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Dr. Keith L. Black A Medical Genius and Innovator

Extraordinary Profiles

His exceptional innovations and desire to help people suffering from brain cancer has earned him accolades as one of the world’s top neurosurgeons. Dr. Keith L. Black is an elite neurosurgeon who performs hundreds of successful brain cancer surgeries each year, many of which are often considered inoperable. His vision is to go beyond just healing people who have brain tumors. His mission is to explore ways to eliminate these cancers. Dr. Black’s passion to eliminate the disease influenced his decision to establish the Maxine Dunitz Neurosurgical Institute at Cedar Sinai Medical Center in 1997, and he also established a Neurosurgery Department at the medical center. As a young lad, Dr. Black always had an interest in science. He has his parents, whom he describes as the ultimate educators, to thank for cultivating that interest, as well as great mentors over the years.

Dr. Black’s vision is becoming a reality as he continues to bring together the brightest and most creative neuroscientists and neurosurgeons to find cures for disorders affecting the human brain. Dr. Black graciously took time from his incredibly busy schedule to talk about his success as a surgeon, his innovative endeavors and his desire to eliminate brain diseases. Monica: Who inspired you to become a doctor and why did you decide to focus on neurology and brain cancer? Dr. Black: I had a lot of great mentors along the way. For as long as I can remember, I’ve always had an interest in science. My parents were educators; my mother was a teacher, my father was principal of an elementary school. I always describe them as being the ultimate educators. As early as second, third grade, when they learned that I had an interest in science, they cultivated that interest. So, it was probably my parents who were my first mentors.

As I went on to college and medical school, my professors took me under their wing, and they shared their experiences with me. That was really wonderful. I became interested in the brain and neurosurgery after taking a class in neural anatomy. I fell in love with the structure and function of the human brain. For me, it was one of the most beautiful structures in the known universe, allowing us to see, to feel, to think and create. So I knew I wanted to spend the rest Dr. Keith Black and the Braintrust. The women of the Brain Trust have been instrumental in raising funds and awareness of my life learning how to benefit Dr. Black's research at Cedars-Sinai Medical Center. In this picture taken during Dr. Keith Black's book signto heal the human brain. ing in New York, are (from left) Ms. Dale Mason, Ms. Gloria Mitchell, Ms. Angelia Bibbs-Sanders, Dr. Carol Bennett, and Ms. Pauletta Washington). Also, in the picture is Ms. Star Jones who was the event's emcee. May-June 2011 | Exceptional People Magazine | 17

Extraordinary Profiles

Monica: Are there symptoms of a brain tumor? If so, what are they? Dr. Black: Yes, there are clearly symptoms and, you know, what makes it a little difficult is that one of the most common presenting symptoms is a headache. Obviously, headaches are one of the most common medical symptoms that we encounter. Everybody gets a headache and we’ve all had headaches, multiple headaches. So the vast majority of headaches are really insignificant; it might be a tension headache, or a migraine headache. But occasionally, a headache that’s very different than what you’re used to, may be a warning sign of either a brain tumor or a ruptured blood vessel in the brain. And it’s important for physicians to be able to distinguish a regular headache vs. a headache that could be a warning sign for something more serious. So a headache is a very common presenting symptom. New onset of a seizure in an adult is one of the most common symptoms or findings that can lead to discovery of a brain tumor. If you’re an adult who has a seizure and you haven't had seizures before, the most likely cause could be a brain tumor. Also, any area that the brain controls -- so difficulty with speech, difficulty with movement, difficulty with sensation, a new onset of double vision, particularly if it worsens over a period of weeks or months, those are very bad signs that could suggest a tumor growing within the brain. Monica: Are brain tumors based on certain conditions, or maybe a certain lifestyle? Do they occur among certain groups of people? Dr. Black: Well, most brain tumors, we do not have a cause that we know of that’s associated with them, so unlike lung cancer, where smoking cigarettes is a clear risk factor, we don’t have a clear risk factor for brain tumors. So probably for 95 percent of patients who develop brain tumors, it’s a development that’s not related to anything that we know of in their lifestyle. Now, certainly there’s been a lot of discussion about cell phones causing brain tumors. 18 | Exceptional People Magazine | May-June 2011

Baroness Monica von Neumann champions the work of neurosurgeon Dr. Keith L. Black, who first met The Baroness after her late husband was diagnosed with brain cancer.

Scientifically, at this point, about 50 percent of articles suggest that cell phone use has no relation to brain cancer, and the other approximately 50 percent suggest that brain cancers may be related to cell phone use. Some articles have suggested that the risk of developing brain tumors may be increased by more than 250 percent if you’re using a cell phone. We know that cigarette smoking is strongly linked to lung cancer, but if you begin smoking a pack of cigarettes a day at 12 years old, we don't expect you to develop cancer at 22. We expect you will develop lung cancer at 42, so after about 30 years of smoking a pack of cigarettes a day, we know that you’re likely to develop lung cancer. None of the studies involving cell phone use have really looked past ten years of use, so we don’t know what the long-term impact would be of using a cell phone over 20, 30 or 40 years. Most of the studies have only looked at people who have used cell phones for a few hours per month, and I believe most people use cell phones for much more than a few hours a month.

