The campuses of St. Jude Children’s Research Hospital
and Le Bonheur Children’s Hospital
sit a scant mile apart from each other.
Despite this geographic proximity, though, the two institutions have contrasting overarching missions. St. Jude is an internationally recognized biomedical research institute making great strides in the battle against childhood leukemia, cancer and other diseases. Le Bonheur is primarily a clinical hospital whose constituency is city-wide and regional, and it is the only nationally certified Level 1 Trauma Center in Tennessee.
However, the two do have their shared priorities. The main one that keeps them on a similar, steady course, according to Jon McCullers, Pediatrician-in-Charge for Le Bonheur and Chairman of Pediatric Care for the University of Tennessee Health Science Center
(UTHSC), is "the kids."
Since 1985, St. Jude and Le Bonheur have had a joint neuroscience program which includes a Level IV Accredited epilepsy program, the highest level possible, and the largest pediatric brain tumor program in the world. While such research is what St. Jude is known for, what may not be known is that all of the surgeries and post-surgical care are done at Le Bonheur.
"St. Jude is doing the radiation and the chemotherapy when it's used in these, but the primary therapy, the surgery, is all Le Bonheur," says McCullers.
As part of this partnership, St. Jude funded Le Bonheur's inter-operative MRI for $7 million, revolutionizing such surgeries. Patients no longer have to be taken from floor to floor, leaving surgery for a scan and then possibly returning to the surgical suite. Everything is self-contained in one state-of-the-art room.
"St. Jude, because they have such a big brain tumor focus, has always had big needs for the world's top experts in neuroradiology and neuropathology--there's not a lot of people with that level of training, particularly with the research interest in that area--so having Asim Choudhri (Associate Professor and Assistant Chair of Research Affairs, Department of Radiology) over here and interfacing with their people over there, having David Ellison (Chair of the Department of Pathology and Director of Neurophathology) on the St. Jude side as a neuropathologist to support those programs, is a big deal. We want to recruit more in that area to add depth, but those guys move back and forth."
McCullers himself is an example of the two hospitals' familial relationship. He came to Memphis and St. Jude from Virginia in 1996 for a fellowship in infectious diseases, a joint program between the hospitals.
"I spent half the time over here (at Le Bonheur) and half the time clinically at St. Jude," he says.
McCullers, who moved from St. Jude to Le Bonheur in 2012, was and is a leader in his field of infectious disease research. Well known among peers, and frequently flying around the world to speak on the subject, he was, quite frankly, content with his station at St. Jude. But when he asked himself what he would do as the chair of such a department at UTHSC and at Le Bonheur, he asked himself what was really important to him as a doctor and researcher.
"What was important, after I really thought about it, was really the kids," he says. "The kids in this region, the constituency of this hospital."
McCullers is working to build the research enterprise at Le Bonheur to raise the quality so that it is better aligned with St. Jude and more useful to that institution.
It is this desire to become the best that elevates each.
"They’re (Le Bonheur) very much at this stage in their development where they want to get up on the national stage and they want to be one of the top children's hospitals in the country, they want to be top 10," McCullers says. "To do that, you have to have the big academic reputation and the programs and be contributing at that level, not just delivering the best clinical care possible, but setting the next paradigm, the next bar, figuring out the next way to do things to do it better. So they wanted to recruit somebody who had a strong academic background, which I did, from St. Jude."
This instance of cooperation between these two stalwart institutions is not exclusive, but speaks to a fraternal sense of collaboration that has been growing over the years within the Memphis medical community.
Le Bonheur opened its doors in 1952 and St. Jude only 10 years later. Since, both have expanded their reach regionally, nationally and internationally, and are looked at on a stage par excellence. Both were recently named in the Top 10 list of Best Children's Hospitals rankings from U.S. News & World Report.
The major healthcare needs in Memphis tend to revolve around poverty, the driver of chronic disease and recurring ailments that keeps the 40-bed emergency department of Le Bonheur thrumming like a perpetual motion machine and the hospital full. The goal McCullers had with his transition to Le Bonheur was to shake up the traditional children's hospital model of dealing only with what is "in your walls."
"I said we need to worry about what's going on out there in these kids' homes and in their schools and in their regular lives, because that's where all the problems are that lead downstream to their interfacing with the medical community and us."
To that end, research is the answer. Programs already in place, such as neurosciences, congenital heart and respiratory virus, have been strengthened, and new programs are being brought online or are in the planning stages. One such program is the Pediatric Obesity Center. Funding for the center was given by the state and by St. Jude, which doesn't work with obesity, yet. McCullers says, "They know that as I'm building this premier program, it's going to raise our national reputation, and we're going to bring in premier nephrologists and cardiologists and people who are that top echelon of national scientists who they can now use in their studies."
As Le Bonheur seeks to recruit leaders for these programs from around the country, St. Jude becomes part of the draw for these scientist doctors. "St. Jude is a big draw for most of the subspecialists because everybody knows St. Jude, everybody knows the quality of the research that's done here."
The two hospitals have completed a joint strategic planning process, and, as further example of how the two are working together towards the future, Le Bonheur is recruiting a new chief of critical care--that person will run the intensive care units at both institutions. A joint search committee is currently looking for a national-level candidate.
"From their (St. Jude's) perspective, they want us to be raised up so that we're going to be able to help them," McCullers says. "And from our perspective, you know, if you want to do research, what better resource to have than St. Jude sitting next to you, and you want to use their minds and their science and their infrastructure and their name to do that."
St. Jude has oncologists, hematologists and infectious diseases, but all of the other specialists--cardiology, pulmanology, nephrology, genetics, etc.--are at Le Bonheur, whose physicians travel the few blocks to practice at St. Jude. St. Jude, in turn, will go east to Le Bonheur if a child needs a biopsy or some other oncology-specific illness or potential illness.
St. Jude has oncologists, hematologists, infectious diseases experts and many other specialists. Other specialists, such as those in cardiology, pulmonology, nephrology and genetics, travel the few blocks to practice at St. Jude.
Le Bonheur will also go west if a child needs a biopsy or some other oncology-specific illness or potential illness.
"You really have to think of it as 255 beds at Le Bonheur, 70 at St. Jude, so we're really a 325-bed hospital that's split on the two campuses because we don't duplicate those services," McCullers says. "The physicians go back and forth, they're just based primarily at one or the other."