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news News Wednesday, January 27, 2021 Wednesday, January 27, 2021 3:19 PM - Wednesday, January 27, 2021 3:19 PM

Care from routine to rare

From broken arms to one-in-a-million conditions, St. Louis Shriners Hospital team can treat it

Care from routine to rare

On a Tuesday afternoon late last year, Lindley Wall, M.D., checked on the progress of Chloe, a teenager whose broken arm she repaired after a tubing accident on the Lake of the Ozarks.

A day later, J. Eric Gordon, M.D., charted the next steps in treatment for Camille, a patient with a literally one-in-a-million leg condition called tibial hemimelia.

This wide range of care often goes on simultaneous just a few treatment rooms away from each other at Shriners Hospitals for Children — St. Louis. That’s by design. It is part of a treatment model physicians and marketing types alike refer to as “care from routine to rare,” and it underscores how different the hospital is today from when it opened nearly a century ago.

Founded amid an epidemic

The St. Louis hospital was part of a wave of facilities founded and supported by members of Shriners International in the 1920s. The first Shriners Hospital opened in Shreveport, Louisiana, in 1922. The St. Louis facility was already the Shriners’ sixth when it began welcoming patients just two years later.

At the time, polio was the epidemic traversing the country, and Shriners Hospitals primarily cared for the children left in its wake. It would be more than 30 years before a vaccine kicked off a quarter-century march to halt the highly contagious virus in the United States.

By the time polio was officially declared defeated in our country in 1979, the St. Louis Shriners Hospital had evolved to treat so much more. Now, it is one of the leading pediatric orthopaedic centers in the country, part of a Shriners Hospitals medical system that stretches from coast to coast, out to Hawaii, up to Canada, down to Mexico and serves kids from around the globe.

‘The key is expertise’

The current roster of physicians who treat patients at the St. Louis Shriners Hospital is under the direction of Chief of Staff Scott Luhmann, M.D. His St. Louis roots run deep. After attending medical school at the University of Minnesota, he completed his internship and residency at a St. Louis Shriners Hospital partner, the Washington University School of Medicine. He then did his fellowship on the staff he now leads. “There aren’t many chiefs of staff who can say they trained at the same place,” he said. “I have a strong, heart-felt attachment to Shriners Hospital in many ways.”

Dr. Luhmann is a nationally known spine surgeon. The appreciation of patients, former patients and their families bubbles over when they talk about him.

“He treated my son for his scoliosis,” said Augusta, a patient mom. “His very aura makes you, as a parent, less anxious.”

Added another mom, Laura: “Dr. Luhmann in an angel from heaven and the best doctor you could possibly have to take care of your baby.”

The plentiful praise does not affect Dr. Luhmann’s humbleness. When families rejoice in the positive outcomes their children see after treatment at the St. Louis Shriners Hospital, Dr. Luhmann points to his fellow physicians, the nursing staff and others on the medical team, as well as his predecessor as chief of staff, Perry Schoenecker, M.D. “Perry is an icon and a legend,” Dr. Luhmann said. “I would be 95 if I were to be chief of staff here as long as he was. He is someone who has an unbelievable dedication to his work and the children.”

Like Dr. Luhmann, Dr. Schoenecker’s path to doctor-hood started in the Upper Midwest, with medical school at the University of Wisconsin. He then came to Washington University School of Medicine for an internship before eventually landing at the St. Louis Shriners Hospital, where he has developed a reputation as an specialist in treating even the most rare and complex hip, knee, foot and ankle conditions.

He, too, receives overwhelming praise from current and former patients, as well as their families.

“The man is a savant-level genius,” said Rebecca, whose son, Joey, is under Dr. Schoenecker’s care.

Rachel was a patient of Dr. Schoenecker’s from infancy until she reached adulthood. “He is the reason I am able to walk,” she said.

