Dr. Sahni – A World Class Physician

In every industry there are people who become known for being innovative and progressive difference-makers, who build and leave a legacy that impacts others. A few are recognized as celebrity titans like Apple’s Steve Jobs or Facebook’s Mark Zuckerberg. But the ones I admire most are those who tangibly impact lives firsthand through their wisdom and perseverance. At Chippenham & Johnston-Willis Hospitals, Dr. Sahni is a neurosurgeon who has done just that. Dr. Sahni has focused his entire 30+ year career helping patients recover despite challenging odds. He is internationally recognized as a pioneer and a visionary in his work in treating both brain cancer and many other debilitating neurological issues. I have had the opportunity to get to know some of Dr. Sahni’s patients and each of them share stories about living today because Dr. Sahni gave them a chance and gave them hope when they didn’t know it was possible.

Dr. K Singh Sahni

Dr. K Singh Sahni

I recently sat down with Dr. Sahni to get his perspective.

Tim: You have had a long successful career at Johnston-Willis Hospital. How did it begin?

Dr. Sahni: I joined Johnston-Willis Hospital (JW) and my group, Neurosurgical Associates, in 1988 when it was a much different program. There really wasn’t a comprehensive neurosciences program at the time on the south side of Richmond. My practice was uniquely brain surgery rather than traditional spine surgery. At the time, every hospital wanted to grow their cranial surgery program. The administration of Johnston-Willis at the time said, “Give me your wish list to make JW your home base.” I wrote down the equipment and staff I needed and eventually opened an office. Today, we have five neurosurgeons covering Chippenham & Johnston-Willis Hospitals.

Tim: Why did you become a neurosurgeon?

Dr. Sahni: In the 8th grade my 5 year old cousin died in a car accident overseas. I was told he died because they didn’t have a neurosurgeon. It was in that moment that I decided to become a neurosurgeon. Eventually I did my medical school overseas at an American university which was affiliated with UPENN and concluded with my residency training at Medical College of Virginia.

Tim: What are the major changes you have seen since the inception of the neurosciences program?

Dr. Sahni: JW is a much bigger institution now with complex and cutting-edge technology often reserved for the most elite academic centers in the country. One example is our Gamma Knife which is one of only three in Virginia. Gamma Knife is a very exquisite form of targeted radiation which only kills the tumor and spares the normal brain. We are fortunate to be one of the Top 10 Gamma Knife centers in the country. Our neurosurgery patients are able to recover in a state-of-the-art Neuro Intensive Care Unit and Neuro Step Down Unit. The personalized care that patients get here at JW is unique. The other important aspect of our program is the consistency of the nursing care on the floors and in the operating rooms. The combination of our physicians and hospital staff has led us to be the only Joint Commission Certified Brain Tumor center in the country. We treat the cancer patient in a multi-disciplinary approach which includes the radiation oncologist, the medical oncologist, and the neurosurgeon. Our patients with brain cancer live longer because of the comprehensive and detailed approach.

Tim: Tell me about your unique specialty focus areas in neurosurgery.

Dr. Sahni: My clinical practice focus is on two things: a facial pain syndrome called trigeminal neuralgia and secondly brain tumors. I started the Virginia Trigeminal Treatment Center. We are proud to have hosted the national symposiums 3 times which is attended by the people from all over the county. These are patients who have pain in their face, which is described as an excruciating electrical pain that happens unexpectedly. It is described as the most painful human affliction. The pain starts intermittently and ultimately becomes long lasting and unbearable. I have been treating these patients since 1983 and have taken care of over 3,000 patients. We treat them with medication and if that doesn’t work, we can use the Gamma Knife or surgery when required.

For brain tumors, I often rely on the Gamma Knife for both benign and cancerous brain tumors. Treatments can be as short as an hour. Previously to do this, when only surgery was available, was a 10-14 hour operation with long recovery and inpatient stay. Now they can even be outpatients.

Tim: I have had the opportunity to see you in many different settings: the hospital, the Board of Trustees, and the broader Indian community. You are one of those unique people that is looked up to for advice and wisdom. I am not sure a lot of people know what really drives you to be so focused on your specialization. Can you share your thoughts on that?

Dr. Sahni: I lost a daughter at 8 years old to leukemia. I am passionate for anything I can do to care for kids. I can’t personally do it because I get too involved. Working with children as a physician would be too emotionally difficult. My wife would tell you I am known more as the big uncle. Not just uncle for relatives but also my community. They look to me to help them with their medical issues even when it isn’t my area of expertise. Often former patients reach out to me when they need something. They feel comfortable calling me to help them navigate their situation. I feel honored. The biggest pleasure and reward that a doctor gets is when your patient does well. I have cancer patients that are 10 years out, when they may have thought that wasn’t possible, and together we are happy because someone with cancer who wasn’t supposed to be alive is still doing great.

Tim: Tell me about your take on serving on Chippenham & Johnston-Willis Hospitals’ Board which you have done for years.

Dr. Sahni: The CJW Board has evolved over the years to be very diversified, both with physicians and community members. As a practicing physician, I feel I have a good understanding for what is going on at the hospital staff level and also from other newer physicians. It allows me to share firsthand experience for how things are going on the floors and be their advocate. I am focused on making this hospital thrive at a higher level by keeping us balanced.

Tim: What is your vision for neurosciences at JW?

Dr. Sahni: Over the last decade we have really focused most of our efforts in the neurosciences around expanding inpatient services. We have a clear vision to compliment these services with a comprehensive outpatient neuro-diagnostic and therapeutic center. Our goal is to be able to care for any patient with a complex neuro problem at Johnston-Willis in one building. These are often patients with very complex conditions and diseases; centralizing the service will make our center what world class centers like Mayo Clinic are today. My hope is that my legacy will be that world class center here in Richmond, Virginia. We are well on our way and this team has a lot to be proud of for the impact on our community and region.

If you have a story or comment about Dr. Sahni please share as a reply to the blog.

Competition Heats up!


Brandon Haushalter playing Hippity Hop Soccer


Getting ready for Hippity Hop Soccer


Serious competition during Minute to Win It


Cardio Crusaders

This past Sunday, we held the annual CJW Olympics at ACAC Fitness Center in Midlothian. These aren’t your ordinary competitions – they are the kinds that bring out the finest elite athletes in the region to compete in events such as: Gaga Ball, Hippity Hop Soccer, Minute to Win it, Pictionary, and Four Corners Trivia.  Now if you are like me, you have very little idea what these particular competitions are all about.  You can also appreciate the fact that they don’t require any extensive physical training or conditioning.

This was really an opportunity to get together in a lighthearted way with work colleagues to compete against other departments at Chippenham & Johnston-Willis Hospitals.  In fact, over 220 employees showed up for the events.  Each team started the Olympics donning their team shirt and embracing their team names: we had the Lab Rats (laboratory), the Jets (respiratory), the Traumatizers (Medical Surgical Trauma ICU), the Levinson Heart Throbs (Cardiovascular Care Unit), the Fast and Furious (Central Registration) and the Cardio Crusaders (cardiovascular Services) to name just some of the 14 total teams.  In the end, the Purple Cardio Crusaders pulled out for the win, followed by the 2nd place Traumatizers, and the third place Fantastic Four.

It was a memorable day filled with a lot of fun and laughter.  It was, more importantly, a great way to just slow down and reflect on some of the amazing members of our CJW team. Providing extraordinary healthcare can be difficult and stressful, so having an opportunity to just take a break and enjoy our extended work family was a great experience.  Because many weren’t able to make it, we had Sweet Frog pull up their big truck and provide their special soft-serve frozen yogurt to both of our medical campuses this week. I appreciate all that everyone does to make this not just a great place to get healthcare but also a great place to work.

Flowers and compassion change everything

Heather Wilson, JW Physicial Therapist

Heather Wilson, JW Physical Therapist

We can all agree that it is often the little things that make the biggest difference. I know personally my greatest memories with my family or friends aren’t the ones tied to fancy trips or presents, but rather brief moments where things just feel right and seem better.

In my last blog I shared how one employee in our inpatient rehab unit found a way to make homemade chicken soup memorable for a patient. She did it from the heart because she knew that it was important to that particular patient.

This week I heard another touching story which exemplified several of our organization’s core beliefs and values. Danita Bosher, Director of Therapies at Johnston-Willis Hospital, shared a story about two of her team members. Heather Wilson, physical therapist, and Kathy Goodman, rehab tech, recently had a patient who was just having a bad day. We can all relate to this especially when your health isn’t doing as well as you hope. Consequently, the patient was disheartened because she had just received some discouraging news that her path to recovery was going to be extended into another facility rather than at home. Heather offered to take the patient outside for a change of scenery and to attempt some therapy by working on wheelchair propulsion. She and her colleague Kathy stopped at the gift shop first to get a balloon for another patient who was celebrating a birthday and then proceeded to go outside. The patient really enjoyed seeing the summer flowers. Heather and Kathy watched her demeanor change as she enjoyed the view, and they clipped a few flowers. Together, they placed flowers on her leg brace and Kathy helped braid some into her hair. After the outing, the patient agreed to complete all of her therapy and was in an overall much happier mood. This was a simple and elegant way of creating a moment to stop thinking about the things that weren’t going as planned and to start thinking about the beauty around us.

Who would have thought sunlight, flowers, and some compassionate employees could make such a memorable, positive difference?

Chicken Noodle Soup – A Patient’s Story

We talk lot about the importance of focusing on our mission of “providing high quality, compassionate patient-centered healthcare”. A different way to describe our mission is to keep our patients as our true north. This week I learned of one employee, Yvonne Cameron in our rehabilitation unit, who exemplified our mission in a big way.


Yvonne Cameron and her Director, John Miller

A patients had a hemorrhagic stroke and was with us for a long stay to recover. Our Johnston-Willis campus is one of only two hospitals in Virginia certified as a comprehensive stroke center. One of the service commitments we make to our patients is to have nursing leadership visit them every day. The goal is to ensure that everything is going well and to address any opportunities to better serve the patient. This particular patient shared the most memorable part of his stay was the day that he was craving chicken noodle soup. You can imagine being cooped up in a hospital and just wanting something as ordinary as chicken soup. Yvonne Cameron, a nurse tech, called the dietary department and ordered chicken noodle soup for him. When his soup arrived, he was somewhat disappointed as it was not exactly seasoned the way he would expect. He ate it anyway, however it was clearly not meeting his expectations that day. Yvonne saw the look of disappointment on his face and went home after working all day and made him homemade chicken noodle soup. The next day she surprised him with her mother’s special recipe. This patient described the compassion Yvonne showed as something he will always remember. This act of kindness isn’t something we could have ever asked for or scripted. It is something that just came from the heart. Yvonne shared “I used my mother’s recipe for the chicken noodle soup which she always made with lots of love. That’s just what we do on the rehab unit.”

So this week I tip my hat to Yvonne for Creating a Wow – a memorable experience when it was needed most. Great job!

Introducing The Snack Shack

SnackShack3Running a 24 hour operation like a hospital has plenty of challenges. One of those includes serving and connecting to the individuals who work through the evening and nights.

Throughout my time here, one of the most frequently received suggestions from night shift employees is to have more available food options between midnight and breakfast, when our cafeteria and food courts are normally closed. To address these concerns, and demonstrate how important your Voice is to us, we are piloting something new and exciting at Chippenham Hospital – The Snack Shack.

SnackShack2The Snack Shack is a “mini-market” that will be stocked with delicious fresh sandwiches, salads, and a variety of both healthy and indulgent snacks. It will have many beverage options, as well as standard “convenience” fare. The Snack Shack has an automated payment function via kiosk that allows you to pay with a credit card or to create an account using cash, and replenish that account as necessary. Our vending partners will be on site through the end of the week to assist with orientation and initial account setup.

SnackShack1The Snack Shack will certainly help meet the needs of our overnight team members, but will also be open 24/7 for any employee who would like to take advantage of its offerings. It is located on the 4th floor of the Levinson building just off the Levinson Lobby elevators. The area will have badge access security, and all staff members will be able to swipe in for access.

The Snack Shack is a great example of your Voice having a direct impact in making CJW a great place to work and care for patients. We hope that you will come check out The Snack Shack soon, and let us know your feedback as we assess bringing this idea to the Johnston-Willis Campus.

Dr. Buxton & the Future of Behavioral Health Services

Dr. Buxton

Dr. Buxton

This week, I sat down with Dr. Martin Buxton, chief of psychiatry and medical director of child & adolescent program at Chippenham Hospital’s Tucker Pavilion. The Pavilion is our 137 bed psychiatric hospital embedded within the Chippenham campus serving inpatient and outpatient patients as young 5 years old all the way through geriatrics adult services. Dr. Buxton and his psychiatric partners at Insight Physicians have been instrumental in leading the clinical services in the area of behavioral health in the Richmond market.

Tim: How long have you been at Chippenham Hospital’s Tucker Pavilion?

Dr. Buxton: I have worked at Chippenham for 20 years and been a child psychiatrist for almost 40. I came to Chippenham because they had an adolescent (13-17 years old) inpatient program and they wanted to expand it to child (5-12 years old).

Tim: Recently, there has been concern raised around behavioral health services both regionally and nationally. What is driving that change?

Dr. Buxton: The spotlight has been both positive and negative. Today, there is greater awareness of mental health wellness. Unfortunately, we often hear sound bites of both the problems and the answers and they don’t tell the whole truth of the story. With that being said, the number of high acuity complex cases has increased. I think in the past mental health issues were more hidden and not as broadly discussed or treated.

Tim: There has been a lot of public discussion about the increased use of psychiatric medication in both children and adults. Some people believe psychiatrist are pushing medications and not getting at the root of the issue. What is your take on the issue?

Dr. Buxton: The scientific evidence supports the increased use of medication in the population. Today we have better medications available than before. However, we still don’t have the quality of medications we need. The efficacy is very good but the significant side effects and tolerability still remains a challenge. On a positive note, we are able to use dual agent drugs that can impact multiple neurotransmitters. In effect this allows us the capability of dealing with multiple parts of the brain at one time with one medicine. There is some truth to the perception about the frequency of prescription writing in the field. However, part of what drives that perception is there are more non-physician therapist so the practicality of the need in the community has forced psychiatrist to write prescriptions and not to focus only on therapy.

Tim: Tucker Pavilion recently opened a state-of-the-art $5M Child and Adolescent unit and are about to open an intensive outpatient facility to serve children with acute mental health needs. Why was this important?

Dr. Buxton: We know there is an unmet need for children to stabilize acute psychiatric emergencies. By expanding the beds and constructing it in a way to meet the varied needs of the population we are able to have a greater impact in a setting that supports the latest evidence based treatment.

Tim: Your son Dr. David Buxton is joining your group, Insight Physicians, as a child and adolescent doctor in September. Tell me about that.

Dr. Buxton: It is more complex than I thought it would be. I am not just his father, I am a colleague. I always envisioned him becoming a physician and psychiatrist but I didn’t know he would join me. It expands our personal relationship and allows us come to understand each other better. At the same time, we have to see each other as colleagues and not father and son, it is an adjustment and needs to be no different from any other psychiatrist on staff.

Tim: We often talk about partnerships as being the key to the success. What your take on the CJW-Insight Physician partnership?

Dr. Buxton: It is a win-win. We are devoted to providing inpatient and outpatient psychiatric care and HCA is a system that has recognized the need for behavioral health outreach. Our goals are aligned. The open and collaborative dialogue has allowed us to improve together.

