UK HealthCast: What Makes Pediatric Neurosurgery Unique?
UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics.
Dr. Randaline Barnett, director of Pediatric Neurosurgery at UK HealthCare, is one of three pediatric neurosurgeons in the state of Kentucky. On this edition of UK HealthCast, Dr. Barnett offers insight into the unique neurological needs of children, how pediatric neurosurgery differs from neurology and why, as an Eastern Kentucky native, she feels an even more special connection with the people she helps.
Read below for some key takeaways from Dr. Barnett’s conversation.
Treating children who need pediatric neurosurgery
Dr. Barnett’s work requires a deep understanding of the physiological, emotional and social differences between children and adults. Pediatric patients are not just smaller versions of adults; their brains and bodies are at different developmental stages, requiring specialized care.
Dr. Barnett tailors her approach to each child’s age and needs, ensuring treatments are both effective and minimally disruptive to their growth and development.
“When you save a kid’s life, you’re not just saving their life; you’re saving their lifetime,” Dr. Barnett said. “And so, it’s really important to me to give them a lifetime of good memories.”
This philosophy guides her focus on preserving not only her patients’ physical health but also their emotional and social well-being. For example, she takes steps to minimize visible impacts of surgeries, such as carefully parting and shaving as little hair as possible, to help children feel more comfortable returning to school and their communities.
Collaboration with neurology and other specialties
Pediatric neurosurgery often involves collaboration with other specialists, particularly pediatric neurologists. While neurologists focus on the medical management of neurological conditions, neurosurgeons like Dr. Barnett step in when surgical intervention is necessary. This team-based approach ensures that children receive comprehensive care tailored to their unique needs.
“For instance, when we talk about seizure disorders, I am definitely not an expert in managing seizures medically,” Dr. Barnett said. “I tell people that, as a neurosurgeon, I can look at an EEG and I know the basics of an EEG, but the neurologist is the expert and they're the ones that have been trained to read those studies and work on managing those conditions with medications. And then, as a neurosurgeon, I become involved in cases when there is a possible indication for surgical management of a neurosurgical condition. And so, I will provide consultations on my opinion on whether or not something could be treated with surgery. And if so, then I recommend the type of surgery that I would perform and talk to our kids and their families about that.”
Dr. Barnett’s schedule is dynamic. Mondays are dedicated to clinic visits, where she consults with new patients and follows up with those recovering from surgery. Thursdays are reserved for elective surgeries. The rest of the week is unpredictable, with emergency surgeries or meetings to advance pediatric care often arising unexpectedly.
Dr. Barnett’s approach extends beyond the operating room to the families of her patients. By fostering a collaborative environment, she helps families feel empowered during what is often a deeply stressful time.
“When I'm treating a child, I focus on the entire family because the family dynamics are definitely going to play a role in the success and the outcomes that this child is going to have,” Dr. Barnett said.
Kentucky roots
Dr. Barnett’s journey began in Breathitt County, where she grew up as the daughter of a coal miner and a stay-at-home mother. She was the first in her family to become a physician, inspired by the family doctor who served as a cornerstone of her community. Her fascination with the brain began during medical school at the University of Kentucky, leading her to pursue a career in neurosurgery.
Following residency at the University of North Carolina and a fellowship in pediatric neurosurgery at Le Bonheur Children’s Hospital and St. Jude Children’s Research Hospital, Dr. Barnett returned to Kentucky to serve the people who had supported her throughout her journey.
“I always wanted to return home to take care of my people,” Dr. Barnett said. “I'd tell everybody that I would not be where I'm sitting today without the community that I had pushing me and was behind me every step of the way, even down to our church groups who would pray for me. Every exam I've ever taken in my life, I mean, it’s really amazing how much people supported me, and I wanted to be able to pay that back for people back home. And so, I'm really happy to be here and able to grow our Pediatric Neurosurgery Program here.”
As one of the few pediatric neurosurgeons in Kentucky, Dr. Barnett plays a crucial role in addressing healthcare disparities in the region. Her intimate understanding of the challenges faced by families in rural areas—from food insecurity to limited access to specialists—enables her to advocate effectively for her patients. She is also working to expand services at UK HealthCare, including developing comprehensive care programs for pediatric brain tumors, spina bifida, spasticity and fetal neurosurgery.
