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Parkinson’s
Disease COVER STORY

It couldn’t be Parkinson’s. At 43, Ron Rutkowski was


sure he was too young for that neurological disease,
and as an outdoorsman and home builder, he was
more fit than most men his age. Yet when he reached
for a screw while hanging a door, his left hand froze;
he could not make his fingers do what they had done
thousands of times before.

“Everything’s getting
back to normal, and
that’s all I wanted.”
- RON RUTKOWSKI

Over the coming months, he crossed the state, seeing


several doctors, all offering the same diagnosis: his
trembling limbs, freezing muscles and shuffling gate
suggested he was in the early stages of Parkinson’s
ABOVE: A month after undergoing deep brain stimulation surgery, Parkinson’s patient
disease. Most offered little hope. Ron Rutkowski lifted his granddaughter, Ava, something he previously could do only
with great difficulty.
Closer to his West Michigan home, he found hope in
FRONT COVER: His head draped with a plastic sheet and clamped to the operating room
Saint Mary’s neuroscience program. Dr. Leslie Neu- table, Parkinson’s patient Ron Rutkowski undergoes deep brain stimulation surgery per-
man, a neurologist specializing in treating Parkinson’s, formed by Dr. Steve Klafeta, a neurosurgeon specialized in the procedure.
suggested he consider deep brain stimulation. Under Hoyt E. Carrier II | Copyright 2009 The Grand Rapids Press. All rights reserved. Used with permission.
the procedure, a surgeon drills two holes in a patient’s For more information about Rutkowski’s case, visit www.mlive.com and type “Ron
skull and inserts electrodes attached to a pacemaker- Rutkowski” in the search bar for a Grand Rapids Press story and audio slide show.
like generator implanted in the chest.

“Nobody’s drilling holes in my head,” Rutkowski said. brain, and two weeks later, Neuman turned on the gener-
ator, sending a low-voltage impulse, interfering with the
As his symptoms worsened, he reconsidered. In an abnormal electrical discharges that occur as dopamine
area of his brain called the substantia nigra, cells that declines.
produce dopamine, a neurotransmitter, were dy-
ing. Without enough dopamine, his brain could not In the months since then, Rutkowski’s life has returned to
smoothly coordinate his muscle movements. Only normal. He knows deep brain stimulation is not a cure,
about five percent of Parkinson’s patients – those but it helps buy time, setting back the disease maybe five
who are young, otherwise healthy, free of dementia years. By then, he hopes researchers discover other treat-
and respond well to medication – are candidates for ments, maybe a cure.
the surgery. Rutkowski was one.
“I can’t say enough about that whole hospital,” he said.
Saint Mary’s is one of the top deep brain stimulation “They’re just wonderful, wonderful people. All I can say is
centers in the Midwest, performing more of those everything’s getting back to normal, and that’s all I want-
procedures than most others. Dr. Steve Klafeta, a neu- ed. You forget what normal’s like until you lose it, and
rosurgeon, implanted the electrodes in Rutkowski’s then you regain it.”

2
Saint Mary’s Parkinson’s Clinic offers
patients a variety of services while Leslie Neuman, MD
Neurologist
participating in research to find bet- Medical Director, Parkinson’s Clinic
Education:
ter treatments. Services offered in the • University of Missouri School of Medicine
• Neurology residency, University of Iowa
new Hauenstein Center include neurol- During his first seven years in Grand Rapids, Dr.
Neuman practiced general neurology, then
ogy, geriatrics, psychiatry, nutrition, social began seeing more Parkinson’s patients who
needed specialized care. As their numbers
services and complementary therapies, as grew, the patients formed a support group, in-
vited Neuman to speak and asked him to serve
well as physical, occupational and speech on the Parkinson’s Association of West Michi-
gan board. Neuman was meeting a growing

therapy. Since 2004, Saint Mary’s has been need that continues today. In 2002, Saint
Mary’s opened the area’s only Parkinson’s
clinic, and Neuman, the area’s only physician
the area’s only hospital offering deep specialized in Parkinson’s, became its medi-
cal director. Treating Parkinson’s patients
brain stimulation, a type of surgery that takes a lot of time, he said, but he gives
each whatever time it takes. “I get a lot of
has fewer risks than traditional surgery. satisfaction,” he said, “because I can make a
difference in their lives.”

Steve Klafeta, MD
Neurosurgeon
Education:
• Loyola-Stritch School of Medicine
• Neurological surgery residency,
Loyola
Dr. Klafeta is the only surgeon in West
Michigan performing deep brain stimula-
tion surgery on Parkinson’s disease patients.
The procedure uses electrodes implanted
in the brain to alleviate tremors and muscle
freezing for many Parkinson’s patients, set-
ting back the disease five or more years.
Since joining Saint Mary’s in 2004, Klafeta
has performed more than 100 such surgeries
and also specializes in spinal reconstruction
surgery. In his third year of medical school,
he assisted in removing a blood clot from a
trauma victim’s brain. “I came home, woke
up my wife and said, ‘This is what I’m going
to do,’” he recalled. “People are coming in, and
LEFT: Dr. Leslie Neuman examines Parkinson’s patient they’re on death’s door, and you’re able to do
Barbara Schaible, two months after she underwent deep something about it. What drives me more now
brain stimulation surgery to relieve her symptoms. “Oh, is being able to help people who are in pain or
it’s been fantastic,” she said. “I love how I feel.” are debilitated.”
RIGHT: Dr. Steve Klafeta is the only neurosurgeon in West
Michigan who performs deep brain stimulation surgery
on Parkinson’s patients.

3
Saint Mary’s Health Care relies on an interdisci- Programs include:
plinary approach in treating neurological dis- • Amyotrophic lateral sclerosis
eases. Team members include nurses, thera- • Alzheimer’s disease and other
pists, social workers, nurse practitioners, case memory disorders
managers, pharmacists, physician assistants, • Epilepsy
administrators, support staff and physicians, • General neurology
all in the hospital’s new Hauenstein Center. • Multiple sclerosis
The one-stop approach is more convenient for • Neuro-ophthalmology
patients who need to see multiple specialists, • Neurosurgery
and it promotes easy interaction among phy- • Parkinson’s disease and
sicians and other staff members for consulta- movement disorders
tions. Saint Mary’s offers the latest advances in • Sleep disorders
treating neurological disorders while retaining • Spinal disease and injury
the trademark personal touch.
• Stroke
4
Saint Mary’s Model of Care
From admission to discharge, Saint Mary’s staff
follows a detailed plan to coordinate the care of
each patient and significantly reduce the chance for
medical errors. The Hauenstein Center promotes
an interdisciplinary approach centralizing
all neurological services in one place. Doctors,
nurses and other staff members can quickly share
information, and patients don’t have to wait long
periods or travel to see different medical providers.

All inpatient rooms are “acuity adaptable,” so


patients aren’t transferred to other units as their
conditions change. Fewer transfers improve
patient safety and care by minimizing the risk
of miscommunication. As shifts change, the staff
conducts bedside reports in the patients’ presence
to assure no information is lost during the handoff.

