USF Health’s Gopal Thinakaran, PhD, is an internationally recognized Alzheimer’s  researcher.

Gopal Thinakaran, PhD, was recently appointed chief executive officer of the USF Health Byrd Alzheimer’s Center and Research Institute. Dr. Thinakaran assumed the position from Harry van Loveren, MD, chair neurosurgery and vice dean for clinical affairs at the USF Health Morsani College of Medicine, who has chosen to step down as Byrd CEO after serving for several exemplary years in this role.

“In the past three years, the Byrd Institute has experienced tremendous growth under the leadership of Dr. van Loveren and the Neuroscience Institute Executive Committee,” Dr. Thinakaran said. “I am honored to have this opportunity to advocate for the Byrd Institute’s research, clinical, and educational missions. I will strive to attract exceptional talent to the Byrd Institute and promote a culture of excellence in basic science and clinical research.”

As the new Byrd Institute CEO, Dr. Thinakaran will work closely with the dedicated team at the Byrd Alzheimer’s Institute, including Amanda Smith, MD, director of clinical research, and Eileen Poiley, director of education.

Dr. Thinakaran, professor of molecular medicine and the Eric Pfeiffer Endowed Chair in Alzheimer’s Research at USF Health, is a permanent member on National Institutes of Health (NIH) study sections and other grant funding agencies, as well as serving on the editorial boards of several major neuroscience journals. He earned his PhD in molecular biology and genetics at the University of Guelph in Ontario, Canada. After finishing his PhD, he completed a postdoctoral fellowship in pathology from Johns Hopkins University and later served as a research associate in the Division of Neuropathology.

He joined USF Health in 2019 as a professor with tenure from the University of Chicago, where he served as a professor in the Department of Neurobiology.  Prior to that, he was an assistant professor in the Department of Pathology at the Johns Hopkins School of Medicine.

For over 20 years, Dr. Thinakaran has directed a highly collaborative research group investigating cellular and molecular mechanisms of Alzheimer’s disease pathogenesis. He has over 136 publications and has repeatedly secured research funding, including numerous NIH R01 level grants. Dr. Thinakaran brings a well-established and funded, internationally recognized research program and a wealth of leadership experience.

Under Dr. van Loveren’s leadership, the Byrd Institute, which is devoted to advancing research, education, treatment, prevention, and the early detection of Alzheimer’s disease, now has $6.7 million in federal awards, including 11 NIH RO1s and $2.8 million in clinical trials funding.

“These amounts represent very significant increases over the past four years and the upward trend is continuing, all a testament to the strength of Harry’s leadership,” said Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine. “I would like to thank Dr. van Loveren for his exceptional service to both USF Health and the Byrd Institute, and express my great confidence in Dr. Thinakaran’s leadership and his vision for the Institute moving forward.”

Greg Strachov of Citrus County, FL, has been an artist for more than 40 years, garnering numerous local, national and international awards for his watercolors.

In the fall of 2017, an MRI scan discovered a softball-sized meningioma tumor near where Mr. Strachov’s brain connects to his spinal cord. Meningiomas, while usually benign, are the most common type of brain tumor and can still cause widespread health problems for the patient. For Mr. Strachov, this included losing his ability to walk or create his art.

Greg Strachov displays some of his watercolors recently in his Citrus County, FL, home. Mr. Strachov, a renowned artist, had a softball-sized brain tumor removed by USF Health neurosurgeon Dr. Harry van Loveren after two successful surgeries.

Mr. Strachov, 69, was referred to USF Health neurosurgeon Dr. Harry van Loveren, who performed a 13-hour surgery on the tumor in January 2018. The surgery removed much of the tumor but left Mr. Strachov paralyzed on the right side with little ability to move his left eye. Over the ensuing months, Mr. Strachov underwent strenuous rehabilitation to regain movement and coordination on his right side. He even picked up a new hobby; he found restoring old hand drills helped retrain his fine motor skills.

Dr. van Loveren determined in mid-2019 that he needed to remove more of the tumor and presented the potential risks to Mr. Strachov. They agreed, and Dr. van Loveren performed the second surgery in August 2019. The operation was a success, although a small piece of the tumor remains inoperable and Mr. Strachov’s physicians will monitor its development in the years to come.

Dr. Harry van Loveren, USF Health Chair of the Department of Neurosurgery.

Mr. Strachov has been able to return to painting and other activities he loves. “Dr. van Loveren,” he says, “gave me back the ability to live.”

Mr. Strachov paints a wide variety of watercolor work, including portraits and still life, but he particularly enjoys landscapes.

“I like to paint places that remind people of a reality that they can actually visit in reality,” he says. In fact, after eventually regaining the ability to paint, his first big project was a painting of a lone desert tree in the American Southwest.

Greg Strachov stands with the first watercolor he completed following a series of surgeries to remove a brain tumor.

