A classroom in a hospital: Doernbecher’s school program

Supporting hospitalized students for nearly a century, the Doernbecher School Program has a long history of helping students learn and grow while they are in the hospital. In an environment often full of unfamiliar faces and noises, Doernbecher’s two classrooms (one on 9S and one on 10S) and dedicated staff provide a sense of normalcy and a sense of community, customizing curricula and experiences to meet each student’s needs and interests.

Hematology Oncology Teacher Anna Balmaseda and Acute Care Teachers Debbie Mettler and Heidi Worden share more about the program and what it means for patients, families and the teachers themselves.

Do all children’s hospitals have school programs? How are they structured and funded?

Children’s hospitals typically have some component of education service, but they are very diverse across the country. Some have licensed teaching staff through local districts; others staff their own teachers. Occasionally, social workers or Child Life specialists play a role in education coordination as well. A dedicated teaching program is ideal for serving the educational needs of hospitalized children.

In our local area, hospital school programs are pretty consistent because of our administration and team format. The Multnomah Education Service District administers our program, which includes several other Portland-area hospitals, so the programs are pretty consistent. The funding for this program comes directly from the Oregon Department of Education.

How does the Doernbecher Hospital School Program differ from a more traditional school setting?

Our classrooms serve students from kindergarten through 12th grade – kind of like a one-room schoolhouse. We strive to individualize instruction but we recognize the importance of being social, so we use group activities to encourage participation and collaboration among students. Our priority is to meet students where they are – medically, emotionally and academically – then encourage them to continue to grow.

One asset of our program is that we try to create a curriculum or experience based on the student’s current interests, strengths and talents. We recognize the need to be relevant to the student and his or her family when we introduce the idea of school in the hospital, which might mean practicing math exercises or taking a spelling test. It could also mean participating in one of our partner programs like science outreach with OMSI or a music class with CCA’s MusicRx.

Generally speaking, the school is a positive experience for parents and for learners. Once parents are reassured that we will meet their child at his or her current level, they see the potential of our collaboration. As is true with the medical team, parents are a big part of the school team.

What’s your favorite part about teaching students at Doernbecher?
Working closely with such special students and families is truly an honor. As educators, we are always looking to discover a student’s gifts, strengths and talents, and this is a unique setting to do that. We’re always inspired by what we find and are encouraged by students’ growth!


Pictured from top left: Linda Criswell, Acute Care Teacher; Anna Balmaseda, Hematology Oncology Teacher; Debbie Mettler, Acute Care Teacher; Margaret Eng, Hematology Oncology Teacher; Heidi Worden, Acute Care Teacher; Kerri Russell, Intermediate Care Teacher



Technology that matters

Recently, friends of Doernbecher Children’s Hospital may have noticed a huge hole in the ground at the southwest corner of the building (not to mention a crane you can spot easily from east Portland).

No, we are not having plumbing problems. Instead, this hole will soon transform into a small but crucial two-story ‘bump out’ that expands the surgical suite area of Doernbecher, and enables one of the most startling and powerful technologies in the world to advance our care of children with brain tumors, epilepsy and other potentially devastating illnesses of the central nervous system.

Neurosurgery is a game of millimeters: just enough removal to cure a child of their serious disease, but not enough to alter their function, their ability to grow and develop, or to change the nature of the special child who came to us for care. When neurosurgery as a specialty was founded at the turn of the last century, my predecessors had to guess where a tumor resided based on a crude neurological examination, and perform ‘exploratory’ surgery of the brain. They operated in dimly lit operating theaters, without magnification or focused light. Survival was low, and morbidity (injury) was high.

Since that time, neurosurgery has marched inexorably forward in attempting to improve the care of patients through better technological aids to diagnosis, navigation in the brain, and visualization. The first step was simple: focused lamps worn on the surgeon’s head to better light the operative field. Then came operating microscopes, and the miracle of CAT scans, allowing us to look inside the brain (and leading to a Nobel prize for the inventors). Most recently, MR imaging improved our ability to tell normal from diseased brain and spinal cord, and computers allowed us, in principle, to navigate with millimeter-level accuracy.

