A Cure and a Career: Meet Dr. Feldstein’s Patient, Carly

When New Jersey high-school student Carly Hirschberg went to see Dr. Feldstein about her Chiari malformation, she ended up with more than she ever imagined: a symptom-free life and a start on the path to practicing medicine.

Carly was in middle school when she started having headaches. “They’d go up the back of my neck and all the way to my forehead,” she says. She also started having some tingling in her fingers and toes, and ringing in her ears.

Her doctors were unable to find an immediate cause and chalked up the symptoms to hormonal changes, allergies or perhaps stress.

“I kept trying to tell everyone I wasn’t stressed,” she says.

No one could find a cause for the headaches, and over-the-counter pain medicine controlled them well, so Carly just lived with them.

Then in her sophomore year of high school Carly fell on the tennis court. The fall left her with a stress fracture in her back, so she was sent to have an MRI.

The MRI revealed more than a stress fracture. It showed that Carly had what the doctor described as a “whopping Chiari malformation.”

In a Chiari malformation part of the brain is pushed down through the back of the skull into the spinal column. This causes—you guessed it!—headaches, tingling and ringing in the ears. The mystery was solved.

Carly’s doctor referred her to Dr. Neil Feldstein, the Director of the Adult and Pediatric Chiari Malformation Center at Columbia University IrvingMedical Center/NewYork-Presbyterian Hospital. She appreciated the fact that he explained everything thoroughly. “I was very into science, and I loved learning about it, figuring out what caused my symptoms and putting it all together,” she says.

“I thought he was very academic and knowledgeable, and he truly specialized in this. I felt he really knew what he was talking about, and he was on the cutting edge of the science that was coming out about Chiari malformation.”

Dr. Feldstein told her that surgery to fix the Chiari was elective, so she could decide when she wanted to have it done. Carly decided to wait. “I did have headaches every single day,” she says, “but it sounded like a big procedure, and I was just reluctant to go through with it.”

She says Dr. Feldstein was supportive of her every step of the way. “He was very matter of fact and academic, but at the same time he was compassionate and warm and didn’t make me feel silly for being so nervous about the procedure.”

While she waited, she had regular checkups with Dr. Feldstein and became more and more fascinated with the human brain—so fascinated that when it came time for her to start college, she decided to major in neuroscience.

But college proved to be a real challenge with her Chiari symptoms. It was much harder to deal with the headaches living away from home. Her symptoms made it impossible to study enough to keep up with the increased workload. It was time to move forward with the surgery.

“When I came home for Thanksgiving I saw Dr. Feldstein and explained the predicament. He said the recovery was not long and it was definitely something I could do over my winter break.”

So Carly flew home for her winter break and had surgery the next day, hoping she’d be recovered enough to have a productive second semester at college. In fact, Carly says she was up and walking around the hospital two days after her surgery and on vacation with her family 10 days later.

“I had zero symptoms. I went right back to school, rushed a sorority, took all my pre-med classes. I went out with my friends and ran at the gym. I think I was back and functioning within a month, for sure.”

Did you notice that Carly said she took pre-med classes? As interested as she had become in medicine, Carly says she hadn’t previously considered becoming a doctor because her Chiari symptoms had made it impossible to do that level of study. But now those symptoms were gone, and Carly’s fascination with medicine had skyrocketed.

She told Dr. Feldstein about her interest in becoming a doctor, and he arranged for Carly to “shadow” him. Carly came to the clinic with him and observed as he worked with patients.

“I learned a lot,” she says. “He’s not only an amazing physician to watch practice, but he teaches really well. I still get questions right on exams because of things Dr. Feldstein taught me when I was 18 years old.”

Throughout her college years Carly was able to continue shadowing Dr. Feldstein, and eventually he had her work on some research projects.

Carly is now 25 and in medical school studying obstetrics and gynecology. She credits Dr. Feldstein with her love of both the surgical and clinical sides of medicine.

“I always say I owe Dr. Feldstein my entire life and my career,” she says.

To fellow Chiari sufferers, she says “[Having the surgery is] a personal decision, and you have to understand the risks and benefits.” It’s a big decision to have elective surgery, which is why she waited until she felt the time was right for her, when the symptoms started interfering with her daily life.

“Looking back, I would definitely say that I should have just done the procedure right away. It wasn’t worth the three extra years of headaches and tingling and all the different symptoms I was having.

“It’s worth living without the symptoms.”