A Life of Sports and Neurosurgery
I grew up in West Texas where life was not terribly complicated: There were studies and there were sports. My father, Henry, was captain of the tennis team at the University of Texas during his collegiate years. He then joined the professional tennis circuit and was at one time tenth ranked in doubles in the U.S., immediately prior to the attack on Pearl Harbor. That event effectively ended his athletic career with the exception of being an avid tennis player and golfer in his post-military years. I was a left handed pitcher and truly loved the game. I played basketball as well but that was largely to condition myself for the baseball season. We won a state championship in 1969 and during my senior year I was drafted by the Baltimore Orioles. My dad strongly encouraged me to accept a scholarship at the University of Texas rather than going professional at that time. This proved to be very sound advice but unfortunately I sustained a rotator cuff tear while at UT ending my baseball career.
Post athletics, neurosurgery was a perfect fit for me. The challenge of neurological diseases as well as the beauty and art of modern micro-surgery in treating rare and complicated disorders has been an incredible honor and a fulfilling career. Sports prepared me very well for my career in neurosurgery and many of the lessons are immediately translatable between these two disciplines.
The Value of Team
All athletes who play team sports know that a true team is much more than the sum of the individual component players. During residency and subsequently in practice it is obvious that we work as a team with a group of diverse professionals who provide mutual support and respect to each other. When a team member is down due to illness, family problems or other upheavals of life, members of the residency or attending staff simply absorb the coverage for their downed player. A history of playing team sports has always been important to me as I recruit residents and faculty. I have found that with rare exceptions the culture learned on the field translates very well into people who handle complex environments such as an operating room or a major medical center with natural grace. Sports teach us lessons that cannot be taught by parents or teachers.
Grace under Pressure
Think of the pressure a pitcher faces in a close and important game when the bases are loaded and the star hitter of the opposing team is at the plate. Under such stress how can one keep movements fluid and the body and mind relaxed, especially when there is a full count? Those same traits allow us to manage intraoperative crises such as sudden uncontrolled intraoperative hemorrhage as well as the non-operative environments in which we too often have to deliver very bad news to loving family members.
When a pitcher delivers a pitch and comes off the mound he or she has to land in a perfectly balanced posture and be able to move in any direction quickly, either to field a ball or to provide coverage at first base or behind the plate. For decades I have taught young neurosurgeons as a component of their preparation for surgery to assume an athletic posture when seated at the surgical microscope. This starts by balance of the hips and shoulders and sets the stage for very precise movements. The situational awareness that helps athletes react immediately to new developments is the same process by which I learned to deal with sudden unanticipated intra-operative rupture of an aneurysm. Using a technique of autosympathectomy, I try to shut everything down, including my heartbeat, to become perfectly still. That avoids the sympathetic discharge associated with crisis management that would result in tremor and other undesired movements. As the body and mind relax, the hands are taken over by muscle memory and attempt to clear the field as the surgeon is assessing options and performing the most desirable ones. I remember experiences on the playing field where a deep breath allowed me to relax at my shoulders and trunk and enabled me to move fluidly.
Teaching Fundamental Skills
In sports I learned to illustrate and teach younger players some of the fundamental techniques that allow maximization of the body’s strength. So much of athletics is based on perfect timing and not brute force. When we teach athletics as well as neurosurgery we teach the nuances of anticipation and opening the mind for innovative solutions not just practiced ones. One of my greatest pleasures especially throughout the graduate medical education components of my career has been observing that incredible moment when a senior resident transitions from a learner to an independent practitioner. That same phenomenon was seen over and over on the playing field.
Conditioning and Preparation
Athletics requires and rewards those who sacrifice. Conditioning is hard work and requires control in all aspects of life. How is that different from the preparation of the young surgeon? In athletics and neurosurgery, carefully thought out strategies, commitment to an outcome, and deliberate and repetitive rehearsal are fundamentally important to success. After an ankle injury from basketball, I had to wear a walking cast for two months. During that time, I threw the baseball for hours each day with the cast on and ultimately knocked a large hole in a brick wall, which my parents did not appreciate!
I am not sure how it happened but I did get the opportunity to use my sports and neurosurgical background to address a very important public health concern in the problem of sports related head and brain injury. Working with Drs. Ellenbogen, Berger, Harbaugh, and others I was honored to have a chance to make a contribution to protect our men, women, boys, and girls involved in athletic competition from the signature sports injury of the 21st century: concussion.
Success in sports as well as surgical medicine requires hard work, dedication and great mentorship. I have been blessed by spectacular mentors in both athletics and medicine. I think of Coach Smathers and Drs. Samson and Drake and can hear their words of sage advice. They made life tremendously better for me, those I teach and those I care for.
Kranzler Chicago Review Course in Neurosurgery
Jan. 24-31, 2020; Chicago
46th Annual Richard Lende Winter Neurosurgery Conference
Jan. 31-Feb. 3, 2020; Snowbird, Utah
Third Annual Cedars Sinai Intracranial Hypotension Symposium
Feb. 8, 2020; Los Angeles
2020 Managing Coding and Reimbursement Challenges
Feb. 14-16, 2020; Las Vegas
13th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 21-23, 2020; Lake Buena Vista, Fla.
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