Camilo R. Gomez

Camilo R. Gomez
Camilo R. Gomez, MD, MBA, 2012
Born	Camilo Ramiro Gomez (1960-09-12) September 12, 1960 Holguín, Oriente, Cuba
Fields	Vascular, Critical Care and Interventional Neurology
Institutions	Neurological Institute of Alabama
Alma mater	Universidad Central del Este, University of Tennessee at Knoxville
Children	Cristina Cecilia and Camilo Aristides

Camilo Ramiro Gomez, (born September 12, 1960) is an American neurologist, medical educator, researcher and writer. He is one of the first 100 vascular neurologists certified by the American Board of Psychiatry and Neurology (ABPN),^[1][2] one of the founders of the subspecialty of interventional neurology in the United States,^[3] and is considered a key opinion leader in his field.^[4][5] He has served on the editorial boards of several scientific journals (e.g. Stroke, Journal of Stroke and Cerebrovascular Diseases, Journal of Neuroimaging), the advisory boards of pharmaceutical and device companies (e.g. Bristol-Myers Squibb, Alsius Corporation), and government-funded healthcare initiatives (e.g. State of Alabama Governor's Stroke Task Force, Delta States Stroke Consortium). He has been frequently invited to be a visiting professor at conferences and academic institutions around the world. He was awarded the first Eden Medical Electronics (EME) Transcranial Doppler Research Award in 1990, the R. Floyd Yarborough EMS Award in 2000 by the Birmingham Regional EMS (BREMSS) and the Interventional Pioneer Award by the Society of Vascular and Interventional Neurology (SVIN) in 2007.^[6]

He has written extensively about a variety of subjects within his specialty, and has authored hundreds of scientific papers and book chapters that summarize the results of his original research endeavors, and that explain his opinions regarding diverse topics in medicine.^{[7][8][9][10][11][12]} Among these, he is credited with having coined the phrase Time is Brain! to denote the sense of urgency required in the treatment of stroke patients,^[7] and introduced the term "Code Stroke" as an in-hospital method for summoning specialists to the stroke patient bedside.^[8]

In 2012, he ventured into the political arena by publishing his latest book, The Downgrading of American Healthcare, as a response to the changes he has witnessed in American medicine over the last 30 years, and for which he holds the Federal Government ultimately responsible.^[13]

Early life

Gomez was born in Holguín, Cuba, in a family of modest means. His father was the youngest of four children born to a Spanish immigrant railroad worker; his mother was the middle of the three children of a Spanish immigrant carpenter. His parents graduated together form a technical accounting school in 1956, and emigrated from Cuba in 1965 due to the political and economic consequences of the emergence of the Fidel Castro regime. The Gomez family landed in Caracas, Venezuela, where Gomez attended the Fray Luis Amigo and Santo Tomas de Villanueva catholic schools, graduating among the top 1% in both.^{[citation needed]} He then attended the Universidad Central del Este (UCE) in San Pedro de Macorís, Dominican Republic, where he attained his M.D. degree in 1981. Considering the rapid deterioration of the political situation in Venezuela, he immigrated to the United States to continue postgraduate education in Saint Louis University (SLU).

Career

Upon completing his last year as chief resident in neurology at St. Louis University, the newly appointed chairman of the department John B. Selhorst, asked him to remain as instructor and director of the yet to be created Stroke Center. Through his early work, he built the first Neurovascular Ultrasound Laboratory and introduced the incipient diagnostic technique of Transcranial Doppler to the care of patients with stroke. This early work earned him the first EME Transcranial Doppler Research Award in 1990, and caught the attention of Sylvia N. Souers, widow of the late Admiral Sidney W. Souers, the first director of the Central Intelligence Group, who had been said to have succumbed to a stroke. Mrs. Souers, after learning of all of Gomez's accomplishments on behalf of stroke care, agreed to donate a large portion of her estate to the creation of the Souers Stroke Institute, which he directed until 1995, and which remains operational.