Saint Mary’s employs 18 certified neuroscience


nurses who undergo in-depth training in caring
for patients with neurological disorders. “This
has provided a level of neuroscience knowledge
for our nurses, which, in turn, has helped nurses
to identify subtle changes in our patients,”
Clinical Services Director Leanna Krukowski said.
“By recognizing subtle changes, we are able to
act quicker and with more evidence when
planning the best care for patients.”
5
Epilepsy
Saint Mary’s offers West Michigan’s
only multidisciplinary epilepsy
program, including an inpatient
monitoring unit. The program offers a Dr. Jürgen Lüders is

range of medical and surgical treatments the only neurosurgeon


in West Michigan
specializing in a type of
to alleviate and, in some case, eliminate surgery to alleviate and,
in many cases, eliminate
seizures caused by epilepsy. It is staffed epileptic seizures.

by nurses, neuro-monitoring technicians


and two epileptologists (neurologists
specialized in treating epilepsy) and a
Cleveland Clinic-trained neurosurgeon.
Saint Mary’s physicians and other specialists meet frequently Dr. Adriana Tanner exam-
to decide which epilepsy patients are candidates for a type of ines patient Rita Sarade
in Saint Mary’s epilepsy
brain surgery that in most cases eliminates their seizures. monitoring unit.

“Oh, it’s an excellent program,” Dr. Hans Lüders, an internation-


ally recognized epilepsy expert, said. He wrote the Textbook
of Epilepsy Surgery studied by neurologists all over the world.
Periodically, he travels from Cleveland, where he is director
of the epilepsy program at the Case Western Reserve School
of Medicine, to review cases with the Saint Mary’s physicians.

He sat next to his son, Dr. Jürgen Lüders, the Saint Mary’s neu-
rosurgeon who performs the operations on epilepsy patients. Dr. Muhammad
Some patients will be scheduled for surgery at Saint Mary’s. Al-Kaylani discusses
Those who need further study will be sent to Cleveland for a patient with other
Saint Mary’s epilepsy
a more precise type of monitoring in which electrodes are specialists.
surgically placed directly on the brain. Later this year, Saint
Mary’s plans to begin performing that type of invasive moni-
toring in Grand Rapids.

“It’s like a navigation chart,” telling doctors precisely where in


the brain the electrical disturbances originate, said Dr. Adri-
ana Tanner, medical director for Saint Mary’s epilepsy pro-
gram. Seventy percent of epilepsy patients can control their
seizures with medication. Half the remaining 30 percent are
candidates for surgery. In the three years since Saint Mary’s Dr. Hans Lüders points
began its epilepsy center, 82 percent of its patients who un- to an area of a patient’s
brain where epilepsy
derwent the surgery were free of disabling seizures – better seizures are believed to
than the national average of 70 percent. be originating.

6
Muhammad Majid Al-Kaylani, MD
Neurologist, Epileptologist
For most of his 21 years, Paul Wiersma’s life was ruled by
Education:
epilepsy. He couldn’t drive, became withdrawn, afraid a sei- • Kufa University College of Medicine, Iraq
zure would embarrass him. They began after he suffered a • Neurology residency, University of Iowa
closed-head injury Hospitals & Clinics
in a fall from bleach- • Neurophysiology and epilepsy residency,
Vanderbilt University
ers at the age of 3 ½.
Dr. Al-Kaylani’s greatest satisfaction is in seeing a pa-
He called them “pre- tient whose life was ruled by epilepsy leave the hospi-
tend tummy aches,” tal seizure-free. Patients with intractable epilepsy are
an intense feeling that admitted to Saint Mary’s epilepsy monitoring unit
would begin in his abdo- where Al-Kaylani isolates the source of their seizures.
In the past, epilepsy patients had few options, but
men, then spread, often recent advances in medication and surgery have
leaving his right side numb. greatly improved outcomes. “I find epilepsy is one
of the most treatable neurological conditions,” Al-
In third grade, he began tak- Kaylani said. “I feel happy for my patients. They
ing medication, and the sei- appreciate what we’re doing. Some of them
went years with seizures before they found
zures stopped. In tenth grade, someone who could stop their seizures.”
he suffered a grand mal seizure,
marked by violent shaking, and
ended up in the hospital. Af- Jürgen Lüders, MD
ter that, the milder seizures re- Chief of Neurosurgery
turned, sometimes three or four a Education:
• University of Chicago, Pritzker
day. While his classmates got driv- School of Medicine
ers’ licenses and dated, Wiersma • Neurosurgery residency,
rode the bus and stayed home. Cleveland Clinic
“I knew I was different from other Dr. Lüders is the only neurosurgeon in West
people,” he said. “I was very self- Michigan who performs a type of surgery to
control and, in most cases, eliminate epilep-
conscious about it. It was really
tic seizures. “A lot of patients, their lives are
hard going through high school.” turned around,” he said. “That’s what I love
about it. It’s wonderful.” As a key member of
His doctors prescribed medica- the Saint Mary’s neuroscience team, he also
tions without success. The end performs several other kinds of spinal and
brain surgeries. Saint Mary’s interdisciplinary
of his senior year, he was ad- approach attracted him here, Lüders said.
mitted to Saint Mary’s epilepsy “It takes a lot to build a program like this,”
monitoring unit, where he met he said. “To be able to do it all in one place
Dr. Adriana Tanner, a neurolo- makes it so much easier.”
gist and epileptologist. When
he sensed a seizure starting, he
pressed a button, alerting the Adriana Tanner, MD
Neurologist, Epileptologist
staff. Electrodes on his scalp Medical Director, Epilepsy Center
recorded his brain activity, isolating the source of the seizures in scar tissue
Education:
in the right temporal lobe. Since medication couldn’t stop the seizures, • Universidad Militar Nueva Granada Escuela
Dr. Tanner suggested he consider surgery. “After a lot of thought and Militar de Medicina, Bogota, Columbia
prayer,” he underwent the surgery, performed by Dr. Jürden Lüders, the • Neurology residency, University of
Kentucky Chandler Medical Center
only neuro surgeon in West Michigan specializing in that procedure. • Epilepsy fellowship, Cleveland Clinic

Since then, Wiersma has been seizure free. He is more outgoing, When she came to Saint Mary’s in 2006, Dr. Tanner
welcomed the challenge of heading the hospital’s
drives and makes friends easily. He is a senior and resident advisor new epilepsy center, the only one in West Michigan.
at his college and manages the university’s climbing wall, which She chose to become an epileptologist – a neurologist
he frequently climbs himself, a source of worry for his mother, specialized in treating epilepsy – because “I realized it
was a field where I can do quite a lot for my patients,” she
Nancy. But she knows it is one way her son is enjoying a world
said. “For some, the difference is enormous.” Epilepsy is “a
he avoided before the surgery. “He used to be the kind of kid very lonely condition,” she said. “They can’t drive. They can’t
who walked around with a black cloud over his head,” she said. get jobs. They lose their independence.” Most patients who
“Now the cloud is gone, and he’s got a smile on his face, and come to the epilepsy center are able to control their seizures
with medication. For others with intractable epilepsy, surgery
he’s embracing life.” is the best option. Unfortunately, some patients suffer in silence,
unaware treatment is available. “It’s sad for me to look at patients,
and they’ve had epilepsy for 20 years,” Tanner said. “Don’t wait.
PHOTOS ABOVE: Before undergoing brain surgery at Saint Mary’s, epilepsy
Send them to me.”
patient Paul Wiersma would not have dared climb the rock wall he manages
at Davenport University.
7
Amyotrophic Lateral
Sclerosis (ALS)
Saint Mary’s Health Care, in
partnership with Mary Free Bed
Rehabilitation Hospital and the
Michigan State University College Deborah Gelinas, MD
Neurologist
Medical Director, ALS Clinic
of Human Medicine, operates and Clinical Neuroscience Research
Education:
a comprehensive center • New York Medical College, Valhalla, NY
• Neurology residency, Letterman Army
dedicated to diagnosing and Medical Center, San Francisco
When she left the California Pacific Medical Center
treating ALS, also known as Lou in San Francisco to join Saint Mary’s, “I thought I
was leaving the best place in the whole world to
Gehrig’s disease. The center is treat ALS patients,” Dr. Gelinas said. “We’re recre-
ating that here.” The clinic is the only one in West
the 38th in the country certified Michigan dedicated to treating amyotrophic lateral
sclerosis patients. Gelinas, a nationally recognized

by the Muscular Dystrophy expert on the disease, has written numerous arti-
cles and two books about it. When she was 10, her
younger sister suffered a stroke, leaving her para-
Association. With an affiliated lyzed on the right side. “She is an incredible human
being,” Gelinas said. “When that experience hap-
clinic on the MSU campus in pens to you, all you can do is be resilient. That in-
fluenced me in working with chronic, debilitating
East Lansing, the center offers a diseases. I’m really committed to resiliency in the
face of neurological disease.”

