AANS Neurosurgeon | Volume 27, Number 2, 2018


Things That Drive Us, According to Driven People

I landed in Los Angeles with enthusiasm at the prospect of attending the 2017 AANS Annual Scientific Meeting. Like many other medical students attending, I was excited to see the latest technology and cutting-edge science in neurosurgery. Thoughts of interacting with leaders in neurosurgery from across the county were intimidating and inspiring.

I was particularly interested in the advances in brain tumor neurosurgery, as I have been spending my research year in Toronto with James T. Rutka, MD, PhD, FAANS, studying brain tumors. From this work, I saw how dire life can be for patients diagnosed with brain tumors and have helped develop advances in drug delivery and targeted therapies to improve the lives of patients. At the AANS Annual Scientific Meeting, I was especially excited to attend an event in honor of Mitchel S.  Berger, MD, FAANS. My mentor introduced me to Dr. Berger, and then I listened and learned as he discussed his trailblazing career as a brain tumor neurosurgeon, operating on lesions that many would consider inoperable. I watched in awe as he described his landmark studies that helped to advance treatments for patients with brain tumors. He also discussed some of his failures and how those inspired him to work harder every day. These failures are what ultimately led him to push the envelope and expand our knowledge in neuro-oncology.

Driving Advancement
This discussion closely intertwined with my own brain tumor research in Toronto. There is a great amount of work being done for the development of novel, targeted therapies for brain tumors. Immunotherapy, focused ultrasound and novel small-molecule inhibitors represent some promising translational research currently under development. New operative adjuncts, such as advanced brain-mapping techniques, laser ablation, intraoperative MRI and intraoperative fluorescence are also emerging to facilitate maximal, safe tumor resection. The desire to improve quality of life in every patient with an inoperable brain tumor drove the development of these technologies. Failure of these technologies will drive further refinement and development.  While many challenges remain, in this way, neurosurgery continues to evolve.  Right now, advances in the care of brain tumor patients seems to be evolving in a particularly rapid and exciting way.

I was constantly reminded by interactions with neurosurgeons at the meeting that there will never be any substitute for learning from each case and that everyone makes mistakes at some point in their career. Dr. Berger concluded his discussion with some commandments for the next generation, emphasizing the importance of one giving his or her very best daily along with always staying humble in the face of a field as unforgiving as neurosurgery. His candor discussing his failures was eye-opening. His emphasis on learning from failures and never accepting anything less than perfection helped me realize what it takes to truly make an impact in the field of neurosurgery. Maybe Dr. Berger’s commandments should be the universal commandments of neurosurgery, and in fact, all of medicine. Medical students across all levels interested in neurosurgery can benefit from these teachings. Ultimately it is from looking in the past that we can understand how to create the future.  I guess some things never change.

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