Up in the air

Thursday I found myself on the smallest plane I’ve even seen! Two seats (per row) in the right one in the left. You couldn’t walk straight in the aisle, you had to bend and slouch. Unusual and fun! I was off to Aberdeen for the spring meeting of the Society of British Neurological Surgeons. I was invited to chair a session in neuro-oncology. And I’ve never been in Aberdeen before. So it was a win-win situation.

At the local airport I hoped on the bus and off to the city centre. Aberdeen was grey, rainy and windy. Houses are  build with a grey stone, (hence the nickname “granite city”). Houses look super strong, like they ‘ve been build to withhold some biblical catastrophe. In the city centre next to the train station there was a super long cue of people waiting to get a taxi. I don’t like queues of any sort. I find the idea of queing up completely ridiculous! I can’t understand people who are queuing outside restaurants and clubs. How absurd! And I don’t like standing still for no reason. You know how they say “good things happen to those who wait”? Rubbish!  Nothing happens to those who wait! Good things happen only to those who take action.

I headed to what looked like a busy street outside the station planning to snatch a taxi before entering the train station. Sure enough, after 3-4 minutes a taxi stopped in front of me to offload a passenger with a three-piece suit! From some distance was somehow familiar. It was Derin, a friend of mine working for BBraun, a neurosurgical technology company who also came for the same conference!

The taxi driver knew well the way to the Ardoe Hotel, venue of the course, he’s been at least 10 times! since that morning. I always talk to taxi drivers. My driver fought at the Falklands!, he told me about a surprise party they were planning to an old friend (and a reunion of 100 ex-solders!) after 30 years that weekend! Talking to taxi drivers always reminds me of Max, the taxi driver in “Collateral” one of the slickest thrillers you’ll ever see (photo).

Late night in LA, Vincent (Tom Cruise) gets into a random taxi. Max, a timid taxi driver (Jamie Foxx), agrees to take him that night to six business stops for a few hundred bucks. Soon enough, Max finds out that Vincent is a professional killer and he is contracted to kill six witnesses of a high profile trial. If you haven’t seen the movie you are in for a treat. Watch it late night with no other lights in the room and (preferably) high volume. Spectacular views of night LA from the air; soft background with vivid colour strokes; fantastic music. Some of the dialogs between Max and Vincent will blow your mind!

Everything happens in one night, in LA. Vincent is talking to Max in Mann’s super sleek thriller.

The hotel of the conference was an old castle (photo). Pointed rooftops and tall windows surrounded by old trees, golf courses, and wild animal life. Early in the morning you can see deers and pheasants. Six rooms only were in the main (stunning!) building. Most of the rooms were in an annex. I arrived at the end of the second day of the conference, so didn’t have my hopes up. I knew there were no rooms in the main building when I booked it a month ago, but I asked for it anyway, (a habit of mine to ask!). Not sure how, but I did end up with a room in the main building. In the room there was long corridor, a massive room with heavy curtains, enormous bathroom. Lovely! Then suddenly I noticed a strange spiral staircase at the end of the corridor in my room! I climbed up and found an upper floor with another lounge with fireplace and views to the forrest (photo)! And from the lounge floor there was yet! another spiral staircase, all within my room! (can’t be possible!). I climbed again the steps but the door (likely leading to the roof) was locked! Phew, it was started getting weird!

A stunning castle, The Ardoe house Hotel, venue of the conference.

Scottish highlands through the windows of the upper floor room.

I had just a few minutes to put my bow tie and off to the Gala dinner. There was a huge, wooden dance floor and free salsa lessons from the course organizers. A couple of pros showed how its done (photo). I thought that most neurosurgeons (especially the senior ones) won’t dare to have a go on the dance floor. How wrong was I! Nearly all! got up and started swinging and bouncing happily. They were adorable. I got a few photos on my iPhone but for the interest of public safety I will not display them :-) I have kept the photos thought, in case I need them someday for blackmailing :-)

Dancing lessons for British Neurosurgeons. What we saw later on the dance floor didn’t quite resemble what you see here!

Next morning there was the neuro-oncology session. Just as I clearing my throat (so to speak!) to start the session my mobile went off, was my registrar from London to discuss an emergency! Typical! Fortunately it could wait for an hour. After each presentation I like to ask an (easy) question first just to loosen people up so they can start participating. Sometimes people from the audience might clump up, thinking “I want to ask something but is it a good question?” “lets wait for someone else to ask a question first” “what if the answer is very obvious?” “is this a clever question to show to everybody how clever I am?” And while all these universal thoughts going through their heads, they keep quite. One of the chairman’s duties is to break the ice!

