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Dr. Ed Hurvitz’s Story: Curing Cerebral Palsy a Little Bit at a Time

April 30th, 2022  | HIElights of Hope

Dr. Edward Hurvitz is a pediatric physiatrist who serves on Hope for HIE’s Medical Advisory Board. Back in the 1980s, when Ed was a student at Wayne State College of Medicine, physical medicine and rehabilitation (PM&R) was still a relatively new field, but the trends suggested that it would be one of the most-needed fields in the years to come. Ed was attracted to PM&R for its growth potential, as well as the way the discipline focused on the person as a whole. Thus, he ultimately decided to complete a residency in PM&R at Sinai Hospital of Detroit. It was then, after being exposed to a multidisciplinary clinic with children, that he was led in the direction of pediatric PM&R. Not only did he love working with a whole consortium of providers, but he found children with disabilities fascinating—they weren’t suffering from loss, but were growing with it.

After completing a one-year fellowship in pediatric rehabilitation medicine, Ed went on to join the faculty of the University of Michigan Department of PM&R, where he has been practicing for almost thirty-five years now. Over time, his clinical care and academic activities became more focused on individuals with cerebral palsy (CP) and other pediatric-onset, brain-related disorders. Ed likes to say that he can “cure cerebral palsy a little bit at a time.” While there may be upwards of fifty or a hundred ways that a child with CP is affected, Ed likes to concentrate on a few key problem areas at a time.

Eventually, as he took a chairmanship role at the University of Michigan Department of PM&R, he stopped seeing new patients so he could offer his long-standing patients the continuity of care they deserve. Before he knew it, his clinic, once full of children, was now full of teenagers and adults with cerebral palsy. So, over the past twelve to fifteen years, he has primarily homed in on overall health and function in adults with CP, as well as the unique problems that kids with CP take with them into adulthood. Ed now juggles a variety of different tasks, including seeing patients, conducting research, teaching at the University of Michigan Medical School, and doing administrative work. He also co-founded and co-directs the Cerebral Palsy Research Consortium of Michigan and the International Cerebral Palsy Health Promotion Group, both of which bring in collaborators from all around the world. He is proud of, not only the work he has done with individuals at the local level, but also of the advocacy work he has done at the national and international levels to promote health, fitness, and aspects of holistic care beyond spasticity treatments for children and adults with CP.

What has kept Ed so interested in the field all these years is how engaged and involved the families he works with are. With the parents he sees, Ed always tries to emphasize that, while he can give statistics, he cannot give reality. He can tell parents what he thinks based on cases he has seen in the past, but each child is a unique individual with their own potential. Particularly for young children, Ed avoids saying they will never walk or talk, because there is so much that is still unknown. At the same time, Ed tries to avoid what he calls “dopey doctor syndrome.” He doesn’t fill parents with stories about children who were told they could never walk and are now in the Olympics, for this isn’t the reality for the vast majority of patients. Instead, in his conversations, Ed talks objectively about the CP diagnosis, lets parents know the many things he thinks their child has the potential to accomplish, and conveys a sense of hope.

With his patients who are already well into adolescence, there is a clearer picture of what their direction is going to be. Thus, Ed can discuss realistic goals with parents, not limiting his patients as human beings, but brainstorming ways to open as many doors for them as possible. Whether it is trying out different therapies or providing a rich environment to help a child grow and develop, there is always something that can be done to ameliorate the presenting problems.

Among the most essential conversations Ed has are those that include long-term planning with parents. If a child will likely go on to lead a relatively independent lifestyle, Ed works with parents to figure out how they can best help their child function in a college environment and in the adult world. But, for families of children with severe disabilities, these conversations become trickier to handle. Oftentimes, the plan parents have conjured in their minds is that they will outlive their child. This frequently doesn’t happen, so Ed encourages parents to think of realistic alternatives. As the father of a thirty-three-year-old with significant disabilities, Ed is personally navigating this same overwhelming process. Thus, he has an acute awareness of just how painful it can be for parents to start thinking further ahead.

Ed likes to tell parents that he has noticed that, the larger a child gets, the older the parents seem to get. He is gently telling them that, as children with cerebral palsy grow up, it becomes much more strenuous for parents to physically transfer them, which can lead to poor parental musculoskeletal health. The single most important thing for any child is having healthy parents, so Ed always discusses personal health for families and ways parents can maintain a sense of well-being.

Inside the clinic, Ed does his best to provide emotional support to parents by incorporating supportive language into his dialogue and by praising families for the work they are doing. He recognizes that, even though he is often under a lot of pressure to see many patients very quickly, he still has an obligation to tend to the mental health of parents by asking them how they’re doing. Should parents need it, Ed helps them find more formal mental health support. He encourages other providers to continue to educate themselves about mental health, for one cannot offer the best care possible to a child without offering care to the parents as well.

In the end, given the positivity in the work Ed does, he focuses on that more so than the devastation. Ed will never forget the time one of his patients didn’t show up for clinic because he ended up sick in the intensive care unit. Ed decided to go to the ICU to check in on his patient, who was hooked up to many different IVs. Despite everything, the mom was genuinely so happy and relieved to see Ed, as her son desperately needed medication renewals and new scripts for physical therapy, braces, and a wheelchair. All Ed did was write some prescriptions, and, while it may not have seemed like much, for the mom, it was everything. It was what could provide her with comfort and peace during such a turbulent time.

It’s interactions like these that fuel Ed’s hope. Though he may not be able to cure a child’s brain damage, there are many seemingly small, but significant, ways Ed can meaningfully impact a family’s life. It feels good to help families see the light that exists in every situation.

Aside from the amazing families he has the privilege of connecting with, Ed continues to feel hopeful when he sees how much the treatment options for HIE and CP have improved throughout his career. In his own field, there have been promising results with the development of therapy techniques that actually lead to neural regrowth for children with CP. Perhaps someday CP will be cured, and he won’t have a job. But, in the meantime, Ed will continue to cure CP a few steps at a time.

 

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