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AANS Neurosurgeon | Volume 28, Number 2, 2019


Are Neurosurgeons Special?

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My grandmother, affectionately known as Nana, was a really smart woman. In 1937, she had the foresight and planning to enable her family to escape Berlin and settle in Haifa, Israel, where she had purchased property decades earlier. In 1940, she orchestrated her family’s relocation to New York City (now with the addition of my mother, the youngest of three children). All told, she was fluent in multiple languages, adding English in her 40s. Her capacity to make smart decisions and to understand life was uncanny, despite having little formal education. Fast forward to 1983, when I announced neurosurgery as my medical field of choice. Few understood and even less supported my decision for a multitude of reasons. As was often the case, my grandmother stepped in and stepped up, giving me the boost I needed to persevere. Sitting in her cozy apartment, probably baking something delicious (sugar cookies and potato latkes were two of her specialties), she turned and faced me. “Why is this such a big deal?” she asked. I mumbled back all the things about long hours, incompatible with a family life, etc. What she said next has stayed with me since. “Debbie, it is better to work 80 hours a week at something you love than 40 hours a week at something you hate.” She went on to comment, “Loving work is not about the rare or special moments, but is about what happens day to day, about the difference that you make.”

Wow – doesn’t that say it all?  As neurosurgeons, most of us do love our job. We like the impact we have daily on our patients and their families. Our minds, therefore, are probably no different than those who love teaching, research, social work and many other professions, we have just found OUR love and pursued it. There is this folklore that neurosurgeons are somehow particularly special (along with rocket scientists), but what does special mean? 

What is Special?

I would urge you to read any, or all, of the following memoirs:

Each poignantly details remarkable musical specialness. This goes well beyond just talent and expertise. These are minds that have the capacity to think about music in ways that few others can. Yet, each also emphasizes that mastery requires hard work, thousands of hours of practice, openness to new ideas and a propensity for collaboration. All of these factors are also critical to neurosurgery.

Just considering some recent happenings, special is a word that applies to a host of diverse individuals, such as:

Clearly, special comes in all colors, shapes and sizes. In fact, it is this diversity of talents that makes our lives so incredibly rich and rewarding. I think the world would be quite intolerable if physicians cornered the specialness market! Without the distractions created by musicians, writers, chefs, visual artists and athletes, I would find it remarkably difficult to find the balance I need to be a neurosurgeon.

Beyond Special

Is there something that does separate the mind of a neurosurgeon from others? Perhaps. After more than 25 years in practice, what feels most remarkable is the stamina that neurosurgery requires and the need to be able to switch on with amazing speed. Our jobs require long hours (the average neurosurgeon works nearly 80 hours every week), considerable physical stress during many hours in the operating room and a significant call burden. Sleep deprivation is a given. Our patients and the hospital are always just a phone call away. Our children grow up anticipating interruptions and unscheduled absences during all family events as well as last minute changes of plan. In addition, we must achieve the capacity to rapidly convert from one state of mind (sleep, enjoying a movie, exercising) to another (assessing a trauma, responding to a nurse, helping a frantic patient). Clearly, as several contributors in this issue elucidate, much of this evolution of the neurosurgeon comes through education, exposure and mentoring. Less clear is whether individuals who choose neurosurgery come with inherent differences in our biology. My mother would be quick to tell you I stopped napping at an early age and always slept considerably less than anyone else in the house – perhaps foreshadowing my future career?

Really Special

The holiday season approaches. Political correctness demands we stay well away from specific greetings and references. However, this time of year is perfect for acknowledging really special things. For me, as it relates to the mind of a neurosurgeon, what is most deserving of honor are those individuals/acts that are daring, expand the horizons, question the status quo and speak out without fear. For 2019, my top nominees are:

  • James Rutka, MD, PhD, FAANS: for his leadership on the Summit Professionalism task force, tackling the incredibly difficult, but timely, issue of harassment in the workplace;
  • Sean Grady, MD, FAANS: for building an outstanding residency program that is 50% female and where all manner of diversity is embraced;
  • Karin Muraszko, MD, FAANS: for breaking yet another glass ceiling by becoming the president of the Society of Neurological Surgeons and thus hosting the 100th annual meeting; and
  • Katie Orrico, JD: for always being ahead in the world of advocacy on behalf of neurosurgery and, most importantly, for our patients.

The Most Special

Without question, this honor goes to Nana. No words can express how her sense, sensibility and support made my life possible and helped shape my neurosurgical mind. She lived just 97 years on earth, but her wisdom is carried deep within me every day. Happy Holidays to all. Please, enjoy the many outstanding and heartfelt pieces in the latest AANS Neurosurgeon – The Mind of the Neurosurgeon.


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