August 2, 2019: Gregory M. Levitin, MD, with baby Noor Nunez, and her mother, Rania Al-Mutairi; father, Joe Nunez; and brother Omar Nunez, 10 days after the July 23, 2019, surgery.

It first appeared as a small rash a few weeks after Noor Nunez was born in 2018 in Kuwait, where she lives with her three older siblings, her Saudi mother, Rania Al-Mutairi, and American father, Joe Nunez. The red mark on her skin, however, was not a rash, but a bright red hemangioma, a benign tumor caused by an abnormal cluster of small blood vessels on or under the surface of the skin. As it grew, it looked as though baby Noor had a small tomato in the middle of her face—located right between her eyes.

Doctors in Kuwait, however, didn’t seem to know how to treat it. They told her parents that it was superficial, and they prescribed topical creams, assuring them it would go away. When it kept growing in size and thickness—and people had started pointing and staring at Noor—her father, a contractor based in Kuwait with the U.S. Army, became determined to find treatment, even if it meant leaving the country.

When Noor was about 5 months old, and as the hemangioma continued to grow, Mr. Nunez started to research treatment options online. “I knew we had to do something to correct this, or it would affect her for the rest of her life,” he says. “I started contacting centers specializing in vascular birthmarks all over the world, but few doctors responded.” However, when he sent an email to Gregory M. Levitin, MD, Director of the Vascular Birthmark and Malformations Program at New York Eye and Ear Infirmary of Mount Sinai, Dr. Levitin replied immediately.

January 2019: Baby Noor, left, with the growing hemangioma. November 2019: Four months after surgery: the hemangioma will continue to shrink and fade.

After reviewing the photos that Mr. Nunez had sent, Dr. Levitin knew he could help Noor. In late July 2019, around the time of Noor’s first birthday, the Nunez family traveled to New York Eye and Ear for surgery. Dr. Levitin, who is also Senior Faculty in Ear, Nose and Throat (Otolaryngology)–Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai, is a nationally recognized expert in the diagnosis and management of hemangiomas and vascular birthmarks.

Hemangiomas typically begin to appear one to three weeks after birth and often fade with time. However in Noor’s case, the hemangioma was so large and deep that it blocked almost half of her eye’s visual field and distorted the bridge of her nose. It was so deep that 90 percent of it was below the surface of the skin. Due to its location and size, it was one of the most challenging hemangioma cases Dr. Levitin says he has ever encountered.

“It was highly vascular, so there was concern about excessive bleeding, and it was in the middle of her face near her eyes, so we had to find the precise place to make an incision in order to debulk the tumor without leaving her disfigured,” recalls Dr. Levitin. “In the end, we placed the incision within the shadow line between her eyebrow and her eye—then, millimeter by millimeter, we carefully removed each feeding blood vessel in a three-hour surgery during which she lost no more than three teaspoons of blood.”

Due to the complexity of the case, the hemangioma could not be removed in its entirety without risking complications or skin grafts, but Dr. Levitin was still able to remove more than 80 percent of the tumor, leaving Noor’s eyes and eyebrows symmetrical, restoring her nose, and significantly improving her appearance. The family regularly shares updates with Dr. Levitin on the hemangioma as it continues to shrink and fade; however, Noor will likely return to New York Eye and Ear this year for two laser treatments to reduce the redness and improve the texture of the hemangioma. According to Dr. Levitin, “In two or three years—maybe less—she will appear almost normal.”

Dr. Levitin fully understands how the family was willing to do everything they could for Noor. “I became passionate about this specialty when one of my twin daughters was born with a disfiguring hemangioma,” he says. “As a head and neck surgeon, and as a parent, I knew I could give other patients the medical expertise and the attentive care they need during a difficult time. I feel like my patients are part of my extended family.”

Beyond the successful surgery, Mr. Nunez says his family was additionally impressed with the caring staff at New York Eye and Ear. “My wife was floored by the treatment Noor got,” says Mr. Nunez. “Watching how the nurses and staff treat patients and their families, it was beautiful to see,” he says.

Robin Glazer, Director of The Creative Center at University Settlement, back row, center, helped celebrate the artists, who included, front row, from left: Regina Scudellari-Ponemon, Barbara Polinsky, Cibele Vieira, and Desi Minchillo; and back row, from left: Marika Hahn, Sascha Mallon, Helen Dennis, and Nikki Schiro.

During an appreciation luncheon held on Wednesday, November 13, Mount Sinai Health System leadership, along with faculty and staff, celebrated nine talented artists who work at Mount Sinai through The Creative Center at University Settlement’s Hospital Artist-in-Residence Program providing art experiences to oncology patients and their caregivers as they receive treatment.