Extraordinary Profiles

We also have reason to believe that the effects are going to be much greater in younger people and children than in adults, because their skulls are thinner. The microwave radiation can penetrate deeper into a child’s brain than an adult brain, so we don’t know what the impact of that would be. Those questions, I think, are still unanswered.

Dr. Black: Yes. We’ve tried to do some very out-of-the-box thinking to find new and novel ways to bring a big impact on our ability to treat patients. One of the things that we’ve developed is what we call a therapeutic vaccine for brain cancer, where we actually take proteins from brain tumors and use those proteins to activate the immune system against the tumors to destroy them.

Monica: You established a neurosurgery department at Cedars Sinai Hospital a few years ago. What types of research are you currently performing, and have you progressed to a point where you are able to apply that research?

We were the first to use this type of vaccine in patients with brain cancer, and what we’ve shown is that for the most aggressive type of brain cancer called a grade four glioma, we can increase the survival rate at two years from 8 percent to 42 percent in patients who receive the vaccine. We’re working to make the vaccine even better in the newer generation of vaccines that we’re making. We’ve also developed ways to get chemotherapy directly into the brain and into brain tumors, to make it more effective and safer. Monica: Your ultimate goal, of course, is to eliminate brain cancer. How close do you think you are? Dr. Black: Well, I think we’re certainly making strides in trying to increase the life expectancy of patients with brain tumors. We’re working to eliminate the need to perform surgery for brain cancer and we’re also trying to develop technologies to destroy these tumors, using non-invasive strategies such as laser and focus ultrasound and microwave oblation. Monica: You and your team are taking a very aggressive approach to eliminating brain cancer, something similar to the Manhattan Project, which was successful in developing the atomic bomb. So you are definitely taking an aggressive approach. What are your thoughts about that type of approach? With that type of aggressiveness, how quickly do you think you may be able to develop a treatment that will eliminate brain cancer?

Dr. Keith Black in the operating room.

Dr. Black: What we’re doing is recruiting the best and the brightest minds to our neuroscience institute to find a cure for brain cancer. We want to develop a treatment that will invert it from a universally deadly diagnosis to something that’s more akin to hypertension, which you can live with and that can be contained. The strides that we’ve made over the last five years have been significant. I see the potential for developing much more effective treatments over the next five years. May-June 2011 | Exceptional People Magazine | 19

Extraordinary Profiles

Monica: How do you recruit the people that you bring onto your team? Dr. Black: Basically, what we do is allow people to work in an environment where they are surrounded by others who are the best and the brightest in the area. And we try to give them the tools they will need to make discoveries to find cures for this disease as quickly as possible. Monica: To date, what has been your most treasured accomplishment as a neurosurgeon? Dr. Black: I think the vaccine that we've developed has really made a difference in the field. It has opened what we call the blood-brain barrier, which means that the brain doesn't take in most drugs, because the capillaries basically form walls that don’t allow drugs to penetrate. We've developed strategies that allow drugs to penetrate into the brain to treat tumors, and that’s a major accomplishment. I’m also personally very proud of the department and institute of neurosurgery that we built at Cedars Sinai. It is now one of the largest and busiest neurosurgical centers in California that’s providing cutting-edge care for patients with disorders affecting the human brain. Monica: That’s wonderful. In your opinion, how much funding will be required to reach a point where the disease can be eliminated? Dr. Black: I believe to eliminate brain cancer, you’re probably looking at an investment of about $10-20 billion. You know, that’s a big number. But when you look at the fact that you have more than 200,000 people dying in the United States every year from brain tumors, being able to save those lives and to improve the quality of life, I think it is well worth the investment. The spillover and the impact of that on other disorders I think will be significant as well. Monica: How has being a brain surgeon affected your view of yourself, as far as your mortality?