It was under Dr. Schoenecker’s direction that the St. Louis Shriners Hospital took a different approach than others in the system to build its roster of physicians. At the St. Louis hospital, each physician has been carefully selected and trained to be a leader in what is called a sub-specialty. Think of the leg as a specialty; think of tibial hemimelia, the condition Dr. Gordon was seeing Camille for late last year, as the sub-specialty.

“The key is the expertise, and we’re all like pieces of a puzzle,” Dr. Luhmann said. “We really get to be high volume super sub-specialists. For example, there are probably only 20 physicians in the country who do the type of spinal surgeries at the volume I do.”

The result of assembling this group of physicians is a carefully crafted team with deep experience and wide knowledge of rare conditions whose members regularly collaborate to deliver positive results that change children’s lives.

‘Wider expanse of care’

Then there is Chloe and other kids like her who come through the hospital’s doors needing treatment for “the routine:” breaks, fractures and sports injuries such as ACL tears. “It helps us provide a wider expanse of care,” said Dr. Wall, who performed Chloe’s surgery a week after the accident, inserting 13 screws and stabilizing plates to bring the bone back together. “It’s nice to have open doors to trauma surgeries because it provides better overall service to the community.”

While the hospital doesn’t have an emergency room to treat the in-the-moment break, an appointment can usually be had within 24 hours to see a doctor whose previous patient might just have been one of those one-in-a-million cases. This level of expertise calms many patients and their families. “For them, my type of surgery isn’t a huge deal,” said Chloe, 16. “They’ve done these crazy, involved surgeries. What I had was routine for them. That made me feel a lot more comfortable.”

An area of particular emphasis this year is pediatric sports injuries, a field of medicine that has exploded in the past decade. But it’s been in the past two decades that the St. Louis Shriners Hospital has been growing its sport-injury unit, Dr. Luhmann said. As sports injuries have grown more complex and the surgeries needed to fix them have become more detailed and intricate, St. Louis Shriners Hospital doctors have stepped up.

“Rapid access to highly specialized physicians in the treatment of sports injuries is important for optimal care,” he said. “We can provide that rapid access to our physicians.”

Jeffrey Nepple, M.D., and John Clohisy, M.D., tackle many of the sports injury cases and receive overflowing praise from patients, former patients and their families. “Dr. Nepple took care of my son’s knee, and he and the whole staff were incredible,” said dad, Sean. “He is back playing basketball at full speed and better than ever.”

Jennifer’s daughter was seen by Dr. Clohisy. “(Before we came to Shriners Hospital), we were told not to expect her to dance again,” she said. “This year she starts her third year of competition dance.”

Most amazing care anywhere

Sitting back in his office chair on a wintery day, Dr. Luhmann thinks about the change the St. Louis Shriners Hospital has undergone to get where it is today, with a full line of treatment ranging from care for routine breaks and fractures to the rarest of rare conditions. Again, he points to Dr. Schoenecker for his vision: “It developed over time. Perry brought the idea. I’m just helping nurture it.”

The physicians who are on the team realize they are a part of something special. “It’s fun for me as a doctor to be able to do something for kids like what we’re able to do,” said Dr. Gordon. “There’s nothing or not much written about cases like (what I sometimes see). So in a way, you’re developing the procedure for kids in these situations. I like the challenge of getting up every morning and thinking about how to fix problems like that.”

Added Dr. Luhmann: “I’ve got the greatest job in the world. Every day when I get home, I know I’ve made a difference in a child’s life, that I did something good today.”

All of this leads Dr. Luhmann to – more than somewhat reluctantly and uncomfortably – brag about where he works as the place to come for pediatric orthopaedic care, whether the need is routine or rare or somewhere in between. “Across the board, I don’t think anyone can go anywhere and get better care than here.”

Operation in progress

Pictured: (top right) Dr. Scott Luhmann is chief of staff of the physician team at Shriners Hospitals for Children — St. Louis, (above) physicians in operating room during procedure.