Cradling The World
Charlotte’s Dr. Brittany Clyne Reaches Out To Women Around The Corner And Around The Globe
By Shay Merritt, Today’s Charlotte Woman Magazine
If your career happens to cross paths with a goddess, you can count your lucky stars and look to the heavens for the blessings sure to follow you. For Charlotte’s Dr. Brittany Clyne, a member of the international medical aid society named for the ancient Turkish (Anatolian) goddess Kybele, those blessings have covered not only her, but also the patients she treats — in Charlotte, and all over the world.
Dr. Clyne, an obstetric anesthesiologist at Southeast Anesthesiology Consultants, which provides services to Carolinas Medical Center, has responded to what she calls the “great need worldwide” for better healthcare for women — especially during childbirth — here and abroad. In November, Dr. Clyne’s volunteer work with Kybele (pronounced Key-bell-a), a nonprofit organization dedicated to improving childbirth conditions worldwide through medical education partnerships, will take her to Eurasia for the third time.
The goddess Kybele, while revered as a mother goddess, was not limited by the conventional definitions of fertility and nurturing. She was a figure of power and protection, believed to be able to touch many aspects of life and to mediate between the boundaries of the known and the unknown — much as an anesthesiologist provides pain management. But for Dr. Clyne, improving the quality of maternity care in the Republic of Georgia is not a myth … it’s a reality.
From Sparkles To Scrubs
Dr. Clyne grew up as an Army brat, until her family settled in Greensboro when she was in the eighth grade. Her father, Dr. Donald Bergin, is an ophthalmologist who graduated from West Point before attending medical school at Duke University. At the age of 5, Dr. Clyne’s earliest career aspiration — to be a waitress like her aunt, who wore a spangled leotard and tights as she worked her way through graduate school — was replaced by the decision to become a doctor.
She attended Duke University, graduating in 1996, and completed her basic medical training at the Wake Forest University College of Medicine in 2000. When the time came to declare a specialty, she contemplated becoming an ophthalmologist like her father, but decided to become an anesthesiologist.
“Anesthesiology is used in so many fields,” she says. “I loved the operating room. I wanted to be a surgeon but not necessarily have a surgeon’s lifestyle. As an anesthesiologist, I still get to be in the operating room and perform a lot of different procedures.”
Following an internship in pediatrics in 2001, Dr. Clyne served her residency in anesthesiology in 2004 and finished up with a fellowship in obstetric anesthesiology in 2005 — all at the College of Medicine at Wake Forest. Today, she is vice chair of obstetric anesthesiology at CMC and spends half of her time in obstetrics and half in the main operating room.
“I love being with people in this very happy time when I can make such a difference,” she says. “Sometimes bad stuff happens in obstetrics, and when it happens, it can be catastrophic. Because obstetrics is my specialty, I feel that when there are bad situations, because of all of my training, I am the one who should be there taking care of them.”
Following In The Footsteps Of A Trailblazer
Kybele was established by Dr. Medge Owen, associate professor of obstetric anesthesia at Wake Forest University College of Medicine. Dr. Owen was one of Dr. Clyne’s attending physicians during her last year of medical school and is someone she greatly admires. “People are very impressed that I trained under Medge Owen,” she notes.
In 1997, Dr. Owen received a Fulbright scholarship that took her to Turkey, where she spent 18 months teaching at Uludag University in Bursa. She also helped develop local obstetric anesthesia and neonatal resuscitation programs. “People [in Turkey] consider Medge Owen the person who brought regional anesthesia — epidurals for labor and spinals for C-sections — to their country,” says Dr. Clyne. It was Dr. Owen’s efforts to stay involved in improving childbirth conditions in the area after she returned to the United States that led her to found Kybele.
“Her idea,” Dr. Clyne says, “was that most doctors can arrange to get two weeks off at a time so they can participate in the Kybele volunteer endeavor. We go to specific hospitals and work with the obstetricians and the anesthesiologists. Sometimes we take neonatologists to help with neonatal resuscitation.”
Kybele has grown to include doctors from around the world. The teams who travel abroad stay in apartments and share the rent. It’s obvious the international camaraderie is an enjoyable part of the experience.
