by Gregory James
Learn how Dr. Jamye Coffman is speaking up to protect the most vulnerable patients: our children. Delve inside the mind of a cardiac surgeon with Dr. Gonzalo V. Gonzalez-Stawinski and go deep-brain into the future of neurosurgery with Dr. Anita Bhansali. Standing on the shoulders of giants and backed up by teams of hard workers, each doctor is leading Fort Worth into new frontiers of greater health and well-being.
Dr. Gonzalo V. Gonzalez-Stawinski
by Gregory James
Cardiothoracic Surgeon at Baylor Scott & White All Saints Medical Center
He’s been called one of the busiest heart transplant surgeons in America — but his award-winning medical career all began with a bullfrog.
Dr. Gonzalo V. Gonzalez-Stawinski, chief of cardiovascular and thoracic surgery at Baylor Scott & White All Saints Medical Center — Fort Worth, performs heart transplants at Baylor Scott & White Health hospitals. Averaging 20–30 heart transplants per year, Gonzalez-Stawinski often undertakes riskier procedures that are considered too difficult by others. “Turning the impossible into the possible, that’s what I like to do,” he says. Practicing for 14 years, Gonzalez-Stawinski worked as an associate staff surgeon at the esteemed Cleveland Clinic and as a visiting professor at Johns Hopkins Medical Center and Duke University. He has been in Fort Worth full time since 2017.
Gonzalez-Stawinski’s interest in the heart began as a child in Puerto Rico. Like most of us, he caught frogs outside his house. Unlike most of us, he would anesthetize them with ether-soaked cotton balls and perform anatomical dissections. “I remember that vividly, [thinking] oh, my God, the heart looks so cool.” Gonzalez-Stawinski was fascinated by the organ’s central role in maintaining life, as well as its metaphorical connotations. “It’s where love lies, it’s where hate lies, it’s where your soul lives probably. You can feel it when you’re in love.”
In medical school, cardiac surgery came naturally. “It was the only thing I was good at,” he laughs. “It just clicked.” The challenge of heart surgery appealed to him, as did the efficacy he felt in the operating room. “The most beautiful thing about surgery is that you get the immediate gratification of solving somebody’s problem right then and there and see the effects at the next moment … I truly love it.”
Gonzalez-Stawinski has a unique talent for visualizing three-dimensional surgical outcomes from every angle, an advantage that he credits to his mother. A gifted seamstress, she could easily envision how to turn two-dimensional textiles into three-dimensional garments — and she passed this trait on to her son. “I do the same thing with cardiac surgery,” he says. “She uses it for clothing; I use it for taking care of patients.”
And Gonzalez-Stawinski has no shortage of patients. Heart disease is the No. 1 killer in America; one in four of us will die from it. Yet cardiovascular disease does not evoke the same terror as other maladies like cancer or coronavirus. “I think it’s because the public has grown accustomed to accept cardiac disease as part of their culture and their lives,” Gonzalez-Stawinski explains. There’s also a lack of emotional reactivity to the disease because it takes a long time to produce problems. “Because cardiac disease usually presents in the latter parts of your life, people have grown to lose sympathy.” Diseases that strike down the young feel much more frightening than those like heart disease, which predominately affect an older population.
But you don’t need to be terrified of cardiovascular disease — you just need to hit the treadmill. “You have to work out,” Gonzalez-Stawinski says. “You have to dedicate an hour at least three times a week and then curtail your daily intake [of calories] … I’m not saying that it’s easy.” The doctor avoids fried foods and fast-food, but he doesn’t count calories. “I try to regiment … [if] I already had a big lunch, I’m not going to have a big dinner.” But Gonzalez-Stawinski loves red meat, which is only a problem when eaten in excess, he says — all too easy to do in the beef epicenter of Fort Worth.
Luckily, the city now has a top-tier cardiovascular program right here at Baylor Scott & White - Fort Worth. “I don’t want anybody to think that they have to go to Houston or Dallas or Plano … because they’re going to receive better care. If you have a cardiac surgery problem or a cardiovascular problem, I can tell you hands down without any concerns that we can do it here in Fort Worth. In the last three years, we’ve built a world-class program, and we’re still growing.”