team of professionals, including


physicians, nurses, occupational
therapists, speech and language
pathologists, dietitians and
respiratory therapists.

ALS is a progressive degenerative


disease that attacks nerve cells in
the brain and spinal cord. While
there is no cure, the center offers
treatments improving the quality
of patients’ lives. Dr. Deborah Gelinas with ALS patient Al Garcia.

8
LEFT: Dr. Deborah Gelinas
listens to Lynn Cooper, whose
paralysis is believed to be caused by ALS.

RIGHT: Gelinas tests ALS patient Al Garcia’s reflexes.

After he was diagnosed with amyotrophic lateral sclerosis, was hoping for similar good news. Like most neurological
Al Garcia drove 2 ½ hours to the nearest clinic specialized diseases, there is no definitive test for ALS. It’s a clinical
in treating the neurodegenerative disease. Then two years diagnosis based on a collection of symptoms. While ge-
ago, Saint Mary’s Health Care, Mary Free Bed Rehabilita- netics may play a part, the majority of ALS patients have
tion Hospital and Michigan State University opened West no family history of the disease. There is no cure.
Michigan’s only ALS clinic 20 minutes from his home. “This
was a Godsend,” he said, sitting in an exam room. “I’d be
foolish to drive 2 ½ hours, and you get to know these “I have a lot of hope.
people more personally. That’s important.”

Garcia, a former high school science teacher and now an


I’ve got a lot to live for.”
- LYNN COOPER
adjunct professor of anatomy and physiology, knows ALS
(also known as Lou Gehrig’s disease) is incurable, although “I don’t know what people with ALS would do without
research is promising. Short of a cure, “slowing down the this clinic,” Cooper said. “I have a lot of hope. I’ve got a lot
relentless progression of the disease” could improve the to live for. I’m asking for at least 18 more years to get my
quality and extend the lives of ALS patients, said Dr. Deb- baby grown up.”
orah Gelinas, who heads the clinic. “I really bring a holistic
view – which is kind of the old-time medical view – to a Gelinas and the rest of the staff encourage their patients
specialty clinic,” she said. to have hope, despite the grim prognosis.

She finished examining Garcia and said, “The good thing “As an individual, I could offer very little,” she said, “but,
is you’re stable. No doubt about it. That’s great.” as part of a team, I can offer hope.” As for the patients,
“these are incredible people,” Gelinas said. “It’s a privilege
Across the hall, Lynn Cooper, a 37-year-old mother of four, to care for them.”
9
Neuro-Ophthalmology
A finger puppet is not the most
high-tech device Dr. Christopher
Glisson uses in his practice,
but it was an essential tool in
examining Lillyanna Marrero
Brander’s eyes.

“Can you follow him with your


eyes?” he asked, and the 2-year-
old obliged. “You are doing a
great job,” he told her.

After the exam, he assured her


mother, Jaclyn Brander, that, Dr. Christopher Glisson, a neuro-ophthalmologist, examines the eyes of 2-year-old Lilly-
anna Marrero Brander, while her mother, Jaclyn Brander, holds her.

contrary to a pediatrician’s
Christopher C. Glisson, DO
concern, her daughter showed Medical Director, Neuro-Ophthalmology
Education:
no signs of neurofibromatosis, a • Michigan State University College of
Osteopathic Medicine
disease characterized by tumors • Neurology residency, Michigan State
University
and neurological disorders. • Neuro-Ophthalmology fellowship,
University of Pennsylvania
Dr. Glisson is a practitioner of an unusual sub-
specialty – neuro-ophthalmology – that uses a
As the area’s only neuro- patient’s eyes as windows to illnesses through-
out the body. “We can look through the eye and
ophthalmologist, Glisson is see a piece of the brain,” Glisson said. “We can
interpret what we see to tell us what’s going on
elsewhere.” In 2007, Glisson returned to his West
trained to diagnose a variety of Michigan roots after completing his Ivy League
training at the University of Pennsylvania. He is
diseases – including multiple the only neuro-ophthalmologist practicing in
West Michigan and among only 400 academic
sclerosis, hypertension, diabetes neuro-ophthalmologists nationwide.

and tumors – by examining a


patient’s eyes.

10
“It was incredible.
I feel normal.” - BRIAN KEY

Grand Valley State


University student Brian Key’s vision
was restored after Saint Mary’s doctors removed a pituitary tumor.

Brian Key was going blind. It began in the failing eyesight. An MRI confirmed “The biggest thing is it was so close to
his left eye, narrowing his peripheral vi- the tumor was pressing on the optic home. There’s not a whole lot of places
sion, then spreading rapidly to his right chiasm, the intersection of the optic that have the medical knowledge to
eye. His eye doctor confirmed the nar- nerves. The tumor also appeared to be do that.”
rowing field of vision, but could find bleeding, and that could be fatal.
nothing wrong with the high school Glisson is among only seven neuro-
senior’s eyes. Neither could a glauco- Glisson walked down the hall and con- ophthalmologists in Michigan and the
ma specialist, nor a retina specialist. sulted with Dr. Jürgen Lüders, a neuro- only one practicing in West Michigan.
surgeon. Less than 24 hours after the For Brian Key, Glisson’s training not
That’s because the problem wasn’t in tumor was found, Lüders removed it. only restored his vision, but might
Key’s eyes; it was in his brain. Dr. Chris- Key’s vision immediately returned to have saved his life.
topher Glisson, a neuro-ophthalmol- normal. “It was amazing how it all lined
ogist at Saint Mary’s Health Care, im- up, that I was able to have the surgery “It was incredible,” Key said. “I feel nor-
mediately suspected a pituitary tumor within 24 hours after they found it mal. Most people wouldn’t even think
at the front of Key’s brain was causing out,” said Key, now a college freshman. that I’d had brain surgery.”

