March 2025

REHABILITATION

SPOTLIGHT ON ANTON N. DIETZEN, MD: FROM RESIDENT TO PEDIATRIC MEDICAL DIRECTOR

Question 1: Can you share a bit about your journey from being a resident at Marianjoy to your current role at Northwestern Medicine?
Answer: I was actually in chiropractic school while my wife was in occupational therapy school. She was working as a respite worker for several families with children with special needs. When she finished school before me, I took over her caseload of kids.
I had about three or four kids who were all Marianjoy patients, and they all saw Mary Keen, MD. The families kept telling me I had to meet Dr. Keen because I would love her. Eventually, I shadowed her with one of my little kiddos, who is now one of my godsons. From that first day, I knew this was what I wanted to do.

Back then, the process to shadow was pretty informal. I just asked Dr. Keen if I could shadow her, and she agreed. I showed up the next day without much paperwork involved. I shadowed her for about a month, two or three days a week, working with the residents. I’m still friends with some of those residents today.

After that, I volunteered in the research department at Marianjoy, working with Dr. Syed and Sue Brady. That was my introduction to Marianjoy, and I knew I wanted to do my training there. Matching into a program was a bit of a mystery to me at the time, but everything aligned, and I matched at Marianjoy for residency. I became a chief resident and later decided to do my fellowship outside the system to gain unique experiences and expertise to bring back. I always intended to return to Northwestern Medicine.
Question 2: What inspired you to specialize in Pediatric Physical Medicine and Rehabilitation?
Answer: I knew I wanted to work with children with special needs. My brother-in-law has quadriplegic cerebral palsy, and my wife and I are high school sweethearts. I used to take my brother-in-law on adventures and do all kinds of things together when we were in high school. This experience made me want to help kids with special needs have the same opportunities and experiences.

When I worked with Dr. Keen, I really liked the approach of Pediatric Physical Medicine and Rehabilitation (PM&R). Medicine is often compartmentalized, but Pediatrics PM&R is very person focused. You look at the whole person, their strengths, and what you can work on to optimize their function. It's not just about one system like the brain or bones; it's about the entire person.

I found this holistic approach fascinating because it involves a lot of different interventions and requires you to be a jack of all trades. You need to know a little about many different things. In Pediatrics PM&R, we see a wide variety of conditions, from burns and genetic disorders to trauma, cerebral palsy, spina bifida, brain injuries, and drownings. It's about recognizing patterns and knowing which tools to use for each pattern rather than focusing on a single condition.

This variety keeps the work interesting because every patient is different. You're always learning new things and encountering rare conditions, which makes the field dynamic and engaging.
Question 3: What are some of the most rewarding aspects of working with pediatric patients in your field?
Answer: I think it's really about the problem-solving aspect of partnering with the patient and their family. At Marianjoy, we worked hard to enable children to do the things they want to do. This often involved looking at various tools, whether it's technology for communication, mobility devices, or different ways to access these tools. When you find the right tool that matches the patient's needs and see them achieve something they couldn't do before, it's incredibly rewarding.
Question 4: How do you feel your time as a resident at Marianjoy prepared you for your current position?
Answer: Marianjoy was fantastic because we had so many resources under one roof. We had therapists specializing in feeding, adaptive technology, and a seating center where patients could try different devices with the help of vendors and physical therapists. For example, if a patient needed a gait trainer and hadn't found one that worked, they could come to the seating center and try several options to find the best fit.

We also had a prosthetic and orthotic clinic. Complex cases could be managed effectively because we could collaborate with physical therapists in the gait lab, conduct gait studies, and design the best braces for independence—all without leaving Marianjoy. This comprehensive approach prepared me well for my current position, where I continue to focus on finding the best solutions for my patients.
Question 5: Can you describe the mentorship and relationship you had with Dr. Keene?
Answer: Dr. Keene initially took on a mentor role for me. I started by shadowing her and observing how she cared for patients. She looked at them as whole people, ensuring every aspect of their growth and development was optimized.

I have four daughters, and my second has special needs. Dr. Keene was one of the first doctors we saw when we didn't have a diagnosis for her until she was almost two. Even without a diagnosis, Dr. Keene identified the necessary therapies, equipment, and mobility aids my daughter needed. We didn't miss a beat in getting her everything she needed to thrive.

As a resident, working with Dr. Keene was great. When I returned after my fellowship, I brought back some new tools and techniques. One of my first patients upon returning was the same patient I had first shadowed Dr. Keene with. He was coming in for a procedure Dr. Keene hadn't seen before, and she asked if she could observe. It was surreal to see this patient, now preparing for college, and have Dr. Keene observe me performing the procedure. It felt like everything had come full circle.
Question 6: Can you describe a particularly memorable or impactful experience you've had with a patient?
Answer: Yeah, gosh, there are so many, but one that stands out is a patient I followed up with today. He had an infectious spinal cord injury as an infant and underwent surgery. He was on my inpatient unit, working on becoming more mobile and walking for the first time, which was great. He was doing well physically.

