Celebrating North Florida’s Doctors
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Experts navigate the world of stroke
By LaNeta Crighton
According to the American Stroke Association, just one minute of brain ischemia can mean the loss of 2 million nerve cells and 14 billion synapses.
When it comes to stroke, one of the biggest challenges physicians face is educating patients on recognizing the warning signs of stroke and the importance of acting quickly. Even after decades of public education campaigns, patient delay continues to be the most limiting factor in stroke treatment.
Hospital processes are also being evaluated. The National Stroke Association has launched a pilot program to improve hospital practices, time-to-treatment and patient outcomes for in-hospital stroke. Studies show mortality is two to three times greater for in-house strokes and time-to-treatment for strokes that happen in the hospital is considerably longer than for strokes occurring outside the hospital. It’s hoped efforts to reduce treatment delays can lead to reduction in long-term disability and mortality.
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All it took was delivering a baby for the first time during her OB/GYN rotation to sell Michelle McLanahan, M.D., on obstetrics. “There is nothing like the elation of delivering that first baby – you can’t compare it to anything else in medicine. I was on cloud nine for months after that,” she recalls.
Not only does she love the thrill of baby delivery, she enjoys every aspect of her OB/GYN practice. “In general people love their OB/GYN and bond with that specialist,” she says. “Some ladies don’t have a primary care doctor; we are it. I feel very fortunate that I could choose something that I enjoy and is fun. My husband calls it a hobby because I love it so much,” she says.
And her husband, David Derbabian, M.D., should know. “He is an ER physician but now he runs the practice. It’s our business and our practice so we work hard to make it comfortable and beautiful for our patients,” says Dr. McLanahan. “We want it to be a reflection of ourselves.”
She and her husband have two sons, Jacob is an 18-year-old and a high school senior and Josh is a year younger and a junior. “Our whole life is centered on their lives,” admits Dr. McLanahan, and she is grateful for the time that she and David can spend with their sons and their activities. “Jacob is interested in photography and plans to go to Pace University in New York City,” she says. He recently won an arts scholarship where he competed against other art forms, and won, with his photography.
Josh’s love is fencing and he has been to the Junior Olympics to compete in that sport. “He does very well at it and it is something that he would like to pursue in college,” his mom explains. They enjoy the time spent going to his competitions around the country.
As for balancing her family and her career, Dr. McLanahan gives credit to her husband. “He evens out the stuff that I am not there for,” she says. A breast cancer diagnosis a few years ago also changed her perspective a bit. “I changed my schedule after that so that I can enjoy my family time more. Having cancer put a perspective on how important family is,” she admits, and enjoys having the best of both worlds.
“When a lady puts her mind to it, she can do anything that she wants. You can do it, it might not be easy, and it usually means making a sacrifice of personal time. But it is worth it.”
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Madeline Joseph, M.D., associate professor, emergency medicine & pediatrics, chief, Pediatric Emergency Medicine Division, Assistant Chair for Pediatric Emergency Medicine, finds that her balance lies between working in the hectic pediatric ER, teaching young physicians, research, attending her children’s many soccer games and taking short walks with her husband, Michael.
As a child, Dr. Joseph always took the doctor role when playing with friends and she says that her own pediatrician also inspired her to follow in his footsteps. She stays calm and focused in emergency situations and found that pediatric emergency care was the perfect fit. Seeing how quickly an emergency can become a devastating life changer also helps her to appreciate life and rejoice in the present with her patients and her family.
Dr. Joseph is also involved in research and is in the final stages of the development of a web based computer game for kids. In conjunction with the Department of Defense and the American College of Emergency Physicians among others, “Disaster Hero” was developed to teach the skills and knowledge to children, parents and teachers needed in a disaster situation.
Because her three children, Andrew, age 17; Christine, age 15; and Matthew, age 10 are all avid soccer players and Dr. Joseph’s current research in traumatic brain injury (TBI), this is a unique way for her family and her work to complement each other. “I am on an expert panel for TBI with the Centers for Disease Control (CDC) to develop guidelines for the assessment and management of TBI in children,” explains Dr. Joseph. She is also involved in research addressing parents’ knowledge regarding sport related concussions in the region. “We want to know what the public doesn’t understand about TBI so we can educate our communities to ensure the safety of our young athletes,” she says. The project involves surveying both Pop Warner football families as well as the First Coast Soccer Association families. “The work is on a national level, but my children also play sports so it is very personal too,” she explains.
Dr. Joseph includes her children in her community work activities as much as possible. She recalls a time when she took her children with her on a Friday night to be at the Children Miracle Network University of North Florida dance marathon since the miracle child was a patient she took care of in the ER with a massive head bleed. The patient was dancing with the UNF students as well as with Dr. Joseph’s children raising money for hospitals that care for children. This feels like a complete circle: her children can see her in her physician role and her patients see her in her mother role. “So when I tell a mother that I will take care of her daughter like my own daughter, she sees that it’s real,” says Dr. Joseph.
She recently asked her children if they thought they had missed anything by not having their mom at home more and she was gratified by the responses. Andrew, who will be starting college next year, said that having a mom for a physician inspired him to go into medicine and research. Christine recognized that her mother always makes time for her children no matter how busy she is, and Matthew, her youngest, pointed out the security in having her take care of them when they are sick.
Her husband is her soul mate. “Michael is an engineering consultant who works from home and that freedom of having someone with flexible hours is very helpful for the children not to miss anything,” she says. “We complement each other very well and according to our children we finish each other sentences. My work in the ER had taught me to value life and count my blessings” says Dr. Joseph.
