Dr. Karin Muraszko

MURASZKO_KarinThough Dr. Karin Muraszko is the only woman leading a neurosurgery department in the country, her gender isn’t the only characteristic that makes her stand out.

The 4-foot-9 inch surgeon has spina bifida — a condition that prevents the spine from properly developing.

“You talk about short handicap women in neurosurgery, you’re probably defining a subset of one — me,” she said in late May while sitting in her office adorned with photographs and medical books.

Muraszko has been in charge of the Department of Neurosurgery at the University of Michigan Health System since 2005. One of the largest in the country, the department houses 20 neurosurgeons and nine research faculty members who work together to save patients from afflictions like tragic car accident injuries, diseases that cause people to lose control of their hands and brain tumors that threaten to cut off the sense of hearing.

It’s a job with a lot of responsibility, and when the department fell into her latex-clad hands, she took it with a surgeon’s vow to not make any accidental moves.

“Many people say that it’s easier to take over something that’s a burning pulpit, meaning that there’s problems,” she said. “So for me, my job was to take a really great department and make sure one, I didn’t ruin it, and two, make it even better.”

With scores of male surgeons making medical breakthroughs before her time, Muraszko is setting the precedent as the first female chair.

“I still feel pressure about the fact that as the first woman, I would hate to screw things up or to make a mistake,” she said.

Out of the 4,918 neurosurgeons in the United States in 2008, 5.6 percent — or 277 neurosurgeons — were women, according to the Association of American Medical Colleges.

With such a low percentage of women neurosurgeons, Muraszko has had few role models in the field. Instead, she extracts qualities from different people she admires and wishes to emulate. Though she is a third-generation female neurosurgeon, Muraszko acknowledges that unlike some male counterparts, she did not face rigid expectations to become one.

“I had to strike on my own road and create that, so in some ways that’s liberating,” she said.

Muraszko knew at age six that she wanted to be a doctor.

As a child, Muraszko spent a lot of time with physicians who tried to treat her spina bifida. She was in a body cast for over a year and also had an operation to shorten one leg to make it the same length as the other.

Now 56 years old, Muraszko remembers being impressed by the physicians who had a large influence on her life. Striving to be like them, she earned good grades, received her undergraduate degree from Yale University and attended Columbia University for medical school.

At first, she decided to study psychiatry because she was fascinated by the mind and people tended to share details of their lives with her. But that path changed during her third year of medical school when she did a rotation in neurology and was required to watch an operation.

Muraszko vividly recalls the procedure: The patient was a male in his 40s with a cervical spinal cord ependymoma. He was losing the ability to use his arms and hold onto his child.

“I can remember following him to the operating room, watching the surgeons do this long tedious, difficult, complex operation and I thought, ‘Oh my God. Here they are in the middle of this guy’s cervical (spinal cord) taking out this tube,’ and the fact that we could get in there, take it out and he would wake up after the operation, actually move his arms, be able to breathe … it was just fascinating.”

But the awestruck student knew entering a neurosurgery career was not as simple as filling out a job application.

“I had to test myself because as a person with a disability, I wanted to make sure that my desire to do something wasn’t going to get in the way of my ability to take care of any patients,” she said.

After completing medical school with flying colors, Muraszko convinced the faculty of Columbia University that she could handle the school’s arduous seven-year residency. She became the first handicapped person to be offered the position, though not without debate.

In 1983, Dr. Bennett Stein, chairman of Columbia’s Neurological Surgery Department at the time, said in a New York Times article that the department did “a lot of soul-searching” before admitting Muraszko.

“We were concerned that her handicap might prevent her from doing the work,” Stein said in the article. “We have found, though, that her intelligence, tenacity and motivation have enabled her to make a remarkable contribution to the care of our patients.”

Nearly 30 years later, the same holds true for the University Hospital. Muraszko came to Michigan in 1990 as a pediatric neurosurgeon. She said she chose Michigan because she liked how surgeons worked together “arm in arm.”

“It’s not that people are so egocentric that they’re in competition with each other,” she said, as doctors clad in white lab coats and blue scrubs scurried outside her office. “We kind of view it as a team sport, and the only enemy on the team is disease. It’s not each other, it’s not other people, it’s really working to take care of the patient as best as you can.”

Besides treating patients, Muraszko trained students who have gone on to become top doctors in the field. Her most recognizable pupil? Dr. Sanjay Gupta, CNN’s chief medical correspondent and associate chief of neurosurgery at Grady Memorial Hospital in Atlanta.

In Atlanta, Gupta sat in his CNN office full of medical books, glass awards and half of a human skeleton and raved about Muraszko’s personality and teaching style.

“She’s a phenomenal person, (from) what she’s accomplished certainly, but also her approach to life and her ability to toggle from operating on a meningioma blastoma to making sure that the resident that she’s training in front of her is living a good life, has good priorities and is going to be a good person,” Gupta said.

“That was really important to her so I appreciate that more about her now that I’m in those shoes training residents — how important it is to train good people as well as good doctors.”

Back in Michigan, Greg Thompson, a John E. McGillicuddy Collegiate professor of neurosurgery who works with Muraszko, compared her to James Abbott — a former Major League Baseball pitcher from Flint who played for the University before moving on to the Angels, White Sox and Yankees. Abbott was born without a right hand.

