Marseilles was founded by Greek sailors about twenty six centuries ago. When I was a kid I remember some TV ads about Marseilles soap. That’s all I pretty much knew about the French city when I arrived at Marseilles early Sunday evening. It was end of October but still the last rays of the autumn sun were painting the sea water of the old port with hundreds of rocking docked boats dark red. Magic!
No I wasn’t in Marseille to buy soap. I was there to attend the official Gamma Knife course, run only at two places in the world, Pittsburgh and Marseille. It was no brainer which one to choose. The licensing course was organised by Elekta, Sweden and run by Professor Jean Regis, a legend in stereotactic radiosurgery. He started Gamma Knife in the early nineties and has done more than fifteen thousand cases (!) but does not make as much noise as some of his American counterparts. Yes he is a (very) opinionated Frenchman but with some european philosophical humility.
Six people were taking the course except me: two lovely neurosurgeons from Jakarta one of which is the Dean of Medical School, a Professor from Seoul organising the next World Congress of Neurosurgeons in 2013 (hosted in Seoul), so I took the opportunity to ask for cool hotels, a neurosurgeon from Deli, one of my old bosses from Oxford when I was a trainee a few years ago, and Howard, a Professor at New York University of Italian origin who visits London much more often that I visit New York, so from day one we agreed that he will come to London catch up very soon. The last day of the course when we were exchanging business cards to stay in touch one of the two Jakarta neurosurgeons gave me as a gift a lovely dark blue silk fabric. People of different civilisations have so much kindness and different ways to express themselves. Needless to say I had no idea what to do with the fabric (!) but I thanked him cordially. It was his first time in Europe and was off to spend the weekend with his wife in Venice! He invited me to visit Jakarta. (So you already know one of my future blog themes!).
We all stayed at a classic hotel overlooking the old port, the view was to die for (photo). The course was taking place at the Timote Hospital, four underground stops away from the hotel. Marseille has a simple underground system, lines one and two, one goes, the other one comes back. Easy!
Gamma knife was a new, revolutionised way in the mid-sixties to treat brain lesions without cutting open the human skull. Lars Leksell, a genius Stockholm Neurosurgeon came up with the idea long before modern imaging was available. He devised a way to focus irradiation from cobalt sources to any area in the brain by guiding the irradiation (gamma) rays through a large helmet with a couple a hundred openings that could open or close, so the beam can target the right spot in the brain. His first treatment was based on air-encephalography, a very primitive imaging method based on plain x-rays and a bit of intracranial air injected through a neck puncture. With the advent of CT and later MRI, Gamma Knife became a high precision instrument that when used for properly selected patients can do wonders.
Learning is never about the material or the syllabus, its always about the teacher. Listening to Jean Regis was a treat (photo). You could watch a grand master in action, sharing experiences he painfully acquired over two decades, with passion, (unsubsiding) high energy and of course (like any other master) his many biases. We discussed the treatment of about eighteen patients with all kind of pathologies: metastatic cancer, acoustic neuromas, arteriovascular malformations, trigeminal neuralgia, skull base meningiomas, even low grade gliomas. Patients referred to him from other parts of France and other parts of the world. Seeing Jean in action was an eye candy.
For lunch we were going to the top floor of the hospital where they had a VIP restaurant. The view was spectacular but the (gourmet!) food was awful! When finally the third day I ask from the lovely waiter to bring me some chees on a toast, and happily agreed to ask the chef, I thought, finally, I will eat something ! Half an our later she brought me an (also gourmet!) piece of dry-as-bone piece of bread with a tiny slice of cheese on a massive plate! I know they meant well but thank goodness they were pizza vans outside Timote Hospital! You can’t go wrong with van-restaurants or pizza!
In the evenings we could spend some time in the city. Marseille is big, second in size after Paris but is a bit run down, chaotic and dirty. Its okay, I like lively cities, where cultures mix, Algerian, Tunisian, Moroccan, emigrants from all parts of the Mediterranean sea. French in the south are very spontaneous, super friendly and a bit rebellious :-) On Monday night we bumped into a street party, Z.E.P., a music band of emigrants started jamming in the park and people gathered around them like pigeons to bread crumbles, started grabbing beers from nearby diners and dancing like there was no tomorrow (photo). How can you resist and not join the party?
I Marseilles I felt injustice, betrayal and revenge! All at the same time!
But not in the course :-) I actually imagined them (vividly) while arriving at the Château d’If, a small island fortress a couple of miles from Marseilles port. This is the notorious prison where Edmond Dantes spend fourteen years after wrongly accused and betrayed before escaping and returning as the rich Count of Monte Cristo. Yes, I am talking about the year 1815 and Alexander Dumas’ timeless gem.