“It’s one of the most beautiful places I’ve seen, and it’s a place that kept itself on my mind while I went through all of the hospitalization and all the surgeries,” he says. “That tree is perhaps me, and it’s survived a very, very difficult environment.”

The USF Health neurosurgery program has seen significant expansion recently, including successfully recruiting several key hires, offering a specialized surgical procedure, and advancing research on spine surgeries.

The efforts are helping the program propel its already stellar reputation for advanced neurosurgery to a broader patient base, drawing patients from throughout Florida and across the United States.

“We have patients from across the country seeking our expertise, especially those with some of the most complex brain and spine conditions, and our growth will greatly expand access to our skilled teams,” said Harry van Loveren, MD, professor and chair of the Department of Neurosurgery and Brain Repair in the USF Health Morsani College of Medicine.

Dr. Harry van Loveren

USF Health’s neurosurgery teams are based in locations throughout the Tampa Bay area. Each location offers its own advantages, including:

• The use of key robotic technology for the complex and delicate brain and spine surgeries;
• Multidisciplinary/comprehensive teams for patients requiring care from multiple specialists, including a critical care team;
• This region’s first and most advanced intra-operative MRI suite.

“Our patients don’t have to look far – all of the expertise in the world is available right here in our program and it’s only the location that might adjust for the type of surgery they need,” Dr. van Loveren said. “That way, we don’t have to reproduce the entire service line at multiple locations. Instead, we build on strengths based at each location. That’s why we have the largest, best-skilled, and most comprehensive neurosurgery team in the region caring for the most complex and diverse patients.”

In total, the USF Health neurosurgery team provides surgical care to thousands of patients each year.

Spine surgery

One of the areas receiving the biggest boost is spine surgery, where three new faculty surgeons are joining USF Health, bringing the total number of USF Health spine surgeons to 10.

“Our emphasis on spine is because there is a serious need for high-level surgeons who have the added training and specific expertise focusing solely on spine,” Dr. van Loveren said. “Our new surgeons will help advance spine care not just in the Tampa Bay area, but across Florida, and most importantly, they will deliver this care in a way that is evidence-based rather than financially driven.”

These new surgeons are:

• In July, USF neurosurgery welcomed Dustin Hatefi, MD, MPH, who was on staff at University of California, Irvine and conducted multiple fellowships in open/endoscopic skull base and cerebrovascular neurosurgery. Dr. Hatefi will also help lead several clinical trials and national registries for the department.
• Joining in August is Erik Hayman, MD, who comes to USF Health from University of Maryland’s neurosurgery program and a fellowship in complex spine at the Swedish Neuroscience Institute, Seattle, WA. He brings with him a significant research portfolio, including a prestigious grant from the Howard Hughes Medical Institute, and will work closely with the USF Health Center for Aging and Brain Repair, collaborating on key research funded by the National Institutes of Health (NIH).
• Also joining in August is Alex Haas, MD, MBA, who just completed a seven-year neurosurgery residency at USF after having graduated from University of Illinois Chicago College of Medicine.

Other key areas of growth

Neuro Endovascular: USF Health’s neurosurgery program has also expanded its endovascular neurology and neuropsychology efforts with the arrival of three new providers.

Joining earlier in the year is Waldo Guerrero, MD, who came to USF Health from Advocate Aurora Healthcare, where he practiced Neuro-Endovascular Surgery and Stroke Neurology. He completed both an Endovascular fellowship at the University of Iowa and a Vascular Neurology fellowship at the University of Texas Houston Health Science Center.

In addition, Keith Dombrowski, MD, joined USF Health as director of Neurocritical Care from Duke University, where he held a faculty position on their neurocritical care team. Dr. Dombrowski completed medical school at Thomas Jefferson University Hospital in Philadelphia, PA, and a neurocritical care fellowship and clinical neurophysiology fellowship, both at Duke University Medical Center in Durham, NC.

Neuropsychology: Tanisha G. Hill-Jarrett, PhD, joined USF Health last fall. Dr. Hill-Jarrett earned her doctoral degree in clinical psychology (neuropsychology track) from the University of Florida and completed neuropsychology internship training at Emory University and Grady Memorial Hospital (adult/geriatric neuropsychology track). She also conducted a postdoctoral fellowship in clinical neuropsychology (geriatric/dementia track) at the University of Michigan.

Functional neurosurgery (i.e. movement disorders, epilepsy, etc.): The functional neurosurgery program, based at Tampa General Hospital, is also growing with plans to recruit another functional neurosurgeon over the coming year. Expansion also includes the cranial neurosurgery team, with TGH’s pituitary clinic, a joint program with USF Health’s endocrinology team.

Education: In addition to these key hires, the USF Health neurosurgery program is expanding its educational efforts by adding fellowships focused on neuro-endovascular surgery and spine surgery.

