- Here at the Cleveland Clinic,
balancing innovation with risk
is one of the most important and difficult things we do.
The most important principle in medicine is "do no harm."
The flipside of that is that if we are excessively conservative
and never try something new,
we will never advance the treatment of disorders.
The days when a single researcher
could come up with the great breakthroughs of medicine
are mostly over.
Our future breakthroughs will be found
not in the mind of a single researcher...
but in the bridges of knowledge
between researchers of different fields.
- Beep, beep, beep.
[baby shouts, woman laughs]
- No, no, no. - No, no, no.
[speaks Hebrew]
[baby babbling]
[man and woman speaking Hebrew]
[child shouting]
[uplifting music]
- Yay! [claps hands]
Da, da, da! [groans playfully]
- My son is Eviatar. He's 4 1/2 years old.
And I'm not objective. [laughs] I have to say that.
But he's a perfect little boy.
And he's smart, and he's funny,
and he's curious and...
Cuckoo!
Really perfect.
But last year he diagnosed with epilepsy.
- Eviatar, what do you like to play with? - He like superheroes.
- Oh, we've got superheroes. We've got... - He is a superhero.
- Of course he is. - [chuckles]
- What's Eviatar down to see us for?
- The brain. - The brain.
- The most important. - That is, that is.
- He's a really brave boy,
and we decided that we tell him everything.
He know that this is the start of seizures.
We have a seizure. This is a seizure.
[serious music]
- [squealing]
- You know, even now, after one year, when I see him "seizuring,"
you can't get used to it.
It's like a knife in the stomach.
- [squealing]
I'm seeing him, and I'm praying that it won't last more than a few seconds...
[speaking indistinctly]
And doing what I can do.
Only kiss him and hug him, but...
I don't want to see him like this.
[mumbles playfully]
[speaking Hebrew] - Here we go.
Oh, good boy. - [grunts]
- There we go.
- So it was many seizures, and his situation got worse every day.
We try another medicine and one more and one more.
We did four different MRI in Israel.
We did two CT in Israel.
It was many, many of those tests,
and the result show nothing.
We was so frustrated.
And we thought, "What are we going to do?
We can't live like this. We have to find a solution."
At first when we heard the word "surgery,"
we thought, "No way.
No one going to touch my little boy brain."
And then we ask this question, "Okay, so where?"
Maybe do surgery outside of Israel.
And I talk with a few mothers that have been here
at Cleveland Clinic.
We heard especially about Dr. Wyllie.
[sighs]
Ah. - Hello...
- Good morning. both: Good morning.
- We found the problem area, and it is so small.
95% of people would not find it.
- Wow. - The whole thing hinges on seeing
that little spot at the bottom of the sulcus.
So this is his MRI.
Can you see the little tiny green arrow there?
- Yeah. - Yes.
- That is the spot. - Wow.
- It's really tiny. - It's very tiny.
It's very tiny.
It's causing a lot of trouble.
We have many different situations where we do epilepsy surgery.
- Yeah. - This is one of those situations
where we have a lot of hope.
- Dr. Wyllie is a ball of fire,
and she had to be.
Like most pioneers, people doubted her.
People thought that she was pushing the envelope too far.
- For epilepsy, it's often a very subtle thing
that we see on the MRI scan,
and as the more powerful the MRI's gotten,
the more subtle things we see.
There's not a handbook that says that this is what that means.
Dr. Wyllie, she was one of the people
who actually interpreted the original findings
into clinical practice
- Hi. How are you? - Oh...
[speaking Hebrew] - He did fantastic.
And we drew some labs for him for his procedure for tomorrow.
Those patients had no other good options
had it not been for us seeing that abnormality
and for Elaine really putting it together.
- At the beginning of my career,
I met families who had been dissuaded against surgery.
It was considered a last resort and risky,
and we didn't understand a lot about who could benefit
and what the results might be.
Consequently, many children missed the opportunity
to get early surgery at that age.
And, for example, with Chad, he suffered for two decades
until he finally had surgery in adulthood.
- Chad was on so many different medications,
lots and lots of medications.
At age 26, Chad was down to 99 pounds.
He wasn't eating. He was angry. He was depressed.
- You had to live it
to actually know what it's like to have a seizure.
It felt...
like your body is in a deep, dark hole.
[music continues]
- We came to Cleveland Clinic...
in '96...
and Dr. Wyllie walks in.
