Candidate Q&A: COUNCILLOR FOR THE WEST What have been your most important or rewarding experiences in your years with CNS or with other professional organizations, and how have these experiences shaped your vision of the direction the CNS might take under your leadership? Joshua L. Bonkowsky, MD, PhD, FAAP:
I believe the most important role for the Child Neurology Society (CNS) is providing the support and structure to carry efforts from the work by a single individual or group, to help children across the country (and world). My favorite personal experience with this role of the CNS has been from work on ALTEs (Apparent Life-Threatening Events). I started this project during Pediatrics residency, and then was given a chance to present my work at the annual CNS meeting while I was still a resident. This validation really encouraged me to continue the work. Then, several years later when we had made our major findings, I was able to present again, this time as a junior faculty member, and a chance to have visibility for my career and research. These presentations and interactions with other pediatric neurologists at CNS led to my opportunity to serve on a national review of ALTE care and management, which led to new standards of care for infants who experience an ALTE, and a re-definition of terminology. Starting from work as a resident, these efforts led to national changes in standards of care for ALTEs, have helped reduce unnecessary testing, and led to new insights about ALTEs (now termed BRUEs) such as the risk for child abuse. The CNS gave me the opportunity to move from identifying and characterizing a neurological issue in kids, at one institution, to changes that are helping children across the country. I would like us to build upon this unique positioning of the CNS. With trainees we can continue to ensure that they are given the financial backing and encouragement to carry their new ideas forward; and with practitioners and specialty groups we can support guideline development and clinical initiatives to make sure that improved care metrics are disseminated and understood. Finally, where we identify gaps, in care delivery, in diagnosis, or in affordability, we can tackle those problems, adopting the approach (loosely quoting Mark Watney) “Do the work. Solve the problem.”
Mark Wainwright, MD, PhD:
My own background and training is eclectic, and this is reflected in the professional organizations with which I have interacted. My undergraduate training at the University of London was in Philosophy and German before emigrating to the US. Pediatric neurology and neurocritical care fellows who have trained with me can be identified by their familiarity with Wittgenstein’s Lecture on Ethics, the Tractatus and the ‘beetle in the box’ thought experiment which is part of their assigned reading. I have maintained this broad range of interests and interdisciplinary approach throughout my career. Together with colleagues from other US and European academic centers I helped to create the Pediatric Neurocritical Care Research Group in 2010. This group now meets 3 times a year and has brought together child neurologists, intensivists, neurosurgeons and basic scientists to promote clinical and basic research. The group’s mission also emphasizes the support of early career investigators including fellows and junior faculty. I remain a member of the executive committee and was chair of the group from 2014 to 2016. We have now developed a partnership with the Neurocritical Care Society for which I serve as the liaison. Together with colleagues from critical care and nursing, I led the creation of a set of pediatric neurocritical care practice guidelines now in preparation by the NCS. The rewards of this involvement have been to see the emergence of novel research collaborations and the opportunities provided for junior investigators, and to contribute to discussions of neurologic care which might otherwise have remained the purview of intensivists. I have been involved with the CNS through attendance at the annual meetings, promoting the CNS mentor lunch at the AAN and organizing a symposium at the 2011 national meeting. Many of my other long-term organizational activities have been with societies which no do not typically involve child neurologists. I have had had the opportunity to work with the Brain Trauma Foundation on the guidelines for severe pediatric traumatic brain injury, the NINDS Common Data Elements project, also for severe traumatic brain injury, and the current American Heart Association post-cardiac arrest management workgroup. One lesson from this experience is that there is a major need for child neurologists to be involved in work of these societies and their workgroup, but our field’s current training does not provide the level of basic science and clinical expertise needed. The relevance of these experiences to the responsibilities of a Councillor to the CNS includes the importance of developing collaborations with other professional organizations, providing value to junior members (professional resources for professional development, opportunities for research, connections to other members and mentors) and balancing support for innovative academic leadership which advances our field, with attention to the fundamental administrative and economic issues which are essential to any child neurology private or academic practice. I do not have answers to these questions but I have struggled with many of them.
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Child Neurology Society | Spring/Summer 2018