Shepherd Center Physicians Work to Heal the Whole Person

Diane Barrineau of Ocala, Fla., set out on a weekend getaway with some friends in spring 2014. Just 30 minutes into their road trip, the driver lost consciousness, and from the backseat, Diane struggled to reach the steering wheel to keep the car from veering into some large oak trees. But it was too late. Upon impact, her seat belt snapped her backwards.

“I knew when we came to rest on a big oak tree I was doomed. I couldn’t feel anything,” says Diane, who sustained an incomplete C-5 spinal cord injury (SCI). Initially treated at the University of Florida Health Shands Trauma Center, she was soon transferred to Shepherd Center for intensive rehabilitation.

“We did our research, and it became very clear Shepherd was where I needed to be,” Diane says.

Shepherd Center is known for its clinical expertise and innovative therapy, providing care for people who sustain spinal cord and traumatic brain injury, including the most complex cases. But as Diane attests, the supportive care offered at Shepherd goes far beyond the day-to-day management of patients’ injuries. The doctors and clinical teams get to know patients and families on a personal level, as well, often developing long-term relationships.

The Human Element of Clinical Care

“The human element of our job is so important,” explains Anna Elmers, M.D., a Shepherd Center staff physiatrist who treated Diane. “We see patients at their lowest lows, and in many cases, we see them going back to school or work, getting married and living a meaningful life – sometimes achieving more than we would have ever expected.”

After nine weeks at Shepherd Center, Diane was able to return home and within days was back to work running a land surveying company.

“I’ve made tremendous progress, and the groundwork was laid at Shepherd Center,” says Diane, noting that the hospital continues to have an impact on her life.

Diane’s therapy team took a special interest in helping her son Travis as he dealt with his mom’s injury. The team educated Travis about the injury. Now, he has so much confidence in Dr. Elmers that he consults with her to make sure his mom’s local therapy is on target.

“We get to know people in a personal way and are able to see things from the family’s perspective,” says Dr. Elmers, who started as a resident at Shepherd Center in 2006. In 2009, she joined the medical staff full time as an attending physician with her own treatment team. “I couldn’t think of a more rewarding field.”

The opportunity to help restore hope and independence to patients is also a motivating factor for Gerald Bilsky, M.D., a Shepherd Center physiatrist who has followed the progress of many of his patients during the 17 years he’s practiced at the hospital. “That’s what it’s all about,” he says. “It’s why we do what we do. We hopefully can make a difference in someone’s life because they certainly didn’t plan to come here.”

Dr. Bilsky tells patients their life isn’t over after a brain or spinal cord injury. He recalls a patient he treated 15 years ago; he recently attended that patient’s wedding. Dr. Bilsky often receives pictures from patients of high school or college graduations, trips and everyday life. “That’s really cool,” Dr. Bilsky says. “There is a level of caring at Shepherd that is different than a typical hospital. There is something different here.”

Andrew Dennison, M.D., another Shepherd Center physiatrist, agrees.

“It’s spiritually rewarding for me to be able to go to work everyday and help people get through what is among the most difficult of situations,” he says.

Dr. Dennison treats people with brain injuries – often from blunt trauma or motor vehicle accidents – and was drawn to the field because it combines neurology and non-surgical orthopedics and because of the unmet need. “Not many people have the expertise or training to put all the pieces together,” he says. “These are patients with unique needs, and I’m afraid some could fall through the cracks without a good advocate.”

Often, his job involves finding medical issues that might have been missed during the initial critical care treatment provided in a trauma center. Of course, because Dr. Dennison takes care of people during the acute phase of their brain injury rehabilitation, he says, “A lot of times, my patients are just starting to remember who I am before they leave the inpatient environment.”

It’s why he tries to see patients beyond their injury and get to know who they were before their injury. “I try to be as open and honest as I can, providing hope, but also giving them a true understanding of what they are facing,” Dr. Dennison says.

Staff physiatrist Ford Vox, M.D., notes, “Our cases are sometimes very tragic, but it’s rewarding to see recoveries, and that’s what keeps you going.” He recalls one patient who was barely able to communicate or move as an inpatient, but is now back at work full time.

Shepherd Center’s caring and compassionate family atmosphere left the biggest impression on Diane. “My treatment team members had other patients to care for, but in my eyes, I was the only one they were focused on,” she says. “They had such patience and listened to every detail. So often when you talk to doctors, they are on one level and you’re on another, and they can be unapproachable.” But she remembers fondly that whenever Dr. Elmers would see her in the hospital’s cafeteria, she would come up to her and ask how she was feeling.

Unparalleled Expertise in a Culture of Caring

Because doctors at Shepherd Center treat such a high volume of patients, their expertise is second-to-none. For this reason, they are often sought after as a resource.

“We get calls from doctors around the country asking basic questions about brain and spinal cord injury,” Dr. Elmers says. “What we do is so specialized that it’s not as intuitive to others.”

The medical staff is so specialized, in fact, that Drs. Dennison and Vox are among the first physicians in the country –and only two of six in Georgia –to be certified in brain injury medicine. Drs. Dennison and Vox have both been asked to write questions for the exam that was initiated as a joint venture through the American Board of Physical Medicine and Rehabilitation and the American Board of Psychiatry and Neurology– part of a board certification that emerged out of a growing need for doctors with a certain level of expertise in treating brain injury.

“It now really means something to call yourself a brain injury specialist,” Dr. Vox says. “This certification will undoubtedly help advance the field and benefit patients.”

Erik Shaw, D.O., a physiatrist at the Shepherd Pain Institute, plays a specialized role, as well, treating chronic pain that often occurs due to an injury or degenerative disease. Like other Shepherd Center physicians, he works to help patients gain the highest possible quality of life and functional ability.

“A lot of these patients don’t have many other places to go,” Dr. Shaw says. “Most of our patients have some level of pain, and that needs to be addressed. Here, we understand the different disease states, how they progress over time and what to watch for.”

Unlike some other rehabilitation environments, Shepherd Center treats people early in their road to recovery.

“We have expertise in very complex cases at very early stages of injury,” Dr. Vox says. “We will take semi-conscious patients who may be on a ventilator and still need a surgery or two – patients who at other centers would still be under the care of a trauma or critical care physician and losing valuable rehabilitation time.”

Data consistently show better outcomes for traumatic injury patients who get an early start in individualized and intensive rehabilitation and therapy.

“It’s to the patient’s advantage to get to rehabilitation sooner,” Dr. Vox says. “Many patients are treated on autopilot in an acute-care setting, but at Shepherd Center, we can anticipate and coordinate care, and focus on neurotrauma, too.”

Teams at Shepherd Center take a holistic view in treating patients. They consider what medications may be good to use or omit, and when it makes sense to intervene with a procedure and other clinical options.

Shepherd patients may receive care from an internist, neurosurgeon and rehabilitation physician. Consulting physicians further extend the variety of surgical and medical subspecialities available to patients to address any medical issues – nerve damage, leaks of brain fluid, etc. – that may arise. This helps avoid transfers back to an acute-care hospital and disruptions in rehabilitation.

While there is a wealth of expertise at Shepherd Center, it’s the culture that sets the hospital apart, physicians say.

“I tell patients it’s like going to Disneyland,” Dr. Elmers explains. “It can be very overwhelming at first, and there’s all this stuff you need to do and you don’t know where to start. But help is all around. And the staff is so happy – from therapists to technicians to the people picking up your lunch tray and cleaning your bathroom.”

Humor and laughter are often part of the healing process.

“We know what we are dealing with is serious stuff, but we don’t take ourselves too seriously,” Dr. Bilsky says. “We try to laugh and be creative in our approach. It doesn’t mitigate the nature of what we do, but most people don’t thrive on serious every minute. I think people want and thrive on normalcy. You have to be here to see it and feel it.”

A Team Approach

Of course, the doctors at Shepherd Center are only part of the integrated mosaic of care providers that are part of every patient’s experience. Treatment teams typically include nurses, therapists, a counselor, dietitian, exercise specialist and a case manager.

“Our doctors have a lot of expertise, but what makes Shepherd Center so special is how the treatment team members work together,” Dr. Elmers says. “I’ve learned so much from the nurses and therapists.”

Dr. Vox says the teams “work closely and well together, and we have a lot of tools at our disposal to be to treat patients and optimize their recovery.”

Paying it Forward

“We try to help patients be as independent as possible and push them to new heights, and they often pay it forward to friends, family and society,” Dr. Bilsky says.

In fact, the mother of one of his patients, who is now married and living on the West Coast, returns to Shepherd Center every year to bring gift baskets and goodies to patients.

Dr. Elmers notes that many nurses and therapists go the extra mile without expecting any recognition. She knows of staff members who have donated gift cards to patients in need. And many hospital staff members contribute to the hospital’s annual employee giving campaign.

“The Shepherd family must be so proud of this incredible place they created,” Dr. Elmers adds. “We have a lot of expertise, but it’s the culture that sets us apart.”

Written by Amanda Crowe, MA, MPH
Photos by Louie Favorite, Gary Meek and Phil Skinner