February 26, 2020

Pioneers of Hope

English Flack, MD, Pediatric Cardiology. Photo by Anne Rayner.

At Monroe Carell Jr. Children’s Hospital at Vanderbilt, our work extends beyond patient exam rooms. We are also searching for discoveries to offer better treatments, provide quality care and train the next generation of clinicians. The profiles here represent only a sampling of the tireless work performed daily to make Children’s Hospital a place of unwavering hope. In each issue, we also include a profile to highlight our longstanding partnership with our community pediatricians who help ensure all children receive the best care each and every day.

Pediatric cardiologist English Flack, MD, reaches for a thank you note pinned to the bulletin board in her office, and tears well in her eyes as she recalls the patient whose mother sent the note with flowers.

English Flack, MD, Pediatric Cardiology. Photo by Anne Rayner.

“One of my dear patients I took care of in the NICU and throughout her long stay had progressive pulmonary vein stenosis, which we don’t have a cure for. The relationship that the cardiac ICU and I had with the family turned out to be the most miraculous situation ever,” Flack said. “I wish we had a cure for it, and I wish she had survived, but she died before her second birthday. Her mom sent me flowers on Easter. That family was so gracious and thankful. That’s just one family of many who have been through the worst times of their lives in our presence and in our hospital, but they continue to give to us, which I think is incredible.”

Flack treats patients with congenital heart defects, which affect 1 in 100 children. Walking with families and children through their medical journey, whatever the outcome might be, is the best part of her job, she said.  

“Congenital heart disease affects people of all backgrounds. It is very innocent in that it often blindsides families, and I felt drawn to pediatric cardiology for the simple reason that it’s a child and it’s no one’s fault,” Flack said. 

“It’s that, combined with the resilience of children. It clicked in medical school when I saw a little boy running down the hall with chest tubes and he had just had a major heart surgery. Adults don’t do that. The possibilities that I saw, and the resilience of the children are so amazing.” 

Flack grew up in Orangeburg, South Carolina, graduated from Wofford College in 2000, and earned her MS and her MD from the Medical University of South Carolina, conducting heart failure research along the way. 

“I just had a pull to science, biology and medicine that had been there for as long as I remember. I was one of those kids in kindergarten who, when asked what I want to be when I grow up, said ‘a doctor.’” 

She came to Monroe Carell Jr. Children’s Hospital at Vanderbilt in 2007 for her pediatrics residency, followed by a pediatric cardiology and advanced imaging fellowship. She then joined Vanderbilt’s faculty and is an assistant professor of Pediatrics. Flack is the Project Adam — Middle Tennessee medical director. Project Adam is a 16-state initiative to place automatic external defibrillators in schools. The Vanderbilt affiliate has been in existence for two years. 

“Our community was not as prepared as other places in our state or in the nation. The purpose of our affiliate was to bring our community up to speed, and now we have become so strong in Tennessee, we’ve surpassed other places in the nation. Our schools are well equipped with AEDs,” she said. “Tennessee was the first state in the nation to pass legislation for schools performing drills and we’re trying to spread that from Tennessee outward. AEDs are important, but you have to know what to do with them. Preparedness and making our schools ‘heart safe’ has been a huge focus for us.”

She and her husband, Jonathan, have three daughters, ages 10, 5 and 2. Flack enjoys running, cycling and outdoor activities with her family. With careful attention to schedules and working within support teams at home and at Children’s Hospital, she can achieve a delicate balance.

“We prioritize family time when we are not working,” she said. “I don’t do anything as an individual at work or at home. At work, I’m not the only person taking care of one patient. Everything is done as a team. That’s what has kept me at Children’s. I take care of very complex patients, but I have 25 members on my team of colleagues who help me.”

by Kathy Whitney

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Bryan Dejanovich, BSN, RN, MBA, Neonatal/Pediatric Transport. Photo by John Russell.

Bryan Dejanovich and his team care for the tiniest and most frail patients that come to Monroe Carell Jr. Children’s Hospital at Vanderbilt even before they pass through the hospital’s doors.

Dejanovich, BSN, RN, MBA, is director of the Neonatal/Pediatric Transport team at Children’s Hospital, supervising a crew of more than 40, including registered nurses, respiratory therapists and advanced emergency medical technicians. Since August 1974, when a retrofitted bread truck named “Angel” made its first trip, the transport team has grown and now has four modern ambulances, three that can transport twins.

