HIGH PROFILE: Little Rock neurosurgeon Dr. Ali Krisht

Dr. Ali Krisht came to the United States from Lebanon to complete his schooling as a neurosurgeon. He now shares his skills around the world and draws others from afar to watch him operate.

“The only thing that grows with my knowledge is my ignorance.To be a master surgeon, you have to remain a master student.” -Dr. Ali Krisht
“The only thing that grows with my knowledge is my ignorance.To be a master surgeon, you have to remain a master student.” -Dr. Ali Krisht

Chad Aduddell knows what to expect. At some point during just about every Sunday pickup soccer game organized by Little Rock neurosurgeon Dr. Ali Krisht, the host will get a phone call. The game will stop as Krisht talks to a physician or nurse in an emergency room somewhere in Arkansas about a patient with a complex or life-threatening neurological condition. He'll give them advice and then, if the patient is to be transferred here, start mobilizing a care team.

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“He has no concept of time in the operating room. It’s millimeter by millimeter, it’s intricate, it’s amazing to watch.” — Sharon Partington, Krisht’s nurse about Dr. Ali Krisht

"He doesn't ever [say], 'Gosh, I don't want to take this patient,'" says Aduddell, chief executive officer of CHI St. Vincent. "He literally is on call for the entire state, and really beyond the state, 24 hours a day, seven days a week, 365 days a year."

Dr. Ali Krisht

• MY FAVORITE SOCCER PLAYER: Pele

• THE MOST REMARKABLE THING ABOUT THE HUMAN NERVOUS SYSTEM: It is a universe of 100 billion cells trying hard to understand itself and our outer universe.

• MY STAFF WOULD SAY I'M extremely hard-working, never giving up, passionate and always available.

• LAST PLACE VISITED: Taipei, Taiwan, while teaching a course

• FAVORITE MOVIE: The Godfather

• IF I COULD CHANGE ONE THING ABOUT OUR HEALTH CARE SYSTEM I WOULD make it more simple so doctors can only worry about patients.

• FANTASY DINNER GUESTS: Moses, Jesus, Buddha, The Prophet and Krishna

• MENU FOR THAT MEAL: bread, olives, grapes and water

• ONE WORD TO DESCRIBE ME: giving

When Krisht can't take a call, it's probably because he's in surgery. He once operated on a patient for 26 hours. Neurosurgeons, he explains, often don't know what they'll find until they actually go to work on a patient's brain or spinal cord. "You may feel like you have to keep going and going," Krisht says.

His longtime nurse, Sharon Partington, says Krisht only breaks to use the restroom during marathon surgical sessions. Nurses will bring him a drink with a straw. Partington believes Krisht gave himself kidney stones last year by not drinking enough water.

"He has no concept of time in the operating room," she says. "It's millimeter by millimeter, it's intricate, it's amazing to watch."

Something like awe creeps into the voices of the people who work with Krisht when they talk about his skills and commitment. And the opinion is pretty widely shared. Krisht ranks among the top 1 percent of neurosurgeons in the United States, according to physician rating service Castle Connolly. In addition to treating patients, he is director of the Arkansas Neuroscience Institute, which trains neurosurgeons from across the nation and around world. Started in 2009, the institute's success is why CHI St. Vincent last month announced a planned $14 million expansion and move to Sherwood.

"His name is what brings them," Aduddell says. "Yes, it's got our name and logo on it, and we're the sponsor, but let's be honest, the people are coming here to spend time with him. Otherwise, they wouldn't be in Little Rock, Arkansas, America."

There's another routine at the soccer games. Krisht announces that it will be the old guys -- himself and Aduddell included -- against the young guys. And the young guys always lose, probably unaware that Krisht once played the sport for money.

Krisht, 57, was born in Nigeria to Lebanese parents. His father had moved to the west African nation to go into the peanut business. Krisht's parents sent their son to an American-run boarding school in Lebanon.