Tim: What keeps you up at night?

Dr. Buxton: Challenging patients keep me up many nights. I think about what I need to do to help specific patients get better. I often question whether I have run out of options. I feel like there are high expectations of my skills and abilities in the community and that can be a lot to live up to. I do better when people have never heard of me without expectations. I put additional pressure on myself to help when I hear from families that I am the last resort.

Tim: What is the biggest misconception about psychiatry?

Dr. Buxton: People often have a lack of understanding about behavioral health. Mental wellness isn’t usually a simple black or white issue but rather somewhere on a spectrum. What makes people healthier is understanding their particular challenges and customizing the care. Patient can’t operate under the notion that they don’t have any mental health issues. The reality is everyone has some degree of mental health challenges. The question is how incapacitated are they and how much do they want to expand themselves. There has historically been a lot of prejudice against mental health patients because people assume they aren’t affected. The opportunity for us is to gently educate the public that being healthy is like walking up a down escalator. If you don’t work at it you will continue to drift downward towards poor mental health.

Tim: I have been in your office and there is no couch to lie down on. Is that only in the movies?

Dr. Buxton: (laughs) I was psychoanalytically trained early in my career. At the time they used a couch. I have a small sofa in my office and sometimes patient arrive and wonder if they should lie down. I have to tell them we aren’t doing that kind of therapy. That is one helpful technique but it isn’t for everyone.

Tim: What is your vision and hope for Tucker in 10 years?

Dr. Buxton: To be the premier mental health site in Virginia and beyond. We have an extraordinary opportunity that is unmatched. With our recent expansion into outpatient care at Tucker we can do more than ever. There are very few sites with our current abilities and our future potential. I have had the opportunity to practice at nationally recognized elite psychiatric centers like Yale, University of Michigan, Medical College of Ohio, and NJ Medical School and have never seen as such a caring, competent staff with an eagerness to learn and stay updated and to try new innovative treatments.

Shark Week!

The-Great-White-Shark-000044158484_LargeI have an obsessed fascination with Shark Week on the Discovery Channel every year. My family knows that during this week I try to align family schedules to allow us to watch this marathon as much as possible. It is hard to believe that so many intriguing television shows can be created around one topic. I admit it makes me timid to go in the ocean, especially when you hear about the unusual flurry of attacks this year in North Carolina. I still don’t buy into the comment the expert always makes that sharks aren’t interested in humans. They insist it is a case of mistaken identity and that they would rather have a high fat seal. My take is that I enjoy eating a small Cornish game hen as much as I do a large plump turkey so why would a shark respond differently?

An aerial view of Chippenham Hospital

An aerial view of Chippenham Hospital

Johnston-Willis Hospital's emergency room entrance

Johnston-Willis Hospital’s emergency room entrance

The most interesting aspect to this year’s media stories has been the first responders and hospitals that cared for these patients in the emergency situation. While I understand that a shark attack is very rare, emergency care and trauma is not. This year we increased our Trauma levels at both Chippenham and Johnston-Willis Hospitals to best serve our community.  We forget how amazing emergency providers are who are on the ambulances and helicopters and in our ERs. Our hospitals have made great strides over the years to grow with the needs of our community. A few weeks ago I announced our construction of a new Emergency Room called Swift Creek ER on Hull Street in Midlothian. The clinical care done in our facilities is continually impressive. It could not be done without the talent of the entire care team.  We have seen 3,000 more patients in the first 6 months of 2015 compared to the same time period last year. That takes us to 69,000 patients in our ERs in the first 6 months. During that same period we experienced close to 1,000 more ambulance drop offs – a 9% increase. The CJW team has a lot be proud of in the care of these patients. Drs. Scott Hickey and Kevin Norieka, our medical directors, do an exceptional job ensuring the highest quality of care at our facilitators. Thank you to the whole team for helping make us a premier medical center.