Home Past IssuesAbout UsContact Us Twitter Icon Facebook Logo LinkedIn Logo

Vital Signs

Union between Uruguay and the Upper Valley passes 10-year mark

By Roger P. Smith, Ph.D.

Treating epilepsy in Uruguay

See photos from the DHMC team's most recent trip to Uruguay
View images

Medicine no longer recognizes national boundaries," says Dr. David Roberts, a DHMC neurosurgeon. "We are all part of the same global effort." Perhaps no one at Dartmouth-Hitchcock embraced that philosophy more enthusiastically than the late Dr. Peter Williamson, a longtime professor of neurology. He traveled the world helping to treat patients and train clinicians.

Field: On a visit in 2000 to Montevideo, Uruguay, Williamson found a group of surgeons poised but not equipped to improve their diagnosis and treatment of epilepsy—a field in which Williamson was an international leader. Uruguay had excellent residency programs in neurology and neurosurgery but needed more sophisticated instrumentation and training in the latest techniques.

Mark Natola, DHMC's manager of neurodiagnostics, was a member of the first team to visit Uruguay, in 2001. His challenge? To make American equipment compatible with foreign electrical circuits and computer networks. On that trip, the team brought monitoring instruments and taught Uruguayan clinicians the fundamentals of developing an epilepsy program; they also identified six patients who could benefit from surgery.

Another DHMC team, including Roberts, Williamson, and Natola, returned in 2002. Working with Uruguayan neurosurgeons, Roberts performed successful lobectomies on five of the six patients identified in 2001; as he operated, he also trained the South American team in how to perform the procedure.

Natola and Williamson made another trip in 2004 to update the equipment and check on the patients. All five reported positive outcomes. Over the next several years, staff from Uruguay visited New Hampshire to observe various aspects of the Dartmouth Epilepsy Program.

Sadly, Williamson died in 2008, but the exchange has lived on. In 2010, one southbound and one northbound exchange took place. In April, Roberts; Natola; Dr. Barbara Jobst, who succeeded Williamson as director of the Epilepsy Program; and Dr. William Spire, a resident in neurosurgery, spent a week in Montevideo supporting the Uruguayans as they began to perform invasive monitoring procedures.

Then Dr. Rodrigo Moragues Gayoso, a sixth-year resident in neurosurgery from Uruguay, spent the month of October observing the Dartmouth specialists at work in their own environment.

Value: Gayoso was impressed by the complexity of the equipment and the delicacy of the surgical techniques he saw. But he says the most important thing he learned was the value of working as a team. Just as a cross-national confederation can lead to good things, so, too, can a cross-disciplinary collaboration produce an outcome that's greater than the sum of its parts.

If you'd like to offer feedback about this article, we'd welcome getting your comments at DartMed@Dartmouth.edu.

This article may not be reproduced or reposted without permission. To inquire about permission, contact DartMed@Dartmouth.edu.

Back to Table of Contents

Dartmouth Medical SchoolDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College