A neurosurgeon and his patient finish their story, 27 years later

Issam Awad, MD, Professor of Neurosurgery and Director of Neurovascular at the University of Chicago Medicine, shows former patient Kathy Hommowun the spot on the brain where he removed a cerebrovascular malformation 27 years ago.

Issam Awad, MD, Professor of Neurosurgery and Director of Neurovascular at the University of Chicago Medicine, shows former patient Kathy Hommowun the spot on the brain where he removed a cerebrovascular malformation 27 years ago.

Kathy Hommowun couldn’t remember the young neurosurgeon who treated her after a debilitating stroke when she was just 29 years old. In fact, she couldn’t remember much of anything from that ordeal. So after 27 years, she and her husband decided to look him up and finish a story that now ends in Chicago.

In 1987, Issam Awad, MD, now Professor of Neurosurgery and Director of Neurovascular at the University of Chicago Medicine, was also 29 years old, practicing neurosurgery at Mission Community Hospital in Mission Viejo, California. He had joined the staff at the small hospital at the insistence of his family, many of whom where also physicians there, after receiving training on cutting edge surgical techniques at places like the Barrow Neurological Institute, Cleveland Clinic and Stanford.

“I was like a fish out of water, one of those young turks coming in with all these new ideas,” he said.

He had been working there only a few months when he met Hommowun. She had suffered a stroke, which was extremely uncommon for an otherwise healthy woman her age. At the time, surgical intervention was not a common practice for stroke, nor were any of the advanced imaging tools we now take for granted, like MRI, in regular use. Awad, fresh off his advanced training, pushed for a more aggressive approach of surgery to find the source of bleeding in Hommowun’s brain that caused the stroke and repair it.

Today, that approach is common. Surgeons like Awad use advanced imaging to find the lesion or blood clot in the brain that caused a stroke, and use precision guided surgical techniques to remove it. But at the time it was controversial, and Awad remembers many personal conversations with Hommowun’s husband, Bob, their family and the more conservative physicians caring for her.

The surgery was successful. Awad found a cerebrovascular malformation, or abnormal tangle of blood vessels in her brain, and was able to remove it. A few weeks later, Hommowun went home from the hospital to begin her long recovery. Awad, the fish out of water, returned to a bigger pond at the Cleveland Clinic later that year, and resumed his academic career. The two of them didn’t speak again—until this year.

Issam Awad, MD, explains his research on hemorrhagic stroke to former patent Kathy Hommowun and her husband Bob.

Issam Awad, MD, explains his research on hemorrhagic stroke to former patent Kathy Hommowun and her husband Bob.

“As you go through life, you’re supposed to build your own story,” said Bob Hommowun. “Well, we always had this story about Kathy, but in my mind we hadn’t completed it yet.”

The missing part of Kathy’s story was the young surgeon from all those years ago in California. The Hommowuns traveled the world through Bob’s work for the United States Department of State, and when he was recently reassigned to a post in the U.S., they decided track him down, leading to a reunion 27 years in the making.

This October, as the Hommowuns and Awad reminisced in the Sky Lobby of the University of Chicago Medicine’s Center for Care and Discovery, Kathy marveled at how their two had crossed paths in Mission Viejo during Awad’s relatively brief stint there.

Since then, Awad has been researching hemorrhagic stroke at places like Yale and later in Chicago. His research is supported by the National Institutes of Health, and has included discoveries that have changed the care of this disease. Kathy later visited Awad’s lab and met with his researchers.

“Had this happened to me a few months earlier or later, I wouldn’t be here today. It’s such a dream, a miracle actually, that you were there,” Kathy told him.

To reunite with such a memorable patient after so many years was special, Awad said, because Kathy represents the human face of a challenging clinical problem he has been studying in the intervening three decades. In particular, he said he remembered Kathy’s smile.

IMG_3868

“In my work, for almost every patient I see, it’s the worst illness of their life. You take care of hundreds of patients, and in some ways they become hundreds of bleeds and hundreds of lesions. But they are also, each one, a real human story, and in some ways the small role that we physicians play in altering that life is such a privilege,” he said.

“For your case,” he told Hommowun, “it had been zero contact for almost three decades. But time doesn’t erase the impact of a very special encounter that fate had for us.” He recalled something he said to Kathy and Bob before they decided to go ahead with the surgery, something he still tells his patients today.

“Whatever you decide, we’re going to be together. We’re going fight this together,” he said.

About Matt Wood (484 Articles)
Matt Wood is a senior science writer for the University of Chicago Medicine and editor of the Science Life blog.
%d bloggers like this: