Meeting the Special Needs of Children

From 2014 Department of Surgery Annual Report

Pediatric and neurosurgeonsPediatric neurosurgeon David Limbrick, MD, and pediatric surgeons Kate Bernabe, MD, and Martin Keller, MD, collaborate on efforts to improve brain injury treatment. WHEN JESSIE TERNBERG, MD, PhD, completed her surgical residency at Barnes Hospital in 1959 and joined the Department of Surgery, she was among very few women in the field. In the decades to follow, she became a valued mentor and national trailblazer.

During a long career at St. Louis Children’s Hospital, Ternberg was known as a courageous patient advocate by families and an outstanding surgeon by colleagues. For 13 years, she was the only full-time general surgeon at St. Louis Children’s Hospital; from 1972 to 1990, she was pediatric surgeon-in-chief and chief of the Division of Pediatric Surgery. She routinely performed more than 500 operations a year. Nationally, she was in the vanguard of surgeons who recognized that children have surgical problems distinct from those seen in adults, a philosophy she emphasized in her 1980 book, “A Handbook for Pediatric Surgery.”

Today, Ternberg is a professor emeritus. The division has six surgeons, the most in its history, with clinical interests ranging from wound care to congenital diaphragmatic hernias. Faculty participate in a number of clinical  trials and have formed a group to look at clinical outcomes. In basic science research, Division Chief Brad Warner, MD, and two full-time researchers investigate how the intestine adapts after surgical removal or injury, a potentially life-threatening condition.

In recent years, under Martin Keller, MD, the St. Louis Children’s Hospital Trauma Center — the only American College of Surgeons-verified Level 1 Pediatric Trauma Center in Missouri and Illinois — has played an increased role in oversight of the trauma field regionally. Keller has been active in development of the Time Critical Diagnosis System in Missouri and sits on trauma oversight committees in both states.

Keller also works closely with neurosurgeons, intensivists and emergency physicians on aggressive protocols for the treatment of intracranial pressure following brain injury. The protocols — which include drugs to improve blood perfusion and sedation to put the brain at rest — were found to improve outcomes in a study published in The Lancet Neurology.

Warner, also the Jessie L. Ternberg, MD, PhD Distinguished Professor of Pediatric Surgery, says the division is well-poised for the future, which may include more of a research role for faculty as the birthrate plateaus and more pediatric surgeons enter the field.

“The next wave is being less clinically busy, but having time to do investigative work on the conditions we treat,” Warner says.