Dr. Gonzalo Gonzalez-Stawinski has set his sights high for the city. “My goal is to make Fort Worth the hub for cardiac care,” he says, “to be a nationally recognized cardiovascular care center — that’s my ultimate goal.”
Dr. Jamye Coffman
by Gregory James
Pediatrician at Cook Children’s Medical Center
It sounds like a horror movie: The mother who is supposed to love and protect you is intentionally making you sick, slowly poisoning you to the point of permanent injury — and even death.
But this terrifying scenario is not something Hollywood dreamed up; it’s Munchausen syndrome by proxy (MSBP). MSBP is a mental illness in which a caregiver creates health problems (or fakes them) in the person they’re caring for, almost always a mother and her child. Mothers with MSBP may poison their child’s food with pathogens or inject fecal matter into IV tubes. They falsify test results and force their children to use wheelchairs they don’t need.
“It’s a very serious form of abuse that people don’t really understand,” says Dr. Jamye Coffman, a world-renowned expert on MSBP who has spoken about the disorder on “The Dr. Oz Show” and “20/20.” Coffman is the medical director for the Prevention of Child Abuse and Neglect at Cook Children’s, which sees close to 2,000 child abuse victims every year. She’s also the medical director for the center’s Child Advocacy Resources and Evaluation (CARE) team.
MSBP has recently bubbled to the surface of pop culture in TV shows like HBO’s “Sharp Objects” and Hulu’s “The Act.” “[Munchausen by proxy] is so bizarre that it grabs people’s attention,” says Coffman. “It seems so unreal.” But with a mortality rate of 6% to 10%, MSBP is all too real for the children affected. It’s also incredibly hard for people to accept that mothers would hurt their children, and that’s why Coffman’s expertise is so important. She has worked at Cook Children’s for two decades and spent 10 years in general pediatrics before that. She appears in court several times a month for child abuse issues.
“It’s difficult for judges to understand, it’s difficult for juries to understand, it’s difficult for doctors to understand, it’s difficult for Child Protective Services to understand,” Coffman says. Those with MSBP often seem like ordinary, well-adjusted people. “The moms that perpetrate this type of abuse will often have a normal psychological profile,” she says. “Usually it’s a medical provider that brings up the concern when a child is having numerous medical visits with multiple providers and nothing makes them better … and the mom is asking for more intervention, more surgical procedures — not like a normal parent that doesn’t want to have procedures done to their child.”
Coffman has made it her mission to stand up and save children from harm. “It wasn’t that I was looking for this type of work; it kind of found me,” she says. “But once I started doing it, I really enjoyed it.” Focusing on the positive impact she makes helps Coffman to stay motivated in a difficult profession. “Seeing how children who have been abused can thrive in a good environment and seeing that you can make a difference are helpful,” she says. “I feel like I get to speak up for children.”
Coffman also has help from Kitty, a golden retriever that’s one of six therapy dogs at Cook Children’s. “She lives with me; she sleeps in my bed … she is at my hip most of the time.” Kitty is always on hand to calm down Coffman’s anxious and often traumatized patients. “When you pet a dog, it brings down your stress hormones. Your cortisol levels come down, your heart rate comes down, your blood pressure comes down.” Staff members also break for cuddle time when the going gets tough — like tax season, when child abuse spikes.
“We don’t want to believe that abuse happens in our neighborhoods, but it does,” she says. “You may not be seeing it, you may not be recognizing it, but it’s all around you. It’s in all demographics.” Even when bystanders do suspect abuse, they may be hesitant to speak up, fearing that the child will automatically be removed by CPS. “That is not the case at all,” Coffman says. “Many times, we find medical problems with these children that mimic abuse; then we can get them to the appropriate specialist.” Other people just don’t want to get involved in what they perceive as another family’s business. Coffman disagrees. “It is everybody’s business to watch out for children … we all have a responsibility, whether it’s our child or not.”
Dr. Coffman’s commitment to speaking out has improved the lives of countless children — and she hopes her message will be taken to heart. “It only takes one person to step up,” she says. “You can make a huge difference in that individual child’s life.”
