PROFILE
s Choice
1
t's hard to know where to
look first when you enter
the office of Dr. Mark
Evans.
As director of reproduc-
tive genetics at Hutzel
Hospital in Detroit,
there's an abundance of
degrees, certificates and
awards that literally
cover the walls from floor
to ceiling. Then there's
the picture of a smiling Phil Donahue,
with one arm casually draped over
the shoulder of a grinning Dr. Evans.
His curriculum vitae, all 42 pages
of it, lists an impressive number of
faculty appointments, committee
memberships, consultantships, and
enough published articles to fill
several books.
Much of his work sounds like some-
thing out of a science fiction novel:
open fetal surgery, genetic engineer-
ing, gene therapy. His views have in-
spired heated discussions among au-
diences on such national television
shows as "Donahue," "Today;' "Larry
King Live" and "CBS News."
In addition to his other duties, he
is a tenured professor in the depart-
ments of obstetrics and gynecology,
and molecular biology and genetics at
the Wayne State University School of
Medicine. He has served as president
of the International Fetal Medicine
and Surgery Society, and has been
listed twice in Who's Who of Emerg-
ing Leaders.
And all 'before his 40th birthday.
Although Detroit may seem an
unlikely destination for a physician
with a reputation that drew job offers
from all over the country, Dr. Evans
is happy that he chose Hutzel.
"The kinds of things I wanted to do
weren't being done anywhere else;' he
said. "This was an opportunity to
come in and establish a program from
the ground floor."
54
FRIDAY, APRIL 17, 1992
Dr. Mark Evans
is a leader in
gene therapy and
reproductive research.
RONELLE ROSENTHAL GRIER
Special to The Jewish News
According to Dr. Evans, Hutzel has
the largest and most resourceful pre-
natal diagnostic program in the coun-
try. It does everything from genetic
counseling and pre-natal testing to in-
utero treatment for patients whose
unborn babies have potentially
serious or fatal abnormalities.
Dr. Evans is one of the pioneers in
the emerging field of in-utero surgery.
He has evaluated more than 100 pa-
tients, and has performed more than
a dozen open fetal surgeries, One ex-
ample is a baby with "prune belly"
syndrome, a flaccid or prunelike ab-
dominal wall that can cause death
from renal or pulmonary insufficien-
cy. By performing surgery while the
infant was still in the mother's
uterus, this condition was successful
ly treated and a healthy infant was
born.
"We do things on the leading edge
— some people say we've gone over the
edge:' said Dr. Evans. "When you do
things that are new and ground-
breaking, some people are going to be
unhappy."
One thing that makes some people
unhappy is Dr. Evans' work with
multi-fetal pregnancies. He has been
accused of "playing God" by his
detractors, sometimes publicly and
viciously. One such attack came on
the Larry King show, by a man whose
wife had been pregnant with eight
fetuses. This couple refused medical
intervention, and all of the fetuses
subsequently died.
Dr. Evans explained that fetal
reduction is often done because the
fetuses are at risk, and the mother's
health may be in danger as well. He
believes this choice is consistent with
Jewish theology, which places more
emphasis on the health of the mother.
"Am I playing God?" he asked. "The
answer is very simple. If you can save
some, isn't that better than saving
none?"
Despite public detractors, Dr.
Evans' work is well-respected among
the Detroit medical community. Most
of his patients are referred by other
physicians. Dr. Jeffrey Obron, a Bir-
mingham obstetrician, refers about 5
percent of his patients to Dr. Evans
for genetic counseling and prenatal
testing.
Mrs. S was one such patient. After
a long history of infertility, she final-
ly became pregnant while taking the
commonly used drug, Pergonal.
Through early prenatal testing, she
learned she was carrying five fetuses.
Dr. Obron referred her to Dr. Evans,
who successfully reduced the fetuses
from five to two. Mrs. Smith now has
healthy twins, delivered at full term
without complications.
"This was done after extensive con-
sultation about many issues — social,
ethical, legal, economic:' said Dr.
Obron. "Dr. Evans gets truly in-
volved. He helps patients make these
most difficult decisions:'
Abortion is sometimes precipitated
by the results of a prenatal test. Dr.
Evans believes abortion to be "a
perfectly appropriate choice" when a
couple learns that their unborn child
has a genetic abnormality that will
seriously impair its health and
development.
But he draws the line at performing
prenatal tests solely to determine the
sex of the unborn child, or using