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Business Profile

Gamma Knife of Spokane

You've got a lot of stuff stored away in your brain. Your children's birthdays. The memory of a lost love. Recipes, golf strokes, languages. All that schooling and on-the-job training. This delicate web of perspectives and perceptions is what makes you you.

So when the diagnosis of an abnormality in the brain arrives — a tumor, a neuroma, a debilitating pain in the facial nerves — it's little surprise that patients are often as worried about protecting a sense of self as about their own mortality.

"Even dying was less frightening than the tumor or badly placed radiation changing 'who I am,'" says Bo Cooke, a managing partner at the Gamma Knife Spokane surgical center, of many patients' responses to the prospects of treatment. "Who they are is in that brain."

The good news is that these conditions are more treatable than they were for our parents' generation; the better news is that we can now treat them with less collateral damage.

Gamma Knife Spokane is one of only 140 treatment centers in the country (and one of the smallest markets) to use the cutting-edge technology of the Gamma Knife — a 44,000-pound machine that can target tumors with previously unheard-of precision, and with minimal effect on the patient.

The key is in spreading out the dose. Rather than propelling a single powerful column of radiation toward the target, the Gamma Knife emits a simultaneous array of 192 microscopic beams of cobalt radiation, all of which enter the head at different points but converge on the target at the same precise spot. The result is that the tumor gets the same dose of radiation, but all the points along the way -- the scalp, the skull, the neurons and ganglia containing all those memories and verb tenses and chip shots -- receive only about 1/200th of that.

"The safety is unmatched, the outcomes are phenomenal," says Cooke. "We can treat a tumor or a malformation of the brain one time and the patient can go home for dinner."

Of course, such precision isn't cheap to provide. Last year, when Gamma Knife Spokane wanted to upgrade to a new model that would be 40 percent faster, they first talked to a Dutch banking giant about helping them with the $5 million price tag. But INB beat the offer from the Netherlands.

"They said, 'We can do better,'" says Cooke. "They were competitive with any international bank. And we had the flexibility of dealing with a bank that understood the nature of the business of medicine. We were really impressed." Besides, he says, "Why send money to the Dutch when we can keep it at home?"

The entire region is reaping the benefits. For 10 years, Gamma Knife Spokane has run a telemedicine program that lets doctors from rural areas of Washington, Idaho and Montana access a technology that would never otherwise be available to them. Working with the center's small dedicated staff and its stable of contributing surgeons, small-town doctors can refer patients for treatment and stay connected at every step of the process. That way, Cooke says, "Kalispell, Montana, doesn't have to invest in an underutilized $5 million piece of equipment."

That access is a plus for any patient -- whether in Kalispell or Colfax, St. Maries or Spokane -- who faces the scary prospect of letting a tumor tell them who they are.

Because of these successes, reach, and the strength of their previous research, Gamma Knife Spokane was one of only 5 centers in the United States offered the Icon, a cone-beam CT scanner that helps track patient movement while inside the Gamma Knife, ensuring even greater accuracy. Which means cutting edge radiotherapy is faster and more comfortable than it’s ever been.

"What killed you 20 years ago in 30 days now we can control indefinitely," says Cooke. "And, after treatment, almost everyone is home by dinner."