In the opinion of Pawan Rawal, MD, the Memphis area was lacking an important diagnostic and treatment tool before he was hired last year as director of Baptist’s Comprehensive Epilepsy Program.
That tool was an epilepsy monitoring unit.
“I had never seen a city of this size not having one,” he said. “It’s almost ‘must have’ if you want to deliver the right kind of care.”
After completing his epilepsy fellowship at Vanderbilt, Rawal was looking for a job and Baptist was looking for a director to help develop its epilepsy program. Andrei Alexandrov, chairman of the Department of Neurology at the University of Tennessee Health Science Center, was helping Baptist in its recruitment, and he knew Rawal from their time at the University of Alabama-Birmingham, where Alexandrov was a stroke director and Rawal was chief resident.
“During the interview,” Rawal said, “I shared the same vision that Baptist leadership had – helping people with epilepsy by establishing a much-needed epilepsy monitoring unit. I’m happy that I have been able to bridge that gap and serve the need of the community.”
The four-bed, adult inpatient epilepsy monitoring unit, which opened this summer, delivers quicker and more accurate diagnoses of patients with seizures and epilepsy, in addition to making patients’ lives easier in other ways.
“Patients are often misdiagnosed to have epilepsy, as often as one in four times, due to lack of specialized testing,” Rawal said. “The epilepsy monitoring unit is indispensable. Any patient who has new onset seizures of an unclear type or known diagnosis of seizures who is still having seizures despite a two-medication trial should be promptly referred and evaluated at the epilepsy center.”
In the past, Rawal added, patients in the Memphis area often had to travel three or four hours to get this kind of care, which not only could be inconvenient but a hardship given that patients with an active seizure disorder are barred by law from driving.
“We know from national data that early evaluation and treatment at an epilepsy center results in better outcomes,” Rawal said.
Epilepsy, he explained, is a tendency to have recurrent seizures, and not all seizures mean epilepsy is present. One person in 26, however, will develop epilepsy at some point in their lives.
“On the brighter side,” Rawal said, “there are much better strategies to control them today.”
Common misconceptions about epilepsy can be held even by some in the medical community, Rawal pointed out.
“Seizure can occur just as a confusion spell or a staring spell with no shaking,” he said. “A seizure monitoring unit and epilepsy surgery are often underutilized. According to national guidelines, any patient with unclear seizure type or patients who have failed two medications should promptly undergo epilepsy monitoring at a specialized center. However, there is often a delay of seven to 10 years for patients to get to a seizure monitoring unit from the time of their diagnosis.
“Unfortunately, delay in the evaluation often translates in delay in appropriate treatment strategies. We are very fortunate to have such a center in Memphis at Baptist where we can help people with epilepsy.”
Rawal comes from the western India city of Ahmedabad, where he attended medical school. After graduation, he came to Houston for a master’s program in health administration.
For years, he had been thinking of a career in medicine.
“As a kid growing up,” he said, “I was simply amazed by the role our family physician played and their readiness to help all the time.”
While he was in Houston, he volunteered for research at Baylor University and became interested in neurology and epilepsy.
“My interest in epilepsy was further fueled by success stories ranging from a patient who was able to drive for the first time at age 28 after getting seizures under control, to a father of three who was able to resume his work after achieving seizure freedom,” he said.
Rawal’s wife, Anita, also a native of India, is a data manager with the lung cancer research group at Baptist. They have a 2-year-old daughter.
They return to India to visit about every other year. His parents and Anita’s come to the U.S. to visit as well, so ties to the homeland remain strong.
Rawal’s transition from India to the U.S. was made a bit easier by the fact that one of his four sisters lives in New Jersey and helped him get settled in this country.
In Memphis, the Rawals are part of an active Indian community, which includes a sizable group of physicians of Indian origin.
“We meet a few times a year,” Rawal said. “Between local events and cultural events, there is almost always something to do. We are very happy being in Memphis. Our daughter has plenty of things to do, from the zoo to Shelby Farms and things like that.”
As for possibly returning to India someday to practice, Rawal said, “That’s not the plan for now. I like what I do here. There is tremendous opportunity to grow here and help here.”
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