Huge challenges still remain, though. As soon as we approach the brain during a surgical procedure, release of cerebrospinal fluid and ‘sagging’ degrade the accuracy of our navigation computers. Also, even with the most modern techniques and high-power operating microscopes, telling diseased from normal brain in the operating room can be very challenging or impossible.

At the end of 2015, Doernbecher will complete construction on the first pediatric high-strength intraoperative magnetic resonance imaging, or iMRI, suite in the state of Oregon, and one of few such facilities in children’s hospitals around the world (it will be the second in the western United States). This ‘3 Tesla’ power iMRI will allow me and the other pediatric neurosurgeons at Doernbecher to more safely and completely remove even more difficult brain tumors and epilepsy lesions in children than ever before, as well as improve treatment for cysts, vascular malformations and many other disorders. The miracle of the iMRI is in allowing us to obtain new MRI images during brain surgery, updating our computer navigation maps, and assuring that we can complete the removal of every bit of a challenging lesion.

Locating the iMRI at Doernbecher appropriately recognizes the spectacular growth and subspecialty sophistication of our program, which welcomed a third faculty neurosurgeon just last month. Christina “Tina” Sayama, M.D., a top national recruit, came to us from fellowship at Texas Children’s Hospital and residency at the University of Utah. Doernbecher is now the only hospital in Oregon history to offer professor-level pediatric neurosurgical care during all hours, all days.

We are also more prepared to use the iMRI facility effectively and efficiently immediately upon opening, due to the skill and expertise of my other faculty colleague, Lissa Baird, M.D., who trained with this technology at the first site in the world to install it: Brigham and Women’s Hospital at Harvard University (our facility at Doernbecher will have twice the imaging power of that original unit in Boston). A nationally recognized tumor and endoscopic surgeon, Dr. Baird will help us lead the way into this new era.

I am tremendously optimistic that Doernbecher will continue to fulfill its mission as a local and regional leader in sophisticated neurosurgical care for the children that need it most. Through careful and coordinated strategic recruitments and commitment to the most effective surgical technology, we will expand this impact even farther, and contribute to the best standards and outcomes possible, anywhere.

Nathan R. Selden, M.D., Ph.D.
Mario and Edie Campagna Chair of Pediatric Neurosurgery
Director, OHSU Neurological Surgery Residency Program
OHSU Doernbecher Children’s Hospital

#FreestyleFriday: OHSU employee Gabe Flores

OHSU employee Gabe Flores got his first pair of Nikes (blue and white with a single Velcro strap) when he was in the third grade.

“I was the talk of the school!” he said. 

The next year, he acquired his first pair of Nike Air Jordans. From the looks of things, it doesn’t appear that he’ll be slowing down anytime soon – he estimates that he has 70 pairs of shoes, 30 of which are Jordans. His collection has grown so extensive, he had to raise his bed 9 inches to store additional shoes.

Gabe, a trainer in Organizational Effectiveness, has been at OHSU for 15 years. He started out in patient transport and worked his way up to his current position. He’s also enrolled in a Business Management program at PSU with plans to graduate next June.

As an OHSU employee and a self-admitted “shoe hoarder,” Gabe’s interest in the Doernbecher Freestyle program comes as no surprise. The program, now in its 11th year, is a unique collaboration between OHSU Doernbecher Children’s Hospital and Nike. Each year, a handful of Doernbecher patients team up with Nike designers to create customized (and highly sought-after) Nike shoe and apparel collections.

“Collecting sneakers is one thing,” Gabe said. “Taking pride and knowing what they’re all about is another thing. It’s not for personal gain; it’s for the kids.”

He’s seen first-hand the impact the program has on patient-designers’ lives – Jordan Dark, a 2009 Doernbecher Freestyle designer, was Gabe’s neighbor growing up in Mt. Angel, Oregon.

“I’ve known Jordan since he was born,” Gabe said. “I saw his reaction to being asked. The program really changes the kids’ outlook on life sometimes – they’re exposed to the marketing and business aspects as well as the design process.”

