A collaborative clinic at UCSF next year will begin welcoming patients seeking answers to complex medical mysteries of the brain.
The Jan and Maria Manetti Shrem Neurology Clinic, named for its donors, was inspired in part by the philanthropic San Francisco couple’s own experience with memory loss.
“It’s a wonderful marriage between a donor and a clinic that we wanted to create,” said Dr. S. Andrew Josephson, UCSF’s chair of neurology.
The cutting-edge clinic, expected to open in November 2020, will specialize in providing answers to patients whose symptoms are not easily defined or treated.
“Neurological conditions sometimes can be very difficult to diagnose,” Josephson said. “Patients often go through a diagnostic odyssey with multiple doctors and tests that take years to get an answer.”
When Jan Shrem became forgetful a few years ago, he sought treatment at UCSF, where doctors diagnosed him with mild cognitive impairment with memory loss.
The couple decided to support the hospital — ultimately making an $18 million donation — because they were impressed by the quality of care and the strides doctors there had made in the challenging field of neuroscience.
Maria Manetti Shrem said nearly every family she knows has been touched by neurological problems, from stroke to Parkinson’s disease to dementia. Her own life has changed since her husband’s memory started slipping. She helps him do the things he’s always loved, like traveling, art and music. But as the memory loss progresses, she must remind him about appointments more frequently, ask him questions constantly and spend more time by his side.
She hopes the clinic will help him, and countless others who deal with issues affecting the most complicated organ in the body.
“We came at the right time,” she said.
The idea of the new clinic will be to streamline the diagnostic process by combining resources and several doctors from different fields — neurologists, psychiatrists and neurosurgeons — in one room for patients to visit like a “one-stop shop,” Josephson said. Many patients whose conditions do not fit inside a box or label struggle through a time-consuming, expensive and sometimes fruitless search for answers.
“The mental toll that this takes on patients and their families, the toll of not knowing what’s wrong … is tremendously frustrating for patients and their families, leading to a sense of hopelessness that makes conditions even worse,” Josephson said.
While it is possible these doctors will disagree, the ability for them to talk through their differing opinions will be paramount.
“I think getting people in the same room is much easier to arrive at an accurate consensus,” he said.
The clinic, part of the Weill Institute for Neurosciences, will feature 14 patient exam and consultation rooms, an MRI and neuro-infusion center, and conference capability for other doctors to participate in discussions.
It will be housed on the first floor of an entirely new building, which will also house research laboratories and institutes for neurodegenerative diseases and brain health.
Josephson said he expects the clinic will draw patients from across the county and world.
“It’s really unique,” he said. “I know nothing like this has really been done nationally.”
Nervous system disorders require rapid treatment, Josephson said, because they can create irreversible brain damage and worsen with time.
Neurological issues that people experience are “innumerable,” but some examples include cognitive problems like difficulty thinking, weakness on one side of the body or in the limbs, or lesions on the brain. The new clinic will focus on complicated disorders that are difficult to diagnose, while patients with more easily recognizable diseases like Alzheimer’s or dementia would be sent to UCSF’s Memory and Aging Clinic.
“It is an incredibly broad, varied set of clinical symptoms,” Josephson said.
Longtime Bay Area philanthropists, the Shrems funded the Jan Shrem and Maria Manetti Shrem Museum of Art at UC Davis, annually support the San Francisco Opera, San Francisco Symphony, KQED and funded a hospital emergency department and cardiology fellowships. Jan Shrem ran a publishing business and established the Clos Pegase winery, while Maria Manetti Shrem, raised in Florence, built a career in fashion.
UCSF ranks among the top neurological and neurosurgical hospitals in the nation, according to U.S. News & World Report, and is known for treating patients with memory issues.
“I think this whole idea is focused on not just resting on our laurels, rather, really trying our best to further improve the care we can give to folks,” he said.