We are all on a journey… Right now we are looking at Neurosurgery… As a resident, a consultant, a senior consultant, chief, retirement and then blank… This is the cycle usually…
Mostly we take a few years at each juncture and get better and better with knowledge in general or in a particular field…And by the time we are really good, it is usually time to retire.. We hold on to those skills, teach some and then walk into the sunset…Some never see the sunset though and become grim reminders of holding on for too long… like over-ripe and sometimes rotten fruits..Some never teach and then walk away, like those fruits which fell to the ground and rotted while never giving anybody a chance to taste them..Some stay on like the legendary Roger Federer and continue to be the best.
What one is as a surgeon is a reflection of what one is as a person.. In my view, A smart person is the type of surgeon who would keep on advocating about the merits of partial resection of a tumour (which could actually be resected with the correct skill acquired through years of hard work in the lab and heartbreaking tiring surgeries…) and then extolling about the virtues of gamma knife with partial resection…. using as well as creating scientific papers to prove the merits of 2 wrong things. Another example is coiling instead of clipping in a poor country, waiting and watching cavernomas die or giving them radiation and of course the spine implants.. Personally, doing a decompressive Hemicraniectomy and then doing a cranioplasty is something I consider as wrong, and I hope to change this….not with the aid of the same old number crunching science of lies, but with more and more people seeing it and trying it out to get excellent results.
The industry is another dangerous example of how our beliefs and perspectives change and we become part of a complex world of lies making money for the industry and in the process becoming the proverbial dog
at the dinner table.
A straight forward surgeon would try, fail, try, fail and then go ahead and resect the lesion and if they cannot, they would either learn to or resign to the fact that it is not safe to…Both cannot be blamed nor are they wrong.. The personality is a trait, you see,.. like our appearance.. Modifiable to an extent, but not a lot.
Another thing is the influence of industry and the corporate world. If one allows his pride, freedom, joy and true judgement to be sacrificed, one could be the big corporate surgeon, making tons of money and being always in the limelight with all the stress eating away from within. The industry is another dangerous example of how our beliefs and perspectives change and we become part of a complex world of lies making money for the industry and in the process becoming the proverbial dog at the dinner table.
Academic Neurosurgeon is another option: In Institutes where one gets a bit more freedom to do things if one is satisfied with the pittance that most institutes provide as the salary. Most academic Neurosurgeons would not survive in a corporate set up, and even if they would, they would not want to. Industry has made dangerous forays into the academic Neurosurgery world as well and this is a way that Academics can take their families for exotic holidays once in a while.
...In the end if a sad lonely and retired person, who was just a shadow of the person who went to do a residency in Neurosurgery emerges, the journey, as one can surmise would not have been a success, despite the numbers of surgeries or the cars owned or the lectures one has given. So what can be changed wherever we are…? What I did over the last 13 years as a Neurosurgeon?
Again, none of this is right or wrong.. It is just about personal choices… It is about who we are and how much are we ready to sacrifice and what are we willing to sacrifice. However, in the end if a sad lonely and retired person, who was just a shadow of the person who went to do a residency in Neurosurgery emerges, the journey, as one can surmise would not have been a success, despite the numbers of surgeries or the cars owned or the lectures one has given.
So what can be changed wherever we are…? What I did over the last 13 years as a Neurosurgeon?
- Constant Improvement and introspection and further improvement in one’s career with improvement in surgical technique
- New lines of thinking, learning from one another.
- Learning to be kind and better human beings
- Learning to enjoy life with travel, good company and other finer aspects of life like adventure, hobbies and knowledge
- Being fit
- Learning to be happy, learning to meditate and the second plane of living…
- Pass on your lessons to the younger generation
These things can be done regardless of where you are and what type of person you are as well as what type of surgeon you are or which part of the graph you are at.. even after your retirement, except with the surgical technique.
May 6, 2020
Neurosurgery in the Himalayas ...
The health scenario of western Nepal is bleak and especially the Neurosurgical facilities are poor. We started the Department of Neurosurgery in April 2008 and has been improvising to do various cases with good success rate. Although not very well equipped, we have tried to do our best and the results have been encouraging.
It was on a September afternoon that I took the decision to go to Nepal. When Dr. Mathai (who is now the senior-most Neurosurgeon in India) asked me over a cup of coffee at his home, even he did not expect me to say yes. And along with him, and my wife, I was also shocked at my response …