Gabe’s older sister was diagnosed with Hodgkin Lymphoma at age 29, a diagnosis that impacted his entire family.

“Knowing what our family had to go through with my sister, I know it’s not only the patient you’re caring for, but the families as well.”

Nike wants to do what Doernbecher does by putting kids’ well-being at the forefront, but in a different way, Gabe said.

“It really shows that both organizations care about kids. It’s really neat,” he said.

So will Gabe be posted up at his computer when this year’s collection becomes available, hoping to snag a pair?



The 2014 Doernbecher Freestyle collection will be unveiled Friday, Nov. 7. If you’re in the Portland area, you can meet this year’s patient-designer crew in person and celebrate their hard work by purchasing tickets here. Follow along online using the #dbfreestyle hashtag and following @OHSUDoernbecher on Twitter. 

Free flu vaccine for patients, parents and families at Doernbecher

Edited 10/20/16 to include up-to-date vaccination information

OHSU Doernbecher Children’s Hospital is offering free flu shots to the parents and close family contacts of its established patients.

The program is intended to protect OHSU Doernbecher’s youngest and most vulnerable patients. Babies younger than 6 months, for example, cannot receive the flu vaccine.The next best means of protection is to “cocoon” the infants, or insulate them from infection, by immunizing their family members.

OHSU Doernbecher’s “Free Vaccine for Parents” campaign for its established patients and their families is funded by the OHSU Doernbecher Children’s Hospital Foundation. The campaign is organized and executed by a group of OHSU Doernbecher pediatric residents who work together with health professions students to deliver as many vaccines as possible to our community.

The workgroup hopes that this pioneering work may become the standard of care for children’s hospital nationwide.


  • Family members must be 18 or older.
  • Family members cannot be employees of OHSU.
  • Family members cannot be currently pregnant.
  • Family members will be screened for flu vaccine contraindications, a condition for which the flu vaccine may harmful to the patient, prior to vaccination.


Free vaccinations will be offered to our established patient family members starting Monday, Oct. 24, subject to volunteer availability.

Dates: Monday, Oct. 24, 2016, until supplies last

Hours: Mondays and Thursdays from 1 to 3 p.m. and Tuesdays from 10 a.m. to noon

Location: OHSU Doernbecher Children’s Hospital first-floor lobby



Behind the illustration with Maryanna Hoggatt (and Simon)

When I was approached to participate in the Amazing Storybook project for Doernbecher Children’s Hospital and their creative agency, Sockeye, I was thrilled. It was an opportunity to work for a well-respected children’s hospital, and as part of a campaign developed by Sockeye, the theme of the illustration closely aligned with something I identify with in my own work: encouraging children to be brave and face their fears.

Adapting my creative style to this storybook illustration for Doernbecher was very natural. Outside of freelance projects, I’m creating a whole army of animal soldiers for a series called “Animal Battle.” This body of work, while meant for all ages, is really aimed at kids. I’ve taken a complex concept, which is about our internal struggles to makedreams a reality, and dressed it up as fuzzy animals wearing colorful costumes and carrying wooden swords. In “Animal Battle,” brave animals fight against fear and doubt. In the Doernbecher illustration, a brave little boy faces illness. Naturally, I put a wooden sword in his hand.

I scratched out a few rough drafts on paper, tweaking the sketches until I was happy with the composition, then I transferred the drawing to watercolor paper. I’m a traditional-medium kind of girl at heart, so I painted this illustration by hand – sometimes with a ridiculously tiny brush. The final stage includes of few sweeps of digital magic before I packaged the whole thing up and called it done.

I’m in the habit of naming my characters. It makes them seem more real. The name “Simon” popped into my head on the first sketch before my pencil lifted from the paper. He just looked like a Simon, and somewhere in my memory a string tugged, and I remembered there was a Simon in the “Alvin and the Chipmunks” cartoon. He also wore glasses, was incredibly smart, witty, and by far the most responsible of the three chipmunks. It was a good fit.

