The neurosurgeon’s mission
By Alex Branch
Dr. Rob Dickerman says UNTHSC prepared him for anything. Now he’s teaming up with his alma mater to take on glioblastoma.
The girl was only 18, but a herniated disc pinched a nerve root in her back so severely that she could barely move her foot enough to push a pedal on a bicycle.
No treatment had helped, so the girl’s family took her to Rob Dickerman, DO, PhD.
Dr. Dickerman, a neurosurgeon and UNT Health Science Center alumnus, recognized that surgery was required and stood over her one morning at Presbyterian Hospital of Plano, gazing steely-eyed through a microscope as he made a 20-millimeter incision in her lower back.
Meticulously, he sliced through muscle and drilled through bone to remove the disc without disturbing the web of sensitive nerves surrounding it.
“When you’re a neurosurgeon people assume you spend all your time doing brain surgery — and, in fact, we did a brain tumor last week,” said Dr. Dickerman, eyes still to the microscope. “But 80 percent of what we do is helping people with spine conditions like this that damage their quality of life.”
Dr. Dickerman’s ability to restore or improve a patient’s quality of life is why he is considered among the best neurosurgeons in the United States. The 1998 graduate of the Texas College of Osteopathic Medicine at UNTHSC operates the Plano-based North Texas Spine and Brain Institute.
He has treated professional athletes such as former PGA champion Lanny Wadkins and people from around the world. He has been recognized among “Top Doctors” by American Way, Newsweek andD Magazine. His research appears regularly in national publications such as the Journal of Neurosurgery, Spineand the Journal of Clinical Neuroscience.
Throughout his successful career, he has maintained close ties to UNTHSC, where he first developed the skills and knowledge to serve his patients. It’s also where he returns to join faculty members to research novel therapies for the most lethal form of brain cancer — glioblastoma.
“Not only did the Health Science Center help me get where I am, but some really innovative research is happening there,” Dr. Dickerman said. “I wish I could make it back to campus more often.”
Prepared for anything
Several of Dr. Dickerman’s more challenging surgeries have received local and national news coverage.
One case involved a North Texas construction worker who was accidently shot in the head with a nail gun, leaving a 4-inch, barbed nail in his skull. Dr. Dickerman successfully removed the nail from the man’s dominant lobe, and he made a full recovery.
In another case, a Chinese exchange student arrived at Presbyterian Hospital of Plano comatose and with severe brain swelling after he was kneed in the head by another player during a club soccer game. Dr. Dickerman saved his life by removing about one-fourth of the student’s skull to relieve pressure on his brain stem.
About two months later, Dr. Dickerman implanted a prosthetic skull plate in the now-healed student.
“I didn’t die,” the student told WFAA-TV. “I can do anything. I can drive. I can walk. I can think.”
What trait most helps Dr. Dickerman work confidently in a medical field with a razor-thin margin for error?
“The willingness to complete the training,” he said.
Neurosurgery is highly competitive and requires extensive training. Since graduating from UNTHSC in 1998, Dr. Dickerman has completed a five-year residency at North Shore University-Long Island Jewish Medical Center and fellowships at the Texas Back Institute and the National Institutes of Health.
He recalled arriving at North Shore, an 800-bed facility, and being thrown directly into the fire.
“Suddenly there was somebody’s brain in front of me,” Dr. Dickerman said. At first, “I wanted to quit every day because it was so hard and I was so tired.”
However, he found that TCOM had prepared him well. He served as Chief Resident in Neurosurgery his final year.
“I can’t say enough about the faculty I learned from at TCOM,” Dr. Dickerman said. “If you are willing to work hard, there is nothing they can’t prepare you to do.”
‘There is no hope’
Despite the countless patients he has helped, Dr. Dickerman remains frustrated by those he cannot.
The life expectancy of someone with glioblastoma, a malignant brain tumor, is a bleak 16 to 18 months. An estimated 12,390 new cases were diagnosed in 2017, according to the American Brain Tumor Association, including U.S. Sen. John McCain.
“Glioblastoma has been around about 50 years, and we have changed the life expectancy by about zero,” Dr. Dickerman said. “All you can do is give them the standard of care even though you know it’s not going to work. There is no hope.”
In 2015, Dr. Dickerman established the Peggy Dickerman Brain Cancer Research Fund, named after his late mother, at the Health Science Center to begin exploring novel treatments for glioblastoma. Dr. Dickerman will work on the research project with faculty members Andras Lacko, PhD, and Walter J. McConathy, PhD, who has retired.
Dr. Lacko’s research centers on a drug delivery system that could improve cancer chemotherapy. The delivery system would rely on drug-carrying synthetic “good” cholesterol nanoparticles that target cancer cells and bypass most normal cells, sparing the patient the harmful side effects of chemotherapy.
Dr. Lacko said Dr. Dickerman brought funding and clinical expertise to the project.
“As a student, he always had a penchant for research,” Dr. Lacko said. “His significant clinical knowledge of brain tumors is of great value to the project.”
‘All worth it’
In the surgical room, Dr. Dickerman successfully removed the young woman’s herniated disc. His nurse practitioner sewed the incision closed while he removed his surgical gloves.
Next he’ll go to the waiting room to assure the woman’s parents that she is fine and then he has to run. He has a narrow window to grab a lunch in the hospital cafeteria before his next patient. He also is on call for neurological cases — gunshot wounds, stab wounds, car accident injuries — in the hospital emergency room.
Manic schedules and 13-hour days are part of life for every neurosurgeon.
“I probably make it sound like I have no life, but this job is fun,” he said. “Today we had a young woman who couldn’t move her foot up and down. When she wakes up, she’ll be able to.
“That’s what makes it all worth it.”