11
Alzheimer’s Disease and
Memory Disorders
Saint Mary’s Alzheimer’s Disease and Memory Kevin Foley, MD
Medical Director, Saint Mary’s Alzheimer’s
Disease and Memory Disorders Program
Disorders Clinic, the only one in West Education:
• Medical College of Virginia
Michigan, offers a holistic approach to • Internal Medicine residency, University of
Michigan Hospitals
care, addressing each patient’s physical and • Geriatric medicine fellowship, University
of Michigan Hospitals
emotional needs. Its services include diagnosis, Dr. Foley had a good reason for opening an
Alzheimer’s Disease and Memory Disorders
patient and family counseling, referral to Program at Saint Mary’s six years ago. “Nobody
else was doing it,” he said. “It was a huge need.”
other agencies and support groups, mood As the population ages, the need will become
greater and the search for better treatments

and behavior management, and research. more urgent. His recent faculty appointment at
the Michigan State University College of Human
Medicine opened the door for collaboration
The multi-disciplinary team includes a between the medical school and Saint Mary’s.
Foley hopes to inspire medical students to join
geriatrician, neuropsychologist, nurse, social the battle against memory disorders. “I looked at
what I was doing at Saint Mary’s, and I was taking
worker, pharmacist and other specialists. care of a landslide of people,” he said. “I wasn’t
making enough of an impact. As division head
of geriatrics (at MSUCHM), I will be able to teach
what I know.”

12
Janice Gwasdacus sat in an exam room, not as the pa-
tient, but the caregiver. On her right was her mother,
Nancy Crowley, in the early stages of Alzheimer’s, on her
left, her father, James Crowley, in the advanced stages of
the same disease. Alzheimer’s, like other neurological dis-
eases, afflicts not just the patient, but the entire family.

Dr. Kevin Foley, medical director for Saint Mary’s Alzheim-


er’s Disease and Memory Disorders Clinic, entered and
grasped Nancy Crowley’s hands, tested her strength and
reflexes, then asked a series of questions to assess her
cognitive abilities.

“She still participates in family celebrations,” Gwasdacus


told Foley. “She still has a sense of herself.” Not so her
father. He dozed in his wheelchair, seemingly oblivious
to his surroundings. “This is pretty typical of him,” Gwas-
dacus said. “We do not attempt to bring Dad to family
celebrations anymore.”

“We’re looking at the


quality of life for the
patient and the family.” TOP: Dr. Kevin Foley opened Saint Mary’s
Alzheimer’s Disease and Memory Disor-
- DR. KEVIN FOLEY ders clinic six years ago.

BOTTOM: Foley meets with Alzheimer


Alzheimer’s is a cruel disease, stealing the essence of a patient Nancy Crowley and her daugh-
ter, Janice Gwasdacus.
person. “We have every service you’d find at Mayo (Clinic)
or the University of Michigan,” Foley said. “We’re looking OPPOSITE PAGE: Foley examines Al-
zheimer’s patient James Crowley,
at the quality of life for the patient and the family” since whose wife, Nancy, suffers the same
there is no cure. Because Alzheimer’s generally is a dis- disease. Their daughter, Janice, sits
ease of the elderly, a drug that delayed onset even five between them.
years could reduce its incidence by half, Foley said.

“Ultimately what we want to find is a disease-modifying


drug that puts it in remission,” he said. Until that drug is
found, the number of patients is expected to rise as the
baby boom generation ages.

“Unfortunately, it’s a growth industry,” Foley said. Since


the clinic’s first year, the number of patients has grown
exponentially. Still, he takes his time with each patient.

“What would you like to be able to do that you don’t do


now?” Foley asked another patient, Helen Ruth Wilson.

“I like crafts,” she said. He urged her to take up the hobby.


“You need to get involved,” he said. “You’re doing great.”

13
Neurosurgery
Saint Mary’s comprehensive
neurosurgery program
encompasses a range of nerve,
spinal and brain procedures. The
hospital’s two neurosurgeons, both
tops in their fields, also perform
deep brain stimulation surgery for
Parkinson’s patients and temporal
lobe surgery for epilepsy patients,
procedures available nowhere
else in the area.

While Dr. Steve Klafeta and Dr. Jürgen Lüders per-


form most of the neurosurgery, other physicians,
including orthopedic surgeon Dr. Scott Russo
and neurosurgeons Dr. Robert Seledotis and Dr.
Lynn Hedeman, frequently operate on patients at
Saint Mary’s.

Advances in computers and electronics provide


the surgeons more-precise images of the brain.
New treatment options permit minimally inva-
sive spine surgery to repair fractures and treat
TOP: Dr. Steve Klafeta meets with a patient about to undergo surgery to repair
a spinal cord compression caused by a cyst.
degenerative disc disease, disc injury and mis-
aligned vertebrae, allowing patients to recover
BOTTOM: Dr. Scott Russo, an orthopedic surgeon, (left) and Dr. Jürgen Lüders more quickly.
discuss a case during a weekly spine conference.

OPPOSITE PAGE: Hoyt E. Carrier II | Copyright 2009 The Grand Rapids Press. All rights
reserved. Used with permission.

14
15
Shelley Freimark, MD

Spine Service
Physiatrist, Spine Center
Education:
• Wayne State University School of Medicine
• Physical medicine & rehabilitation
residency, Sinai Hospital, Detroit
Dr. Freimark’s goal is to alleviate her patients’ pain and
help them lead a normal life. “Some patients have sat
around for months with this pain by the time they come
in,” she said. Some have been injured in auto accidents
or on the job. Others have arthritis, herniated disks, Saint Mary’s Spine Service relies on
spinal stenosis or other degenerative conditions. In
each case, Freimark and a team of physical therapists,
pain management specialists, orthopedic surgeons,
physicians from seven specialties
neurologists, social workers and psychologists try to
alleviate or eliminate the pain with medication and
and a host of other medical profession-
physical therapy. “Our goal is to avoid surgery and
determine when it is necessary,” she said. “You take als to deliver the best care. The Outpa-
someone with extreme pain, and you get them
back to no pain.” tient Spine Clinic evaluates and treats
degenerative conditions, such as arthri-
Teri Holwerda
Nurse Practitioner, Spine Center tis, spinal stenosis, slipped vertebrae and
Education:
• Master’s degree in nursing, Grand Valley
degenerative disc disease, as well as trau-
State University, Grand Rapids
• Doctoral candidate in nursing, Michigan
matic conditions, such as spinal fractures,
State University
Holwerda and other specialists regularly hold
dislocations and herniated discs.
spine conferences to discuss cases. “It’s this re-
markable thing where all these providers come
together and talk about spine cases,” she said. The team includes physiatrists, neurologists, neurosurgeons, or-
“It’s an open forum where I can ask, ‘Am I miss-
ing something?’” That interdisciplinary approach
thopedic surgeons, psychologists, radiologists, internal medi-
continues outside the conferences. If she needs cine specialists, pain specialists, nurses and nurse practitioners.
to consult with a neurologist, she walks down the
hall. That hallway goes both ways. A neurologist Saint Mary’s also collaborates with rehabilitation specialists at
can refer a Parkinson’s patient suffering back pain Mary Free Bed Rehabilitation Hospital. The approach always is
to the spine center. “I love my patients,” Holwerda
said. “I love the intellectual challenge of figuring
conservative and the goal to find the least invasive treatment
out what’s going wrong. And I love watching a possible, with surgery recommended only when necessary.
patient get better over time. It’s very satisfying
to know you got someone back on their feet and Saint Mary’s is the leading West Michigan hospital offering
functioning again.” minimally invasive spine surgery, which allows faster recov-
ery, less post-operative pain and shorter hospital stays.

LEFT: Dr. Shelley Freimark is a physiat-


rist specialized in treating spinal dis-
ease and injuries.

RIGHT: Nurse practitioner Teri Holw-


erda prepares to review the file of a
patient suffering severe back pain.

