Dr. Dennis A. Hart is a pediatric physiatrist who recently joined Joe DiMaggio Children's Hospital as chief of Pediatric Physical Medicine and Rehabilitation.
He specializes in caring for patients with developmental disabilities or patients recovering from neurological or orthopedic injuries such as stroke, traumatic brain injury, spinal cord injury, peripheral nerve injury, spasticity and other conditions that require rehabilitation.
While getting settled into his new role, Dr. Hart took some time to share his journey to a career in pediatric medicine and his goals for the rehabilitation program.
What inspired you to pursue a career a medicine?
I originally went to school and graduated with a finance degree. I then worked in a bank for about four years but decided that banking wasn’t what I was meant to be doing.
So I went back to school, but wasn’t really sure what to pursue. I looked at various options including jobs in the sciences and at graduate school, medical school and veterinarian school.
I decided to volunteer at a local ER at night, just so I could get a sense of what medicine was like. I quickly fell in love with it and realized that this was what I wanted to do.
What then led you to focus on pediatric rehabilitation, and work with children and adolescents with chronic pain?
At the end of my third year of medical school, I was doing a rotation in the surgical ICU and one of rehab residents was doing a consult with a patient. I liked how that resident explained his work, so I decided that during my fourth year of medical school I would choose rehab for my elective rotation. Turns out, I really loved it.
At that point, I decided I wanted to focus on chronic pain management. I went to Kentucky for an internship and residency in adult Physical Medicine & Rehabilitation, still focusing on pain management. But I had to do a three-month rotation in pediatric rehab, where I had an “aha” moment.
I had been in the pedi rehab for about three weeks and had just finished my shift when one of the nurses I had gotten to know said something that changed my life. She said, “You know Dr. Hart, you need to do pedi rehab because when you first came here you were miserable, grumpy and didn't smile. And since you've been with these kids, I see your eyes light up when you walk into a room.
I went home that night and sat there in my apartment for probably four hours thinking about what she said. And I realized that, yes, it was a big difference for me. So I decided to focus on pedi rehab.
What are some of the challenges of treating pediatric patients with chronic pain?
Rehab always has an element of pain management to it, but when I went to Johns Hopkins, there really wasn't anyone in the outpatient setting taking care of kids with chronic pain.
I had a lot of training in pain management so I agreed to start taking on those patients. There really aren’t enough physicians trained in pediatric chronic pain management or chronic pain syndromes.
Pediatric patients with chronic pain are often very challenging cases but are also some of the most rewarding.
Many of these kids have been labeled. A lot of the time, doctors can't find the cause and don't have the answers, so they decide that it's in the child's head.
Many of the kids I've seen were once straight A students, they are very intelligent, and many were athletes who've developed this chronic pain. And people assume that because they are in chronic pain and not doing much anymore, they are trying to get away with something. When, in reality, most of the time these kids just want to get back to the life they had.
Often times, we can't completely cure or treat the condition and make all of the pain go away. But these patients can and do have good success with pain management.
I may not be able to fix everything, but I can help them become more functional and help them live a happier life.
When I see kids are improving and getting back into the community, it’s a wonderful experience knowing that I was a part of making that happen.
Do you think your role as a parent impacts your work?
Definitely. I’m a father myself. I have quadruplets and two of my children have autism. A big part of treating pediatric patients is working with their families. Chronic pain and disability – especially in children, teens and young adults – affect the whole family.
I really believe in treating the whole person -- not just a diagnosis or single problem. So when I start working with a new patient and their family, I ask a lot of questions so I can understand how their symptoms and struggles are impacting their daily life and activities –- for the patient and the family. This includes the physical aspects but also their emotional health and the family dynamic. We must take this all into consideration to create a treatment plan that will ultimately help to improve their life. Getting to know them in this way initially, and then over time, naturally creates a connection and bond with patients and their caregivers.
And as a dad of two children with special needs, I have a deeper understanding of what these families are going through. I know firsthand about some of the daily struggles and can relate to the challenges they are facing.
I also know how seemingly small changes and improvements can make a huge difference for everyone in the family. I think families appreciate that I understand where they are coming from. And we become closer partners as we work together toward the shared goal of helping their child live the fullest life they can live.
What are your hopes for the rehabilitation center at Joe DiMaggio Children’s Hospital?
Joe D is a very unique hospital in that the administration is really committed to partnering with physicians to build the programs and services that are needed to change lives. And everyone – from the doctors and specialists, to the nurses, therapists, receptionists and maintenance staff – are committed to putting the needs of our patients first. This is especially true of the Pediatric Physical Medicine and Rehabilitation program.
My hope for the program is that we can grow by partnering with the acute care physicians including the trauma team, oncology, orthopedics, neurology, neurosurgery and other specialties to provide seamless patient and family centered care from the patients initial medical injury or illness through maximum recovery potential to allow them to participate fully within the community. Rehabilitations role in recovery is to address the physical and cognitive limitations caused by the illness or injury and to advocate for the family to address the school, community and societal barriers.
I also hope to build and strengthen our team through improved communication, working towards shared goals, and iterating our processes so we can continue to enhance care that leads to improved patient outcomes.
What do you like to do in your free time?
My family has a small hobby farm with a menagerie of animals. I enjoy working on the farm and relaxing with my family. I am also an old movie buff.