If you were to watch New York-based neurosurgeon at work, you would likely notice the expert precision of her hands as she navigates the delicate anatomy of her patients. You might sense her acute concentration and ability to maintain focus while remaining attuned to her surroundings. You may even notice her mastery in handling surgical tools with both her left and right hand, a skill she developed while a second year student at the University of Hawaiʻi at M膩noa (JABSOM).

These same skills are not limited to her work in the operating room—they carry over into the art studio.

“My art is closely tied to medicine,” said Ko. “I can go from the operating room into the studio and some of the same ideas, challenges, failures and successes carry over from the scalpel to the paintbrush. It creates a continuum of thought and feeling which brings balance and richness to both sides.”

A graduate of Kalani High School, Ko earned her bachelor of arts degree in zoology and her medical degree from 东精影业 M膩noa. She moved to New York to continue her education and pursue her interest in neurosurgery. Ko became the first female JABSOM graduate to become a neurosurgeon. After completing her residency, she went on to work in several level one trauma centers in New York City. She now has more than 30 years of emergency surgery experience.

Around mid-career, Ko was serving as chief of neurosurgery at a level one trauma center in the Bronx when she began to feel that something was missing in her professional life. On a whim she took a few beginner鈥檚 courses in painting at a local YMCA and slowly realized her passion for art. She later went on to earn a master of fine arts degree in representational painting.

“My art isn鈥檛 specific to any particular patient,” added Ko. “What鈥檚 more important is the message; the message of survival, of challenges, and of the fight. It鈥檚 an important message that as a surgeon, is not easy to communicate to the world. I鈥檓 able to articulate this better on canvas.”

The power of kindness

Reflecting on her time at 东精影业, she credits the medical school with teaching her the importance of kindness and respect.

“Being from Hawaiʻi, kindness and aloha are sort of inherent in your nature, but the medical school really emphasized these values,” said Ko. “I think that鈥檚 what set me apart and allowed me to be successful in a place like New York City.”

Ko鈥檚 ambidexterity also came about as a result of her coursework at JABSOM. To improve her concentration during the long and extensive lectures, she trained herself to write with her left hand—something that less than 1 percent of the population can do naturally.

Looking back, she believes her ambidexterity may have been the key to unlocking her passion for art.

“I think my career became richer and more balanced after I went into art,” added Ko, “and I think a message to the younger generation is don鈥檛 be boxed in. In this short life, you shouldn鈥檛 leave any dream untried.”

Kathryn Ko can be found as @doc_ambidexter on and Figure 1 (a medical app similar to Instagram). Additional details about herself and her work can be viewed on .

—By Kapiʻolani Ching

Laughter is good medicine, except when it actually is the symptom of an illness. Medical residents at the University of Hawaiʻi at M膩noa (JABSOM) helped a man who suffered from nearly a lifelong affliction that caused him to laugh with no control over when it happened or why.

“This was a very medically intriguing case. Prior to this case, I didn鈥檛 know seizures could manifest in such a way as uncontrollable laughter,” said Nina Leialoha Beckwith, a family medicine resident at JABSOM who worked on the case with fellow residents under the supervision of JABSOM clinical professor Kore Kai Liow, neurologist and chief of staff-elect at .

The case was academically compelling but also stirred great empathy in the physician trainees. The patient, 40 years old at the time, had suffered from the uncontrolled laughter since the age of eight.

“I believe his story can help us as clinicians to identify and provide better care for patients suffering from similar conditions,” said Beckwith. “I can only imagine what it is like for this patient to suffer from these bizarre seizures for so many years. I鈥檓 grateful to have been a part of his care.”

A rare form of epilepsy

As the physicians reported in the , the medical term for the condition was a gelastic seizure. They wrote, “Gelastic seizures (GS) are a rare form of epilepsy characterized by inappropriate, uncontrolled laughter. They are highly associated with abnormal cognitive development and behavioral problems in patients. Research has shown that GS can originate from,” non-cancerous tumors on the hypothalamus region of the brain. “GS have also been observed in patients with frontal and temporal lobe lesions.”

The man had a history of both a brain tumor and of diabetes mellitus and schizophrenia, in addition to the laughing fits, which struck two to three times a week. He had been considered by some to have longstanding behavioral issues. But when it came to the uncontrolled laughter, there was indeed a physical cause, and when the hypothalamic hamartoma was detected and the patient treated with medicine, the laughter was brought under control, according to Liow.

The researchers concluded that gelastic seizures need to be included in diagnosing patients with uncontrolled laughter. They wrote, “Thus, a thorough workup should include neuroimaging with attention to the suprasellar region and EEG or electroencephalogram. Accurate, early diagnosis and patient education are critical in avoiding excessive and unnecessary treatments.”

Learn more about this case on the .

—By Tina Shelton

Neurologist Beau Nakamoto, associate professor of medicine at the John A. Burns School of Medicine, received a two-year, $421,313 grant from the National Institute of Neurological Disorders and Stroke (National Institutes of Health) to examine whether a new magnetic resonant imaging (MRI) contrast dye can be used to detect the inflammation that is believed to signal decline in memory and thinking. The contrast dye that Nakamoto will be studying will specifically target the immune system’s white blood cells, which are believed to play a key role in the development of HIV-associated cognitive impairment.

About 2,900 people in Hawaiʻi live with HIV/AIDS, and there continue to be new cases every year. In the last two decades, as people live longer under a daily regimen of anti-viral HIV-fighting medicine, the Hawaiʻi Center for AIDS has noticed that HIV patients are suffering dementia at rates greater than people without the virus.

While severe HIV dementia is uncommon with effective combination antiretroviral therapies, milder degrees of cognitive impairment continues to affect up to 50 percent of HIV-infected individuals. Even mild cognitive impairment can have a big impact on important parts of a person’s daily life. Employment difficulties arise because of fatigue, driving is difficult or dangerous and people forget to take their medications (without daily doses of life-sustaining HIV antivirals, HIV patients will die).

Nakamoto, a neurologist at Straub Clinic and Hospital, is a member of an elite team of researchers at the Hawaiʻi Center for AIDS who suspect one of the main types of cells which protect the body against infection also play a key role in causing HIV-associated dementia. It is believed that once these infection-fighting cells (monocytes) have switched on to battle HIV, an unintended consequence is the production of toxic chemicals in the brain that cause uncontrolled inflammation and ultimately cognitive impairment.

Nakamoto is one of few researchers in the nation to utilize novel MRI contrast agents to track those infection-fighting cells in the brains of HIV-infected patients. If successful, this technique could potentially be used in future clinical trials aimed at targeting the HIV-infection fighting monocytes with the hope of finding a treatment for HIV-associated dementia.

—By Tina Shelton