Dr. J.D. Day held a skull model in his hand and pointed at the place in the eyebrow where he cuts a bit of skull away to get to an aneurism. He can go through the nose, to get at a pituitary tumor. "A lot of what I do," he said, "is minimally invasive," a good thing when you're talking about brains.
The skull-base surgeon came to UAMS at the end of March to head up its Department of Neurosurgery after two of UAMS' neurosurgeons, Ossama al-Mefty and Ali Krisht, defected from gown to town to join St. Vincent Health System. (Al-Mefty, who at UAMS was the highest paid state employee, has since moved to Brigham and Women's Hospital in Boston.)
UAMS does what is increasingly rare at community hospitals — operate on complex brain diseases and emergency care. Private practice neurosurgeons have dropped their cranial privileges at hospitals to avoid high malpractice insurance rates. UAMS, as the state's first hospital to be designated a Level I trauma center, must have neurosurgeons on call 24 hours a day and a designated surgeon in-house at all times to handle head trauma.
Day, who was director of cranial base surgery at the University of Texas in San Antonio, has put together a cerebrovascular team to deal with stroke, which includes on the surgical team a stroke specialist, neuroradiologists and a neurointensivist (who cares for critically ill patients). In "rebuilding" the Neurosurgery Department, he's hired Dr. Erika Petersen (functional neurosurgery) and Dr. Atom Sarkar (neuro-oncology) and is recruiting for a trauma neurosurgeon, a neurosurgeon with a specialty in spinal trauma and tumors, and a pediatric neurosurgeon.
Once you can get doctors to visit Arkansas, it's easy to get them to stay, Day said.
Day, 47, whose professional aspiration was to be chair of a department someday, didn't necessarily aspire to UAMS — until he visited. "I couldn't believe what was here," he said. "It's hands down the nicest facility I've been at," he said, exceeding the University of Southern California Medical Center, Allegheny General in Pittsburgh, the Lahey Clinic in Boston and UT San Antonio.
As a teacher as well as surgeon, Day said the Yasargil Microsurgical Education Center at UAMS is the realization of a dream. He said the teaching lab, where he provides specialized training to residents in skull-base techniques, "is second to none in the country." The Yasargil lab is named for Gazi Yasargil, the celebrated neurosurgeon that came to UAMS in 1994 and was named in 1999 "Neurosurgeon of the Century" by Neurosurgery, the journal of the Congress of Neurological Surgeons.