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Tulipan’s career as ‘humble’ giant of Neurosurgery honored

Jun. 11, 2015, 9:00 AM

Noel Tulipan, M.D., center, at last week’s event honoring his career at Vanderbilt with, from left, Reid Thompson, M.D., John Wellons III, M.D., Haley Vance, DNP, APN, and Robert Naftel, M.D. (photo by Anne Rayner)

Noel Tulipan, M.D., has left an indelible mark on many facets of life during his pioneering career at Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt — from his impact on the field of neurosurgery and fetal surgery repair; to the children and families he cared for; to the residents he trained; to the operating room team he scrubbed in alongside; to his many friends and colleagues.

But he did it in the quiet way that has defined Tulipan, known by many as just “Tuli.”

After a distinguished career spanning three decades, Tulipan, professor of Neurological Surgery, hung up his white coat last week for retirement and was celebrated by family, friends and colleagues during a reception in the Children’s Hospital Theater.

“Those who have operated with him, those who have been taught by Noel uniformly describe his incredible gift in the operating room. He is an efficient, fast and a really beautiful technical surgeon,” said Reid Thompson, M.D., the William F. Meacham Professor of Neurological Surgery and chair of the department. “It is an emotional time to think about him stepping away from neurosurgery, and it is emotional time to think about his retirement. He is beloved and we will miss him.”

Tulipan earned his undergraduate and medical degrees from John Hopkins University in Baltimore, where he also did his internship in surgery and residency in neurosurgery. He arrived at Vanderbilt in 1986.

“To my co-workers it is difficult to express the joy that working with you has brought me over the last 30 years,” Tulipan said in a letter to colleagues announcing his retirement. “Our mission has always been to provide the best possible care to our patients, and I believe we have succeeded in that mission.”

In the 1990s, he began a groundbreaking journey that put Vanderbilt on the map in neurosurgery and fetal surgery. He questioned if a better way existed to treat babies born with open, neural tube defects, specifically spina bifida (myelomeningocele), the most common birth defect in the central nervous system.

Noel Tulipan, M.D., is surrounded by operating room colleagues at last week’s reception honoring his Neurological Surgery career at Vanderbilt. (photo by Anne Rayner)

He performed the first in utero repair of spina bifida in 1997, which subsequently led to the seven-year, landmark Management of Myelomeningocele Study (MOMS) involving Vanderbilt, University of California San Francisco and Children’s Hospital of Pennsylvania. The results showed babies who have corrective surgery for a serious form of spina bifida while still in the uterus experience a reduction in potentially life-threatening hydrocephalus (fluid on the brain) and have an increased ability to walk.

“It’s Noel’s innovation that led to the MOMS trial. He has made a huge difference to that community of children around the world, and he has done more of that surgery than anyone in the world,” said John W. Brock III, surgeon-in-chief, director of Pediatric Urology and Monroe Carell Jr. Professor.

“His quiet demeanor a lot of time belies his incredible passion for what he does. He is an outstanding, ingenious surgeon, and we should celebrate the work he has done. He is a great guy and friend, and I will miss working with him.”

Tulipan’s dogged fortitude made the MOMS trial possible, despite naysayers who questioned the risks of the in utero approach, said William Walsh, M.D., professor of Pediatrics and chief of Nurseries at Children’s Hospital.

“His foresight and determination have revolutionized the care of spina bifida and there are at least 10 centers in the U.S now performing the Tulipan procedure using techniques developed by him specifically to perform the surgery safely,” Walsh said. “More importantly, there are hundreds, and will be thousands, of children walking better with fewer shunts because of his determination and hard work.

Tulipan worked across multiple disciplines as he strived to give the best care to patients.

“It has been my pleasure and privilege to work with Dr. Tulipan for the past 24 years,” said Gregory Mencio, M.D., director of Pediatric Orthopaedics. “He has been a good friend and tremendous colleague. We have shared numerous patients and families, all who have nothing but superlatives to say in regards to their interactions with Noel. Dr. Tulipan has been a leader in our spina bifida clinic, and his work on fetal closure of defects in children with spina bifida has been groundbreaking. He will be missed by all of us at Children’s and I wish him the best in retirement.”

Despite tremendous success and international recognition of his work, Tulipan never stepped into the spotlight as he cared for patients across the life spectrum, from infants to 90 year olds.

“He was content to stand back and just do the work and do it well,” said Thompson. “It’s a remarkable attribute. Many people would have focused the light on themselves, but that’s not who he is. That will be a lasting contribution that he made, in addition to the many thousands of patients he cared for.”

Tulipan knew his retirement wasn’t far off and worked with Thompson to identify and recruit his successor, John “Jay” Wellons III, M.D., MSPH, to take over as chief of Pediatric Neurosurgery three years ago.

“Noel has been here for three decades and his impact on Vanderbilt Pediatric Neurosurgery has been tremendous. He is a surgeon first and has taught scores of residents his craft. He has impacted many careers in a remarkably positive way,” Wellons said.

“One of the things about having been Noel’s partner is that all the parents and children look at you funny when you walk in the room because they all want to know where Dr. Tulipan is.”

Trisha Cooper, a physician assistant who worked by Tulipan’s side daily since 2012, calls that the “Tuli effect,” when Tulipan’s mere presence puts families at ease.

Beyond the gifted, talented surgeon, Tulipan’s team members, including Cooper, saw him in another light. They witnessed his skill in the operating room, but also his dry humor, love for travel and great food as well as his knack for novel writing, with two published medical mystery “whodonit” books.

“He’s brilliant and very good at what he did. But he also has a great sense of humor,” Cooper said. “We had a good time, but we worked hard.”

Tulipan’s team teased that he “didn’t have any headlights on his car” because he was so efficient in his skill that he finished the day before sunset. “I just miss him,” Cooper said. “I owe him for my career at Vanderbilt.”

Nick Metoyer, Tulipan’s scrub nurse, was responsible for setting up the OR before Tulipan started a case. He recalls Tulipan’s signature tennis headband to catch sweat as he operated and focused on tasks.

“He made me a better scrub tech. We didn’t want to let him down. I knew how much the children mattered to him so I wanted to have my side of the table perfect to match his skill set. I checked everything twice,” said Metoyer. “Certain people are put in our lives to enhance us, and Dr. Tulipan certainly was that for me.”

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