Nuts!

On Sunday I spoke to a National Medical Students conference in London. The conference was about students who want to follow a surgical path. They had invited speakers from all surgical specialties. I was there to talk about brain surgery. The conference was at the cruciform building of UCL. The tickets were sold out weeks before the event. It was Sunday morning so I found a spot to park and off to meet the people who invited me and never met before. I tested my Mac, the projector couldn’t see it. I converted it to Power Point but the memory stick was too small for the movies. Between ten medical students we find a large memory stick to transfer the converted files. Ready to go!

A urologist hiding behind the lectern spoke before me. I was sitting there watching him showing rigid instruments going through various…routes. Explained how urology combines medicine and surgery, how wonderful specialty it is. Hmmm…The Neurosurgery session out of three parallel session was oversubscribed. I left the lectern and went close to the students. “I consider myself to be very clever” said with emphasis and paused after starting my talk. The students laughed! “Not because I am a brain surgeon but because I am being paid to do a job I would do for free! As a matter of fact I would pay to do what I do! But the people who pay me don’t know that, please don’t tell them!” Laughs again.

I carried on: When I was two years of age I wanted to be rubbish collector (prolonged laughs). Staying at home I could see these big men come everyday in a big track (in Greece they collect rubbish daily! not every two weeks, that’s civilisation by the way), grab the rubbish with their tough gloves, throw it on the track and then hop on to disappear to some mysterious place. Yes, at the critical age of two my career path was set in stone, I was going to be rubbish collector! A bit later I thought that rock star was a bit more glamourous (photo). The medical students laughed again with my photo. I told them why I finally decided to be neurosurgeon, long before going to Medical School, if it wasn’t for neurosurgery I wouldn’t go to medicine at all, which is completely true!

One of my presentation slides to medical students, an aspiring rock star, a little before I decided to sacrifice my music career for brain surgery!

I gave them a glimpse of a life less ordinary but also what matters is being happy! It doesn’t matter if you are a goat herder in the mountains if you enjoy it! I told them that and I meant it! You should never do a job because you think that you will be cool. Cool comes only from inside! I spoke to them exactly how I felt. They were so quite and hanging on every word. They were adorable! And a bit worried that its too competitive. Truth is they won’t get it unless they believe in it.

I showed them images of what it takes of being a neurosurgeons, the good and the small print. At the end, I told them about an operation I performed on a lovely and very brave young woman the week before. A woman in her thirties with a very difficult type of brain tumour. We did the operation with the patient awake to avoid damage to her language function. She was draped with transparent drapes, her head fixed on a clamp, her brain was exposed, the most stunning structure in the know universe, right in front of us. Electrodes were attached to her brain and connected to an EEG machine interpreted by two neurophysiologists. A neuropsychologist was performing tests asking her to count or name objects.

My patient was so chatty to all (like being at the hairdresser)! My anesthetic team was monitoring closely all aspects of a very difficult operation. I was looking through a powerful microscope, using ultrasonic aspirator, switching from white to blue light to see fluorescent parts of the tumour. In the operating theater there must have been fifteen people. And holding the stimulator and touching the brain I could see the brain being temporarily paralyzed, my patient was unable to count or name a common object such as a watch or a a car.

While operating and helping this patient of mine, for a split second I thought what an extraordinary experience that was (and what I experience every single day), standing there at the operating theatre 3 at Queen Square, the world’s most famous neurological institute. “When I was medical student, like you!, I wanted to do that, I saw it in my dreams! If you have dreams, follow them, don’t let anyone or anything stop you!” I wished best of luck and finished my talk. At the end there was a super long queue of students waiting to talk to me. The organising committee of medicals students worried about delays draw a line after 4-5 students and said “that’s it, you can’t speak to Mr Samandouras any more”! Hey guys, go easy on the students!

On thursday we had Professor Schramm from Bonn, Germany talking to Neurosurgeons and Neurologists. Months before he retires, a man who’s seen it all in Neurosurgery was relaying his experiences. His talk was delayed for half an hour as we could not get his laptop to talk to the projector. With a full lecture theatre of quietly observing delegates we were trying to swap projectors, memory sticks, convert files. When the first slide appeared on the screen everybody cheered and applauded. There you go, we got an applause even before we started. I am not sure what’s with me and computers, they always try to play games with me but not for too long, my shiny darlings!

Prof. Schramm at a gastropub of Great Queen Street. My colleague Laurence Watkins on his right.

We took Johannes at a gastropub at Great Queens Street after his talk. He is lovely chap although rumors are that he has been quite a tough boss in Germany.

Next day I had an email from the editor of Nuts magazine, yes the one that… some male readers might be aware of. The one demonstrating women with…how can I put it medically…fat distribution at strategically important anatomic areas. No, no photo this time folks! They wanted an interview. I was very… flattered :-) but I passed!

