought his father to the U.S. for treatment and began searching for the best surgeon to do his father’s operation. But, to Dr. Badie’s surprise, his father already knew who the best surgeon would be. It was his father’s wish to have his son remove the tumor. Such a decision was fraught with ethical concerns, but his father would not waver. After much consultation with colleagues, Dr. Badie granted his father’s wish, and with help from colleagues at the University of Wisconsin, he successfully removed the tumor. The final diagnosis of the tumor was glioblastoma multiforme (GBM), the most aggressive form of brain tumor. His father made a good recovery and lived for over a year after surgery before succumbing to the fatal disease.

cIn 2005, Dr. Badie made the decision to move his practice from Madison, Wisconsin, to City of Hope, a world-renowned independent research and cancer and diabetes treatment center, in Duarte, California. He has served as chief of the Division of Neurosurgery and director of the Brain Tumor Program at City of Hope since his arrival. Inspired by his experience with his father, Dr. Badie made this career change because he wanted to be at the cutting edge of new therapies for brain tumor patients. He still keeps a picture of his father on the wall of his office. At City of Hope, Dr. Badie has been involved in groundbreaking clinical work using new immunologic techniques in the treatment of the most aggressive types of GBM. A recent breakthrough at City of Hope has captured media attention. Using a patient’s own immune cells — specifically, a type of cell known as a memory T cell designed with a unique receptor called a chimeric antigen receptor (CAR) — Dr. Badie and colleagues have devised a technique that uses these cells to attack GBM cells. This approach has shown early success in a small number of patients with very aggressive and advanced forms of the disease. Much work still needs to be done, but Dr. Badie and his colleagues at City of Hope believe that this technique can be useful not only in GBM but in other disease processes such as tumors that metastasize to the brain from other parts of the body.

Dr. Badie has committed his career to clinical excellence and scientific discovery. He believes that the value of achievement in these realms is far more valuable than financial success. His story of turning personal tragedy into professional accomplishment is an inspiration to us all. We salute Dr. Badie for his efforts to improve the treatment of patients with devastating brain tumors.

Posted in Faces of Neurosurgery, Guest Post, Health, Medical Research | Tagged , , , , , , , , , , , , , , , |

Voices of Our Patients — Becoming Legendary Requires Being Bold

kimon2Kimon Bekelis, MD
Department of Neurosurgery, Thomas Jefferson University
Instructor, the Dartmouth Institute for Health Policy and Clinical Practice

Greg was seven-years-old when his family received the devastating news that he was suffering from a brain tumor with a dismal prognosis. Due to his parents’ persistence, he received a revolutionary operation at the Mayo Clinic in Rochester, Minnesota from Patrick J. Kelly, MD, FAANS(L). After months of rehabilitation, Greg was able to look at life through a positive lens again. He is now an ultramarathon runner and enjoys every second of his life. Greg distilled his early life struggles and passion for life in a book titled, “Enduring Strength: The Story of the Other Hansbrough Brother.” Here, in his own words, is Greg’s story.

By Greg Hansbrough

“History is made by the bold.” One of the classic movie quotes from “Sandlot” said it best, “Heroes get remembered, but legends never die.” Bold moves have laid the foundation for incredible advances in medicine. Throughout the years, the Mayo Clinic has remained one of the leading medical institutions in the country, providing technology and developing procedures that set it apart from other hospitals. In this context, it laid the groundwork for legends of the profession to develop. It is through this foundation that a heroic doctor became a legend and performed the surgery that saved my life.

Before my surgery, I was the best athlete and student in my class. My future looked bright, and everything in my life was easy. I then began to experience headaches and heard stories from my friends about getting headaches from school. I assumed that must be what was going on and dismissed the pain. But, the headaches became more intense and felt as though I had a lead weight in my head.

One night, my dad, an accomplished orthopaedic surgeon, asked me to eat dinner with my left hand. I tried with everything in my seven-year-old body, but could not accomplish this simple task. As a precaution, we went to the hospital, where a CAT scan revealed a tumor in my brain.  We drove through the night to a research institution for treatment. It was at this hospital the doctors delivered a grim message to my parents. They told them that there was nothing they could do and they should prepare for my death in a few months. We drove home after receiving this news.

Dr. Patrick J. Kelly

Dr. Patrick J. Kelly

My dad went above and beyond in search of a miracle for me and set out on a quest for a second opinion. He called all the medical contacts he could use trying to find a doctor that would perform the risky procedure to save my life. After an exhaustive search, he identified two surgeons that could perform the procedure to save my life. One was Dr. Patrick J. Kelly at the Mayo Clinic, and the other was a surgeon in Siberia. My dad called Dr. Kelly, and during the conversation, he agreed to use a procedure that was experimental and incredibly risky at the time. The Mayo Clinic was the only institution with the technology available for Dr. Kelly to take one step closer to becoming a legend.

Once we arrived in Minnesota, Dr. Kelly explained the risks of performing the operation and that the stereotactic procedure he was going to use was experimental and there was a good chance that I would not make it out of surgery. 