The event included vivid and inspiring stories about care and compassion, and the powerful impact art has on enhancing the patient and staff experience. The lunch, held in the Annenberg Center for Innovation and Discovery, was hosted by Sinai Spotlight, a Health System employee recognition and appreciation program sponsored by the Division of Talent Development & Learning, in partnership with the Mount Sinai Health System Office of Development.

The artists work in various locations throughout the Health System—both bedside and at outpatient units—helping patients, and even their visitors, to momentarily turn a traumatic, frightening, or overwhelming experience into one of joy, life, and positivity through art.

Artist Sascha Mallon, who has participated in the program for nine years, meets with inpatients at the bone marrow transplantation center and outpatients at The Mount Sinai Hospital. Ms. Mallon says she first determines their eagerness to participate, and then, their preferences.

“They make macramé and jewelry. They sculpt and paint. I find out what is exciting for them,” says Ms. Mallon. “I don’t see the illness—the doctors and nurses do. I see the healthy part of the patient, the strong part, the happy part.”

The team involved in the treatment and care of patient Jeannie Gaffigan included, from left: Colleen Geary, OTR/L, Rehabilitation Specialist in Occupational Therapy, Department of Rehabilitation and Human Performance; Jeffrey T. Gilligan, MD, Neurosurgery Resident (PGY-5); Neha S. Dangayach, MD, MSCR; Robert J. Rothrock, MD, Chief Neurosurgery Resident (PGY-6); Leslie C. Schlachter, PA-C; Joshua B. Bederson, MD; Kurt A. Yaeger, MD, Neurosurgery Resident (PGY-5); Johanna T. Fifi, MD, Associate Professor of Neurosurgery, Neurology, and Radiology, and Associate Director, Cerebrovascular Center; Joseph Waugh, NP, Neurosurgery Intensive Care Unit; and Holly E. Oemke, Program Manager, Neurosurgery Simulation Core.

In 2017, Jeannie Gaffigan, a popular director, producer, and comedy writer, urgently needed to consult with a neurosurgeon. An MRI had revealed that the seemingly harmless symptoms that she had been experiencing, and ignoring for at least a year—including headaches, dizzy spells, and loss of hearing in one ear—were the result of a massive, life-threatening brain tumor, pushing against her brainstem. Ms. Gaffigan, the mother of five children with her husband, comedian Jim Gaffigan, feared she was going to die.

Joshua B. Bederson, MD, Professor and Chair of Neurosurgery for the Mount Sinai Health System, reassured her that he could perform complex surgery and safely remove the tumor. In a 10-hour operation, Dr. Bederson and his team—relying on years of experience combined with advanced augmented reality technologies—were able to precisely see the brain’s delicate structures, allowing Dr. Bederson to systematically separate each of the nerves and myriad blood vessels from the 6-cm pear-shaped choroid plexus papilloma, a rare type of slow-growing benign tumor.

Now, in a book that was released this month, When Life Gives You Pears, Ms. Gaffigan recounts—with characteristic humor—her extraordinary medical journey at Mount Sinai, acknowledging those who provided her with expert and compassionate care.

Jeannie Gaffigan

“There are many people involved with a patient’s neurosurgical care beyond the surgeon,” says Dr. Bederson. “In Jeannie’s case, she was helped not only by me and my immediate team, but also by neuroendovascular surgeons, neurocritical care staff, pulmonologists, otolaryngologists, physiatrists, physical therapists, and others.”

Leslie C. Schlachter, PA-C, the Department of Neurosurgery’s Chief Physician Assistant and Clinical Director, played a significant role in guiding Ms. Gaffigan through the surgical process and coordinating care across specialties. “Our relationship continues to this day with intermittent text messages where I assure her that she is on the road to an excellent recovery,” says Ms. Schlachter.

After surgery, Ms. Gaffigan spent a period of time in The Mount Sinai Hospital’s Neurosurgery Intensive Care Unit (NSICU), and she later required more hospitalization and a prolonged period of rehabilitation.

Says Neha S. Dangayach, MD, MSCR, Assistant Professor of Neurosurgery, and Neurology, and Co-Director of the NSICU, “Because Jeannie’s surgery was very complex, she required extensive neurocritical care to help her embark on the perfect trajectory for a successful recovery.” Dr. Dangayach adds, “I commend Jeannie for being a great team player, for her sense of humor, and exceptional patience with us. I also commend our team of neurointensivists, fellows, physician assistants, nurse practitioners, specialty-trained nurses, and rehabilitation specialists for providing her exceptional care throughout her weeks-long stay.”