"I still speak Nigerian, but I'm rusty," he says.

Krisht finished high school in Beirut and earned a biology-chemistry degree from American University there. During his undergraduate years, Krisht played professional club soccer, winning an Athlete of the Year award in 1980. A speedy striker with a knack for scoring, Krisht aspired to play professionally full time in Europe. But he received a compound leg fracture in one game, endured several surgeries and realized that dream was over.

"Initially you're not sure you're going to walk," he says. "After that you're happy you can. By that time I was accepted to medical school. It's like the powers of this world and God were changing my course."

Krisht graduated from medical school at American University in 1985, in the middle of Lebanon's civil war, which killed an estimated 120,000 people from 1975-1990. He was working in a hospital emergency room when it received about 130 casualties from the 1983 bombing of the U.S. Embassy in Beirut.

"This was the type of life we had," he says. "During the war, the way human beings and human blood becomes cheap, it just changes your perspective, and you don't want your kids to go through what you've gone through. I wanted to make sure there's long-term stability if I want to raise a family."

A LIFETIME OPPORTUNITY

Krisht's father had once told him that, given the opportunity to start over again, he "wouldn't have gone to Nigeria, but would have gone to the United States." That statement stuck with his son. After delays caused by the civil war, Krisht came to the United States and finished his surgical residency training at Emory University in Atlanta in 1994.

He came to Little Rock the same year, lured by the prospect of working with Drs. Ossama Al-Mefty and Gazi Yasargil in the neurosurgery department of the University of Arkansas for Medical Sciences. At the time, Krisht says, Yasargil was "the most famous neurosurgeon in the world," responsible for a drastic reduction in deaths during surgery on aneurysms, and Al-Mefty wasn't far behind in reputation. Both had been recruited by then-Chancellor Dr. Harry Ward as part of Ward's aggressive expansion of UAMS. Although Krisht taught in the department, he had really come to learn from his two older colleagues. He initially planned to stay one year.

"When I realized the opportunity to work with two pioneers in the field and be sandwiched between them and learn from them, it was a lifetime opportunity. And we had good chemistry together."

Krisht became a full professor and then vice chairman of the department, helping establish a cerebrovascular clinic dedicated to treating strokes and aneurysms during his tenure.

In the fall of 2009, he and Al-Mefty left UAMS to start the institute under the auspices of CHI St. Vincent, just down the street.

"It was a tough decision, because by nature we are academicians, and we have loyalty to the place we work," Krisht says. "But at the same time, we felt like we were hitting the wall in achieving our vision, which was to make our place a destination for neurosurgery and training other people."

SLOW, DILIGENT WORK

Trim and tan, with a head full of close-cropped hair, Krisht has a bounce in his athletic sneakers as he shows a visitor around the Arkansas Neuroscience Institute. The institute has continued to grow despite Al-Mefty's departure for a post in Boston. Krisht and its five other neurosurgeons perform more than 1,000 operations a year.

Krisht says he was drawn to surgery as a specialty "because you can influence things, and it has an artistic side to it" -- by which he means the intricate, minute work of repairing or removing damaged tissue, blood vessels and other body parts. The especially grueling physical demands of neurosurgery appealed to the athlete in him as well.

"You're not allowed to have any mental fatigue," he says. "For this patient, this is the most important day of their life. And physically, you have to be in really good shape. That's why I exercise almost daily."

Krisht's areas of expertise are cerebrovasular problems, such as strokes and aneurysms; pituitary gland tumors, which can cause headaches, affect vision and hormone functions; and skull base tumors, which in addition to causing problems such as paralysis of the facial muscles, are located close to critical nerves and blood vessels in the brain, neck and spinal cord.

"The nerves are so delicate in this region that the only way you can save the function is if you work very slow, very diligently," he says.

Krisht, who also edits Contemporary Neurosurgery, one of the top journals in neurology, is known for being able to discuss complex medical procedures with his patients in terms they'll understand.