16
Neuro-Rehabilitation
She was an athlete, swam three miles a day, water skied
and could dive 100 feet down without breathing equip-
ment. At the age of 58, she drove in a demolition derby.
That was one month before a stroke left her paralyzed
on the left side.

“Anything dangerous I love,” Betty Vreeman said. “I was


very physically fit.” Her challenge these days is in learn-
ing to walk or rise from a chair without falling. Her neu-
rologist, Dr. Leslie Neuman, recommended she work
on those skills with Judy Overmyer, a physical therapist
whose office is just down the hall from his in the Saint
Mary’s neuroscience program.

“OK, we’ve got to do some fun stuff today,” Overmyer


said. She helped Vreeman rise, step onto a small plat-
form and face a large, flat-panel television. For the next
several minutes, Vreeman played a Nintendo Wii game,
helping her improve her balance and twirl a virtual hula
hoop. “I was a champion,” she said, swiveling her hips.
“This is great. I’m excited.”

“You did very well,” Overmyer assured her.

Nearby, other therapists worked with patients, help-


ing them regain skills most of us take for granted. “The
multi-disciplinary model is an awesome experience for
the patient,” said James Hartlein, a physical therapist
and manager of rehabilitation services. With several
specialists all in one place, “we’re able to move things
along much quicker,” he said.

Patients include those with Parkinson’s, multiple sclero-


sis, back and neck pain, stroke and Alzheimer’s. Speech
therapist Kimberley Paszkowski helps patients who are
having trouble with speaking and swallowing. Occupa-
tional therapists also are available to help patients re-
learn basic life skills.

Before her stroke, Vreeman, with a doctorate in leader-


ship, was a community development consultant, work-
ing with clients all over the world.

“Hopefully, I’ll be able to work again,” she said.

TOP: Kerwin Koetje exercises the muscles in his right arm and shoulder, weakened
from disuse due to a pinched nerve in his neck.

BOTTOM: Stroke patient Betty Vreeman, assisted by physical therapist Judy Overmyer,
plays a Nintendo Wii game to help regain her balance.

17
Neurologic
Sleep Disorders
They come in hoping for a good night’s sleep. This is not
a hotel, but a Saint Mary’s hospital unit with 10 rooms
equipped to diagnose a variety of sleep disorders.

In a monitoring room at the sleep disorders center


Dr. Joseph Krainin studied a computer screen show-
ing a polysomnogram, a sleep study for a patient
who had spent a night in one of the rooms across
the hall. The screen showed several physiological
changes that occurred during the patient’s stay.
Squiggly lines traced the brain wave activity. Oth-
er sensors monitored the patient’s blood oxygen
content, respiration and heart rate. A microphone
picked up snoring, and a video camera recorded
movement. Combined, those changes would help
Krainin diagnose the precise disorder disrupting
the patient’s sleep.

“It’s such a young field – it’s


really just coming into its own.”
- DR. JOSEPH KRAININ

“Sleep fundamentally is a neurological process,”


he said, and essential for overall health. Yet it has
not always received the attention given to other
neurological disorders, a void Saint Mary’s is filling.
Many patients are unaware their daytime fatigue is
caused by sleep disorders, such as sleep apnea, rest-
less legs syndrome, narcolepsy, sleep walking, sleep
talking, and circadian rhythm disorder, said Dr. Mu-
hammad Al-Kaylani, another Saint Mary’s neurologist
specialized in treating sleep disorders. A doctor can
prescribe a range of treatments, including medication,
a continuous positive airway pressure (CPAP) machine
and lifestyle changes.

Sleep disorders are exceedingly common, afflicting


some 30 million Americans and exacting a heavy toll on
patients and a drag on the economy due to lost produc-
tivity. “The more we learn, the more we study this, the
more we realize this is problematic,” Krainin said. “It’s such a
young field – it’s really just coming into its own. I hope I can
bring more awareness of it to the Grand Rapids community.”
Dr. Joseph Krainin reviews a patient’s sleep study.

18
Dr. Muhammad Al-Kaylani, specialized in treating
epilepsy and sleep disorders, discusses a case with
colleagues.

Joseph Krainin, MD
Neurologist
Education:
• Tufts University School of Medicine,
• Neurology residency, Kaiser Los Angeles
Medical Center
• Sleep disorders fellowship, University of
Michigan Hospitals
Growing up in the Boston area, Dr. Krainin was
only vaguely aware of Grand Rapids when he
accepted a job at Saint Mary’s. “I really pictured
some declining Michigan industrial town,” he
said, so he was surprised when he saw the
vibrant city with its growing medical com-
munity, particularly the new Hauenstein Cen-
ter at Saint Mary’s Health Care. “At that point,
I realized I had fallen in love with Grand Rapids
and the hospital and the people running the
hospital,” he said. As a new member of the
Saint Mary’s staff, he practices general neurol-
ogy and specializes in sleep disorders. “Neurol-
ogy,” he said, “is a very cerebral field – no pun
intended. It is very demanding.” And very re-
warding when he can help patients suffering a
variety of sleep disorders.

19
Stroke, Emergency
and Critical Care
Saint Mary’s offers a variety of
services to tackle stroke, the nation’s
third leading cause of death behind
cardiac disease and cancer. The
interdisciplinary approach
emphasizes speed, efficiency and the
latest technology to minimize damage,
promote rehabilitation and avoid a
recurrence. The Joint Commission
on Accreditation of Healthcare
Organizations has designated Saint
Mary’s a Primary Stroke Center in
recognition of its efforts to improve
outcomes for stroke patients.

Muhammad Farooq, MD Darryl Varda, MD


Vascular Neurologist Neurologist
Education: Education:
• Punjab Medical College • University of Iowa
Faisalabad, Pakistan • Neurology residency,
• Neurology residency, Sparrow University of Iowa Hospital
Hospital, Lansing and Clinics
• Stroke fellowship,
Michigan State University Dr. Varda has seen a lot of progress
in treating strokes in recent years.
As a member of the Saint Mary’s “There’s a lot of technology that
stroke team, Dr. Farooq works closely can give us answers we never had
with the emergency department before,” he said. Stroke remains the
physicians, making sure patients
leading cause of disability and the
arriving with stroke symptoms are
third leading cause of death in the
quickly diagnosed and treated. If a
United States, after heart attack and
CT scan shows a patient is having
an ischemic stroke – the most com- cancer. Saint Mary’s is participating in
mon type in which a vessel in the a study into the benefits of educat-
brain is block by a blood clot – a drug ing emergency physicians to admin-
promptly is administered to dissolve ister clot-busting drugs within 4 ½
it and minimize damage. Having the hours after the onset of symptoms.
emergency department in the same “The problem is getting people here TOP: Dr. Farooq checks stroke patient Sandy Drent’s coordination.
building as the neuroscience pro- within that window,” Varda said. MIDDLE: Dr. Varda tests the coordination of patient Dorothy Grigsby,
grams “is very helpful,” Farooq said. “They get a tingly hand, and they de- while her daughter, Dawn Griffin, watches from a nearby chair.
“We can be there in a few minutes. cide to go to bed and see how it is
BOTTOM: Dr. Emily Gualtieri, medical director of the critical care
This is the unique thing in the Hauen- in the morning, which is outside the
unit, talks with Mirian Mejias, mother of patient Pedro Mejias, who
stein Center: all these specialists are window of opportunity.” was injured in an accident.
in the same place.”