“On our first trip, to the Republic of Georgia, we had two Canadians, two Belgians, two Scotsmen and six Americans from Texas and Boston, and Wake Forest, Duke and Charlotte hospitals,” Dr. Clyne says. They worked through interpreters who speak Russian and Georgian, the two languages spoken by most of the doctors there. “That was an extended-site visit, where we visited nine hospitals to collect data and see how anesthesia and obstetrics are performed. I participated in two regional anesthesia placements for C-sections, and my team was involved in around 15, total. When we return this time, we will work in groups of two for a whole week at the maternity houses and should do more anesthesia with the physicians.”
In developing countries such as the Republic of Georgia women’s healthcare lags far behind men’s healthcare. There are few truly modern hospitals, and most babies are born in maternity houses, which are not anywhere near state-of-the-art. Issues relating to pregnancy and childbirth are leading causes of death, disease and disability for women and children. For example, the current maternal mortality rate in the Republic of Georgia is 50 deaths per 100,000 patients, and the infant mortality rate is 19.3 per 100,000. By contrast, the maternal mortality rate in the United States is only eight deaths per 100,000 patients, with an infant mortality rate of 6.4 per 100,000.
Just how far behind is the Republic of Georgia in its medical practices? According to Dr. Clyne, “They are practicing 1950s medicine, and I am not saying that to impugn them. They have some amazing surgeons. Georgia is an old country with a relatively young government, and there are many changes occurring in the health system right now. But until five years ago, this country routinely had power outages. You go into a hospital today, and there are bathtubs filled with water just in case they lose water. They manually ventilate. There are no ECG leads to monitor heart function. They don’t have pulse oximeters — standard since the 1980s — to check the mothers’ oxygen levels. We’re really trying to make a difference by going in and working with other people who want to make a difference in women’s healthcare.”
Putting Birthing Mothers At Ease
One of the most important opportunities for the Kybele team is encouraging the use of regional anesthesia — epidurals and spinal blocks — over general anesthesia. While there is no research that says the use of general anesthesia results in less healthy babies, a woman who has been “put under” is unable to communicate changes she feels in her body, and that may mask complications — particularly important in cases in which the mother has developed toxemia or preeclampsia. In addition, with general anesthesia, the mother is deprived of any active participation in the birth event. Regrettably, in the Republic of Georgia, epidurals are very expensive and are rarely used for labor. Spinal blocks are less costly, and the Kybele doctors hope to see an increase in the use of spinals, especially for Caesarean sections, as the teams continue working with doctors there.
“In some of these countries, having a pain-free labor is not a priority,” says Dr. Clyne. “And patients may not be able to afford to do it. But having spinals available for C-sections can make a dramatic difference in the country’s morbidity and mortality rates for women. By helping institute that one change that costs pennies, we can make a dramatic difference in the quality of anesthesia the women get.
“We work with and educate the anesthesiologists and obstetricians in their environment, so that when we leave they are able to carry on,” Dr. Clyne explains. “We build friendships and establish communication for problems that occur when we aren’t there. In short, we try to empower a country’s physicians. We also monitor statistics of places we visit and how our teachings improve maternal and neonatal safety.”
Dr. Clyne and the rest of the Kybele team are counting the days until their November trip to Republic of Georgia. “There’s still tons of work needed,” she reflects. “Kybele went there to sort out the best way to do this — because there are lots of politics and a little bit of ‘This is the way we have always done it’ mentality. Fortunately, there are a number of young doctors who trained in St. Petersburg or trained abroad. It’s usually these doctors who spark change, and that’s who we connect with and help to work within their system.”
During her most recent visit to the Republic of Georgia, this past February, Dr. Clyne made a presentation on behalf of Kybele to government healthcare officials, including the deputy minister of health and First Lady Sandra Roelofs. Dr. Clyne spoke of the work accomplished on earlier trips, what the Kybele team members have learned, what they recommend for the future and how the government can help. Roelofs was reportedly moved by the information that was shared and declared that she would put everything else she was working on aside to devote herself to women’s and children’s healthcare. She has since given birth herself and experienced the conditions for women firsthand.
“Because of her experience, she has been an incredible impetus for change, and she is very supportive of Kybele,” Dr. Clyne says. “That relationship is one of the biggest achievements Kybele has accomplished.”
Dr. Clyne and her husband, Dr. Stephen Clyne, an otolaryngologist at Charlotte Eye, Ear Nose and Throat Associates, live in Charlotte with their two dogs. The couple hopes to have children at some point but, for now, Dr. Clyne finds purpose in working to fulfill the Kybele mission and in helping to deliver babies at CMC. “I work with an amazing group of physicians,” she says. “I am always in awe of them. I really respect what I get to do, and I am just blessed to be a part of it.”
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