“We are impressed with the talent in our new surgeons,” Dr. van Loveren said. “Each of them brings tremendous added value to our team. This level of recruitment is an added advantage for patients looking for the best in every facet of neurosurgery.”

A common problem at the end of medical office visits is patients being unable to clearly remember what was talked about, including details about their diagnoses or recommended changes to their diet, activity levels or medications.

In fact, the federal Agency for Healthcare Research and Quality says studies show that patients can forget up to 80 percent of information shared during an office visit and almost half of what they do remember can be inaccurate.

That forgetfulness can obviously negatively affect the patient’s health. It can lead to unnecessary medical complications, added health costs and duplicated effort when the patient or caregivers invariably contact the doctor’s office with follow-up questions.

USF Health’s Department of Neurosurgery is offering a new tool that can avoid many of those issues by providing patients with an online video recording of their visit with their physician, which they and their family can review afterward.

Called the Medical Memory, the service is designed to be HIPAA-compliant and user friendly for both the patient and health care providers. The physician records the visit on a tablet computer, and the recording is then uploaded to a secured website. The Medical Memory emails a link to the video to the patient and anyone else connected to the patient’s account, such as family members or other caregivers.

Fayyadh R. Yusuf, PhD, is the director of physician development in the USF Health Department of Neurosurgery. Dr. Yusuf said he appreciated The Medical Memory’s “simplicity” and how it provides USF Health patients a permanent record of their consult with their physician.

“Knowing that a lot of things get missed in the moment, there’s great security knowing they can simply turn on the video, re-watch it, watch it with family, watch it with their home physician and go, ‘Ok, this is what the doctor said, these are the instructions, this is what we are supposed to do,’” Dr. Yusuf said.

A tablet is used to record a patient-doctor visit.

The Medical Memory, the company that produces the service, was founded in 2015 by Phoenix, Ariz.-based neurosurgeon Randall Porter, MD. According to the company’s website, the company was founded to “improve patient comprehension, satisfaction and trust.”

USF Health was the first health care organization in Florida to adopt the system when it was implemented in January 2020, Dr. Yusuf said and is now part of a pilot project focused on patients in the critical care division. He said having The Medical Memory is useful as the COVID-19 pandemic has limited visitors within the hospital.

“We’re hoping that this really facilitates and eases the burdens on the families that can’t come in and see their loved ones,” he said.

Besides providing videos for patients, physicians can also use The Medical Memory to create libraries of two- and five-minute videos where they can describe health conditions and treatments and then share those videos as part of patient education.

Harry van Loveren, MD, is chair of the Department of Neurosurgery and Vice-Dean of Clinical Affairs in the USF Health Morsani College of Medicine. He said providers have begun regularly using The Medical Memory as part of their clinic hours.

“Why would you have this lengthy in-depth discussion and then not record it?” Dr. van Loveren said.

He said the service has already led to improvements in patient satisfaction and reduced calls to his staff. Dr. Porter’s company said that, in a study involving 400 patients, half of whom used the video recording and upload system and half of whom didn’t, the video patient group generated almost 24 percent fewer calls to their physicians’ offices, freeing up staff time and other resources.

“The number one question (patients) are asked by family members is, ‘What did the doctor say?’” Dr. van Loveren said. “The number one phone call we get about the office visit is, ‘I don’t remember what the doctor told me.’”

The neurology program is also looking to use The Medical Memory to overcome limitations of patients diagnosed with such conditions as dementia or brain tumors, or patients who may have received a critical or even fatal diagnosis and may have trouble processing the rest of what they hear during the visit.

“(With) a diagnosis that might affect clarity or thinking, we are very relieved to know the whole session is being video recorded so their caregivers and significant others can view it,” Dr. van Loveren said, adding, “I think this should be the way that every medical visit is conducted. It is a fantastic record of the visit.”

Video, photos and article by Allison Long

This summer, Jennifer Krawczyk, MS, APRN, helped USF Health break new ground.

Krawczyk in June 2019 became the first graduate of USF Health’s Advanced Practice Provider Neurological Fellowship, a year-long program aimed at giving advanced practice nurses and physician assistants further expertise in neurosurgery.

Jennifer Krawczyk, MS, APRN, AGACNP-BC, was all smiles near her mother and brother during a celebration of Krawczyk being the first graduate of the advanced practice provider neurosurgical fellowship.

The program, co-administered through USF Health Morsani College of Medicine Department of Neurosurgery and Brain Repair and the USF College of Nursing, is the first of its kind in the United States, which weighed on Krawczyk’s decision to apply in 2018.

“The opportunity to pioneer as the first neurosurgical fellow for advance practice providers in the nation was something I couldn’t pass up,” said Krawczyk, who earned her bachelor and master in science degrees from USF in 2014 and 2017, respectively.

She said she chose neurosurgery chiefly because the subject matter was daunting for her.

“Neurosurgery was an area I found challenging,” she said. “What better way to conquer that challenge and reservation about a specialty than to just dive right in?”