I remember being wheeled in my bed down the hallway towards the surgical unit, my parents gripping my bed and holding my hand until they could no longer follow me. As I was being wheeled through the doors, I looked up and saw my parents breaking down crying in each other’s arms as they experienced the realization that they may never see me alive again.               

It was then that Dr. Kelly stepped into the light and performed the procedure that would save my life. As the anesthesia caused me to close my eyes, the surgeon began to add another example of his legendary craft. As the hours rolled by, he meticulously performed the operation.    

I awoke the next day with the lead weight feeling removed from atop my shoulders. They immediately tried to get me on my feet to see the damage that the surgery had created. As I tried to stand, doctors and my parents both ready to catch me if I fell, the boy that was the best athlete in school could not walk. All I could do was hop on my right leg, but I was alive. After a couple of months of rehab, I relearned to walk. I went on to be the captain of my high school basketball team, run marathons, and am now an ultramarathon runner that has a burning passion for trail running and an inner glow for life. My life would not be possible had it not been for the boldness of the legendary brain surgeon who chose to be intrepid and further solidify his legend in the world of neurosurgery.

Greg Hansbrough (middle)

Greg Hansbrough (middle)

Posted in Faces: Of Our Patients, Health, Tumor | Tagged , , , , , , , |

AANS Annual Meeting Spotlight: Idea Economy — It’s Not Brain Surgery

hs2Jessica Rabski, MD (left)
Neurosurgical Resident, University of Ottawa
Ottawa, Canada

Eve C. Tsai, MD, PhD, FAANS, FRCSC (right)
Suruchi Bhargava Spine and Brain Regeneration Chair
Assistant Professor, Neurosurgery, The Ottawa Hospital, Ottawa Hospital Research Institute
University of Ottawa
Ottawa, Canada

meg2222“My job is not life and death.”

These words were spoken by Meg Whitman at this year’s 2017 AANS Annual Scientific Meeting in Los Angeles. Whitman, the 2017 Cushing Orator, assertively took to the stage and captivated the audience immediately with her intriguing introduction to the Idea Economy and its unlimited potential in the advancement of medicine. This statement exemplifies her humble nature, and in no way depreciates her well-known understanding of the power and influences her expertise, wisdom and insight have had on the innovation and advancement in the field of business. Meg Whitman is an American business executive and political activist, who is currently the president and chief executive officer of Hewlett-Packard Enterprise.

Whitman emphasized that in today’s business world, the ability to turn ideas into usable products has become remarkably simplified and success is dependent on how quickly one can turn their ideas into something functional. Failure results from the inability to respond and compete with new technological threats. We have essentially entered an age of “digital disruption” in business and will inevitably see it in the field of medicine. Uber, Airbnb and Spotify were cited as examples of “disruptive” businesses that utilized the Idea Economy.

Even though Whitman’s explanations and short video clips of the seven major trends in the Idea Economy were intriguing and captivating, it was her final remarks which were most impressionable. She introduced a list of personal key principles that she reflects upon when guiding her business decisions. She shared them with the hopes of motivating and encouraging her neurosurgical audience with their innovative efforts.

  1. She stressed that you need to have the right person, at the right time, in the right place, with the right attitude which can be particularly challenging and frustrating to find. This means if the combination is not right then one can’t force it to work. This is a concept that is difficult for most neurosurgeons to accept.
  1. Next, you must focus on the customer since customer service in health care has never been so important. She attested to the importance of actively listening to others while maintaining an open mind since “you do not know what you do not know.” Our patients provide us with unique insight and perspectives that we need to acknowledge to create solutions that properly address their actual problems.
  1. Also, you need to disrupt yourself before someone else disrupts you! Whitman highlighted the importance of constantly thinking of new ideas and ways of doing everyday tasks rather than remaining stagnant. Change is inevitable, whether you embrace it or have it thrust upon you.
  1. Her fourth principle involved creating efficient cost structures to ensure sustainability of our ideas and to ensure the efficient use of limited resources in health care. This crucial concept ensures the success of our ideas and prevents lack of buy-in due to limited finances.
  1. Her last principle, simple but true, emphasized the need to have thick skin. To be brave, follow through with one’s ideas and handle the pressure. This concept is pressed upon surgeons from an early stage and ultimately ensures our professional advancement and obsession with striving for surgical

Whitman’s speech not only offered a glimpse into the ever-evolving world of business, but it also provided insight into an intriguing challenge that physicians should be eager to tackle — how to utilize Idea Economy to better our patients’ treatments, experiences and overall welfare. As physicians, we have unique insight into the technical failings of our health care system and are privileged to have our patient’s share their experiences, feelings and opinions with us. Today’s technology can help us realize our ideas more efficiently, thereby allowing us to focus more on the impact of our innovations and improving their quality and efficacy. Whitman was both inspiring and informative and hopefully sparked the interest of neurosurgeons to “disrupt” their ordinary ways of thinking and to create solutions to better the lives of their patients. This challenge is quite exciting, and as such, we are grateful to Whitman for having initiated this spark!

Posted in AANS Spotlight, Health | Tagged , , , , , , , , , , , |