- Neurological Surgery
- Complex Spine Disorders
- Minimally Invasive Spine Surgery
- Brain TumorSurgery
- Stereotactic Radiosurgery
- Pediatric Neurological Surgery
Clinical Professor, Neurosurgery
Board of Directors, Chairman & CEO, Accuray, Inc. (manufacturer of the CyberKnife) (1997 - 1999)
Board of Directors, California Association of Neurological Surgeons (1996 - 1999)
Board of Directors, Chairman (2009-2010), Dalai Lama Foundation (2007 - 2016)
International Board of Advisors, Council for a Parliament of the World's Religions (2009 - Present)
Advisory Board, Heroic Imagination Project (2009 - Present)
Board of Directors Vice-Chairman, Friends of New Orleans (2008 - 2015)
Board of Governors, Tulane University School of Medicine (2007 - Present)
Advisory Board, The Fogarty Institute of Innovation (2007 - Present)
Board of Directors, The Brain and Creativity Institute at USC (2008 - 2011)
Founder & Director, The Center for Compassion and Altruism Research and Education at Stanford (2008 - Present)
Director, The Neuroscience Institute at El Camino Hospital (2008 - Present)
Advisory Board, Social Chocolate SuperBetter (2011 - 2014)
Board of Directors, Association for Medical Ethics (2012 - 2015)
Advisory Board, Greater Good Science Center (2012 - Present)
Honors & Awards
"Best Doctor", America's Best Doctors (2005-2018)
America's Top Surgeons, Consumer's Research Council of America (2005-2018)
"Healthcare Hero", New Orleans CityBusiness Journal (2008)
Member (Outstanding Alumnus-Tulane University), The Paul Tulane Society (2008)
Member, Founder's Circle Stanford University (2009)
Medical Education: Tulane University School of Medicine Registrar (1981) LA
Internship: Tripler Army Medical Center GME Training Verifications (1982) HI
Board Certification: Neurological Surgery, American Board of Neurological Surgery (1990)
Residency: Walter Reed Army Medical Center (1987) DC
M.D., Tulane University, Medicine (1981)
B.S., University of California, Irvine, Biological Sciences (1978)
Current Research and Scholarly Interests
My interest for many years has focused on neuro-oncology (brain tumors) and utilizing both surgery and stereotactically focused radiation to treat solid tumors of the nervous system primarily utilizing the CyberKnife.
In addition, I am an expert in complex and minimally invasive spine surgery.
More recently, my interests revolve around understanding the neural, social and mental bases of compassion and altruism using a multi-disciplinary approach.
- Independent Studies (5)
- Altering the Trajectory of Affect and Affect Regulation: the Impact of Compassion Training MINDFULNESS 2018; 9 (1): 283–93
The Current and Future Role of Heart Rate Variability for Assessing and Training Compassion.
Frontiers in public health
2017; 5: 40-?
The evolution of mammalian caregiving involving hormones, such as oxytocin, vasopressin, and the myelinated vagal nerve as part of the ventral parasympathetic system, enables humans to connect, co-regulate each other's emotions and create prosociality. Compassion-based interventions draw upon a number of specific exercises and strategies to stimulate these physiological processes and create conditions of "interpersonal safeness," thereby helping people engage with, alleviate, and prevent suffering. Hence, compassion-based approaches are connected with our evolved caring motivation and attachment and our general affiliative systems that help regulate distress. Physiologically, they are connected to activity of the vagus nerve and corresponding adaptive heart rate variability (HRV). HRV is an important physiological marker for overall health, and the body-mind connection. Therefore, there is significant value of training compassion to increase HRV and training HRV to facilitate compassion. Despite the significance of compassion in alleviating and preventing suffering, there remain difficulties in its precise assessment. HRV offers a useful form of measurement to assess and train compassion. Specific examples of what exercises can facilitate HRV and how to measure HRV will be described. This paper argues that the field of compassion science needs to move toward including HRV as a primary outcome measure in its future assessment and training, due to its connection to vagal regulatory activity, and its link to overall health and well-being.
View details for DOI 10.3389/fpubh.2017.00040
View details for PubMedID 28337432
- A wandering mind is a less caring mind: Daily experience sampling during compassion meditation training JOURNAL OF POSITIVE PSYCHOLOGY 2016; 11 (1): 37-50
- Multiple Facets of Compassion: The Impact of Social Dominance Orientation and Economic Systems Justification JOURNAL OF BUSINESS ETHICS 2015; 129 (1): 237-249
- A randomized controlled trial of compassion cultivation training: Effects on mindfulness, affect, and emotion regulation MOTIVATION AND EMOTION 2014; 38 (1): 23-35
Pilot study of a compassion meditation intervention in chronic pain.
Journal of compassionate health care
The emergence of anger as an important predictor of chronic pain outcomes suggests that treatments that target anger may be particularly useful within the context of chronic pain. Eastern traditions prescribe compassion cultivation to treat persistent anger. Compassion cultivation has been shown to influence emotional processing and reduce negativity bias in the contexts of emotional and physical discomfort, thus suggesting it may be beneficial as a dual treatment for pain and anger. Our objective was to conduct a pilot study of a 9-week group compassion cultivation intervention in chronic pain to examine its effect on pain severity, anger, pain acceptance and pain-related interference. We also aimed to describe observer ratings provided by patients' significant others and secondary effects of the intervention.Pilot clinical trial with repeated measures design that included a within-subjects wait-list control period. Twelve chronic pain patients completed the intervention (F= 10). Data were collected from patients at enrollment, treatment baseline and post-treatment; participant significant others contributed data at the enrollment and post-treatment time points.In this predominantly female sample, patients had significantly reduced pain severity and anger and increased pain acceptance at post-treatment compared to treatment baseline. Significant other qualitative data corroborated patient reports for reductions in pain severity and anger.Compassion meditation may be a useful adjunctive treatment for reducing pain severity and anger, and for increasing chronic pain acceptance. Patient reported reductions in anger were corroborated by their significant others. The significant other corroborations offer a novel contribution to the literature and highlight the observable emotional and behavioral changes in the patient participants that occurred following the compassion intervention. Future studies may further examine how anger reductions impact relationships with self and others within the context of chronic pain.