As a fellow, Krawczyk was able to experience facets of neurosurgery that advanced practice providers often miss because they typically are working on the floor. She said these experiences helped fine-tune her clinical expertise and provide more in-depth training.

“I think without the fellowship the knowledge and skills I have now would have taken me years to develop,” Krawczyk said.

Jennifer Krawczyk (left), photographed with Harry van Loveren, MD, professor and chairman of USF Health department of Neurosurgery and Brain Repair, during a celebration for Krawczyk for being the first graduate of the advanced practice provider neurosurgical fellowship.

It is that type of opportunity that persuaded officials with the USF Health’s Department of Neurosurgery and Brain Repair and the USF College of Nursing to volunteer to be the first specialty to offer this type of fellowship.

“It (the fellowship) had so many potential benefits, we didn’t think twice about participating,” said Harry van Loveren, MD, a USF Health professor and the neurosurgery department’s chairman. “We are extremely proud that (Krawczyk) was the first student to graduate from this program.”

The complex and varied treatments for conditions and diseases associated with neurosurgery also influenced officials to experiment with helping further develop advanced practice providers.

“We started with neurosurgery because it takes a while to become familiar with the nuances,” said Marcia Johansson, DNPO, ARNP, who is a USF Health assistant professor in the College of Nursing as well as director of the Advanced Practice fellowship.  These nuances, Johansson said, “make it very necessary to have some specialty training.”

Jennifer Krawczyk, MS, APR, with a neurosurgery patient at Tampa General Hospital in August 2019.

Based on Krawczyk’s success, the fellowship will continue. Currently, there are three advanced practice fellows participating in the program, including fellows in neurosurgery, oncology (in partnership with the Moffitt Cancer Center & Research Institute) and otolaryngology.

“They (the advanced care providers) are now ingrained in the systems, they have developed friendships, and they have improved their education,” Dr. Johansson said. “Fellowships are going to become the norm for advanced care providers.”

Advanced practice fellows are hired by USF Health during the year-long program and earn 80 percent of their normal salary as well as benefits.

Krawczyk’s success, ensures the fellowship will continue and future advanced practice provider will be receiving certificates from Marcia Johansson (left), DNP, APRN.

The latest neuroscientist recruits will help USF Health accelerate new discoveries in Alzheimer’s disease and other neurological disorders 

The USF Health Neuroscience Institute, home of the Johnnie B. Byrd Sr., Alzheimer’s Center, brings together scientists and physicians to investigate the complexities of the brain and its impact on human health and behavior.

Internationally recognized Alzheimer’s disease researcher Gopal Thinakaran, PhD, has been recruited by USF Health to help accelerate the interdisciplinary work of its Neuroscience Institute (NSI), home of the Johnnie B. Byrd Sr., Alzheimer’s Center. Dr. Thinakaran, a professor of neurobiology at the University of Chicago, will join USF Health on Aug. 1.

University of Chicago neurophysiologist Angèle Parent, PhD, will also arrive here Aug. 1 as an associate professor of molecular medicine and member of the Byrd Alzheimer’s Center.

“Dr. Thinakaran and Dr. Parent are outstanding additions to our growing USF Health Neuroscience Institute,” said Charles J. Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine. “Building upon the success of the Byrd Alzheimer’s Center, Dr. Thinakaran will help us advance interdisciplinary research among USF Health scientists and physicians looking at the brain in unique ways to accelerate discoveries to cure a broad range of neurological disorders, including Alzheimer’s and related dementias, Parkinson’s, ataxias, epilepsy, multiple sclerosis, ALS and stroke.  Moreover, Dr. Parent brings to the USF Health NSI a critical line of research into the mechanisms of memory dysfunction in dementia”

Gopal Thinakaran, PhD

Over the last decade Dr. Thinakaran built one of the country’s leading laboratories investigating the molecular and cellular processes underlying Alzheimer’s disease, the major form of dementia afflicting an estimated 5.8 million Americans.  He uses cutting-edge cell biology techniques and mouse models to probe nerve cell pathways responsible for Alzheimer’s disease pathology and neuronal dysfunction, with the goal of finding treatments to significantly reduce or delay cognitive decline.  Recently, he began exploring the molecular link between type 2 diabetes and Alzheimer’s disease progression.

Supported by $5.5 million in National Institutes of Health (NIH) grant funding, Dr. Thinakaran’s work has implications for other age-related and chronic neurodegenerative diseases that, while diverse, share some common characteristics such as abnormal protein aggregates and excessive nerve cell death.

At USF Health, Dr. Thinakaran will assume leadership roles as associate dean for neuroscience research and NSI associate director of research, in addition to his appointments as a professor of molecular medicine and the Bagnor Endowed Chair in Alzheimer’s Research. He will work closely with NSI CEO Harry van Loveren, MD; Stephen Liggett, MD, vice dean of research for the USF Health Morsani College of Medicine; and David Kang, PhD, director of basic research at the Byrd Alzheimer’s Center, to expand and integrate basic, translational and clinical neurosciences research across USF.

