As the lead off event at the GW School of Medicine and Health Sciences (SMHS) annual MD Reunion Weekend, neurosurgeon Gail Rosseau, MD ’85, stepped to the lectern to deliver the 14th annual Frank Miller Lecture and address a personal and professional passion: global health and how to deliver care to everyone who needs it.
Rosseau, a GW SMHS clinical professor of neurological surgery, used the endowed lecture to show how leadership and advocacy have shifted surgery, once dismissed as too costly and complex, into the center of global health.
“Advocacy and leadership go hand-in-hand,” she said. “If you’re a leader, people ask your opinion, they want to know what you stand for, what you care about.”
In her welcoming remarks, Barbara Lee Bass, MD, FACS, vice president for health affairs, and dean of GW SMHS, Walter A. Bloedorn Chair of Administrative Medicine, and professor of surgery, recalled first meeting Rosseau long before she joined the Class of 1985.
“I was a surgical resident here at GW, in training from 1979 to 1986, when I first met Gail, perhaps in the middle of the night in the surgical ICU,” Bass recalled. “She was an ICU nurse at that time, and one of those nurses you were really happy to see [on your shift].”
Shortly after that, Bass noted, Rosseau enrolled in the GW SMHS MD program, pursued a specialization in neurosurgery, and went on to have “a magnificent practice for over 25 years as a very successful clinical neurosurgeon in Chicago.” Throughout her career, she added, Rosseau has been driven by her passion: “In her particular world, that is figuring out how [to bring surgical care] to the developing nations of the world.”
In her lecture, Rosseau charted the rise of global surgery, a field only recently fully defined. She recalled how former medical school classmates Jim Kim, MD, PhD, who later became the 12th president of the World Bank, and Paul Farmer, MD, PhD, who were both internists, founded Partners in Health to deliver high-quality health care globally to those who need it most. Once established, the organization struggled to care for patients facing traumatic injuries or acute surgical emergencies. The frustration led them to refer to surgery as “the neglected stepchild of public health.”
The phrase, added Rosseau, originates from multiple reports and articles in global health from 2015, highlighting how essential surgical care is often ignored in low-income countries, seen as a luxury rather than a core health system need, despite impacting millions and being vital for economic development.
Their observation spurred the Lancet Commission on Global Surgery to outline the massive unmet need: 5 billion people without access to emergency and essential operations, more than 5 million neurosurgical cases left undone each year, and a shortage of 23,000 trained neurosurgeons.
Since those early days, Rosseau’s field has responded by partnering with others to create a new subspecialty — global neurosurgery — and setting measurable goals to train surgeons, expand infrastructure, and build partnerships across continents. “We’re kind of a ‘Goldilocks’ field,” she said, large enough to matter but small enough to act swiftly.
Tipping her hat to Hippocrates, she noted that globalization has given physicians a second core responsibility: “support those initiatives that bring the best possible care to every patient.”
She urged the audience to view the challenge as an investment, not a cost or burden. The Lancet Commission estimated a $350 billion price tag to expand surgical access, but warned that the cost of inaction — lost lives and lost productivity — could reach $12.3 trillion.
Concrete progress, Rosseau said, depends on achievable targets. She cited the efforts of the Global Alliance for the Prevention of Spina Bifida, whose advocacy led the World Health Assembly in 2023 to unanimously pass a food-fortification resolution to help prevent the neural tube disorder. “That was our first big success for neurosurgery in global advocacy,” she recalled.
This year, that advocacy expanded into the Boston Declaration, where neurosurgeons, nurses, engineers, and health-system leaders pledged resources, training, and research collaborations. The goal was to break down a seemingly impossible task into “SMART goals: specific, measurable, actionable, realistic, and time-bound.
To Rosseau, the work begins with lessons learned at GW. “We learned discipline. We learned training. We learned perseverance. It was never easy, and it became our passion,” she said. “How are we translating those elements of the culture of leadership we learned here to being able to help the world?”
Rosseau urged the audience to meet the moment and added, “That’s what global medicine is about.”
Following her remarks, Rosseau highlighted GW’s role in shaping the next generation of global health leaders and the work of the GW Global Clinical Care Alliance’s inaugural cohort of Global Health Legacy Fellows. Two fellows — Timothy Singer, MD, and Rizul Naithani, DO, MPH — presented brief updates on their respective projects: the impact of climate change on neurodevelopmental disorders, and expanding ophthalmologic care in low-resource settings.
Timothy Singer, a PGY4 neurosurgery resident at GW, presented updates on his project, “Neural Tube Defects in a Changing Climate: Systems, Surgery, and Preparedness in Tanzania.” Singer, who holds an MD and a master’s in environment and resources and previously completed a pediatrics residency with a focus on global child health, is working to establish an epidemiologic link between climate change and conditions like hydrocephalus and spina bifida, particularly in East Africa.
Multiple studies, Singer said, have shown that not only folic acid, but also environmental exposures and other factors are driving the incidence of spina bifida and numerous other neurosurgical pathologies. He noted that it remains unclear exactly how neurosurgical, cardiac, oncologic, and obstetric conditions are affected by the changing climate. In his research, Singer is exploring how ambient temperatures during early gestation influence neural tube formation.
Rizul Naithani, a PGY2 ophthalmology resident, discussed her comparative evaluation of patient-reported quality of life following different surgical interventions for glaucoma in Southern India. Her project, titled “A Comparative Evaluation of Patient-Reported Quality of Life Using the Indian Visual Function Questionnaire (IND-VFQ-33) Following Combined Minimally Invasive Glaucoma Surgery or Trabeculectomy with Phacoemulsification in Patients with Primary Open-Angle Glaucoma in Southern India,” applies her extensive experience in public health and research.
Glaucoma is a leading cause of irreversible blindness, often due to increased pressure inside the eye. It affects the optic nerve, which transmits vision from the retina of the eye to the brain. Because the incurable disease progresses slowly and often lacks noticeable early symptoms, it can go undiagnosed until too late.
Naithani is reviewing patient-reported data to assess the real-world impact of different surgical approaches, with the goal of improving glaucoma care and accessibility in low-resource environments.
“Our study objective,” she explained, “primarily consists of looking at the Indian visual functioning questionnaire and seeing the support and comparing it at different stages of post-op period between those individuals who have a traditional traculectomy versus those who got the [MIGS procedure].”