In the early 1990s, Gomez realized the importance of interventional neurology as a natural evolution of his own subspecialty, and began to seek a way into it. He partnered with the director of interventional cardiology at St. Louis University, Morton J. Kern, and began to apply some of the recently acquired cardiac technology to the brain circulation.^[9] Such an effort did not go without significant political opposition within the university.,^{[citation needed]} and led to his resignation as Associate Professor of Neurology and Director of the Souers Stroke Institute. He was aggressively and rapidly recruited ^[14] by the late John N. Whitaker, chairman of neurology of the University of Alabama at Birmingham (UAB). After intense negotiations, in 1995, Gomez moved to Birmingham, Alabama and became the founding director of the Comprehensive Stroke Center (CSC) of UAB, a post that he held until his resignation in 2003. Since then, although he has been in private practice, he has continued to lecture and participate in a variety of research projects, including the Reasons for Geographic and Racial Differences in Stroke (REGARDS),^[15] a project headed by Dr. George Howard and intended to uncover the underlying causes for the existence of the Stroke Belt. This collaboration led to Dr. Howard appointing him to the rank of Adjunct Professor in the Department of Biostatistics of the UAB in 2005.

Neuroimaging

Since very early in his career, he cultivated a keen interest in the use of imaging techniques to diagnose neurologic conditions, particularly stroke. He joined the American Society of Neuroimaging (ASN) in the mid-1980s, a professional organization over which he would later preside. Although his original interest stemmed from the application of diagnostic vascular ultrasound, he demonstrated expertise in all the disciplines such as computed tomography (CT), magnetic resonance imaging (MRI), and eventually angiography. He has published extensively in these topics, conducted unique research that earned him awards, and holds the certifications that paved the road for the creation of neuroimaging as a subspecialty of neurology under the United Council of Neurologic Subspecialties (UCNS). He is the medical director of the first 3.0 Tesla MRI system introduced in Birmingham, Alabama.

Interventional neurology

Following his work with Morton J. Kern in St. Louis,^[9] he moved to the UAB working with the then director of interventional cardiology, Gary S. Roubin. The close collaboration allowed him to polish his interventional skills. He also collaborated with Marco A. Zenteno, director of interventional neuroradiology of the National Institute of Neurology and Neurosurgery in Mexico City. He traveled several times per year to Mexico to perform procedures together with Zenteno, who less frequently traveled to Birmingham for the same purpose.

There was significant political turmoil in the 1990s with respect to which of three major specialties,^{[16][17][18][19][20]} neurology, neurosurgery and neuroradiology had the right to pursue training and practice the procedures designed to treat the cerebral blood vessels from within. Traditionally spearheaded by neuroradiologists, the subspecialty had attracted the attention of both neurologists and neurosurgeons, leading to a bitter turf war. In the midst of this, the then president of the American Academy of Neurology (AAN), Francis Kittredge, appointed Gomez to head a task force charged with the negotiations with the other two specialties for the right of neurologists to be part of this field. Delegates from all three groups met in New Orleans, but the results were, at best, lukewarm. Among the neurology representatives were Lawrence R. Wechsler and Anthony J. Furlan, the chairs of neurology at University of Pittsburgh and Case Western Reserve University respectively. Gomez and his two colleagues continued to push the issue along the political spheres of their specialty and were instrumental in having vascular neurology become an accredited subspecialty,^[2] and a prerequisite for interventional neurology. Eventually, all specialists interested in this discipline would become recognized, regardless of their parent specialty, as having joined the field of neurointerventional surgery designated by the Accreditation Council for Graduate Medical Education (ACGME).

Over the years, he has continued to be in the forefront of this field.^{[citation needed]} by accumulating some of the earliest and now more comprehensive experience with procedures such as elective stenting of the basilar artery and the intracranial internal carotid artery. His work on mechanical neuroendovascular rescue of acute ischemic stroke ^[21] preceded all the work that led to the more recent approval by the U.S. Food and Drug Administration (FDA) of devices specifically designed for this purpose, including the MERCI Retriever ^[22] and, more recently, the Penumbra, Solitaire and Trevo Pro devices.