Dr. Parent studies how the brain remembers and what goes wrong with memory storage mechanisms in neurodegenerative diseases, focusing on communication between nerve cells (synaptic transmission) and neuronal plasticity. This April, Dr. Parent’s team published a study in Cell Reports demonstrating that sustained amyloid precursor protein (APP) signaling favors adaptive changes in the brain and prevents memory decline in an Alzheimer’s disease mouse model. She recently received a five-year, $1.75-million NIH grant to examine how differences in APP metabolism affect memory in sleep-disturbed Alzheimer’s mice.

Angèle Parent, PhD

An accomplished scientist who does not hesitate to explore uncharted territory, Dr. Thinakaran is also “a wonderful communicator, spokesman, and builder,” Dr. Liggett said. “As USF Health intensifies its effort to conquer Alzheimer’s disease and other dementias, as well as related neuroscience research, he will play an integral role in moving us forward. His combination of excellence in these skills is not that common, and I look forward to working with him to reach new heights in these research areas.”

NSI’s Dr. Van Loveren, chair of neurosurgery at MCOM, said Dr. Thinakaran recognizes the power of bringing different disciplines together to tackle the complexities of the brain and its impact on human health and behavior. “He is a scientific leader who understands the challenges of translating laboratory findings into new therapies that can target the root causes of neurodegenerative diseases – and the value of coordinated teamwork needed to bridge that gap.”

Both Dr. Thinakaran and Dr. Parent were recruited with the help of funding allocated through USF’s designation as a Preeminent State Research University.  The University of Chicago neuroscientists are the newest NIH-funded faculty members recruited since fall 2018 to strengthen and complement existing talent at the NSI’s Byrd Alzheimer’s Center. Others include:

• Krishna Bhat, MD, PhD, professor of molecular medicine and the Mary & Harry Goldsmith Endowed Chair in Alzheimer’s Disease, studies the genes and proteins that regulate the division of neuronal stem cells.
• Lianchun Wang, MD, professor of molecular pharmacology and physiology and USF Endowed Chair of Neurovascular Research, investigates the structure and function of a common linear polysaccharide, heparan sulfate, in inflammation, blood vessel development, stem cell biology, cancer and Alzheimer’s disease.
• Alexa Woo, PhD, assistant professor of molecular pharmacology and physiology, studies how multifunctional B-arrestin proteins contribute to tau pathology, a hallmark of Alzheimer’s and other neurodegenerative diseases in the brain.

Dr. Thinakaran said he was impressed by USF Health’s support of its well-established Byrd Alzheimer’s Center and the university’s drive to create an institute internationally known for its collaborative neurosciences research and training.

“I look forward to the opportunities to expand USF Health’s expertise in other neurological diseases and generate energy that will feed existing Alzheimer’s research,” he said.

Tampa, FLA (Jan. 17, 2017) — The University of South Florida has launched a neurosciences initiative to integrate the latest treatment and research for a wide range of neurological and psychiatric disorders.

With the state-of-the-art USF Health Byrd Alzheimer’s Institute as its centerpiece and driving force, the new neuroscience initiative is being spearheaded by Dr. Harry van Loveren, vice dean of clinical affairs for the USF Health Morsani College of Medicine and chair of the Department of Neurosurgery and Brain Repair. Dr. van Loveren has a proven track record of highly effective administrative and clinical leadership skills, having served as interim dean of the USF medical school and developed one of its most successful departments. He is widely respected regionally and nationally as a top neurosurgeon and researcher with expertise in skull base surgery as well as microneurosurgical techniques.

Harry van Loveren, MD

The multidisciplinary initiative will bring together medical, surgical and research specialists from USF Health’s departments of neurology, neurosurgery and psychiatry – all dedicated to advancing treatment and prevention of brain, spinal cord and other nervous system disorders.

“The primary goal of this larger neurosciences initiative is to foster and coalesce interdisciplinary research collaboration among USF Health scientists looking at the brain in unique ways to accelerate new discoveries for a broad range of neurological conditions – including Alzheimer’s and related dementias, Parkinson’s, ataxias, epilepsy, multiple sclerosis and stroke – leading to improved treatment and prevention for the patients we serve,” said Dr. Charles Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine.

“Dr. van Loveren has the expertise and commitment to build a preeminent, strong neurosciences model that will provide an even greater infrastructure for moving neurological discoveries from bench to bedside,” Dr. Lockwood said.

By consolidating disease-specific areas of care for a wide spectrum of neurological conditions, the initiative is expected to strengthen collaborative, complementary research across USF neuroscience disciplines and allow patients to better access the care they need.

