Dr. Mary Zupanc awarded prestigious Arnold P. Gold Humanism in Medicine Award

Dr. Mary Zupanc has achieved many superlatives over her long career in medicine; accolades and awards have followed.  But the co-medical director of the CHOC Neuroscience Institute and UCI professor of pediatrics and neurology considers the Arnold P. Gold Foundation Humanism in Medicine Award her highest honor of all.

Dr. Mary Zupanc, co-medical director of the CHOC Neuroscience Institute

The Child Neurology Society (CNS) has announced that Dr. Zupanc will receive this special distinction at their annual meeting in October 2021.  She is only the eighth individual to be thus honored in the 50-year history of the society, which represents the nation’s pediatric neurology subspecialists.

The Humanism in Medicine Award will be presented to Dr. Zupanc — who specializes in childhood epilepsy — for practicing “extraordinary and ongoing humanism” throughout her medical career. Included in the criteria noted by her peers are:

  • Compassion and empathy in the delivery of patient care
  • Respect for patients, families and co-workers
  • Cultural sensitivity in working with patients and family members of diverse backgrounds
  • Effective, empathetic communication and listening skills
  • Understanding of patients’ need for interpretation of complex medical diagnoses and treatments
  • Comprehension and respect for the patient viewpoint
  • Sensitivity to patients’ psychological well-being and patients’ and families’ emotional concerns
  • Ability to instill trust and confidence

“You may be the greatest scientist in the world, but if you don’t have empathy and compassion for patients and families, you can’t advance the field of medicine,” says Dr. Zupanc. “To me, as a clinician bringing science to the bedside – this is the ultimate award.”

This award also has personal meaning and sentiment for Dr. Zupanc, because as a faculty member at Columbia University, she and Dr. Gold – the award’s namesake – became good friends.

“Dr. Gold was one of the kindest, gentlest, most intelligent child neurologists I’ve ever known,” she says.  “He had a real compassion for children, and we just hit it off.”

Dr. Gold, who died in 2018 at the age of 92, frequently complimented Dr. Zupanc: “He went out of his way to tell me that I had taught him some things about epilepsy that he didn’t know,” she says. “I was sure that couldn’t be the case, since he was senior to me, with such knowledge and wisdom. But he insisted, and that was the kind of person he was; always offering encouragement and making people feel special.”

A trailblazer for both women and the epilepsy subspecialty

Dr. Zupanc has received many accolades over the years, including being the first woman to graduate top of class from UCLA Medical School, and at a time when women were just beginning to be have more representation in medicine.  She was later named one of 10 “outstanding young women in America.”  She has garnered many teaching awards from medical students and residents, and continues to be listed among the best doctors in America.

Dr. Zupanc is board-certified in four different medical specialty areas: pediatrics, neurology, neurophysiology and epilepsy. Her primary mentor, Dr. Raymond Chun, encouraged her to return to her home state of Wisconsin and become a child neurologist. Dr. Zupanc initially hesitated, but ultimately agreed, thinking it would simply be a good learning opportunity from her mentor. While there, she learned that pediatric epilepsy didn’t have many treatment options aside from a handful of drugs. However, there was exciting innovation with pediatric epilepsy surgery just starting to be performed in young children. 

“Epilepsy surgery in children was in its infancy at this time, and people thought we were crazy,” Dr. Zupanc says. “The advances we’ve made since then are astonishing. We can do things we’d never dreamed of before.”

Now, she says, she feels like Sherlock Holmes when she works with a new patient. Each child is different, and a physician must determine how to best help them in terms of their specific situation – medically, socioeconomically, culturally and religiously. It’s imperative to partner with families, listen to them and come to an agreement, Dr. Zupanc says.

A legacy that goes beyond awards

Throughout her career, Dr. Zupanc has been very active in the CNS and the Child Neurology Foundation, a parent/provider advocacy group linked to the CNS. A handful of her other legacy accomplishments include her work in infantile spasms and epilepsy surgery; transitioning care of pediatric patients to adult care; and, most recently, chairing the CNS relative value unit (RVU) task force, resulting in a seminal article about physician workload, compensation and burnout.  