“She is truly the Jim Abbott of neurosurgery — a Michigan icon, seemingly unaware of her disability and a living inspiration to countless young people and her colleagues as well,” Thompson said. “Her achievements transcend neurosurgery, and help to redefine understanding of the word ‘handicapped.’ ”

Muraszko says her job always keeps her on her toes, but the kids she operates on keep her going. Like them, she understands what it’s like to live with a disability.

“When I look at kids in those teen years — that 13 to 18 year timeframe when everybody’s awkward and everybody’s uncomfortable, and some of these kids get very sad and very depressed of the thought that they are different — and what I want to say to them is just, ‘Hold on. Hold on until you get to about 18 or 19 and everybody around you gets more mature, and you’re going to find out that everybody’s different,’ ” she said.

And it’s not just teens on her operating table. Muraszko has had to cut into newborns and premature babies shy of 24 weeks old. She explained it’s like operating on a fetus.

“It’s still not someone who has fully matured to the point of being a full term baby,” she explained.

Over the course of a year, she works with nearly 400 patients. Even after operating on thousands of children, Muraszko says she feels privileged that parents trust her based solely on her reputation and knowledge.

“I walk into a room, and by virtue of my title and the white coat that I’m wearing, a parent who’s never met me before turns over the most precious thing that they have in their lives — their child — to my care,” she said.

In 2009, Muraszko performed brain surgery on Ryan Smith, a sophomore at Jackson Community College who had Chiari malformation — a neurological disorder that can cause migraines, anxiety and numbness. Before the operation, Smith had throbbing headaches and often kept to himself.

Afterward, the headaches disappeared. Smith’s mother, Catherine, described in a May 2011Michigan Daily article how the surgery transformed her son and made him more social.

“It was like he was re-birthed at 17 and became a completely different person,” she said in the article.

She later added, “I give Dr. Muraszko all the credit for giving me my kid back.”

Like with many professions, it’s easy to get tired and frustrated, but Muraszko tries not to let that show when talking to parents who are deeply concerned about losing their child.

“I recognize that particularly for that patient and that family, this interaction is paramount. And you may be the 15th or 20th patient for me that day, but to that family and to that individual, you’re the only one,” she said.

The stress and pressure slips away whenever Muraszko receives a card from patients who are now graduating high school or are getting married and having their own kids.

“You find out that it really does matter that you’re there. … Sometimes you can influence a life, even just by a conversation that you have,” she said.

By saving other parents’ children, Muraszko has sacrificed time with her own kids. Her 7-year-old twins are often in bed when she comes home and still sleeping when she leaves at 5:30 a.m. from her home in Ann Arbor. Sometimes she won’t see them for a few days at a time.

Muraszko’s husband, Scott Van Sweringen, said they’re used to their mother being gone.

“One time I said ‘Mommy’s home,’ and the kids ran to the telephone instead of the garage door,” he recalled.

Muraszko admits her regular absence bothers her.

“I’m here. It’s not like I’m away, it’s not like I’m on a trip,” she said.

However, like all physicians, she’s made a “sacred obligation” to her patients, which means she may not arrive home in time to help the twins study for their spelling tests every Wednesday.

The secret to having a successful marriage as a neurosurgeon is not to marry another neurosurgeon, Muraszko jokes.

“If you need someone to complete you, a neurosurgeon may not be the best person to be involved with,” Muraszko said with a laugh. “Just because we do have extremely demanding jobs.”

Scott, an architect, also doesn’t put his wife on a pedestal.

“He keeps me grounded,” Muraszko explains. “He says, ‘Sweetie, just because you raise your hand in the operating room and instruments fall into it, doesn’t mean that when you get out of the operating room, that that’s going to happen.”

“The reason why I love him is he doesn’t worship me.”

Odette Althea Harris, president-elect of a group called Women in Neurosurgery, says neurosurgery is “a challenging field for anyone,” but women neurosurgeons may find it even harder if they’re also pregnant or trying to raise a family.

“In a profession that is so demanding of your time, of your energy and takes so many years to train, those issues become augmented,” said Harris, an associate professor of neurosurgery at Stanford University.

Besides balancing family and work, women neurosurgeons face gender inequalities such as a lower promotion rate compared to men and a lack of female mentors. In 2008, Muraszko was part of a group of surgeons who wrote a paper on the recruitment and retention of women in neurosurgery.

Despite more women than men applying to medical school each year since 1995, the report found that the number of women neurosurgeons remains drastically low.

Each year from 1998 to 2008, only 10 percent of neurosurgery residents were women. As of the late 1990s, 30 percent of neurosurgical residency programs had never graduated a woman resident, according to the report.

Even the American Academy of Neurological Surgeons — with more than 8,000 members worldwide — had not admitted a woman surgeon until Muraszko joined in 2007.

However, Harris says more women have become neurosurgeons in the last few years and are mentoring female medical students to help direct their careers. Muraszko is one of them — acting as a role model for Harris.

“I think she is a pioneer and a champion. I don’t have enough good things to say about her,” Harris said. “Her job is probably one of the most difficult ever, and I have nothing but praise for how she conducts herself professionally.”

As more women enter a neurosurgery career, Muraszko says she knows she will not be the last woman to head a neurosurgery department.

“In some ways, I’m saddened a little bit that seven years into it, I’m still the only woman,” she said. “But I think that it’s going to change, and it will change, as we see more women rising in the ranks.”

The Michigan Daily

By STEPHANIE STEINBERG, Editor in Chief
Published September 9, 2011

http://www.michigandaily.com/news/muraszko