Sometimes, it’s hard to know if what I’m doing is making any difference. With Doernbecher helping children every single day in the battle against illness and injury, all I can hope is that maybe my characters and drawings can be a small light in the darkness. Maybe a parent will see this illustration and show it to their child, like a page from a storybook, and say, “Look, you can be brave, too.”
Just like Simon.


Maryanna Hoggatt
To find out more about Animal Battle, visit www.animalbattleart.com, or visit Maryanna’s portfolio site.


From strength to strength: our people

I am proud to announce the recruitment of another superb young pediatric neurosurgeon to Doernbecher Children’s Hospital at Oregon Health & Science University for the service of children and families in Oregon and our region.

Dr. Christina Sayama studied bioengineering at the University of California, San Diego, and medicine at the University of Utah, where she also earned a Master of Science degree in public health. She was trained in neurological surgery at the University of Utah and in pediatric neurosurgery at Texas Children’s Hospital.

These are spectacular credentials, but they only tell a small part of the story.

Most importantly, of the roughly one dozen specially trained surgeons from around the country we interviewed for the Doernbecher position, Dr. Sayama stood out in terms of her confidence, humility and humanity. She also brings special training and expertise in complex surgical problems of the spine in children, from trauma and spina bifida to scoliosis.

Dr. Sayama’s recruitment also opens up new avenues for the world-class care of children never previously available in the state of Oregon. Most importantly, the pediatric neurosurgical service at Doernbecher is providing attending surgeon-level pediatric specialty care around the clock, year round, for the first time in the state’s history. Our three full-time pediatric neurosurgeons are all board certified or tracking towards certification by the American Board of Pediatric Neurosurgery  (three  of only four such surgeons in the State of Oregon, and the only three currently in active practice).

Interdisciplinary programs in pediatric brain tumor, hydrocephalus, craniofacial disorders, epilepsy surgery, and spina bifida regularly bring children needing special care to Doernbecher from as far away as Idaho, Alaska, Montana and Hawaii. Dr. Sayama’s work here will enhance and expand our existing strengths in complex spinal surgery.

At Doernbecher, the skill and compassion of our people define our mission of helping children, advancing the science of care, and educating the next generation of health professionals. Dr. Sayama will be a wonderful part of our team.

Nathan R. Selden, M.D., Ph.D.
Mario and Edie Campagna Chair of Pediatric Neurosurgery
Director, OHSU Neurological Surgery Residency Program
OHSU Doernbecher Children’s Hospital


Flu vaccine decreases a child’s risk of serious illness

Each winter or spring, millions of people are infected with influenza, thousands of children are admitted to pediatric intensive care units, or PICUs, for complications of influenza infection, and as many as 200 of them die.

Influenza, or flu, virus infection causes a respiratory illness with symptoms that may include fever, chills, cough, sore throat, headaches, body aches, fatigue, vomiting and diarrhea.

Vaccination is the most effective way to prevent flu infection and its complications, but rates of flu vaccination are often low, even in vulnerable populations.

A recent study published in The Journal of Infectious Diseases showed that flu vaccination decreased children’s risk of needing PICU care for an influenza infection by 74 percent. This adds to growing evidence that the flu vaccine is effective not only at avoiding influenza infection, but also at decreasing the severity of infection, even for those who get influenza.

Who should be vaccinated against the flu?

The U.S. Advisory Committee on Immunization Practices recommends that everyone older than 6 months should be vaccinated every year.  Because there are many different types of flu virus that can change over time, the vaccine itself changes from year to year to provide the best protection.

Vaccination is particularly important for people at high risk of severe flu illness, including:

—  Children younger than 5

— Adults older than 50

— Adults and children who have a chronic disease, including asthma and diabetes

It’s also important for anyone who lives with or cares for someone at high risk for severe flu to be vaccinated each year.  This not only protects the person being vaccinated from getting flu, but also can help protect a vulnerable loved one from developing a life-threatening flu infection.

Which flu vaccine is right for my child?

Children ages 6 months to 2 years old should get a flu shot; they are too young to get the nasal spray flu vaccine.  For some children ages 2 to 8, the nasal spray flu vaccine may be more effective if it is available, otherwise, the flu shot is the best option.  For people older than 8, the flu shot and the nasal spray are equally effective.