Next week we had another VIP speaker at Queen Square, Professor Isaam Awad from Chicago, USA, a well known vascular neurosurgeon. Funny thing happened, computers and projectors worked well this time! What’s going on, it didn’t feel right! :-) We went for a few drinks with our trainees at the Swan (photo) and then for a dinner at VATS in Great Conduit Street. Lovely chap, he invited us to spend sometime in Chicago before the next CNS meeting in coming fall.

Prof. Awad talking to our trainees (and also talking to "the hand"!) at The Swan pub.

Monday I went to a two-day “Communications Skills Course”. Everybody who deals with cancer patients has to do it! Two of the participants were months before retirement but still had to do it! Don’t get me started on the course, I’ll only say that it was two days of my life I will never get back :-) Moving on to a more interesting course in Debrecen, Hungary, that was three days well spent. We were discussing minimally invasive surgery and endoscopy, cadaveric dissections and lectures. I made new friends, had a road trip from Budapest to Debrecen (second in size city in Hungary), saw the semi-westernized Hungary, tried Hungarian cuisine in old cellars with the course members while hungarian violins were sobbing  (photo), and bought paprika, the hungarian secret of spicy food.

Private dinner at a lovely restaurant in Debrecen, Hungary. This is what they mean "bring out the violin"

On the way back, while boarding on the plane the smiling BA stewardess asked me routinely “how are you?” “Great!” I said, as I normally do reply (my friends and colleagues often lough at me when I say things like that!). She was a bit surprised and after a second said “we are…great here too”! and smiled. A bit later came to my seat and started chatting as I was writing my blog (I am writing this blog on the way back from Budapest), and she saw the title “Nuts”, so I had to tell her the story. She told me all the gossip from the crew :-) The rest of passengers were looking as they couldn’t figure out if I was some celebrity traveling incognito so the stewardess spent so much time above my seat chatting like old friends :-)

We are used to standard ways of communication and behaviour. For example, look at the people in underground. One copies the other in behaviour, they are all so desperate to look “normal” not deviation from average behaviour. Standard questions, standard answers. People avoid small talk, avoid looking at the eyes, social conditioning at its best.  That applies to all types of behaviour, people want to have average behaviour, not hostile, not overly friendly. They don’t say what they think, they don’t act what they think. I am talking about free spirited thoughts and acts, not sociopathic or malicious behaviours! Social conditioning is great for society but detrimental for persons. Average behaviours will very rarely bring results more than average. Every time you deviate from the average there is only one factor which determines if you will come across as weird or cool: how strong your reality is, how comfortable you are in your own skin.

On landing it was well passed ten in the night, the sparkling London from the air was exquisite. Then back to hospital as I had a long operating list on Wednesday. In the end of March and close to midnight London was nearly summery, warm breeze, tourists in the streets, people holding glasses outside pubs, London’s ambitious buzz of the day transforms to a laid back chatter in the night.

Oh, I nearly forgot! Do you know Gray’s Anatomy? No, not the TV soap, the one where every single doctor lives at least a few tremendous personal dramas every day while saving lives and hooking up to every other doctor in the vicinity :-) I am talking about the real thing, the most influential anatomical text in history.  I had an invitation from Susan Standring, the Editor-in-Chief of Gray’s Anatomy to become one of the editors in the forthcoming 41st edition. Imagine an iconic book that has survived forty one editions and its going from strength to strength. A book that started in 1858 by Henry Gray an anatomy lecturer in St George’s Hospital Medical School and its life has exceeded a century and a half. What a unique privilege to help shaping the new edition!  My brain cannot explain why but I feel excited and humbled at the same time!

The poster of a legendary course. I know it hasn't happened yet, but its still legendary! For a full brochure go to http://www.online-neurosurgery.com or email Patricia.Laube@uclh.nhs.uk

 

Do you remember about a big neurosurgery event I told about coming up in May? Scratch that date! Here’s the new and final one: Saturday 7 and Sunday 8 July 2012 (photo). An “All Star” faculty from all over the world at Guys Campus under the shadow of “The Shard”, London’s most modern skyscraper (photo).  No, no tower can scratch the sky, but its a physical gesture of the human spirit, higher and higher, nothing wrong with that, especially when its stunningly imbalanced, like “The Shard”. Symmetry can be boring, a little bit of “messing up” sparkles attraction, very much like the two halves of human brain. More about that in my July course, that is if (!) you are one of the very fast and very lucky to get one of the twenty four exclusive places!

Its not Mordor from The Lord of the rings, its the peak of The Shard (of glass), a pyramid shaped skyscraper designed by Renzo Piano (what a name for an architect! shouldn't he be a musician?), and is the tallest building in Europe.


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