Terra Miller

July 1 comes ‘round once again. I examine my practice and revisit my patients’ lives. I am transported back to an earlier July by the image of my former patient with a brain tumor. Unable to come to clinic, I drive to her home. The living area is converted into a hospital room, the atmosphere personal and medicinal. She...

Surgical intervention for the treatment of severe, chronic pain has been used successfully for centuries. With patients living longer and surviving cancer, chronic pain is skyrocketing. Techniques have evolved considerably over the years to become increasingly more precise, more effective and less invasive. Surgical options have progressed from effective, ablative procedures towards innovative, neuromodulation techniques and have become accessible...

Celebrity drug overdose stories have sent shock waves through Hollywood for years…Hank Williams, Elvis Presley, Prince…many of the greats gone before their time, forever enshrined upon the pedestals upon which America placed them. Historically pushed from the limelight are the demons with which they wrestled and which ultimately lead to their untimely deaths. Less heralded but equally devastating deaths...

For decades, pain surgery has been neurosurgery’s stepchild. Few took interest in it, lesioning of the nervous system suffered the stigma inflicted by psychosurgery, and the field was being slowly absorbed by anesthesiology and physiatry. Luckily, the neurosurgeon’s attitude towards humanity’s most prevalent chief complaint is changing. Along with changing attitudes come changing techniques and technologies, which are making...

Eric Topol, MD, Basic Books. New York. 2015. In 1966, Marshall McLuhan said, “Every aspect of Western mechanical culture was shaped by print technology, but the modern age is the age of electronic media … electronic media constitutes a boundary between fragmented Gutenberg man (to an) integral man.” Eric Topol, MD, embraces this and thinks the time for this is now. A...

This week, a 28-year-old presented to my office with symptoms secondary to a recurrent herniated lumbar disc. Seeing his name as the last patient of my day produced a cacophony of thoughts and emotions. His story demonstrates poignantly how neurosurgeons are in an incredibly unique position to understand and impact what many are calling a national emergency, the opioid...

I distinctly remember a group discussion in my second year of medical school regarding a patient in the emergency department complaining of lower back pain. She was a postal worker who had been taking opioids for lower back pain for several years. Her prescription had recently run out, and her primary care doctor was refusing to refill the prescription...

As medical students, there is a lot to learn. Pain management — specifically the use of opioid medications — is currently a hot-button issue, reaching every burgeoning physician across the nation. According to the Centers for Disease Control and Prevention (CDC), overdose deaths involving prescription opioids and heroin in the U.S. have quadrupled since 1999. Prescription opioid sales have...

Thoracic Outlet Syndrome This 47-year-old, right-handed, otherwise healthy gentleman with history of pulmonary embolus presented with right upper extremity pain, numbness and weakness of the right hand grip causing him to drop objects. He repairs roof fire sprinkler systems, work that requires routine sustained arm elevation. His symptoms started after an episode when he experienced significant upward traction...

The evolution of neurosurgery has been remarkable. And, the pace of that evolution is accelerating. We are blessed to be part of a specialty that attracts dynamic and visionary colleagues and allows our daily work to offer us a unique perspective on neurological disease, new possibilities for treatments and on how patients react to these illnesses and their therapies....