“We will build upon the success of the Byrd Alzheimer’s Institute in becoming a vital treatment and research center for Floridians affected by Alzheimer’s disease and other memory disorders,” Dr. van Loveren said.

“The neurosciences initiative will unify and coordinate all resources at the university for neurological and neuropsychiatric disorders so we can expand our neurosciences footprint and serve even more patients and their families. We envision USF Health becoming a national destination for all things related to brain disorders and brain health.

The endeavor will also help position USF to take advantage of new federal funding opportunities such as the National Institutes of Health’s BRAIN Initiative, a pioneering project aimed at revolutionizing the understanding of the brain and accelerating the development and application of new technologies for brain disorders.

                                                                                                                   -USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and the USF Physicians Group. USF Health is an integral part of the University of South Florida, a high-impact, global research university dedicated to student success. For more information, visit www.health.usf.edu

Media contact:  
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu

This story is part of a series highlighting faculty who are shining examples of quality and compassionate patient care and patient safety. Every day, these health care providers put their patients first. In the process, they create successful models of advanced care focused on empathy, safety, technology and evidenced-based medicine, models that carry through everything they do – into their practice, their teaching, their research, their community outreach, and into the USF Physicians Group.

//www.youtube.com/watch?v=N9sOG4qVSq4

Over and over again, Harry van Loveren, MD, walks through a surgery in his mind before actually cutting open the brain of his patient, perfecting every step and accounting for everything he will encounter, the expected and the unexpected.

Dr. van Loveren is chair of the Department of Neurosurgery in the USF Health Morsani College of Medicine, senior associate dean for Surgical Subspecialties at USF Health, and chief medical officer of the USF Physicians Group. Along with a brilliant mind and capable hands, his visualization technique has made him an accomplished and much sought after neurosurgeon.

Dr. Harry van Loveren.

“To prepare for the kind of operations I do you have to mentally do the operations a number of times before you walk into the operating room,” he said. “And you have to understand it all – the anatomy, the surgical instruments, the surgical techniques – so your mental experiments are valid, that what you see in your mind is what you will see in the patient’s head. That these things you see in your mind are true and that if it works in your mind it had better work in the operating room. And if I can’t see that in my mind’s eye, I go back to the (training) lab, go back to text books, and review videos and figure it out until I can create a paradigm in my mind where I complete the surgery successfully.”

How does someone decide to become a neurosurgeon? For Dr. van Loveren, it was because it’s considered the most difficult area of medicine and requires the longest amount of training.

“To be honest, I don’t know why other people go into neurosurgery but I know why a lot of us do – because we’re so egotistical and because we want to be the best,” he said. “As we’re going through medical school we look around and ask what would be the hardest thing I could do? What would be the biggest challenge? But I don’t think we’re the only ones who do that. For instance, look at people who go into the police force and say ‘I want to be on the SWAT team’ or go into the military and say ‘I want to be a Navy SEAL.’  There’s an element of that to becoming a neurosurgeon. We’re looking for the greatest challenge.”

Meeting that challenge has made him one of the most sought after neurosurgeons in Florida.

In fact, when he joined USF Health about 10 years ago, he set a goal for his Department to become the go-to neurosurgery department in Florida. Starting with only six neurosurgeons, he has built the Department to about 30 surgeons and nine PhDs, becoming a hub for the most complicated cases.

“My practice is a little bit unique,” he said. “It’s called complex cranial so I do the more complex side of brain operations and a lot of my practice is taking care of patients for other neurosurgeons in the state either for those things they don’t want to do or don’t feel they ought to be doing. That can be a bit of a lonely and frightening position to be in. But nobody wants to see any lack of confidence in us and we don’t really want to feel that lack of confidence.”

His other reason for choosing neurosurgery is because he saw it as the one specialty in which he would never stop learning.

“I chose it because it looked like my learning curve would go on forever,” he said. “When I looked at neurosurgery, I saw older neurosurgeons still making great contributions and the acquisition of experience is so valuable to neurosurgery. So the finish line is, wonderfully, always just beyond our reach.”

He admits, though, that the real reason he chose neurosurgery might truly be because he thinks “the brain is cool.”

“The brain is who we are, it’s what we think, it’s what we believe,” he said. “The ability to affect a person’s life by manipulating that organ is profound and extremely interesting. And we really get some insight into brain function when we’re operating on someone while they’re awake and speaking to you. And with certain stimulation you can bring back very specific old memories for the patient, you can play music, you can run videos. It’s all stored in the brain and you can recall it and make it come out for the patient.”

With a laugh, he added “It’s just a really satisfying career. You should try it sometime.”

By taking some of the most difficult brain surgery cases – the ones other neurosurgeons feel might be outside their scope and skill – Dr. van Loveren has built a solid reputation for helping some of the most vulnerable patients, those whose conditions might otherwise be deemed inoperable. That reputation is based on knowledge and surgical skill, but also involves his ability to relate to patients, to calm them and impart feelings of comfort, but also confidence.