The ambulances have specialized equipment for transporting the tiniest of premature babies, including advanced ventilation and a cooling system for children with brain injuries.

Dejanovich’s passion for transport dates to the start of his career as a paramedic in his home state of Michigan. After six years of serving the Ann Arbor community and putting himself through nursing school at the University of Michigan, he came to Vanderbilt in 2010 as a nurse resident. His first job was in the pediatric Emergency Department, where he met his wife, Molly. He then joined the Neonatal/Pediatric Transport team, rising to clinical staff leader, and spent a lot more time with neonatal patients.

“The patients are very sick,” he said. “It was just a totally different population than I had never taken care of. I really enjoyed going to hospitals and working with the babies who were just delivered…getting them stabilized, bringing them back here. That’s my favorite part.”

Dejanovich briefly left Vanderbilt in 2014 and earned his Master of Business Administration from Western Governors University, returning in 2016 in his current role.

“I like the pace of this,” he said. “I like that you can see a lot of patients in your shift. These patients are sick, and they’re looking for knowledgeable people who can come help them and continue what they’ve started to get the patients here. I think it really comes down to trying to help continue high-quality care of the patient while they are getting here.”

Dejanovich’s team handled 1,585 calls for service in 2018, transporting patients all over Tennessee and Kentucky, in addition to occasional trips to northern Alabama and even Missouri. 

“We’re offering Vanderbilt’s level of care to any of these hospitals that might need it,” he said. “We’ve had steady growth. As the hospital grows, we’re growing as well.”

The team commonly treats premature babies, even assisting with some deliveries. Babies with cardiac issues and children with asthma and other respiratory issues round out the largest number of patients served. 

Its outreach efforts include assisting with neonatal transport in the Florida area impacted by Hurricane Michael in 2018.

When Dejanovich isn’t at work, he’s spending time with his wife, Molly, and son, Connor, 5, and daughter, Ella, 3.

“Both kids have started ice skating at Ford Ice Center, so we enjoy taking them ice skating,” he said.

Dejanovich and his wife are active in their children’s school, St. Joseph Catholic School in Madison. The family enjoys trips to Walt Disney World and regularly goes on cruises.

“During our time off, we’re always looking for fun events around Nashville,” he said. “It can be going to an apple orchard or a Nashville Predators game. We enjoy going out as a family.”

– by Matt Batcheldor

•••

Lori Jordan, MD, PhD, Pediatric Stroke. Photo by Joe Howell.

Were a family or referring physician to search online for a pediatric stroke specialist at Monroe Carell Jr. Children’s Hospital at Vanderbilt, the results would return one name: Lori Jordan, MD, PhD.

Director of the Pediatric Stroke Program, she is one of only a handful of child neurologists in the world with formal, subspecialty training in cerebrovascular neurology. Jordan is quick to clarify that she works as part of the pediatric neurovascular team devoted to treating this unique population of patients.

Jordan earned her B.S. in biology from the College of William and Mary in Virginia, received her medical degree from the University of Oklahoma and her PhD in clinical investigation from the Johns Hopkins Bloomberg School of Public Health. She completed residencies in pediatrics and pediatric neurology as well as a fellowship in cerebrovascular neurology (stroke) at The Johns Hopkins Hospital. In 2011, she joined Vanderbilt’s faculty as an assistant professor in the Division of Pediatric Neurology in the Department of Pediatrics. 

Jordan has expertise in ischemic stroke, brain hemorrhage, vascular malformations and the neurological complications of sickle cell disease. 

As she treated children with stroke during her residency, she began to realize there was a lack of medical literature on outcomes, which, for children, can be life altering. There was only one pediatric stroke fellowship in the world at that time, so she instead did an adult stroke fellowship and researched how the mechanisms of stroke applied to children. 

“By the end of that year, I realized some of what I was learning was applicable, but really more research and data was needed. And I did two things: got involved with International Pediatric Stroke Study group, which was just forming, and I enrolled in a PhD program.” 

Jordan wanted to understand the concepts behind research, statistics and study design, and today her clinical research program focuses on predicting and improving outcomes after pediatric ischemic and hemorrhagic stroke and on stroke prevention, particularly in sickle cell disease. She is also an investigator for the Vanderbilt Kennedy Center.

