Section News
Section on Pediatric Neurological Surgery
This is the edited version of a story by
Robin P. Humphrey, MD. It appeared in the Fall 2001 Pediatric Short Cuts. E. Bruce Hendrick, MD, died in August at the age of 76.
It may have occurred to more than one neurosurgeon while operating on a cerebral Galenic venous malformation that it was “like sitting beneath Niagara Falls in a basket of quivering serpents.” At least that is how E. Bruce Hendrick, MD, once described his experience with the lesion. There are few surgeons who have been able to articulate their surgical vistas or instructive bon mots in quite the colorful but memorable terms as this founder of Canadian pediatric neurosurgery.
Bruce Hendrick was a rare Torontonian who was actually born in the city in which he practiced and resided. He was neurosurgeon-in-chief for 22 years at The Hospital for Sick Children.
Bruce brought originality to the daily conduct of pediatric neurosurgery, as typified by a question to a patient with a spinal cord tumor and paresthesia. He asked the patient if “your legs feel like ginger ale looks?” The Hendrick aphorisms will remain with students and residents longer than the logical sequences of thought that the rest of us teach.
Forever the generous Good Samaritan, Bruce opened his wallet and his home to a variety of old friends and new visitors. Newly arrived residents who had not yet found accommodations would be housed temporarily at Leggett Avenue. And, if later on one of them or their family suffered from a winter illness, they would likely find Bruce at their doorstep ready to reactivate his family practice skills.
Bruce had been part of the nascence and maturation of the specialty of pediatric neurosurgery. He was on the founding committees of the International Society for Pediatric Neurosurgery and the American Society of Pediatric Neurosurgeons. He was a past president of the Canadian Neurosurgical Society and was a board member of the AANS, which in 1998 honored him as the first recipient of the Franc D. Ingraham Lifetime Achievement Award.
Bruce’s greatest and lasting devotion was to his small patients. He brought joy to the children for whom he cared, and fatherly counsel to young parents seeking hope and reassurance.Women in Neurosurgery
This is the edited version of a story by Jamie Leigh Wells, MD, that appeared in the Fall 2001 Women in Neurosurgery News.
“So, have you met any other females on the neurosurgery trail?” he asked with a smirk while we sat in the generic conference room waiting to be called for our next interview.
To that I said, “Not yet. Why? Have you?” His response, was, as I would soon discover, anything but rare: “Yeah, I met one and she was crazy. You wanna know why? Because she talked.”
Initially, I was stunned. Could he possibly be serious? Sadly, yes. Having not encountered such attitudes when interviewing for medical school, I was surprised when I encountered them in pursuit of neurosurgical training. But I quickly realized that, while these situations were routine, their impact was absolutely within my control. Understanding this fundamental tenet early on made the remainder of the interview trail rather enjoyable. I began to revel in the acquisition of newer and funnier interactions. Ultimately, it taught me to remain true to myself and encouraged me to forge ahead with confidence and fortitude. I understood that the responsibility was mine to portray myself in the best possible light and focus on my record, a history that no one could dispute.
I have gleaned some useful insights that I would like to share: 1) It is necessary for women to be almost 5,000 percent certain of their ddecision or the end result might not be worth the means required to accomplish the goal. 2) There are gems among the adversarial masses who do wish you to succeed. 3) Women, more often than not, are compelled to be exponentially better than average. 4) Most importantly, be yourself and let no individual dissuade you from pursuing your dream.
Only as time passes and women assume more senior positions will the pendulum shift toward a ubiquitous solidarity that disposes of gender lines. Till then, quiet effectiveness is the most formidable defense.Section on Tumors
The following story by E.A. Chiocca, MD, PhD, of Massachusetts General Hospital first appeared in Tumor News.
A number of preclinical studies have showed promising anticancer effects by oncolyic viruses (OV). These are attenuated viruses that have been genetically mutated so that they will grow, destroy and spread only in glioma cells, sparing normal cells in the brain.
At least three Phase I clinical trials of such viruses have or are in the process of being completed for recurrent malignant glioma. One such trial, initially performed at the University of Alabama at Birmingham (UAB) and Georgetown University, stereotactically injected an OV (based on herpes simplex virus) into the brain tumor. Doses were escalated in serial cohorts of patients until the final group received a tumor dose of 3 x 109 infectious viruses. There were no serious adverse events attributable to the OV injection. Another type of herpes OV was injected into the brain tumors of patients in Glasgow, Scotland. In this trial, much lower doses of OV were used (105 infectious viruses) due to regulatory mandates. Again, no evidence of viral toxicity was reported.
As part of the NABTT (New Approaches to Brain Tumor Therapy) consortium, a trial of injection of a third type of OV (based on adenovirus) is being conducted at MGH, Emory University (Atlanta), Henry Ford Hospital (Detroit), UAB, Johns Hopkins, University of Texas (San Antonio) and Moffitt Cancer Center (Tampa). Twelve patients have been treated so far without serious adverse events attributable to the OV and additional patients are being enrolled to determine a safe dose for this particular OV.
The future of OV therapy seems promising because it could provide the oncologist with a weapon against these tumors that is completely different in its anticancer action than that displayed by current standard treatments. Clearly, the possibility of toxicities with these types of agents (brain inflammation, edema, meningitis or encephalitis) mandates careful analysis of results and characterization of non-toxic doses.
The future of OV therapy also includes: a) combining with standard radiation/chemotherapy, b) using intravascular routes (superselective catheterization) to administer the OV to multiple sites within the brain, and/or c) using increasingly more tumor-selective OVs. Since OVs have also been shown to possess the capacity of delivering anticancer genes, this strategy can also be used to augment their efficacy, at least in animal models.
Young Neurosurgeons Announce New Listserv Members of the Young Neurosurgeons Committee and CSNS Young Physicians Committee, as well as interested neurosurgery residents and fellows, can join this list to facilitate communication with one another. The discussion list will include information on upcoming activities, meetings, training and opportunities, as well as updated information on the “Young Neurosurgeons” and “Residents Corner” pages. To join the listserv, visit www.neurosurgery.org/listserv, select “Subscribe” and “Young Neurosurgeons” from the list. |
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