Children getting a flu vaccine for the first time should get two doses at least 28 days apart.  There is a small group of people who should not get the flu vaccine.

Your health care provider can help you determine which strategy makes the most sense for you and your family.

Carl Eriksson, M.D., M.P.H.
Assistant Professor of Pediatrics
Division of Critical Care Medicine
OHSU Doernbecher Children’s Hospital



Brain cancer patient pledges to ‘Kick Cancer’s Booty’ — one dollar at a time

Eleven-year-old Alexa, known to her friends and family as “Princess Lexy,” wants to kick cancer’s booty.

Diagnosed with brain cancer when she was 14 months old, Alexa has had multiple major surgeries to combat the brain tumor and has been undergoing chemotherapy treatments for seven years. In 2012, she lost her vision. Alexa receives bi-weekly chemotherapy treatments at OHSU Doernbecher Children’s Hospital.

When Alexa’s mom, Monica, heard about Phil Knight’s $1 billion challenge to OHSU last September, she showed her daughter and her 15-year-old son, Cameron.

“The kids thought this might be the breakthrough we need. A billion dollars could cure Alexa and her many, many friends also suffering with cancer – she always thinks of the other children with cancer,” Monica said.

So Alexa and Cameron’s fundraising challenge was born – they issued a challenge to their friends, family members and fans of Alexa’s Facebook page to donate a dollar or more to help “Kick Cancer’s Booty” (view their fundraising site here).

“People started sending money like crazy,” Monica said. “It came in envelopes with stickers, cards and dedications. One 10-member family sent 10 $1 bills – one for each family member. Alexa and Cameron were very proud.”

To date, they have donated $645 to the Knight Cancer Challenge.

Alexa and her family are working hard to raise awareness about the challenge and its importance for fighting pediatric cancer. Last month, Alexa and her family met with Portland Mayor Charlie Hales, who officially proclaimed September – and every following September until a cure is found – Children’s Cancer Awareness Month in Portland.

On September 24 and 25, Portland’s Morrison Bridge was illuminated gold in honor of children with cancer, which Alexa’s family initiated. They gathered at the Tom McCall Waterfront Park to view the lights together (see photos from the event here).

Find out more about the Knight Cancer Challenge and how you can help OHSU meet Phil Knight’s challenge here.

Lisa McMahan
Social Media Coordinator
OHSU Doernbecher Children’s Hospital


Sleep is awesome!

Sleep is awesome! Just like food and water, we need it for our physical and mental well-being. The problem is that many of us are not getting enough or good quality sleep on a regular basis.

The goal of this post is to highlight some of the amazing things that happen during sleep and to stimulate the reader to think about making small changes in the daily routine that might have a big payoff.

How much sleep do we need?

The average newborn will sleep around 14 to 16 hours per day and half of that time is spent in rapid eye movement sleep (stage of sleep during which most of us dream). It is downhill from there on, and sleep length gradually decreases as we get older.  The average healthy adult will need about eight hours of sleep to function optimally and will spend much less time in dream sleep. The magic eight-hour number has been determined from large surveys and laboratory studies that gave healthy people an opportunity to sleep without having to worry about going to work and with very limited access to electronics.

We also know that sleep debt — similar to a credit card debt — can creep up on a person. If you are getting just 20 to 30 minutes less sleep per night than what your body needs, you will accumulate a big deficit over time. This deficit then contributes to not feeling and performing well.

What happens in the brain during sleep?

One common assumption is that the brain gets switched off when we are sleeping, when just the opposite is happening. When we are in dream sleep, the brain is firing on all cylinders and the cells in the brain are “shaking hands” and “talking” to each other non-stop. The result of all that activity is the formation of new connections and networks which allow us to remember learned information and to apply it.

Getting the right amount and high-quality sleep is especially important for children and teenagers as their brains are undergoing tremendous growth and they need to process huge amounts of information.

We all know that a sleep-deprived brain is not a happy brain. Sleep lifts our mood and helps us keep a positive outlook on life.  Parents of teenagers likely agree that a well-rested teenager is much more fun to be around.