Dr. Anita Bhansali
by Gregory James
Neurosurgeon at Texas Health Fort Worth
Dr. Anita Bhansali is at the vanguard of functional neurosurgery, a brave new world where electrical pulses from brain implants treat motor disorders, epilepsy — and even psychiatric conditions.
A neurosurgeon at Texas Health Fort Worth and the Center for Epilepsy, Bhansali is fellowship-trained from Seattle’s acclaimed Swedish Neuroscience Institute. She has practiced in Fort Worth at the North Texas Neurosurgical and Spine Center since March 2019.
The nervous system is what makes us human; it’s why anything we experience feels good or bad, pointless or meaningful. Neurosurgery is one of the youngest fields of medicine and is constantly changing. “I’m not sure that a neurosurgeon from 50 years ago would recognize a lot of the things that we’re doing,” Bhansali says.
As a functional neurosurgeon, Bhansali treats conditions that interfere with the operation of the nervous system, including pain syndromes and movement disorders. Neurosurgical issues rarely have clear-cut solutions. Cures can be elusive. “Sometimes all you can do is work around [the problem],” she says. “Finding a way to keep someone’s quality of life as high as you can is really attractive.”
For patients with epilepsy, this means reducing the frequency and severity of seizures. One percent of the population has some form of epilepsy, over 3.4 million people in the U.S. alone. “It touches a lot of lives,” says Bhansali. “It’s a difficult disease to live with, and it’s a difficult disease to manage and treat.” But epilepsy doesn’t always look like the dramatic, grand mal seizures that we see on TV. It’s a spectrum disorder, and seizures can be much more subtle — a blank stare for a few seconds or a repetitive twitch of the arms.
Undiagnosed epilepsy can be a real problem, especially for children. “If they’re zoning out in class and missing what’s going on around them, that’s a big deal,” says Bhansali. “They’re going to appear as if they’re inattentive or they’re not interested in school, but, because of the epilepsy, really their brain is working against them. That can be just as debilitating as a seizure that appears more dramatic.”
Patients with epilepsy received new hope in 2018 when the Food and Drug Administration approved treatment with deep brain stimulation. Used to treat Parkinson’s disease and essential tremor since the ’90s, deep brain stimulation (DBS) helps to control the brain’s activity with electrical pulses emitted by implanted neurotransmitters. “Deep brain stimulation is one of my favorite surgeries,” Bhansali says. She completed the first DBS case at Texas Health Harris Methodist Hospital Fort Worth in January on a Parkinson’s patient. “It can have a major effect on [the patient’s] quality of life.” DBS is also being studied in clinical trials to treat addiction and mood disorders like major depression. Could we see a future where garden-variety anxiety is treated not by tweaking your meds but by tweaking your implant? Not so fast, says Bhansali. It’s still brain surgery.
But the potential is there — and growing. For Bhansali, the most compelling new treatment for epilepsy is the responsive neurostimulation system (RNS). The RNS is a smart implant that records and interprets the brain’s electrical activity, then uses that information to “predict” seizures — and to respond with timely stimulation to ward them off. “This is different from the other devices that are out there … because they just deliver stimulation at a set rate, frequency, and amplitude, regardless of what’s going on clinically.” With the RNS, neurologists can periodically download the information recorded and then train the device to respond to each patient’s unique brain activity. The result? “Seizure control gets better and better over time, unlike other therapies,” she says. “It’s a technology that is just so fascinating … I get really excited about this stuff.”
Bhansali brings her expertise and enthusiasm to Texas Health Fort Worth’s Center for Epilepsy, which offers the only comprehensive epilepsy program in the Greater Fort Worth area. She’s helping to create a pathway for patients as they navigate the disorder, which often requires long-term monitoring. It’s a path that doctors and patients must walk side by side as partners, especially when weighing the risks and benefits of brain surgery.
“It’s very much a conversation with the patient … I take as much time as I can to go over the imaging and explain the options,” says Bhansali. “I like that aspect of it — the shared decision-making.” With communication at the heart of her medical philosophy, Bhansali provides patients with an important touchstone in the complex and ever-changing field of functional neurosurgery.
