Henican: Brain surgeon pushes scanning for tumors
February 27, 2008
Millions of women go for mammograms, seeking early signs of breast cancer – and hoping not to find any. Millions of men get their prostate-specific antigen test, trying to get a jump on detecting prostate cancer.
Sixty and 70 years ago, the U.S. Public Health Service drastically reduced tuberculosis with thousands of mobile X-ray machines, driven into schoolyards and onto factory floors. In Harlem, residents celebrated V-E Day in 1945 by lining up for free chest X-rays.
By now, pretty much everyone agrees: Screening means early detection, and early detection saves lives.
“So why not screen for brain tumors?” Dr. Patrick J. Kelly was asking the other day. “It’s easy to do. Low-cost screening is available. You could save many, many lives.”
Kelly has a personal stake in this. One of America’s leading neurosurgeons, his job is to climb inside when tumors go undetected for months or years, expanding like balloons at a birthday party, threatening the neurons, glial cells and all the other delicate infrastructure that makes up the living human brain.
“We believe in early detection for all these other diseases,” said Kelly, who is chairman of the department of neurosurgery at NYU Medical Center. “How did brain tumors get left off the list? With a simple, low-cost screen, we can tell you if you have a brain tumor or not.”
Kelly must be the least likely brain surgeon ever – and not just because of his cheery banter and refusal (despite the horrific cases he confronts in the operating room) to appear glum. As the son of hardscrabble Irish immigrants in the steel-mill country of western New York, his childhood was a succession of foster homes, Catholic orphanages and dingy apartments with overdue rent.
“My father was a hopeless alcoholic,” he said. “Every time he got a job, he’d go out and celebrate and wouldn’t show up for work in the morning.” Kelly’s mom was mostly overwhelmed. She was hospitalized for years at a time with variety of physical and emotional ailments.
But like many lucky boys, Kelly had a teacher who took an interest; an ancient nun who taught music. She detected a keen intelligence and helped to build young Pat’s self-confidence.
Over the objection of the family’s social worker, who thought he should go work in the local steel mill, Kelly got a scholarship to the University of Michigan and attended medical school at the State University in Buffalo. He joined the U.S. Navy, volunteered for Vietnam and was stationed at the Naval Support Hospital in Danang.
“There is nothing I have ever seen in an operating room that can upset me after that,” he said. “Now we might have a little bleeding in the brain.”
But through his internship, residency and postgraduate training, he kept coming back to the brain – and the three-dimensional techniques of stereotactic neurosurgery.
“There is nothing really that complicated about brain surgery,” he said. “You just have to know where the tumor stops and the regular brain begins.”
But that can be tricky. “You’re like a boat in the fog in there,” he said.
If you ever have a brain tumor, Kelly said, make sure you get a surgeon who’s been there many times before. “Of the 265 neurosurgeons in New York, 258 do between two and 10 operations a year,” he said.
Kelly’s done more than 7,000.
He could be cutting into his own business here, but what would really help, he said, is early detection of brain tumors.
“Why not have mobile MRIs the way they sent out those chest X-ray machines against TB?” he said. “This really should be part of everyone’s basic physical. And it doesn’t have to cost much.”
Kelly’s involved with a Web site, www.brainscans.com, that’s arranging simple scans for $169.
“We really have to do this,” he said. “The brain is what allows you to enjoy life. The brain truly makes you who you are.”
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