Sleep is the brain’s housekeeper. Recent research suggests that a major function of sleep is the flushing out of metabolic products that could harm the brain; similar to the rinse cycle on your washing machine.

The sleep-deprived brain works as poorly as a drunken brain. A study of healthy adults found that 24 hours without sleep resulted in the same poor performance test as having a blood alcohol level of 0.1 percent. Unfortunately, like the drunken brain, the sleepy brain does not really know how impaired it is.

What happens in the body during sleep?

Sleep makes muscles perform better. All elite athletes know this and make sure that they are getting enough sleep during training and before competitions. A study in college basketball players showed improved 3-point shooting averages and a one-second improvement in 282 feet sprint time with no change other than sleeping more.

Sleep strengthens our immune system. Not getting enough sleep can increase the risk for illness due to infections.

Things to consider for more and better sleep

If your child is getting the age-appropriate amount of sleep per night and is alert after waking up and during the day, stop reading right here. Otherwise, read on.

  • Measure sleep

In order to get a better feeling for the magnitude of the sleep deficit, it can be helpful to keep a daily sleep diary for a week or two. The diary should include the bedtime routine and the time of falling asleep and waking up. If the average daily sleep duration is adequate but your child is still very tired, something might be wrong with the sleep quality. Poor sleep quality could be caused by medical problems, medications, stress or sleep apnea. If the sleep is not refreshing, or your child has a very hard time falling asleep at night, it might be a good idea to talk to your child’s doctor.

  • Develop healthy sleep habits

Try to provide an environment that helps with the transition to sleep. Keep the room dark (small nightlight OK if needed). Find the temperature that is most comfortable (too cold or too warm makes it harder to fall asleep). Avoid a heavy meal or exercise right before bedtime. Keep all electronic entertainment devices out of the bedroom. This can be hard to do if the child has gotten used to these devices. It is best to set rules early on and have a dedicated space outside of the bedroom for computer, game station and all the fun handheld devices.

Advise your child to only go into the bed when ready to fall asleep. Avoid reading books, playing video games or other activities in bed. The brain gets used to being entertained in bed and then keeps seeking that stimulation instead of being able to switch to sleep mode.

  • Supercharge the brain with naps

Short naps are extremely effective. A 10-minute nap will improve your brain power for a full 2.5 hours. Pretty good return on investment, I’d say. The beauty of the short nap is that it is short (you can also do it more than once a day). Most importantly, you avoid the groggy or dopey feeling you might get after a longer nap.

  • Back to school

Teenagers often struggle with the transition from the summer break back to school. Their body clock has adapted to a very late bed and wake-up time. The first couple of weeks of school can therefore be a real drag. The transition to school can be made less stressful by starting a week or two before the end of summer break. Going to bed at a slightly earlier bedtime every night and getting up a bit earlier every day is often easier than the hard transition in just one night. Bright light in the morning and avoidance of electronic devices in the evening will also help adjust the body clock to an earlier time.

Holger Link, M.D., M.R.C.P.
Clinical Associate Professor of Pediatrics
Pediatric Sleep Medicine Program
Division of Pediatric Pulmonary Medicine
OHSU Doernbecher Children’s Hospital



Q: How can I help my child prepare for surgery?

A: Although specific details will depend on your child’s age and the surgical procedure, it’s always best to be clear and honest, as well as reassuring. In other words, don’t baby your child — explain what the surgery is for, what’s going to happen during it, and how he or she might feel after waking up.

You don’t need to explain every potential complication, but you do need to be truthful so your child knows what to expect: Kids are tougher than we sometimes give them credit for.

If you are concerned about your child’s fear or apprehension regarding surgery, the OHSU Doernbecher Children’s Hospital Child Life Program uses age-specific approaches to help lessen a child’s anxiety about any aspect of a hospital or surgery.

More information: Preparing for Surgery at OHSU Doernbecher

Kenneth Azarow, M.D.
Division of Pediatric Surgery
OHSU Doernbecher Children’s Hospital


Doernbecher Best in the Country U.S. News & World Report


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