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Research Assessment #1

Date: Sept, 3, 2017

Subject: Neurosurgery

MLA Citation:

Pardes, Arielle. 11 Things I Wish I Knew Before I Became a Neurosurgeon.

Cosmopolitan, Cosmopolitan, 12 April 2016,



Before I jump right into my dreams of becoming a neurosurgeon, I need to figure

out if this field is best for me by reading about other neurosurgeon reactions to the real
world and how the field is. The biggest tips that I saw in this whole essay was in the
first tip. Neurosurgery is more art than science.

She says that the practice is an art because it requires the surgeons choice on
what type of treatment the patient gets. As she explains, neurosurgery is more of
guesswork because experiments cannot be done as easily in this field like others. The
surgeon has to always come up with a plan to treat the patient depending on his
previous cases or studies. This really work for me because I love making ideas that
might work all the time just imagining various solutions to problems that could be
solved easier. The more surgeries I perform as I enter this field, I will have more
knowledge to work with and how to save a patients life as soon as possible because
time is a very essential part in neurosurgery.

As time is a very key part, I can see that she writes about a question many people
may have when they get into their work. When is it a good time to have a child? As
she explains there is almost never a god time to have a child because neurosurgeons
have to endure a lot of their medical school and also their residency. That means that
the time they have should go towards their family and their work all the time. Most of
the time though they may miss the important things in life, like the first steps of their
baby or even their first day of preschool. This is the sacrifice that neurosurgeons have to
make to save lives at work. I feel that I am a person with a lot of time sense and I always
like to be wherever I go early, so I wont be late. This would really help me in the long
run because I will understand my timings and work around them to be with my family.
The last tip that I found very useful for me while reading this article was surgery
being all about teamwork. It may sound really clich, but its actually true. Many
surgeons fail in surgeries because their bond with their colleagues is weak or that they
just cant convey the information to all the people in the surgery room effectively. This
is really important because what if a fellow surgeon was to mess up and give the wrong
numbers on his vitals. This could in the end cause problems in the patient or even
death. I feel this really applies to me because I love to talk to others and be a great team
mate. I play lots of sports and understand how hard a defeat can be on the players and
the coach. This will really help me in the future understand the problems and talk to my
fellow surgeons to explain what is wrong or right.

In the end, I feel that I have learned about what a day in the life of a
neurosurgeon would be like. The stresses that they could have and the types of things
that they could be are very fascinating because we view them as almost gods because
they save peoples lives, but in fact they are still human and have problems just like the
rest of us. I feel that I am more prepared to step foot into the world of medicine and
learn about neurosurgery. I believe that I have the patience for the amount of schooling
and the confidence to work in a team and not fear to call someone out for their mistake.

(Article starts on Page 3 below.)