20
The neurology team meets with patient
Evelyn Holst during morning rounds.

This is when speed matters. A patient arrives in Saint and “acuity adaptable,” so patients are not moved as
Mary’s emergency and trauma department suffer- their conditions change. Fewer moves means fewer
ing a possible stroke. At the moment the patient felt chances for miscommunications and errors, and is
the first symptoms, a clock began ticking, giving the more comforting for patients.
stroke team only a few hours to confirm a blood clot is
causing the stroke and administer a drug to dissolve it.

The patient is rushed to the CT scanner in Saint Mary’s


“I get calls from people in
new emergency and trauma department inside the
Hauenstein Center. A radiologist reads the scan, de-
other states asking, ‘How
termining if it is an ischemic stroke, the most common
type, in which a clot is blocking blood flow to the did you pull this off?’”
- MICHELLE PENA
brain. The emergency doctor consults with a neurolo-
gist one floor above the ER. If the stroke is caused by a
clot, a drug immediately is administered to dissolve it. “I think the biggest improvement is having families
present during bedside rounds,” allowing them to ask
“We’ve done as much as we can to get this process go- questions and become acquainted with the staff, said
ing as soon as possible,” said Dr. Michael Olgren, medi- Dr. Emily Gualtieri, medical director for the critical care
cal director of the emergency and trauma department. unit. That kind of coordination was central to the de-
sign of the Hauenstein Center.
If admitted, the patient won’t have far to go from the
emergency and trauma department. All 32 patient It improves patient care from the moment they arrive
rooms in critical care and the 30 rooms in the neu- until they are discharged, said Michelle Pena, clini-
rological unit are close by in the Hauenstein Center. cal services director. “I get calls from people in other
All are private, large enough to accommodate families, states asking, ‘How did you pull this off?’” she said.

As medical director for Saint Mary’s emergency Michelle Pena, clinical services director for Dr. Darryl Varda (right), a neurologist, and Dr. Zamir
and trauma department, Dr. Michael Olgren is a emergency, trauma and critical care, confers with Podgorica, a hospitalist, discuss a case. Hospitalists
key member of the hospital’s stroke team. Dr. Olgren. are important members of the Saint Mary’s team,
21 providing around-the-clock care for inpatients.
Multiple Sclerosis
At first he thought little
about the tingling and The letters went out last fall invit-
numbness in his feet,
although somewhere
ing the area’s multiple sclerosis
in the back of his mind, patients to an open house an-
Dave Veltema won-
dered: could this be nouncing a new service at Saint
multiple sclerosis? His
younger brother had Mary’s Health Care. No longer
been diagnosed with MS
years earlier and eventu-
would they have to drive all
ally used a wheelchair. over or as far away as Detroit to
MS generally is not regarded as hereditary, although, like get the comprehensive care
many neurological diseases, it might have a genetic com-
ponent. In the spring of 2005, after Veltema suffered a sei- necessary to keep their disease
zure, a neurologist diagnosed him with probable MS. Sei-
zures are not typical symptoms of MS, but its indications in check. Saint Mary’s multiple
and progress vary widely, making it difficult to diagnose.
Symptoms often include fatigue, numbness, tingling, loss
sclerosis clinic, following the
of balance, slurred speech, tremors and stiffness. model of its other neuroscience
MS is believed to be an auto-immune disease in which
the body attacks myelin, the insulation protecting nerves
programs, offers an interdisci-
in the brain and spinal cord. It is not fatal, but can be plinary approach, allowing MS
disabling.
patients to see various special-
“It was scary,” Veltema recalled, particularly because he
had seen how rapidly it had progressed in his brother. He ists and get necessary tests in
visited an MS clinic in Detroit 150 miles away.
one place and in one visit. The
Last fall, Veltema received a letter announcing Saint Mary’s
was opening a clinic for MS patients and decided to give clinic, a leader in West Michigan,
it a try. “I was impressed,” he said. “If I come in and have an
issue with my eyes or my balance, I don’t have to drive all
is led by Dr. Deborah Gelinas
over town. The fact that it’s all here makes it easier.” and Dr. Christopher Glisson, both
That was the idea when Dr. Deborah Gelinas proposed highly experienced in diagnosing
creating the clinic, said Dr. Christopher Glisson, who helps
her run it. When he and Gelinas hosted an open house and treating MS.
announcing the new clinic, they expected 35 MS patients
might attend. Instead, more than 100 showed up.
PHOTO: Patient David Veltema talks about his
“I think the greatest value for the patient is the opportu- experience at Saint Mary’s during a routine visit.
nity to come to a facility that addresses every aspect of
their disease, from diagnosis to treatment to managing
the symptoms that affect their quality of life,” Glisson said.
“That’s the benefit of that multi-disciplinary approach.”

22
Education
After following Dr. Deborah who also is on the school’s faculty. Not only does Saint
Gelinas on her rounds one Mary’s help educate new doctors, he said, but “the
morning, medical student benefit to the community of Grand Rapids is we have
Brian Holowecky decided the opportunity to access and utilize the resources of a
to consider neurology as a huge university.”
specialty. “I was able to gain
Holowecky, in his second year of medical school, has
some insight on her ap-
plenty of time to choose a specialty, but neurology is
proach, her philosophy of
high on his list. So is the related field of physiology. “I’m
medicine, her compassion very interested in long-term health and the holistic ap-
with patients,” he said. “It proach, which is what drew me to neurology and physi-
was a very enjoyable expe- ology,” he said.
rience, very eye opening.”
At Saint Mary’s, he saw a well-organized clinic, and he
That’s a major part of Saint Mary’s mission: training to- was impressed with the team approach. “I think that’s
morrow’s physicians who will care for tomorrow’s pa- so important for the patients, to have that team work-
tients. Saint Mary’s partnership with the Michigan State ing on their side,” he said. “I want a job where I can
University College of Human Medicine, particularly as make a difference. I don’t want to work in an office and
MSU prepares to open its new medical school head- make a paycheck. That’s why I’m happy to be in medi-
quarters in Grand Rapids, is mutually beneficial, said Dr. cal school, to have a skill to help others. The money will
Christopher Glisson, one of the hospital’s neurologists, come. I choose not to spend my life worrying about it.”

Michigan State University’s College of Human Medicine


in 2010 will move from its temporary building in Grand
Rapids (foreground) to its new headquarters a block away.
23
Research
Dr. Deborah Gelinas is Saint
A few blocks from Saint Mary’s Health Care, scientists an- Mary’s Director of Clinical
alyze blood samples from Parkinson’s patients, looking Neuroscience Research.
for genetic clues that might help unravel the degenera-
tive disease. The research is a partnership of Saint Mary’s,
the Van Andel Institute and Michigan State University. tients, we could
not impact hu-
It is one of several studies Saint Mary’s has joined in the man health,” said
search for better treatments of neurological diseases, in- Jeff MacKeigan,
cluding Alzheimer’s, epilepsy, multiple sclerosis, stroke PhD, a Van Andel
and amyotrophic lateral sclerosis (also known as Lou scientific inves-
Gehrig’s disease). “That’s the point of medical research: tigator. Dr. Leslie Neuman, a Saint Mary’s neurologist
to find something better,” said Brian Berryhill, PharmD, specializing in Parkinson’s, provides blood samples for
who oversees clinical research for Saint Mary’s neurosci- the Van Andel scientists to analyze. The institute will be
ence programs. the repository for blood and tissue samples from Saint
Mary’s patients, which could hold clues to other neuro-
logical diseases, said James Resau, PhD, deputy director
“Saint Mary’s is really, clearly for special programs at the Van Andel Institute.

