Neurosurgeon Wins MacArthur

Research begun in Uganda helps children world-wide

Benjamin Warf, Harvard Medical School associate professor of surgery and director of the Neonatal and Congenital Anomaly Neurosurgery Program at Boston Children’s Hospital, has received a 2012 MacArthur Foundation fellowship, more commonly known as a “genius grant.”

Benjamin Warf. Photo courtesy of Boston Children's HospitalWarf is one of 23 recipients recognized by the John D. and Catherine T. MacArthur Foundation for their “extraordinary originality and dedication” to their chosen fields. The honor comes with a no-strings-attached grant of $500,000, paid over five years, which recipients may use to fund the creative, intellectual, and professional pursuits of their choice.

Nominations are anonymous, and recipients are not told in advance that they are under consideration — meaning that the phone calls notifying them of their awards come as a bit of a shock.

Warf was at a hotel in Rio de Janeiro, planning to speak at a conference, when he received the news.

“It was a little awkward. The [cellphone] connection wasn’t so great,” he said with a laugh. “I was floored.”

For Warf, the award is a recognition of hard-won innovations made halfway across the world.

In 2000, Warf, his wife, and their six children left his native Kentucky for Uganda, where he started a pediatric neurosurgery hospital under the auspices of the Christian medical nonprofit CURE International.

While there, he noticed that the country’s poor children suffered an unusually high incidence of hydrocephalus, a fluid buildup inside the skull that puts pressure on the brain. He went on to publish groundbreaking research on the causes of infant hydrocephalus, linking it to prior brain infection.

Warf also developed a novel technique for treating hydrocephalus. First-world doctors often rely on shunts, tubes that allow fluid to escape from the brain into the abdominal cavity — though half of shunts fail within two years of the procedure.

In developing countries such as Uganda, where neurosurgeons are scarce and access to nearby hospitals is limited, Warf created a workaround procedure that dramatically lessened the need for follow-up emergency procedures. The technique, known by its shorthand ETV/CPC, cauterizes brain ventricle tissue so that less cerebrospinal fluid is produced, and with minimal invasion makes an opening inside the brain that reroutes the dangerous fluid buildup to the base of the brain, where it is supposed to flow.

“That’s the interesting and quirky thing — a procedure that was developed and proven in terms of outcomes in sub-Saharan Africa is now starting to influence care in the United States,” Warf said. “It’s the way that I treat hydrocephalus in babies now here at Children’s. I think over the next decade or so, it’s going to increasingly become the first treatment for babies with hydrocephalus.”

The family returned to the United States in 2006, and Warf came to Children’s, where he had been a fellow earlier in his career, in 2009. He has continued to oversee the Ugandan hydrocephalus project from abroad, including a program that has trained 20 neurosurgeons from developing countries in Warf’s methods. It has been an expensive and challenging juggling act that the MacArthur grant will make much easier, he said.

“I feel a bit of a weight of responsibility,” Warf said. “There’s this opportunity that’s just fallen into my lap that I wasn’t expecting. I want to be able to be a good steward of that and make the most of it.”

Adapted from Harvard Gazette.