11 Things I Wish I Knew Before I Became a Neurosurgeon
There isn't always one "right answer" for how to treat a patient.

1. Neurosurgery is more art than science. When I was in medical school, I understood
everything in medicine as evidence-based. You have clinical trials, which you
randomize, and you draw scientific conclusions. But in many cases, you're not able to
do clinical trials because it's not ethical. For example, you'd never be able to run a
clinical trial comparing surgery versus no surgery for removing a brain tumor, because
no patient would want to be in the "no surgery" group (and most doctors and research
review boards would be uncomfortable "experimenting" on patients this way). So the
practice of neurosurgery involves more educated guesswork than most people would
expect. Because the stakes are higher in neurosurgery than in some other fields, there is
less likely to be a clinical trial establishing superiority of some treatments over others,
which can lead to variability in practice. Every surgeon ends up doing what they think
is best for the patient, but there isn't always one "right answer."
2. If you're working with brain trauma, be prepared to handle life-or-death decisions every
day. I work at the largest level-one trauma center in the Midwest. Level-one centers
are hospitals that are equipped to handle the most severe total body emergencies, so as
a trauma neurosurgeon, I treat whatever comes in the door, and generally on very short
notice. The first question the family asks when someone's had a traumatic incident is,
"Are they going to live?" And if they are, the second question is, "Are they going to
really live?" Meaning, will they be able to speak and interact and function the way they
could before? Will they drive? Will they work? For many families, it's the most
harrowing experience they'll ever have; for neurosurgeons, this is just the daily routine.
Nearly every patient is a high-stakes case, which can make this work feel incredibly
important but also nerve-wracking.
3. Delivering bad news never gets easier. In a microsecond, things can change for the worse,
and it makes you realize that life is so precious and so short. Telling people that their
loved one won't be the same is very difficult and very draining. Most adult
neurosurgery involves things like older people falling or car accidents, and with that
kind of stuff, people already expect a poor outcome. So if you can save somebody,
they're so grateful. The good outcomes definitely outweigh the bad ones, by about
10 to one.
4. When someone else's brain health is in your hands, you have to take exceptionally good
care of yourself. If I'm operating, I make sure to go to bed early the night before, eat a
hearty breakfast, and drink tons of water. I'm vigilant about that stuff, because you
never want to be in a situation when you're not at your best. The one time I tried to
exercise in the morning before a surgery, I had to leave the operating room because I
was dehydrated from not drinking enough water after working out, so now I only
exercise in the evenings. You absolutely cannot be sloppy about your own health,
because doing so could affect your patient's health.
5. A scientific study can be interpreted to say anything you want it to say. Here's a good
example: A recently published study said 30 percent of men who played contact sports
would develop a form of dementia in adulthood. That conclusion was all over the
media, but when you actually read the paper, it turned out that they were asymptomatic
from this form of dementia, meaning it's not clear that they had dementia at all. As a
scientist and a clinician, I have to read the data from other people's research myself and
draw my own conclusion to inform my practice.
6. Neurosurgery is heavily male-dominated, so don't expect to always have mentors who
look like you. Finding female mentors in neurosurgery can be tough. Only about 6
percent of all board-certified neurosurgeons in the country are women, and in
academia, it's even fewer. Some of the women ahead of me have provided me with
great mentorship, but I've also had fantastic male mentors. The best mentors are people
who have a vested interest in your success often, the people who hired you and if
you emulate the behavior of people you admire, you will succeed.
7. Often, you'll have to make a choice between being a surgeon and doing research. I've
been very lucky to work in a hospital system that values my work as a researcher, so
I'm able to work in a clinical setting three days a week and work on research two days
a week. It's a fantastic arrangement, and we just started one of the largest brain studies
in the country. That said, it's becoming less common for hospitals to allow their
neurosurgeons to work on research, since it's more economical for a hospital to have
them operating all the time.
8. Try a bunch of different things before you commit to a specialty. It's very common now to
choose a subspecialty of neurosurgery during residency. This could be focusing on
something like cerebrovascular surgery, spine surgery, neurotrauma, or pediatric
neurosurgery. When I first started out, I planned on doing pediatric neurosurgery, but
then I had a kid of my own and realized I was not emotionally capable of doing it. It
was too upsetting to see a negative outcome with a child. So now I specialize in
trauma, and I'm much happier.
9. There's no "good time" to have a kid. After medical school, you have seven years of
residency and then one or two additional years of fellowship before you can even
become a neurosurgeon. I had a baby when I was a resident, and it was really hard,
even with an extraordinarily supportive family. I was working about 140 hours a week
during my pregnancy. When I gave birth, I took 12 weeks off and when I returned, I
was senior enough to cut down my hours to a very leisurely 90 hours a week. I missed
out on so many things my son's first steps, his first day of preschool, his classroom
presentations. Now, I work about 70 hours a week, but I still miss a lot, which can be
very hard as a parent.
10. Surgery is all about teamwork. People tend to think of operating rooms as very austere,
isolated places, but you're always working with a team, and everyone plays an
important role. I work with neurosurgery residents, a scrub nurse, and an
anesthesiologist; as with any team, you're only as strong as your weakest member. No
one person can make or break the operation, but if one person makes a mistake,
another person needs to catch it. Something as trivial as failing to check a preoperative
laboratory value can have fatal consequences. The stronger your team, the easier it is to
avoid that situation.
11. Each day at work feels like solving a complicated, beautiful puzzle. I often tell my friends
I have the highest job satisfaction of anyone I know. It's challenging work, yes, but
when I'm operating, it feels like the whole world melts away because I'm so engrossed
in what I'm doing. I don't look at the clock, ever. And when I leave the operating room,
I'm hungry and exhausted, but I'm also so satisfied. I think I work a little bit too
much usually 12-hour days, and I tend to go in on the weekends but that's my
own doing. The gratitude you see in people's eyes when you tell them an operation
went well and their loved one wakes up from surgery that's not something you can
replicate in the typical 9-to-5 job.
Uzma Samadani, PhD, MD, FACS, FAANS, is an attending neurosurgeon at the Hennepin
County Medical Center, where she serves as Rockswold Kaplan endowed chair. She is
also an associate professor of neurosurgery at the University of Minnesota and is
currently leading the largest single-center traumatic brain injury study in the country.