A Neurosurgeon’s Stroke Recovery Story
At 44, I was the picture of health. I played soccer, tennis, golf and ran marathons. I did not smoke, and I rarely had an alcoholic beverage. I was in a seven-person neurosurgical practice I had joined the previous year, after a 20-year career in the Navy. My life changed one weekend when I was on call for our group. My wife and kids had gone to visit relatives for the weekend, since I was usually busy during my weekend call. I came home in the evening after taking care of a patient with an acute ruptured aneurysm. I read for a while, then went to bed. I woke up in the middle of the night, and noticed the right side of my face was tingling. I tried to get out of bed, but discovered that I had a right hemiplegia. I remember sitting on the floor muttering to myself, “I think I had a stroke”. I picked up the phone to call for help, but could not remember 9-1-1. I finally was able to hit the operator button, but when the operator came on the line, I had a dense expressive aphasia and could not give her any information. Fortunately, she traced the phone call and sent help. I was still sitting on the floor in the bedroom, holding the phone, when the police, EMTs and firefighters all came in my room.
My brain MRI revealed a non-hemorrhagic left thalamic infarct. My medical workup was comprehensive and included carotid Doppler’s, echocardiogram, a bubble test and lab studies looking for a hypercoagulability disorder. All studies were normal. Fortunately, my strength and speech began to improve over the next three days. By discharge from the hospital, I was ambulating with a walker and my speech was understandable.
After discharge, I had extensive speech, occupational and physical therapy. It began with simple tasks, such as writing the alphabet and using a pegboard. Initially, I despaired that I would ever return to my practice and wondered how I was going to support my family. I am blessed to have a great wife, who was my rock throughout this ordeal. I had great partners, who stood by me during my recovery, and I drew strength from their unwavering support.
My recovery progressed fairly rapidly over the next 3-4 months. My improvement was so dramatic that I began to think that I might be able to return to my practice. I had many discussions with my partners, but we were all concerned regarding what criteria to use in order to determine whether I could safely return to clinical neurosurgery. My partners contacted neurosurgical colleagues around the country, to determine if anyone had ever gone back to practice neurosurgery after having suffered a cerebral stroke. We could not locate anyone who successfully returned to work. We were left with having to come up with a process and criteria that would satisfy my partners, the hospitals where I was on staff and our liability carrier.
My process involved several steps. First, I had extensive testing by the physical and occupational therapists. I also underwent thorough neuropsychological testing and was examined by the chair of a top academic neurosurgical program. I then returned to work in stages, first just seeing patients in the office. This was followed by a gradual return to the operating room, initially in an assistant capacity and then as a primary surgeon, with one of my partners acting as my assistant. When my partners and I felt confident in my abilities, I returned to independent practice.
I had a successful and rewarding neurosurgical career for another 16 years, retiring last year secondary to health issues unrelated to my stroke. My life changed after my stroke. I was forced to accept my mortality and I developed a true appreciation of what my brain-injured patients and their families endure. To this day, I feel incredibly thankful for my family, partners and friends who supported me during my recovery. While there can be just one right path, by sharing my personal experience of returning to neurosurgery practice after a devastating medical event, perhaps the advice will prove useful for others.
12th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 22-24, 2019; Lake Buena Vista, Fla.