Michigan State University, due in 2010 to open its new


invested in the neurosciences” College of Human Medicine building across the street
- JACK LIPTON from the Van Andel Institute, is joining the partner-
ship by moving an elite team of Parkinson’s researchers
The research could produce more clinical trials and new from the University of Cincinnati to Grand Rapids. They
treatments for Saint Mary’s patients. “We all work to- are bringing a $6.2 million National Institutes of Health
gether to accomplish this,” said Susan Hoppough, PhD, grant. If not for the Van Andel Institute’s labs and Saint
RN, Saint Mary’s director of research and innovation. Mary’s patients, the researchers and their grant likely
“One institution alone can’t do it.” would not be coming, said Jack Lipton, a member of the
team. “Saint Mary’s is really, clearly invested in the neuro-
Saint Mary’s has something the Van Andel Institute and sciences,” he said. “If we can’t cure their disease, we can
most other research facilities lack. “We could be doing at least help patients outlive it. It’s an extremely difficult
world-class research here, but without access to pa- area to work in, but it’s going to pay off eventually.”

Saint Mary’s doctors and Van Andel Institute scientists Jack Lipton, PhD, a professor in the Michigan State Univer- Susan Hoppough, PhD, RN, Saint Mary’s director of re-
plan to expand their joint research beyond Parkinson’s sity College of Human Medicine, discusses his Parkinson’s search and innovation, oversees the hospital’s participation
into other neurological diseases, said James Resau, PhD, research with Saint Mary’s doctors and administrators. in many clinical trials in the search for better treatments.
the institute’s deputy director for special programs.
24
Saint Mary’s physicians are collaborating with re-
searchers at other institutions in the search for bet-
ter treatments and, perhaps, cures for several neu-
rological diseases.

Dr. Deborah Gelinas is participating in a study,


based at Massachusetts General Hospital, to
determine whether the drug ceftriaxone can
protect motor neurons in the brains and spinal
cords of patients with amyotrophic lateral scle-
rosis (also known as Lou Gehrig’s disease).

Dr. Christopher Glisson is participating


in a study to learn whether early treatment
with the drug glatiramer acetate can reduce
the risk of patients with optic neuritis from
developing multiple sclerosis.

Glisson also is helping conduct a study


of whether men who took the drug PDE5
inhibitor for erectile dysfunction had an
increased risk of developing non-arte-
ritic anterior ischemic optic neuropathy,
sometimes called a “stroke of the optic
nerve,” which can result in vision loss.

Gelinas, Glisson, Dr. David Kaufman


and Dr. Muhammad Farooq are par-
ticipating in a study of whether the drug
teriflunomide can reduce the risk of pa-
tients who display early symptoms of
multiple sclerosis from developing clini-
cally confirmed MS.

Gelinas, Glisson, Kaufman and


Farooq also are participating in a study
of whether the same drug can reduce re-
lapses in patients diagnosed with MS.

Dr. Adriana Tanner is helping conduct a


study of the effectiveness and safety of the
drug brivaracetam in controlling epileptic
seizures.

Dr. Leslie Neuman is helping conduct a


study of the drug Preladenant (SCH 420814)
in controlling dyskinesia, a side effect caused
by other drugs in patients with moderate to
severe Parkinson’s disease.

Dr. Kevin Foley is participating in a study of


whether the drug PF 04494700 can slow the
decline in patients with mild to moderate Al-
zheimer’s disease.

Dr. Michael Olgren and Dr. Darryl Varda are


participating in a University of Michigan study into
the benefits of educating emergency physicians to
administer clot-busting drugs within 4 ½ hours after
the onset of stroke symptoms.
Brian Berryhill, PharmD, oversees research
for Saint Mary’s neuroscience program.

25
Neuro-Radiology
Without advanced imaging, much
of what happens in the Saint Mary’s
neuroscience program would not be
possible. That’s why the staff relies
on a team of highly trained radiolo-
gists to interpret the detailed images
created with the most advanced
MRI, CT and PET-CT machines. “Oh,
the technology has grown by leaps
and bounds the last few years,” Dr.
Zdravko Skrtic, an interventional radi-
ologist, said, examining images of a
patient’s brain on two large monitors.

The hospital’s new PET-CT combines two types of imaging


– computed tomography and positron emission tomogra-
phy – to create highly detailed pictures of patients’ brains.
The CT uses X-rays to create a three-dimensional image.
The PET looks at the metabolic activity of cells. Com-
bined, the two images help the radiologists identify areas
of increased or decreased metabolic activity in patients’
brains. A decrease could indicate Alzheimer’s. An increase
might be due to cancer.

PHOTOS: Dr. Christopher Massin, a radiologist, meets with epilepsy specialists


to discuss candidates for neurosurgery (top photo). Radiologist Dr. Zdravko
Skrtic examines a patient’s brain scans (second photo from top). Technologist
Joel Bakos operates the hospital’s new PET-CT scanner (middle photo). Skrtic
prepares a patient for an MRI (second photo from bottom). Bakos readies the
PET-CT scanner for the next patient (bottom photo).

26
Neuro-Diagnosis
After an initial examination by Tests include:
one of the staff neurologists, • Nerve conduction studies to evaluate numb-
many patients are referred to ness, tingling or weakness in the arms and legs.
• Electromyography to check the health of mus-
Saint Mary’s neuro-diagnostic
cles and the nerves that control them.
lab for a battery of tests to • Electroencephalography to record the electrical
identify the precise nature of activity of neurons in the brain.
their neurological disorders. • Evoked potentials tests to measure the electri-
cal activity produced by stimuli, such as light
flashes and sound clicks.

The electrodes attached


to Brad Thornton’s head
produce an electroenceph-
alogram, helping doctors
diagnose the cause of
seizures he has suffered
the past few years.

27
Administration
It’s not a question he normally For patients, having all those neu-
hears from a patient. Seven years roscience clinics under one roof
ago, Saint Mary’s Health Care CEO means quicker diagnosis and treat-
Phil McCorkle stepped into the ment and fewer trips to specialists
hospital room of Ralph Hauen- all over town. The center’s inter-
stein, a Grand Rapids businessman disciplinary philosophy promotes
undergoing treatment for chronic better com-
bronchitis, to ask if his accommo- munication
dations were OK, but Hauenstein
turned the tables. “Is there any-
among the
specialists,
“It’s the natural relationship
thing I can do for you?” he asked. said Leanna
Krukowski,
between a Big Ten university and a
As it happened, there was, but
neither McCorkle nor Hauenstein
clinical
services
sophisticated medical community.”
could envision what would grow director for - DR. DAVID KAUFMAN
from that casual conversation. It the neuroscience program. “You
opened in February 2009, a multi- can do all the bricks and mortar
specialty neuroscience center in a you want,” she said. “If it’s not all
new building at Saint Mary’s called intertwined, it’s irrelevant.”
the Hauenstein Center, the only
such facility in West Michigan. Initially, Hauenstein offered to
help McCorkle raise money for a
“There are very few places like this Parkinson’s clinic in an existing of-
that are dedicated to the neurosci- fice building at Saint Mary’s. When
ences,” said Dr. David Kaufman, it opened in 2003, McCorkle was
medical director for Saint Mary’s surprised by Hauenstein’s reaction:
neuroscience program and chair “Phil, this thing is way too small.”
of neurology and ophthalmology
at Michigan State University. “It’s Hauenstein had a history of think-
never just a building. It’s always ing big. As a colonel and chief of
the people that propel the pro- intelligence for the U.S. Army’s
grams. The building will allow us European Theater of Operations
to attract the people.” in World War II, he was intimately
involved in planning for D-Day
Even before construction began, and other key military operations.
Saint Mary’s recruited neurosur- Raising money for a neuroscience
geons, neurologists, therapists, center would be easy by compari-
nurses, psychologists and others son. Hauenstein made a substan-
specializing in treating Parkinson’s, tial donation and helped raise $15
epilepsy, stroke, headache, spinal million toward the $60 million
injuries, multiple sclerosis, sleep project.
disorders, amyotrophic lateral
sclerosis, Alzheimer’s and other McCorkle called it “a great asset
memory disorders. for our community.” Hauenstein
was typically modest about his TOP: Michael Yee, ambulatory neuroscience
“Our goals are very lofty,” said Dr. contribution. “I wanted to share manager, and Pamela Villarreah, business office
David Baumgartner, Saint Mary’s the fruits of what my country had coordinator.
vice president of medical affairs. given me,” he said. “I’m extremely BOTTOM: Wesley Gruno, business office coor-
“The more I’m involved in this, the pleased with it.” dinator.
more potential I see.”