As a clinical professor in academic medicine, she has continued to teach medical students, residents, fellows and colleagues, as well as mentor young faculty, especially women.

“Fifty percent of medical school classes are now women, but there is still a glass ceiling in terms of being leaders in our field,” she says. “We’ve come a long way, but the progress is slow. Having diversity, inclusion and equity in medicine makes the field better and stronger.”

Dr. Zupanc was recruited to CHOC 10 years ago to build the neurology division. She now considers her greatest accomplishment to be CHOC’s designation as a Level 4 Epilepsy Center – the highest level of specialization – providing “complex forms of intensive neurodiagnostic monitoring; extensive medical, neuropsychological and psychosocial treatment; and complete evaluation for epilepsy surgery, including intracranial electrodes and a broad range of surgical procedures for epilepsy.”

Since arriving at CHOC, she has grown the pediatric neurology division from four physician subspecialists to the present 16, specializing in areas such as epilepsy, sleep disturbances, movement disorders, concussion, stroke and autism. This growth has resulted in the reorganization and consolidation of the neurology division with the neurosurgery division, becoming today’s CHOC Neuroscience Institute. 

In working at CHOC, Dr. Zupanc has found inspiration from helping families who believe they have no hope. When they arrive here, she says, some feel as though their lives are falling apart; their child may have difficult-to-control epilepsy or is struggling developmentally. The quality of care they receive from CHOC is transformative and changes their lives, she says.

Medical outreach, both nationally and internationally

To only give honor to Dr. Zupanc’s academic and scientific accomplishments would be to miss a great part of what her life has been about, as reflected by the Humanism in Medicine Award. Throughout her medical career, she has continually been involved in family and community outreach and advocacy; actively participated in family support groups; and developed outreach programs for underserved communities.

Her passion and advocacy have even reached beyond national borders. She was a member of the board of directors of Physicians for Social Responsibility, the American section of the International Physicians for the Prevention of Nuclear War (IPPNW), when the group was awarded the Nobel Peace Prize in 1985. In that role, she traveled with an American delegation to the Soviet Union and met with like-minded Soviet physicians to share ideas for pulling their nations back from the brink of nuclear disaster.

More recently, Dr. Zupanc traveled to India, Armenia and Vietnam on missions of teaching and providing medical care in areas where doctors are rare and medical specialties often non-existent. Back home, her passion is family-centered care, and she is a regular guest speaker at family support groups.

“My patients and their families have taught me so much,” Dr. Zupanc says. “They’ve taught me humility, how to truly listen, to be open-minded and that deeply caring for the patient and family reaps great rewards.”

“One of the wonderful things about child neurology,” she explains, “is that you often embark on a decades-long journey with families.” She still receives letters and cards from patients she treated 30 years ago. “You transform a child’s life and a family’s life. That’s what this profession is all about, and why it has always been more than a job for me. It’s a calling.”

Learn more about the CHOC Neuroscience Institute.

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I’m a pediatric neurosurgeon. Here’s why I’m excited about the technology at our fingertips.

By Dr. Suresh Magge, medical director of neurosurgery at CHOC, and co-medical director of the CHOC Neuroscience Institute

Even as a child, I was fascinated with science, and it was ultimately the concept of using science and technology to help people that drew me to medicine. Today, I’m more excited and optimistic than ever about our ability as clinicians to provide best-in-class treatment to the patients we have the privilege to care for – particularly in a minimally invasive way.

While every effort is made for nonsurgical intervention, neurosurgery can often be the answer to saving or improving a child’s life. At CHOC, we are committed to creating a personalized treatment plan for each child, based on his or her needs.

When surgery is necessary, we strive to perform minimally invasive surgery whenever possible for the myriad benefits it brings our patients. Minimally invasive neurosurgery offers a smaller incision, less pain, minimal blood loss, shorter time spent in the operating room, shorter recovery time, shorter hospital stays and hidden scarring.