“The children and their families drew me into the field. Children are amazing. They will have a serious medical illness and will come out of it and soldier on and want to recover, wanting to go play, run and get back to life,” Jordan said. “Their drive to recover is so strong that I thought these are kids I want to help, and I found it an important problem to work on.”

Jordan enjoys following her patients long term, watching them grow and live their best lives.

“Every year in May, I get super excited and proud when a few of them go to college, and many times I will have followed them from when they were very young.”

How frequently she monitors her patients depends on their recovery and the cause of their stroke. Some children will have no ongoing problems after their initial stroke, but others have complications such as epilepsy, hemiparesis (weakness on one side) and cognitive difficulties. 

Jordan enjoys spending time with her husband, Taylor, who works in The Center for Technology Transfer and Commercialization at Vanderbilt University. They are often found on the sidelines cheering on their two athletic children, ages 15 and 12. Her patients are never far from her mind, though.

“It’s hard to put into words how amazing and inspiring a lot of the patients’ families are. Parents of children with serious illness and ongoing disabilities are just fantastic. They are tireless in their support of their children and their desire to see them improve and find the best treatments.”

– by Kathy Whitney

•••

Lisa Lowe, MD, Community Pediatrician. Photo by Anne Rayner.

Lisa Lowe, MD, remembers announcing to her sixth-grade class that she was going to be a pediatrician. Her family was always fully supportive of her dream, but her high school physics teacher was another story.

“He said, ‘Oh, you’ll come back here after four years of college with an engagement ring, and you won’t do it,’” she laughed. “Well, I made sure he got an invitation to my college graduation and to my medical school graduation. Then, ironically, when I moved back to Murfreesboro, I saw his children as my patients.”

After completing an undergraduate degree at Middle Tennessee State University in her hometown of Murfreesboro, Tennessee, Lowe earned a medical degree at Quillen College of Medicine in Johnson City, Tennessee. She completed her pediatric residency at Sacred Heart Children’s Hospital in Pensacola, Florida. 

Remaining close to family has always been a top priority, so in 1987, Lowe returned to Tennessee to join Murfreesboro Medical Clinic. At that time, she was not only the first full-time female pediatrician at the long-established practice, but also the first full-time female pediatrician in the entire city. That fact didn’t fully register at the time, she said.

“I didn’t think of myself as doing anything unusual until some of the later partners said, ‘Wow, you were a real trailblazer,’” Lowe said. “When I was about to have my first child, the four male partners at that time were like, ‘What? You’re going to have a baby?’ That wasn’t something they’d ever had to think about before.”

Murfreesboro Medical Clinic is now the largest multispecialty, physician-owned practice in Rutherford County, and during her 32 years at the practice, Lowe has endeavored to be a mentor for other women and for younger clinicians who’ve come on board. She’s also enjoyed several generations coming to her for care. 

“I’m at the stage where I have parents who were my patients bringing in their children for me to care for,” she said. “I even have patients now who are the grandchildren of my initial patients. It’s flattering because those families don’t have to make the choice to come to me. I do like to think that I’ve been a good resource for them, and that I helped educate them about how to be a good parent and a productive member of this crazy world we live in.”

Lowe has also had a front row seat to watch the construction of Monroe Carell Jr. Children’s Hospital at Vanderbilt’s new 37,500-square-foot surgery and clinics facility in Murfreesboro — a stone’s throw away from her office.

“We can see it from our clinic’s front door,” she laughed. “It’s been fun to watch it go up. We’ve always had a great working relationship with Vanderbilt. Traveling is especially challenging for families with a special needs child, so having the new facility so close to us is wonderful for patients who won’t have to make a trip to Nashville if we need to refer them to specialists.” 

Lowe has often been called a unicorn because she’s lived in the same city most of her life, and she doesn’t mind the label at all. Her husband, Mark Parsley, is also a Rutherford County native and works as an elementary school teacher leading the Science, Technology, Engineering and Mathematics Lab at John Pittard Elementary. The couple raised their children, Phillip, 30, and Claire, 26, in Rutherford County, and between years of supporting local sports, being active in parent-teacher organizations and fellowship with church members, there’s likely few people in Rutherford County they don’t have a connection to. 

“Being a part of the community is such an important part of being a good pediatrician,” she said. “I’m lucky I got to come back to my hometown to practice, and I love it that people say hi to us just about everywhere we go. To me, that’s the way it should be.”

– by Jill Clendening