28
Dr. David Kaufman, medical director for Saint Mary’s neuroscience programs, works
closely with Leanna Krukowski, the department’s clinical services director.

David Kaufman, DO Leanna Krukowski, RN, MSN


Neurologist, Medical Director, Neuroscience Programs Clinical Services Director
Chairman, Department of Neurology and Ophthalmology, College of Osteopathic Education:
Medicine and College of Human Medicine, Michigan State University • Bachelor of science in nursing, Saginaw Valley State University
Education: • Master’s of science in nursing, Wayne State University
• College of Osteopathic Medicine, Philadelphia
Before the Hauenstein Center opened, Saint Mary’s Health Care al-
• Neurology residency, University of Wisconsin
ready offered many neuroscience services – just not all in one place.
• Harvard research fellowship in neuro-ophthalmology,
So when the new center opened in February, 2009, Krukowski and
Massachusetts General Hospital
colleague Michelle Pena were responsible for integrating those ser-
• Clinical fellow, Massachusetts General Hospital
vices under one roof. “Some hospitals say they are multi-disciplin-
To Dr. Kaufman, the partnership between Saint Mary’s and Michigan State makes per- ary,” she said. “We are interdisciplinary. That’s the hallmark of how
fect sense. He already was busy teaching and directing the neurology education at we set ourselves up.” The Hauenstein Center promotes collegiality,
MSU when he was approached about heading Saint Mary’s neuroscience programs encouraging physicians and other providers in different specialties
in 2008. “It’s the natural relationship between a Big Ten university and a sophisticated to work together. That approach improves patient care by promot-
medical community,” he said. The partnership gives MSU’s medical students and re- ing better communication and coordination. The patients’ rooms,
searchers access to a large patient population, and it allows Saint Mary’s physicians to all private, are “acuity adaptable,” she said, so as patients’ conditions
expand their research through collaboration, he said. Kaufman’s own research has fo- change, they usually are not transferred to another unit. “Putting the
cused on stroke and multiple sclerosis. He has conducted countless studies of MS and patient at the forefront – that’s something that’s pervasive,” Kru-
was the lead author of the practice parameters for treating optic neuritis for Neurology, kowski said. “It’s palpable. It all plays into the best care.”
the official journal of the American Academy of Neurology.

29
A letter
from Ralph
Hauenstein
What a year it has been since the opening of the Hauen-
stein Center at Saint Mary’s Health Care. The brick and
mortar building, impressive in itself, is only the structure
allowing us to bring together highly trained specialists of-
fering a variety of neuroscience services, including many
previously unavailable in West Michigan.

For me, it is a tribute to two men who had a great deal of


impact on my life: my close friend, Jay Van Andel, and my
father. I saw both men struggle with and eventually suc-
cumb to Parkinson’s disease, so when Saint Mary’s CEO Phil
McCorkle mentioned the need for a Parkinson’s clinic, I was
more than happy to help raise money for it. That clinic was
the seed for the comprehensive neuroscience program now
housed in the Hauenstein Center, which also includes a first-
rate critical care unit and a state-of-the-art emergency and
trauma department.

The critical care and emergency physicians work closely with


the neuroscience specialists in treating not only Parkinson’s,
but epilepsy, spinal disorders, multiple sclerosis, amyotrophic
lateral sclerosis, stroke, brain tumors, sleep disorders, neu-
roopthalmology and memory disorders, including Alzheim-
er’s. The latter is important to me personally, because my
dear wife, Grace, died of Alzheimer’s in December, 2007.

In the year since the grand opening, the center has contin-
ued growing, attracting more top-notch specialists and
more patients, and it has engaged in research with other
organizations, including the Van Andel Institute, found-
ed by Jay Van Andel. Nationally there is a critical need
for such neuroscience programs, particularly as the
population ages and diseases such as Parkinson’s and
Alzheimer’s become more common. No longer will
West Michigan patients have to travel to Chicago or
elsewhere to get treatment for these neurological
disorders. The Hauenstein Center is a testament
to the generosity of the West Michigan com-
munity and proof of Saint Mary’s commitment
to providing health care services unavailable
Philanthropist Ralph elsewhere in the area. I am pleased to have
Hauenstein (left) and Saint played a part in it.
Mary’s CEO Phil McCorkle
stand in the lobby of the new Sincerely,
Hauenstein Center, a multi-
specialty medical facility Ralph Hauenstein
born in a casual conversation
between the two. 30
A letter from Phil McCorkle
Ralph Hauenstein often expresses gratitude to The neuroscience program, with its support-
our community for its generosity during the ing critical care and trauma services, already
fund raising campaign for the Hauenstein Cen- has developed a national reputation. With in-
ter, but it was Ralph’s generosity that sparked creasing frequency, neurologists and sub spe-
and nurtured the project. His desire to see a cialists from around the country inquire about
world-class center (“our center,” he often calls joining the program. The interdisciplinary care
it) for the diagnosis and treatment of neurolog- model, the collegiality of the staff, the growing
ical disorders, and his tireless efforts to make research capacity, and the beautiful facility at-
the vision a reality are the foundation of the tract physicians to this healing place.
Hauenstein Center. We are, indeed, grateful to
our community, but Ralph’s efforts were the After only one year of operation, the growth
heart and soul of the project. of the neuroscience program has far exceeded
our expectations, thanks to the efforts of many,
The Hauenstein Center was the most ambi- but especially to Ralph Hauenstein.It was his
tious project ever undertaken by Saint Mary’s vision and dedication to the idea that world-
in our nearly 120-year history, and its presence class care for those suffering from Parkinson’s,
so close to the site of the first Saint Mary’s Alzheimer’s, epilepsy, stroke, and other neu-
Hospital building is particularly significant, be- rological disorders should be available to the
cause the center carries on the tradition of ex- people of West Michigan.
cellent medical treatment, delivered with care
and compassion, that has always been Saint Sincerely,
Mary’s hallmark. Phil McCorkle
President and CEO, Saint Mary’s Health Care

Philanthropist Ralph
Hauenstein in the
lobby of his namesake
building with Saint
Mary's CEO Phil
McCorkle.

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The Hauenstein Center at Saint Mary’s
220 Cherry Street SE | Grand Rapids, MI 49503
(616) 685-5000 | www.smhealthcare.org
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