“Taking care of patients, taking care of people, is what this is all about,” he said. “What I try to do is make people feel the way you might feel if you had a serious brain problem and your brother was a neurosurgeon. That kind of comfort level, that your brother is someone you know, someone you trust, someone who knows you, someone who cares about you, and everything your brother tells you will be the truth and the best for you. That’s my approach with patients. With the family and the patient there’s the ability and the need to walk in and say hello and reassure them that I see them, that I’m aware of and care about who they are and how afraid they are, that I’m fully focused on them, that I care. I let them know this is not just another case. And I let them know a little bit about myself, reveal my human side. I hope they gain some comfort from that interaction.”

All this intensity can make for only serious conversations but in chatting with Dr. van Loveren, you will quickly see other sides, including his love for skydiving. In fact, he admits that freefalling to the earth is the only activity he has found that lets him completely stop thinking about neurosurgery.

Photo courtesy of Harry van Loveren.

“Brain surgery is always with you,” he said. “You’re always thinking, wondering, analyzing, or performing surgery. You’re always being nudged by your wife walking down the beach and she says ‘where are you now?’ Which is one of the reasons I’m a skydiver. It is a profound break in concentration and lets me focus completely on something else. I’ve tried a lot of things, from golf to fishing, to be distracted. But I find that throwing the door open at 14,000 feet and getting out of the airplane, that’s when neurosurgery stops for a while.”

Photo courtesy of Harry van Loveren.

Story by Sarah Worth, photos and video by Sandra Roa and Mihaela Madsen, USF Health Office of Communications.

Tampa General is the first hospital in the Tampa Bay area to acquire the advanced imaging technology

Neurosurgeons at Tampa General Hospital, including doctors from USF Health, will now be able to use the first intraoperative MRI (magnetic resonance imaging) in the Tampa Bay area.

MRI is a powerful tool that allows neurosurgeons to see the difference between healthy and diseased brain. So powerful, that Tampa General brought the MRI right into the operating room; TGH is only one of six hospitals in Florida to acquire it.

USF Health-TGH neurosurgeon Dr. Harry van Loveren stands next to the intraoperative MRI recently installed at Tampa General. The powerful imaging technology allows brain tumors to be removed more completely the first time, helping avoid repeat surgeries.

“We cut the ribbon on the most advanced and first-of-its-kind operating theater in the Tampa Bay region,” said USF Health-TGH neurosurgeon Harry van Loveren, MD,  interim dean of USF Health Morsani College of Medicine and chair of the college’s Department of Neurosurgery and Brain Repair.

“The state-of-the art 3 Tesla MRI ‘floats’ in and out of the room on command to monitor the progress of surgery, so we can now see how a patient’s surgery is going and affect the outcome rather than see how surgery went and accept the outcome.”

A Breakthrough in Technology and Care

In most operating rooms, neurosurgeons must make their best estimation when removing brain tumors during surgery. It isn’t until an MRI is completed after surgery—sometimes days or weeks before doctors know if the entire tumor was successfully removed.

With the new advanced and powerful real-time imaging technology, neurosurgeons at TGH can remove tumors more completely the first time and avoid repeat surgeries.  The intraoperative MRI can also be used for a variety of other neurosurgical procedures and conditions.

The two-room suite functions as an operating room on one side while the other room is used to store the MRI when the equipment is not being used for surgery.  While in that storage area, it can also be used for routine diagnostic scans. The equipment, called VISIUS Surgical Theatre, has a ceiling mount that allows it to move between two rooms. The intraoperative MRI is housed in a room next door to the operating room behind thick surgical sliding doors and on command, the doors open and the MRI is powered in on a track and placed around the patient’s head on the operating room table while in surgery.

The use of this intraoperative imaging system is much safer, because the patient is never moved once positioned for surgery. The high-resolution images provide better precision in complicated neurosurgery procedures, likely resulting in fewer repeat surgeries for brain tumor patients.

TGH has also developed a method to connect, in real time, the patient and the anesthesia machine to the patient’s electronic record via a wireless connection. This continually feeds vital signs and inhaled gasses information used to keep the patient asleep into the hospitals electronic record software system.

Graduating medical students at the USF Health Morsani College of Medicine celebrated the next step in their careers at Match Day Friday – but first they and leading advocates took time out to call for increased support of graduate medical training.

Without increased federal funding for graduate medical training, the nation’s looming physician shortage will get worse, U.S. Rep. Kathy Castor said Friday at USF’s Match Day celebration. With more medical school students and no increase in residency slots, it’s getting harder each year for students to “match” into a residency space.

“Medical schools expect to graduate more students, but the number of available residency training slots will not keep up with this trend unless Congress invests in developing our residency programs to meet the health care needs of our aging population,” U.S. Rep. Castor said. “Giving teaching hospitals the opportunity to grow their training programs makes sense in their mission to provide quality health care and makes economic sense for Florida because doctors tend to remain in the region where they complete their medical training.”

