Nicholas Boulis, MD, is immersed in a neurosurgical career focusing on research, thanks in part to a $40,000 grant from the Neurosurgery Research and Education Foundation (NREF) of the American Association of Neurological Surgeons (AANS). Dr. Boulis is the recipient of the 2002 Young Clinician Investigator Award for his proposal to define small peptides that would allow for enhanced uptake of genes and proteins into the nervous system. If successful, the study could pave the way to development of surgical therapies for amyotrophic lateral sclerosis, which is more commonly known as ALS or Lou Gehrig’s disease.
Dr. Boulis proposed to use the “neurotropic properties of neurotoxins in conjunction with the technique of phage display to define small peptides capable of triggering the uptake and retrograde transport of these therapeutic proteins and vectors.” The “phage study” took on increased importance this year as the need to understand how neurotoxins work became vital in response to the threat of bioterrorism and biological warfare. Dr. Boulis has applied for additional grants from both the Department of Defense and the National Institutes of Health in order to continue the study.
Humanitarian Work Began Early
Before embarking on the phage study, Dr. Boulis had developed a laboratory to pursue gene therapy for the spinal cord. At the same time, he organized Project Shunt, an effort to help Guatemalan children with hydrocephalus and spinal bifida. His experiences working in developing countries early in his career helped prepare him for this lifesaving project.
After graduating from Yale in 1988, Dr. Boulis worked in Nicaragua, Costa Rica, Haiti and the Dominican Republic, concentrating on human rights and medicine. On his return from the Dominican Republic in 1990, he worked at the Walter Reed Army Medical Center where he became interested in neurosurgery, but wished to connect his new interest with helping underserved people in developing countries. After graduating from Harvard Medical School and beginning residency at the University of Michigan, Dr. Boulis became involved with the Michigan Chapter of Healing the Children, a national relief organization, and was introduced to the epidemic of neural tube defects and hydrocephalus in Latin America.
In 1997 Dr. Boulis participated in a trip to Guatemala to evaluate the potential for a collaboration between Healing the Children and the Pediatric Foundation of Guatemala. When he arrived in Guatemala he began evaluating children with neural tube defects. “Many of the children who didn’t have access to American help had either died or were deteriorating,” Dr. Boulis said. “For many of the hydrocephalics who did manage to get shunts, it was too late. The poor supply of shunts led to patients languishing in hospitals for months with externalized infected systems.”
Project Shunt Aids Guatemalans
The fact-finding mission demonstrated that the Guatemalans desperately needed shunts and many more neurosurgeons to perform the procedures. In 1998, Dr. Boulis organized an eight-person medical team, led by Karin Muraszko, MD, to return to Guatemala to help children with hydrocephalus and spina bifida. Upon the team’s arrival 50 families showed their appreciation with a standing ovation. Initiating what became known as Project Shunt, the team performed 13 shunt operations on children with hydrocephalus and 11 spina bifida repairs.
“We worked nonstop under incredibly difficult conditions. It was extremely hot and the team was exhausted,” Dr. Boulis said. “But it was an unbelievably valuable experience.” The trip was successful not only for the patients and doctors, but it helped improve the way Americans are viewed by the people in Guatemala. “The parents of these children will always view Americans in a positive light,” he said.
For his work on Project Shunt, the AANS Young Neurosurgeons Committee awarded Dr. Boulis a public service citation. Since that initial trip to Guatemala, he has put in place a system with standard operating procedures that allows the project to continue. Now a participant rather than a project leader, Dr. Boulis said he hopes that eventually more than 10 teams will be able to make the trip each year.
Whether he is concentrating his efforts on helping children in third world countries, working on his phage display study, or beginning a new project, Dr. Boulis continues to use his education and training to assist patients and further his profession.
Laurie M. Singer is marketing coordinator in the AANS Marketing Department.