20 | Exceptional People Magazine | May-June 2011

Dr. Black: Well, I recently wrote a book called Brain Surgeon: A Doctor’s Inspiring Encounters with Mortality and Miracles, and I talk about the real heroes. And the real heroes are my patients because you think that if you’re given a diagnosis of brain cancer, you say, “Well, I’m just going to give up and take the American Express card and go to Tahiti.” But that’s not what they do. They take time to speak to their kids and tell them things that they want them to remember for a lifetime. They tell their spouses that they love them, things that they want them to know. They teach us how to live a life worth living, and a life of meaning. You can live a lifetime in one or two years, and so I think that the biggest gift that I’ve gotten from my patients is they teach me how to live a life worth living. Monica: I understand that you also developed a program called Brainworks. Can you talk a little about that? Dr. Black: One of the things that I think is critical is giving kids the knowledge and encouragement that they can be whatever they want to be. And I think you need to start doing that early; the earlier, the better. So we have a program where we’ve brought in about 1,500 kids from lowincome areas in the Los Angeles unified school systems. They have an opportunity to become brain surgeons, neuroscientists or neurologists for a day. They perform a simulated operation on the brain using a half-million-dollar surgical microscope. They look at sheep brains and experience various things with the nurses. So we want to encourage and inspire them to realize that a career in the sciences is a cool thing. If they have a lot of passion for science, we want them to work hard so that one day they can become future neurosurgeons and doctors and scientists. Monica: Excellent. What do you hope to accomplish scientifically in the next three to five years? Dr. Black: Well, we have a lot of things on the plate. I think we’d like to get the vaccine as part of standard care for patients with brain cancer. We’re working on what we call a nano-drug that can get chemotherapy directly to brain tumors that will allow those drugs to be more effective. We’ve just published a paper where we are now potentially able to diagnose Alzheimer’s disease by looking through the eye, and we’re working on a vaccine for Alzheimer’s disease. So that’s a very exciting project. We’re using a camera that NASA used to look at the edge of the universe to view the brain. This will allow us to distinguish between a normal and a diseased brain, so that’s another very exciting project. So I think if those things all work out, it would be a good five years.

Extraordinary Profiles

Monica: Absolutely it would. Of course, what you do is very intense and it requires a lot of dedication and commitment on your part and also with your team members. What do you do to enjoy life – to get away from that? Dr. Black: The water is my sanctuary, so I can always get rejuvenated. It’s like purification and rebirth by water. I have a sailboat, so I love being out on the water in a boat. I love scuba diving. I love being close to the water. Monica: What do you enjoy most about your profession? Dr. Black: I think the biggest gratification is that every day that I get up, I know that it’s an opportunity to help somebody – a patient – and that’s a real special gift. I wake up every day saying, “Maybe I can help somebody today.” Monica: What kind of legacy would you like to leave your family and your patients – all the people whose lives you have changed? Dr. Black: Well, I have two great kids. My daughter recently graduated from college, and she’s now working in New York. My son is in college and I’m proud of them, as proud as any dad can be. They’ve turned out to be great people and great kids. And I think the legacy that I want to live is, I just hope to leave the world a better place as a result of me being here, trying to take care of my patients and trying to find cures for bad diseases. Monica: You certainly have made an enormous contribution to that. You’re doing excellent and amazing work. I can’t imagine a person of your stature in terms of what you have accomplished and what you are doing, how much pressure is on you. I’m sure you will continue to explore and achieve amazing things. You’ll probably come through with a major innovation and we’ll be there to honor you for it. Dr. Black: Thank you. Monica: Paulette and Denzel Washington joined forces with you to promote summer research scholarships funded by the department of neurosurgery. Can you talk about that experience and the scholarship program? 22 | Exceptional People Magazine | March-April 2011

Dr. Black: Oh, this is really a wonderful program where we bring two students from undergrad and two students at the grad level who are Paulette and Denzel Washington Gifted Scholars. People apply from all over the country, and they are able to work in the research lab to help find cures for brain disorders. We continue to mentor them throughout their career. And one of the very special things about the program that Denzel initiated, is that we began presenting the scholar’s award in inner city high schools. We’ve given the presentation in inner city schools in South Central Los Angeles, in Harlem and Shreveport, Louisiana, to inspire other students to achieve, work harder and become the best that they can be. Monica: How important is it for African-American children to become involved with science? Dr. Black: Well, I think it’s critical, obviously. I love science; I think that a lot of people think science is hard. They think that it’s not meant for them. But I would say it’s important to have an open mind; that if you love science, don’t be afraid to become involved. I can tell you if that’s what you enjoy, there isn't a more rewarding profession than being in medicine, helping people, helping save lives, helping make new discoveries for diseases that are devastating. So it can be an extremely rewarding field. Monica: Your last word? Dr. Black: Well, the one thing that I would like to say to young kids who may read or hear this is that you should find out what you really love to do, because when you do what you love to do, it’s not work. And if it’s not work, you don’t mind doing it. So if you’re up at 2:00 in the morning doing what you love -- that’s what it takes, I think, to be really good at anything. Malcolm Gladwell, says in his book, Outliers – you have got to spend 10,000 hours before you get really good at something. But when you love what you're doing, those 10,000 hours don't matter. And if you have any talent for it, then that combination comes together. You have a gift for what you do, you love what you do and you don’t mind working hard at it – that’s what really creates someone who can be happy and successful in life. 

May-June 2011 | Exceptional People Magazine | 21

Dr. Keith L. Black  

A Medical Genuis and Innovator

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