L to R: Dr. Harry van Loveren, interim dean of the USF Health Morsani College of Medicine, with U.S. Rep. Kathy Castor and Alicia Billington, a graduating USF Health medical student, at Match Day 2014.

Just before USF Health’s Match Day celebration began, Rep. Castor (D-FL) announced that she and U.S. Rep. Joe Heck (R-NV) introduced the Creating Access to Residency Education (CARE) Act of 2014 on Friday. The CARE bill aims to create a $25 million CMS grant program that would allow hospitals in states with a low ratio of graduate medical education (GME) training slots – including Florida – to apply for matching funds to support increases in slots.

USF Health leaders and students applauded Rep. Castor’s support of increased funding.

“We congratulate our students for reaching this milestone in their medical careers. On Match Day, we want to celebrate this culmination of their hard work and drive,” said Dr. Harry van Loveren, interim dean of the Morsani College of Medicine. “We’re also mindful today that the path they have traveled is becoming more difficult to navigate. We’re so grateful to have U.S. Rep. Kathy Castor with us today to push to increase federal funding and ensure that future medical students, both here in Florida and across the country, can enjoy this same success.”

Graduating students came to Match Day to learn their fates, finding out at Match Day where they would spend the next several years of their careers. Despite the suspense, students found time to be advocates. They chose to highlight the GME funding crisis on their Match Day T-shirts this year, which read “#save GME” across the back.

Before the Match Day celebration began, Congresswoman Castor announced the introduction of proposed legislation to support more residency training slots. Billington, right, is one of the nation’s leading student advocates for increased graduate medical education funding.

“We decided to do this after realizing, ‘What is the best present you could give to your classmates?’ A residency slot,” said graduating student Alicia Billington, one of the nation’s leading student advocates for increased GME funding.

“We stand in solidarity for your future Match Day,” Billington said Friday to future medical classes at USF. “We’ve got your back.”

Billington, who will graduate with an MD/PhD, learned Friday that she matched in plastic and reconstructive surgery – one of the country’s most competitive specialties – at her top choice, the USF Health Morsani College of Medicine. Billington interned in Washington, D.C., with the American Medical Association and has focused her political efforts on increasing funding for GME.

National medical leaders thanked both Rep. Castor and Billington for their support of increasing funding, saying change is needed to avert a physician shortage that will limit access to health care.

“Match Day is a day of excitement, enthusiasm, and joy for medical students around the country,” said Dr. Darrell G. Kirch, President and CEO of the Association of American Medical Colleges (AAMC). “While we celebrate with these students, we also look ahead to the next decade when our nation will face a shortage of more than 90,000 physicians of all types.  This makes increasing federal support for graduate medical education a critical priority. The AAMC applauds the efforts of Rep. Kathy Castor, who is a true champion on GME and physician workforce issues.  And we thank student advocates like USF medical school senior and GME advocacy champion Alicia Billington for their hard work educating their communities about these important issues.”

In recent years, medical school enrollment has increased, while the federal funding that is the main funding source for the nation’s residency programs has remained capped. Last year, 528 medical students did not match – more than double the number of unmatched students the prior year.

“Not every medical student in the United States is going to get a spot this year,” Dr. van Loveren said to the USF Health students assembled for Match Day Friday. “Can you imagine going through all this and no residency training?”

Castor flashes the USF “Go Bulls” sign as Billington, recipient of the first match letter, finds out she’ll be doing a residency in plastic and reconstructive surgery at her first choice — the USF Health Morsani College of Medicine.

Florida has only 19 medical residents per 100,000 state residents, well below the national average of 26.8 residents, according to a 2012 study by the Association of American Medical Colleges. While Florida is the 4^th most populous state, it ranks 42^nd in the number of graduate medical residents per Florida residents.

With 3,898 medical students but only 3,769 residency and fellow positions, Florida also doesn’t have enough slots to go around. That means Florida is a “net exporter” of medical students – many students train here, but must go elsewhere for graduate training. Because so many students stay where they receive graduate training, exporting students means Florida loses future physicians.

That needs to change, Castor said Friday to USF Health’s Match Day crowd.

“It doesn’t take a brain surgeon,” she said, pointing to Dr. van Loveren, “to know we need talented doctors here in the state of Florida.”

Of the 121 USF Health students participating in Match Day, 39 percent will stay in Florida; 30 percent of the class matched at USF Health. Other students scattered across the country, going everywhere from Massachusetts General Hospital to UCLA Medical Center.

Every USF Health Morsani College of Medicine student participating in this year’s Match was matched to a residency slot. On the flip side, the College of Medicine also filled every one of its available residency slots with graduating medical students.

Photos by Eric Younghans, USF Health Communications