Room 411 in the Wethington building on the University of Kentucky campus was the heart of an international connection Tuesday.
Dr. Joseph Berger's lecture on a rare neurological disorder, Behçet's disease was not only heard by a room filled with white-coated doctors and medical students from UK, but it also was streamed live to doctors in Jordan, Brazil, Ethiopia and — a slightly less exotic but equally important location — Morehead.
Within the last few months, the traditional weekly grand rounds have gone global.
"One of the academic missions at UK is that we are increasingly recognizing the potential to bring education to the world," said Berger, chair of the UK neurology department. Grand rounds are part of the medical tradition in which experts present a patient or problem to a group of students and doctors.
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"This is very, very rare what we are doing," he said. "I know of no other institution in the United States" with a similar program.
The weekly grand rounds are broadcast to King Abudullah Hospital in Irbid, Jordan; Addis Ababa University in Ethiopia; Sirio Libanes Hospital in Sao Paulo, Brazil, and Morehead Clinic in Kentucky. Berger said all the hospitals became involved through a personal connection to UK.
Dr. Enawgaw Mehari, a UK graduate, considers Berger his mentor. Mehari now works in Morehead but has ties to his home country, Ethiopia. For that nation, access to neurological expertise can be life changing, he said. The country of some 80 million people has only five or six fully trained neurologists. The neurology program at Addis Ababa has just graduated its first doctors, he said.
A key part of medical training is exposure to a variety of professionals and different ways of assessing a situation, Mehari said.
"In the states, there are neurological presentations, formal workshops, professional journals; there are a lot of different ways of exchanging information," he said.
The same isn't true around the world.
Because of the fledging state of neurology in his homeland, "any information, learning from another doctor, that's invaluable," said Mehari, who heads a non-profit organization called People to People that provides health and education aid to Ethiopians.
He called the telemedicine conferences "beautiful," adding that medical professionals can truly talk a global language. A CAT scan taken in Lexington should be interpreted the same by doctors in Brazil and Ethiopia, for example.
"No one or one country owns medicine," he said.
And, Mehari said, while UK has greater resources, the Ethiopian doctors and other international participants can sometimes offer valuable expertise because some neurological diseases are more likely to be found in certain populations.
For example, Berger said, he sees perhaps one patient a year with Behçet's disease. It is far more common in Middle Eastern countries, such as Jordan.
Rob Sprang, UK's director of telemedicine, sat at a laptop computer in the back of the meeting room while Berger clipped through the wall-size images of his presentation at the front. A portable camera mounted above a monitor sat a few feet behind Sprang. On that screen were video boxes showing the doctors listening at each of the remote locations.
Telemedicine is widely used at UK Chandler Hospital, with some 40,000 patient exams a year, Sprang said. That could range from a patient virtually meeting with a specialist to doctors examining prisoners.
But the Tuesday conferences are a unique application of technology, he said, because they offer both a way to support the educational mission of the university and to expand the profile of the neurology department.
He wants to see the network include other remote hospitals and have UK neurology considered in the same light by the general public as the Mayo Clinic or Johns Hopkins University.
At the end of Tuesday's 45-minute presentation, Room 411 quickly emptied as doctors moved to their next appointments. Berger lingered for a few minutes, standing directly before the camera Sprang monitored at the back of the room and took questions from his peers in Ethiopia and Brazil.
While Berger has done some digital consultations on individual cases, he sees the benefit of the Tuesday rounds as much broader.
"Listen," he said, "teach a man to fish, and you've got food for the rest of his life. This is like teaching a man to fish."