First thing out of her mouth is,
"Chad, I think it's time we considered surgery."
And I'm like... [laughs]
[music continues]
- She told me I'd be seizure free.
And I didn't believe her.
- Good morning. - Good morning.
- We here for surgery this morning? - Yeah.
- Okay, I'm gonna take your temperature.
Turn it over for me.
All right.
- Just a little check mark right there. - [laughs] Little tickle.
[music continues]
- We're Eviatar's team, okay?
[inhales deeply] So we're gonna take a deep breath.
[inhales deeply]
Dear God, thank You for being with us
here this morning in this room.
We feel Your presence.
We are asking for Your guidance at this time.
Dear God, please give the medical team that is here
the wisdom and the strength...
to walk with Eviatar in this process.
[up-tempo piano music]
[indistinct chatter, monitor beeping]
[serious music]
- Dr. Bingaman is probably
the most experienced epilepsy surgeon in North America.
[machine hissing, man speaking indistinctly]
- We're gonna confirm the lesion
based on where the team tells us.
We never rely just on that.
[dramatic music]
[monitor beeping]
Dr. Bingaman and Dr. Wyllie,
their collaboration is really what the Neurological Institute is about.
Two doctors with different training backgrounds
focused on one problem,
to be able to treat seizures
that were previously thought as incurable.
[up-tempo piano music]
- So surgery went very well. Take a deep breath.
Eviatar's doing fine.
We're just closing finishing the skin incision.
The nurses in our ICU are very good. They'll take good care of him.
He behaved himself the whole time.
- [laughs] He was a good boy. - He was a good boy the whole time.
[music continues]
- [sniffles]
- Are you Mom and Dad? both: Yeah.
- Okay, you guys ready? - Of course.
- He did really well.
- Yeah? - Yeah.
He's still kind of sleepy.
- Life with epilepsy can be very hard,
and we're weighing that against the opportunities
of stopping the seizures with surgery.
And when we think of it that way,
the opportunity to innovate can be a chance for a better life.
- [speaking Hebrew]
[both speaking Hebrew]
[emotional music]
- I'm seizure free 26 years.
- "Chad Emery is living a happy life."
I just couldn't be happier for Chad.
He's happy in his life right now. He really is.
- I'm still totally shocked that...
a surgery can change a person's life.
[music continues]
- At Cleveland Clinic,
our North Star is "patients first."
And this shared mission puts us on the same page together,
collaborating all for the good of our patients.
Simply being a part of their journey and serving
is my greatest reward.
- Hello, hello. - [speaking Hebrew]
- Before you guys go, we have to take the IV out.
Okay?
You're gonna feel so much better after I take this out.
[both speaking Hebrew] Done. All done.
- We are going out from the hospital without the helmet.
That was the dream,
that we can walk without it.
[music continues]
- Many innovations that we are putting in place
are very exciting at the time that we're inventing it,
but the true value of those innovations
can only be appreciated in retrospect.
70, 80 years later,
we do understand the true impact
that work of Dr. Mason Sones and Rene Favaloro
made on cardiovascular care.
I have absolutely no doubt
that the innovations in neurological care
by Dr. Wyllie, Dr. Bingaman, and Dr. Machado
will resonate in the same way
several decades later.
[uplifting music]
- [laughing]
- Can you tell me, how is Eviatar doing?
- He's wonderful. His recovery is great.
- Oh, that's beautiful.
- He's more calm.
He's more concentrate.
He's with us. He can hear us. He's listening.
Now we can see how much he's different.
We didn't understand how much the epilepsy
affects his life, his behavior, and our life.
We got a new boy. [laughs]
Want to see who he gave the helmet?
[laughter]
- Was that his idea? both: Yeah.
Oh, that is so funny.
I love that.
- Ah, he's showing the frog.
- Yes, you gave him your helmet. Perfect.
- [laughs]
He said in Hebrew, "Thank you that you take my seizures away."
- Thank you so much.
- [laughs]
[music continues]
- The culture at Cleveland Clinic is ideal for innovation.
It's a culture of collegiality
and collaboration.
Innovation really stems from our desire
to be able to do better than what we have done in the past.
We are proud of the care that we provide today.
We think it's second to none.
And yet, we're not satisfied with it.
We want to always make that care better
by investing in the treatments of tomorrow.
[music continues]