There are a number of tools that we use to make surgery less invasive. For example, we can use a small camera, called an endoscope, to look inside the brain without having to make a large incision. In some surgeries, we can use a specialized robot, called a ROSA robot, to allow for precise placement of catheters or electrodes, and to operate on tiny areas of the brain.

Here are four surgeries I’m excited about as a pediatric neurosurgeon. In each surgery, the child is asleep and does not feel any pain during surgery. 

  1. Endoscopic surgery — This option for many types of brain surgery allows the neurosurgeon to identify and treat conditions deep within the brain. A tube-like instrument with a camera is inserted into the brain through a small incision in the skull. In some cases, we can insert the tube through the nose and avoid making any incisions in the skull. This allows the neurosurgeon to have a clear picture of the tumor. Then, we use specialized surgical instruments to remove the tumor or damaged area. When possible, we use this technique for brain tumors, hydrocephalus, arachnoid cysts, craniosynostosis and skull base surgery. In treating craniosynostosis, endoscopic surgery can replace larger and more invasive surgeries but still achieve excellent outcomes.
  2. Responsive neurostimulation (RNS therapy) —The RNS system is similar to a heart pacemaker. By monitoring brain waves, it can detect seizure activity and then the system can respond to stop the seizure. What simultaneously amazes me and comforts families about this piece of technology is that patients can’t feel the device once it’s programmed. They don’t feel pain or anything unusual. Studies show RNS therapy reduces seizures and improves quality of life for most people who have used it.
  3. Deep brain stimulation This surgical treatment can offer lasting relief for many children who experience abnormal movements. CHOC offers DBS surgery for children with movement disorders of all degrees, including very complex cases. We are one of the only centers in the world to use a multiple stage approach that allows us to better target the correct areas of the brain, without the need to wake a child during surgery. DBS surgery at CHOC involves the placement of electrodes in the brain and wires that connect to a stimulator device implanted in the chest. The device is like a pacemaker; it sends impulses to the electrodes that tell the brain to stop or minimize uncontrolled movements throughout the body. Our specialized team places up to 12 electrodes, when needed, to target different areas of the brain to attain a good outcome. Surgeries take place in a state-of-the-art operating room at CHOC, which includes the latest navigation system for safer, more precise procedures and the ROSA 3D-mapping robotic system that aids surgeons in locating the exact areas to operate.
  4. Laser Interstitial Thermal Therapy (LITT) – Also known as laser ablation, this emerging technology provides pediatric patients with epilepsy and other conditions a range of benefits more traditional procedures can’t match and offers a potential solution for brain tumors that are hard to reach with traditional surgery. Instead of doing a craniotomy where a large incision is made to open up the skull, the neurosurgeon first makes a small hole in the skull just a few millimeters in a diameter. Then, under MRI visualization, the neurosurgeon can precisely position the laser probe and deliver heat to the specific area, which destroys the abnormal tissue. Laser ablation is especially useful in patients with tumors or seizure-generating abnormalities deep within the brain. Precision is essential in implanting the catheter, which guides the laser, since it allows the neurosurgeons to limit the thermal energy delivered to the tumor area only. Most LITT is minimally invasive and requires a short time in the operating room, and patients are often able to go home the next day.

Throughout my career, I’ve been fortunate to see firsthand how neurosurgery has advanced tremendously over the years, particularly through research and innovation.

I’ve had the privilege of studying and providing care at a number of institutions – Harvard, the National Institutes of Health, the University of Pennsylvania, Boston Children’s Hospital, and Children’s National Hospital (Washington, DC) — before coming to CHOC. At each of these institutions, it’s evident that through innovative technology and minimally invasive surgery, we as neurosurgeons can alleviate suffering and have a significant impact on the lives of children.

As a team here at CHOC, we always ask ourselves, “What is the best thing we can do for each child in the least invasive method, with the least amount of pain?” and then we try to do it in the most compassionate way possible.

It’s an exciting time in medicine, in part thanks to advances in technology — especially the pieces of technology that allow us to provide these minimally invasive surgical options that make a true impact on children and their families.

For more information about the CHOC Neuroscience Institute, click here.

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