At the same time, we had another patient on the unit who was six years old and had a brain tumor and underwent resection. As a result, he had significant impairments, emotional lability, personality changes, and couldn't speak. He struggled to participate in therapy. The first patient, who was eight years old, took him under his wing. The brain tumor patient looked up to him and wanted him to watch his therapy sessions and cheer for him. The therapists incorporated him into therapy as a motivator, with the parents' permission. They even had pizza parties together in the evenings.
I thought it was so neat because, while we can control parts of rehab like medicines, braces, and exercises, the motivation piece is crucial. Seeing this patient recognize his positive impact on another was incredibly rewarding.

Another memorable experience involved a high schooler with a brain tumor who was a high-level dancer before her diagnosis. She had been very sick and underwent a life-saving bone marrow transplant from a family member. She was so thin and deconditioned, like a shadow. She joined our day rehab program, and one day, I walked past the pool and saw her physical therapist working on dance lifts with her. She was in her dance pose, and the light caught her just right as she popped out of the water.

It was the coolest thing because when I first saw her, she couldn't even sit up during my visit. She had to lay down due to weakness. Seeing her work on dance lifts in the pool made me want to cry. She had been through so much, but through hard work, she was able to get back to something she was passionate about. It was amazing to see the teamwork and dedication of our specialists and case manager, who kept a close eye on her mood and progress.
Question 7: Do you often consult with other specialists in Adult Physical Medicine and Rehabilitation (PM&R) when dealing with complex cases like spinal cord injuries or brain injuries in children?
Answer: It'll happen with patients who are older. For example, I had a patient with a traumatic spinal cord injury at 16. He was on the pediatric side with us for inpatient rehab, but we felt that for outpatient rehab, an adult PM&R specialist would be a good fit because the patient was almost an adult and adult-sized.
So, I talked to one of the adult PM&R specialists, explained the situation, and asked if he would be comfortable managing the patient's care after discharge. He agreed, which was great. They've had a couple of follow-ups since then, and it has been a good fit.
Question 8: Considering the pediatric program at Marianjoy allows for a seamless transition into an adult program within the same facility, would you regard this as a significant advantage?
Answer: Yes, it is indeed a significant advantage. Today marks the first day of our adult CP (Cerebral Palsy) Transition Clinic, which has been a long-time vision of Dr. Keene. Establishing this clinic took considerable effort because determining the right time to transition patients can be challenging. Many of Dr. Keene's patients have been under her care since their initial CP diagnosis, and their families trust her deeply.

When these patients, now in their mid-20s, transition to adult providers, it can be daunting. Even though the adult providers are highly skilled, they may not have the same experience with childhood-onset disabilities. The CP Transition Clinic facilitates a warm handoff, with Dr. Keene present alongside Dr. Hublikar and Dr. Witkowski, the adult providers. This ensures a smooth transfer of care and continuity.

Additionally, the clinic includes a social worker and a nutritionist to address complex care needs. Having a pediatric program within a PM&R hospital that allows for such seamless transitions is quite unique. We have board-certified specialists in spinal cord injury, brain injury, and pediatric PM&R all working together in the same space, which greatly benefits our patients.
Question 9: Where do you see the field of Pediatric Physical Medicine and Rehabilitation (PM&R) going, and are there any new directions or developments you would like to see?
Answer: I think one of the big movements in medicine in general is towards multidisciplinary clinics. During my fellowship, we had a multidisciplinary clinic with surgery and movement disorder specialists for complex movement disorders. This allowed us to explore surgical interventions and other treatments for patients with complex tone or movement issues.

Similarly, we had a multidisciplinary orthopedic surgery clinic. Now, at Marianjoy, we have integrated neurosurgery with Dr. Raskin, who visits every other month from Lurie Children's Hospital. This enables us to see patients together and determine if they are good candidates for neurosurgery procedures. We're also looking at doing something similar with orthopedic surgery, having pediatric orthopedists come in so we can evaluate patients together.

Many of our patients see multiple specialists, and each visit is just a snapshot of their condition. Their clinical presentation can vary greatly from day to day or even moment to moment. Seeing them simultaneously with another provider who offers different tools can be very helpful in developing the best plan for them and ensuring its success.

I'd love to see more multidisciplinary clinics, like an orthopedic surgery clinic, now that we have a spacious clinic area. One of the neurologists at CDA, who specializes in concussions, is interested in starting a multidisciplinary concussion clinic, which I think would be great. Leveraging expertise from different specialties and evaluating patients together in the same place is something I believe will greatly benefit the field.
Question 10: Having worked at several hospitals, what do you think makes Marianjoy stand out? ​
Answer: I think Marianjoy stands out because it is the most mission-driven place I've ever worked. The people here are genuinely dedicated to their work; it's their life's mission, not just a job. When I met Dr. Keene, I was inspired by how invested she was in her patients and the Marianjoy mission. The more time I spent here, the more I realized that many people share this passion for their work and for Marianjoy.
This dedication is a legacy carried down from the Franciscans and is still very much alive at Marianjoy. The staff's commitment to their work and the mission of the hospital creates a unique and inspiring environment.
Anton Dietzen, MD, Pediatric Medical Director at  Northwestern Medicine Marianjoy Rehabilitation Hospital.​​

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