View details for PubMedID 27499883
- Enhancing Compassion: A Randomized Controlled Trial of a Compassion Cultivation Training Program JOURNAL OF HAPPINESS STUDIES 2013; 14 (4): 1113-1126
Social Connection and Compassion: Important Predictors of Health and Well-Being
2013; 80 (2): 411-430
View details for Web of Science ID 000322505100008
Intramedullary spinal cord metastasis from prostate carcinoma: a case report.
Journal of medical case reports
2012; 6 (1): 139-?
Although vertebral and epidural metastases are common, intradural metastases and intramedullary spinal cord metastases are rare. The indications for the treatment of intramedullary spinal cord metastases remain controversial. We present the first biopsy-proven case of an intramedullary spinal cord metastasis from adenocarcinoma of the prostate.Our patient was a 68-year-old right-handed Caucasian man with a Gleason grade 4 + 3 prostate adenocarcinoma who had previously undergone a prostatectomy, androgen blockade and transurethral debulking. He presented with new-onset saddle anesthesia and fecal incontinence. Magnetic resonance imaging demonstrated a spindle-shaped intramedullary lesion of the conus medullaris. Our patient underwent decompression and an excisional biopsy; the lesion's pathology was consistent with metastatic adenocarcinoma of the prostate. Postoperatively, our patient received CyberKnife® radiosurgery to the resection cavity at a marginal dose of 27Gy to the 85% isodose line. At three months follow-up, our patient remains neurologically stable with no new deficits or lesions.We review the literature and discuss the indications for surgery and radiosurgery for intramedullary spinal cord metastases. We also report the novel use of stereotactic radiosurgery to sterilize the resection cavity following an excisional biopsy of the metastasis.
View details for DOI 10.1186/1752-1947-6-139
View details for PubMedID 22657386
View details for PubMedCentralID PMC3419088
Image-guided robotic radiosurgery: Clinical and radiographic results with the CyberKnife
4th International-Stereotactic-Radiosurgery-Society Congress
KARGER. 2000: 23–33
View details for Web of Science ID 000170815200003
Treatment of cavernous sinus tumors with linear accelerator radiosurgery
SKULL BASE SURGERY
1999; 9 (3): 195-199
Since 1989, 79 patients with benign or malignant cavernous sinus tumors, have been treated at Stanford University with linear accelerator (linac) radiosurgery. Radiosurgery has been used as (1) a planned second-stage procedure for residual tumor following surgery, (2) primary treatment for patients whose medical conditions preclude surgery, (3) palliation of malignant lesions, and (4) definitive treatment for small, well-localized, poorly accessible tumors. Mean patient age was 52 years (range, 18 to 88); there were 28 males and 51 females. Sixty-one patients had benign tumors; 18 had malignant tumors. Mean tumor volume was 6.8 cm(3) (range 0.5 to 22.5 cm(3)) covered with an average of 2.3 isocenter (range, 1 to 5). Radiation dose averaged 17.1 Gy. Mean follow-up was 46 months. Tumor control or shrinkage, or both, varied with pathology. Radiographic tumor improvement was most pronounced in malignant lesions, with greater than 85% showing reduction in tumor size; benign tumors (meningiomas and schwannomas) had a 63% control rate and 37% shrinkage rate, with none enlarging. We concluded that stereotactic radiosurgery is a valuable tool in managing cavernous sinus tumors. There was excellent control and stabilization of benign tumors and palliation of malignant lesions.
View details for Web of Science ID 000083016700004
View details for PubMedID 17171089
View details for PubMedCentralID PMC1656740
Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors
1998; 38 (11): 780-783
The Cyberknife is an image-guided "frameless" dedicated radiosurgical device. This instrument has several distinct advantages over frame-based systems, including improved patient comfort, increased treatment degrees of freedom, and the potential to target extracranial lesions. Clinical results thus far with respect to the treatment of malignant intracranial tumors has been promising. Additionally, the Cyberknife will likely revolutionize the application of radiosurgery to extracranial sites. A description of the components, treatment planning, and clinical results of the Cyberknife will be reviewed.
View details for Web of Science ID 000077103400031
View details for PubMedID 9919913
The cyberknife: A frameless robotic system for radiosurgery
XIIth Meeting of the World Society for Stereotactic and Functional Neurosurgery
KARGER. 1997: 124–28
The Cyberknife is a unique instrument for performing frameless stereotactic radiosurgery. Rather than using rigid immobilization, the Cyberknife relies on an image-to-image correlation algorithm for target localization. Furthermore, the system utilizes a novel, light-weight, high-energy radiation source. The authors describe the technical specifications of the Cyberknife and summarize the initial clinical experience.
View details for Web of Science ID 000074800300019
View details for PubMedID 9711744