PERFORMING FOR A CROWD

Krisht has traveled the world to perform surgery. Partington has scrubbed for him in Taiwan, Italy, the Netherlands and Finland. In Helsinki, she recalls, "We would do five surgeries, one every day. You would have between 50 and 60 [physicians] watching his surgery, watching his technique."

The technique requires working with micro-forceps, micro-scissors and other tools with tips the size of a needle. He ties knots with suture thread finer than a human hair.

In Little Rock, he's usually performing for a crowd, too. The neuroscience institute generally hosts between five and 10 physicians who've traveled here to complete a six-month or yearlong fellowship. More surgeons come for shorter training -- about 200 in all last year from North America, South America, Europe, Africa, the Middle East and Asia. Many end up at one of Krisht's soccer games.

Krisht may explain a few things he's doing during surgery, but in general he prefers quiet. "It's like a concert," he says. "You cannot be interrupted." But afterward, he invites discussion. "There's always a quest to be better, and not just for himself, but for the outcome for his patients," he says.

Krisht, whom Partington calls "full of philosophy," agrees. "The only thing that grows with my knowledge is my ignorance," he says. "To be a master surgeon, you have to remain a master student."

One day this month, Krisht operated on a woman who'd been battling a brain tumor since 1995. She'd had five previous operations and two sessions of radiation, and the tumor had still come back. She'd lost the sight in one eye, but "still had a lot to live for," as Krisht says.

He believes the woman's tumors may have returned because other surgeons weren't comfortable working in the ultra-sensitive cavernous sinus region. Krisht says he "cleaned the whole tumor out. Now she is starting from a much cleaner tumor bed" preparatory to treatment by proton beam therapy, a relatively new approach in the United States. As the neuroscience institute grows, Krisht hopes more patients will be referred to it for cases like that.

The institute is on two floors of the Blandford Building, part of CHI St. Vincent's main campus at Markham Street and University Avenue. Plans call for it to be moved to the St. Vincent North campus, off U.S. 67/167 in Sherwood, where there's currently an underutilized 58-bed general-care hospital. A new research and education center for the institute will be built next door to the hospital. St. Vincent has committed $10 million for the project and is trying to raise another $4 million from the community.

The expansion would allow the institute to add about four or five more surgeons. In all, about 100 nurses, researchers and other St. Vincent employees would be involved in the move.

Dr. Drew Kumpuris, a cardiologist and chairman of St. Vincent's board of directors, says "only time will tell" the institute's future. But he notes that Krisht has already achieved a couple of unusual feats. One is drawing patients from all over the state, a testament to his accessibility and ability "to do things in the surgical arena that other physicians in other locales cannot do." The other is building an education and research center within a private practice, rather than in a traditional academic setting.

"Almost every month it grows," Kumpuris says of the neuroscience institute. "Certainly every quarter it grows. I can only image it will continue to grow."

"There is no complex neurological problem that we shouldn't be able to tackle," Krisht says. "If nobody [else] can do it, we should be the ones to do it."

He has achieved one of the goals that prompted him to leave Lebanon. He and his wife, Nashwa, have four children: daughter Geenah, a film producer in Dallas; daughter Liana, a junior pre-med student at Southern Methodist University in Dallas; daughter Ayah, a high school student at Pulaski Academy; and a son, Hassun, who's in middle school. Nashwa, a dietitian, runs Cafe Brunelle, a coffee shop and deli in west Little Rock that Krisht and his brother, Little Rock businessman Abbas Krisht, opened in 2014.

He appears to be well on his way to his vision for the institute. Friends marvel at Dr. Krisht's ability to balance a demanding surgical practice, teaching, research and international travel with family time -- and a regular soccer game.

"My life is centered around my patients and my family," Krisht says. "It may look like a boring life, but it's good to me."

High Profile on 04/23/2017

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