Urgent and intensive stroke care

The leap to interventional neurology was greatly facilitated by his prior approach to the urgent and intensive care of stroke patients. Having recognized very early in his career the importance of aggressively approaching this common clinical problem, he introduced both theoretical and practical ideas that helped advance this dimension of neurologic practice. In the early 1990s he coined the phrase Time is Brain!, as an argument for the need to expedite the treatment of stroke victims at a time when this was not the norm.^[7] Also around that time, he introduced one the first experiences using a "Code Stroke" system for managing these patients, in parallel to the existing procedures for treating patients with cardiac arrest.^[8] Upon his arrival at the UAB, he created a vascular and critical care neurology clinical service, dedicated to the management of the sickest neurologic patients in that institution. As part of this work, he promoted the use of hypothermia for the management of critically ill neurologic patients, including stroke.^[23] This and other of his out of the ordinary practices were highlighted in a 2001 article and television piece by CNN.^[24] When he arrived in Birmingham in 1995, he had also been interested in the possibility of creating a system for transporting stroke patients from the field to dedicated hospitals in the same manner as trauma systems already existed throughout the world. He partnered with Joe E. Acker, executive director of Birmingham Regional Emergency Medical Services System (BREMSS), to construct a regional stroke transportation system that was unique in the country, more advanced than anything available at that time. It served as a model for national guidelines.^[25][26][27] It became operational in 2000 and, for the first time, used a dedicated computerized system to link dedicated stroke centers within the six counties that surround the city of Birmingham, and allowed them to work in a symbiotic way.^[28] The system included a process for approving stroke centers based upon a set of criteria and paved the way.^{[citation needed]} for the current stroke center certification process by the Joint Commission.

Military career

In 1986 he took the oath of citizenship of the United States, and the oath of his commission as a captain in the U.S. Army Medical Corps. He became a member of the Saint Louis University Medical Detachment of the 21st General Hospital, 102nd Army Reserve Command (ARCOM). At that time, and even though he was the de facto chief of neurology for the 21st General Hospital, the duties were not terribly involved, consisting largely of the one weekend per month and two weeks per year that have characterized military reserve obligations. He spent his reserve time largely in St. Louis, although he had the opportunity to travel to various posts, including Fort Sam Houston, Fort Benning, Fort Meade and Camp Parks. In December 1990, he was called to active duty in support of Operation Desert Storm, giving him the opportunity to gain more experience in military medicine. He was honorably discharged in 1993.

Honors and awards

Dr. Gomez receiving the Interventional Pioneer Award from SVIN First President Dr. Adnan I. Qureshi

He has had many honors bestowed upon him, including that of being the commencement speaker for the graduation ceremonies of his Alma Matter (Universidad Central del Este) in 1988. He is a member of the Phi Kappa Phi and the Beta Gamma Sigma honor societies in business, and received the Outstanding Service Award from his classmates upon graduating from business school (see below). He has been listed in several editions of Best Doctors in America.^[29] He was awarded the first EME Transcranial Doppler Research Award in 1990 for his work on cerebral perfusion during cardiopulmonary resuscitation. In 2000, BREMSS awarded him the R. Floyd Yarborough EMS Award for being instrumental in organizing the care of stroke patients in the counties that surround the city of Birmingham, Alabama. He then received the Interventional Pioneer Award by the SVIN during their inaugural meeting in 2007.

Business degree

In 2006, he completed and earned the degree of Master in Business Administration (MBA) from the Physician Executive MBA (PEMBA) program at the University of Tennessee at Knoxville.^[30] He remains one of the representatives of his class to the student council.

Personal life

He married Sandra Maria Lopez Quiroga in 1981, but they separated in 2003 after having had two children. The eldest, Cristina Cecilia Gomez, is a captain in the United States Army, having served two tours in the Middle East following her graduation from the United States Military Academy at West Point in 2009. The youngest, Camilo Aristides Gomez, is a lance corporal in the United States Marine Corps Reserve and works in the private security industry.

Political and economic views

In his most recent book, he admits to being very conservative and a "lower case" libertarian, comparing himself to Charles Murray and Milton Friedman. He also explains his interest in capitalism, the Austrian School of economics, and the objectivist philosophy of Ayn Rand.^[13]

Publications (books only)

• Tegeler CH, Babikian VL and Gomez CR. Neurosonology. Mosby-Yearbook Publishers. St. Louis, MO. 1996
• McCartney JP, Thomas-Lukes KM and Gomez CR. Handbook of Transcranial Doppler. Springer-Verlag Publishers. New York, 1997.
• Gomez CR. "Critical Care Clinics of North America". Endovascular Therapy and Neurocritical Care. 15 (4). October 1999.
• Geyer JD and Gomez CR. Stroke: A Practical Approach. Lippincot. Philadelphia, PA. 2009.
• Gomez CR. The Downgrading of American Healthcare, On-Demand Publishing. 2012

References