A neurologist inspired by his patients

When Irving S. Cooper, M.D., was perfecting the stereotactic cryosurgery to treat Parkinson disease in the late 1950s, William D. Gaillard, M.D. ’85, was spending summers down the block in Tannersville, N.Y. Developer of the first surgical procedures for Parkinson disease, a pioneer in cryosurgery, stereotactic surgery, and functional neurosurgery, as well as a close family friend, Cooper invited Gaillard to spend a summer during college working with him.

“He was bright and innovative, as well-versed in literature as he was in medicine. My interest in neuroscience stems from his influence,” said Gaillard, who chose pediatric neurology instead of surgery. Gaillard, chief of the Division of Epilepsy, Neurophysiology, and Critical Care Neurology at Children’s National Medical Center in Washington, D.C., felt surgery wouldn’t allow time for a family, which now includes his 19-year-old son, 16-year-old daughter, and his wife, Adelaide S. Robb, M.D., a principal investigator at Children’s National Medical Center. Gaillard proudly describes Robb as “the best pediatric psychopharmacologist east of the Mississippi River. And west.”

Gaillard’s work, like Cooper’s, helps free patients from debilitating or life-threatening neurological conditions. As director of the comprehensive pediatric epilepsy program at Children’s National, director of the Intellectual and Developmental Disabilities Research Center Imaging Core, associate director of the Center for Neuroscience Research at Children’s Research Institute, and professor of neurology at George Washington and Georgetown universities, Gaillard focuses on difficult-to-control seizures.

In a field that can take a heavy emotional toll, Gaillard draws inspiration from his patients and their parents. The pediatric neurologist tells the story of a 13-year-old patient with Rasmussen encephalitis, a rare inflammation of one hemisphere of the brain that causes severe seizures, cognitive disabilities, paralysis on one side of the body, and possibly death. If medications don’t control the seizures, the only cure is removal of the affected hemisphere of the brain. Typically surgery is not recommended if it will affect movement, memory, or language—functions Gaillard describes as “essential to being human.” But even after falling into a coma, the girl was seizing uncontrollably.

“We didn’t have any options if we wished to save her life,” Gaillard said. So he recommended removal of the left hemisphere of the young girl’s brain.

The surgery cured her seizures—but as expected, she couldn’t speak or understand. She was depressed, using a wheelchair, and taking numerous medications. A year after surgery, during which Gaillard managed the treatment of a movement disorder the surgery had caused, the once-bright and outgoing girl could speak only one word. “Six months later,” Gaillard said, trying to control his emotion, “she walked into my office and said, ‘Hello, Dr. Gaillard.’ ”

Still Gaillard’s patient, the young woman now speaks and walks and is back in school; she no longer takes either seizure medications or antidepressants. Gaillard gives all the credit to the patient and her mother, who encouraged her daughter when even the girl’s schoolteachers said they anticipated no further improvement. She worked tirelessly for her daughter,” he said.

Due in part to Gaillard’s imaging research, physicians can now determine noninvasively whether seizures are located in the areas of the brain that control language. Among the more than 100 studies Gaillard has led or co-authored, many in collaboration with the National Institutes of Health, he is most excited about his research on using functional magnetic resonance imaging as a replacement for invasive methods of brain mapping. Imaging can reveal which portions of a patient’s brain control language to determine whether surgery is a viable option to cure seizures.

Gaillard is quick to explain that he chose pediatrics because “it’s more fun.” He admires pediatricians’ willingness “to play in the sandbox” and “laugh at themselves.” For Gaillard, the ability to laugh at himself comes with the ability to “know what you don’t know.”

“If you really want to take care of someone, it’s best if you work closely with others with the skill sets you don’t have,” he said. Gaillard’s own playfulness, not to mention school spirit, is apparent in his bulldog-printed bowtie and e-mails occasionally signed “Boola Boola.”

Drawn to medicine by an aunt who was forbidden to go to medical school because “a lady did not take a man’s job,” Gaillard pursued neurology after a spring spent at University College London’s Institute of Neurology at Queen Square. He credits Laura R. Ment, M.D., associate dean of admissions and professor of pediatrics and of neurology, with encouraging his interest in pediatrics and child neurology, and Richard H. Mattson, M.D., professor emeritus of neurology, with encouraging his interest in epilepsy.

“What’s really rewarding is to try to help a child have a normal life,” Gaillard said.