Albert researching shaken baby syndrome

If Gregory Albert, MD, MPH, were afraid of a challenge, he wouldn’t have become a pediatric neurosurgeon and cut kids’ heads open for a living. He wouldn’t have concurrently pursued a medical degree and a master’s degree in public health to improve his research opportunities. And he wouldn’t be dedicating himself to the study of nonaccidental pediatric brain trauma – particularly what is commonly known as “shaken baby syndrome.”

Albert, who finished his fellowship in June and then joined the staff at Arkansas Children’s Hospital in July, said he was drawn to that subject because so little is known about it.

“We have an idea of how to treat it based on our experience with accidental brain injury – motor vehicle accidents, ATVs, falls, that sort of thing,” he said. “But a lot of people, including myself, feel that nonaccidental trauma is a little bit different, that shaken baby syndrome is not the same thing as a head injury you might sustain from a motor vehicle accident or a fall, and therefore maybe different treatments are better.”

The dearth of knowledge starts at some of the most basic levels, including defining which children are most at risk, what are the prognostic factors, and what are the best treatments, Albert said. He said neurosurgeons believe that injuries caused by shaken baby syndrome are cumulative, but they don’t really know that for sure. What they do know is that the injuries are real, they can be life-threatening, and they can lead to long-term developmental delays and cognitive problems.

Studying the issue won’t be easy. While Albert did a lot of traumatic brain injury research using animal models and molecular biology during his residency, here the research would be more clinical. Many traditional scientific methods won’t work with this condition, so he’ll be interviewing caregivers who often won’t be forthcoming about the actions that led to their children’s injuries. To get to the truth, he’ll be working with pediatricians who specialize in child abuse, psychologists, and others in the medical field.

It might seem difficult for Albert, a husband and father of two young children, to sit at a table and coolly ask a parent what happened to their injured baby. But Albert said it won’t be a new experience.

“I do that already,” he said. “It’s just I’m taking care of these patients. Really, in all of medicine, including neurosurgery, there are things that you deal with at work that you don’t bring home with you, and it’s something you kind of compartmentalize in your life, and that’s what I’ve done through my career so far.”

For Albert, the challenge of interviewing abusive parents will pale in comparison to what he does most of the rest of the week – treat pediatric brain disorders. It’s a job that requires a unique perspective that understands that, in most cases, the patient will not be completely cured and will become a multi-year project.

“I went into this field knowing that this was going to be the case, and that’s part of the reason why I wanted to go into this field,” he said. “It was because I want to take care of this person for years on end and follow their progress and help them whenever I can. Certainly, there are certain conditions that I treat where I fix them up and send them on their way, but there are other patients who I need to (continue) following until they’re in their early 20s and graduate to an adult practice.”

He long ago grew accustomed to the concept of performing surgery on a child’s brain, though he said it is “a little bit scary to think about operating on a sometimes hours old child.” He said great caution is required because the line between success and failure is so thin.

“The brain is very unforgiving,” he said. “You use all the tools at your disposal. You take great care. You don’t hurry anything. And if you’re not sure, you step back and you figure it out or ask for help if you need it.”

 Albert came to Little Rock after meeting Mark O’Brien, MD, the hospital’s director of pediatric neurosurgery, at a conference in Cleveland and agreeing to interview here. He said he was drawn to the practice opportunities at Children’s as well as the support he believed he would receive here and from UAMS. O’Brien and he will be joined by two other pediatric neurosurgeons in the next several months.

“I actually like Little Rock a lot,” said the native of Hartford, Connecticut. “It reminds me of where I grew up but with a better climate, believe it or not.”

Albert attended medical school at Tufts University in Boston, where he earned both a medical degree as a well as a master’s degree in public health hoping to use the two in research. He then did his residency in neurosurgery at the University of Iowa in Iowa City.

That was followed by his one-year fellowship at The Hospital for Sick Children – yes, that’s its real name – in Toronto.

Spending a year in Canada, which has government-funded healthcare, gave Albert an eye-level perspective on the debate over healthcare reform in the United States. From a day-to-day standpoint, the practice of care was not that different, but in Canada there was no billing to worry about. Because each province has a healthcare budget, however, it can be harder to obtain certain treatments.

“Each side has its pluses and minuses,” he said. “Certainly, I think there’s easier access to care in the United States, but it’s also much more expensive, and you have people who don’t have health insurance, who end up not being able to get the consultations they need or not being able to get the tests that we feel are indicated, or you fight with insurance companies. None of that goes on in Canada. You just do whatever you think is necessary for the patient, and the province picks up the tab. … And certainly you wait longer for expensive tests like MRIs, but you get your MRI eventually, and if you need something done emergently or urgently, it gets done emergently or urgently. But for routine tests that can wait, you do tend to wait a little bit longer than you might in the United States.”

At the time of his interview with Medical News of Arkansas, Albert was still moving into his house and getting settled. He said he doesn’t have time for hobbies once he has fulfilled his work responsibilities and played with his children. He’s here to stay and looking forward to treating patients – some for the next 20 years.

“I’m moving into my office,” he said. “I’m moving into a house. I’m settling in for a life in Little Rock.”

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