Before leaving Aberdeen, Muhammad, one of the local hosts offered me a tour of Aberdeen in his car. We had two other interesting passengers, two neurosurgery legends (photo). Ossama Al Mefty, Professor in Harvard and Raymond Sawaya, Professor in Houston. They were both invited speakers for the conference. We chatted quite a bit, I tried to steer the conversation away from neurosurgery (not very easy with senior neurosurgeons!) but finally managed to talk a bit about Paris (Ray has sisters living there and always stops in Paris when going to Europe), the glorious French lunches, the red wine. We got a few photos in the waterfront with a super strong wind, trying to stay still for the photo (not very easy).

With Sam (aka Professor Ossama Al Mefty, Brighams and Women Hospital, Boston and Harvard Medical School) on my right and Ray (aka Professor Raymond Sawaya, MD Anderson Centre, Houston and Baylor College of Medicine) on my left. A (very!) windy afternoon on Aberdeen waterfront, 20 April 2012.

On the way back, same super small plane but flying above the clouds was breathtaking (photos). That was my (just less than 24 hours) trip to Aberdeen.

Lovely sunshine above the clouds (like a giant bubble bath), miserable rain underneath. What you see, often depends on where you stand…

Outside my plane window the evening sun glows on the sea water south of the English coast. Look at the curved horizon, earth is definitely round!

A calm sea of clouds, you feel like you can walk on top of them!

The following Monday I was off to Gatwick to pick up relatives. M25 was gridlocked. Start and stop again. And again. And again. Was a raining, grey evening. Couldn’t see fifty feet ahead. Radio songs were coming out of the speakers. Was flicking stations. Then there was this song, a woman’s voice, I felt like it was suddenly a summer evening, one of these evenings when you wear a white shirt with rolled up sleeves, you feel a warm breeze on your face, one of these evenings you want to drive with the windows down, when you feel everything is possible. It was still raining but my feeling was now different, my brain was sending different messages, amazing how a sound, a friendly voice, a loving memory, can change how you feel instantly. I shazamed it from my iPhone before it was over and got the title. OK, OK here’s the song Blue Jeans from Lana Del Ray.

What music do neurosurgeons listen to? I don’t know about others but I can tell you about myself: not boring! Here’s another favorite of mine the last few days: Pafuera Telarañas from Bebe. Don’t listen to it on headphones and not in the gym/tube/walking (no need to shut out the world; the world around you is full of wonders and opportunities, don’t miss them!). Listen to Bebe on speakers, loud, you need to feel some vibration on your skin and guts.  Super cute accent, a bit of sweet sadness, a wisp of hope. Its like a walk in the streets of Havana, passing outside bars with neon signs. Yummy song.

Tuesday morning I was going through my correspondence, dictating  replies, sorting requests, nearly managed to go through a tall pile of letters and notes. As I was started feeling liberated and ready to leave my desk my secretary walked in with a fresh big pile! At the top of the pile a card got my attention. It was a very unusual “Thank You” card. It  was custom-made professionally. Not the ones that you can customize online, but uniquely made (photo). In the inside a photo of my patient, a young woman in her twenties, in ITU, giving me the thumbs up! I instantly remembered Sophie, how could I forget? She came in a pretty serious condition with a large blood clot in her brain, paralyzed in one side of her body and in a coma.

The blood clot came from an arteriovenous malformation in her brain, a tangle of abnormal arteries and veins, most likely formed at birth. This malformation had been discovered a few days earlier and she was waiting to see a colleague of mine the following week! The malformation didn’t wait though! and completely unpredictably, as it usually happens, bursted releasing catastrophic blood clot. The scan looked horrible, I spoke to her mother and explained that she might not make it. Always the most difficult part, how can you tell a mother that her daughter might not make it? I find that in difficult times is even more important to be honest.

I took her the theatre, removed to blood clot and excised the malformation. She stayed in Intensive Care Unit for weeks. We were monitored her intracranial pressure and other parameters. She gradually turned the corner, started talking alghough still paralysed in the left. But she had a big smile on her face, with extreme determination to get better, extraordinary courage, always thanking me when I was going round to see her progress until she left for renab. So that’s the story behind her card. It will go on the wall of fame.

Front page of Sophie’s card

Inside the card, Sophie is giving a masterclass in courage! (I had her consent to post her card online), thanks Sophie!

Wednesday I had operating theatre, a young woman with a large fourth ventricle medulloblastoma, a woman with a cavernous malformation in the brain, a man with a malignant glioma in the speech area of his brain who needed an awake craniotomy. A bunch of medical students from London, Bristol and Munich were observing in theatre. One of them decided to become my personal photographer, here’s a photo from that day.

Operating on a posterior fossa medulloblastoma in  operating theatre 3, Queen Square. No, I haven’t started bodybuilding, it was a lucky shot! :-)

Thursday I had invited a legend of biology and genetics, Professor Stephen Beck to talk to our neurosurgery trainees. Stephen was one of the key people behind the human genome project that broke the DNA code. It started 15 years ago and decoded 2.85 billion nucleotides of the human DNA.  The legendary paper was published in Nature in 2001. (Nature 409, 860-921 – 15 February 2001). I always invite some of the best people to talk to our trainees, so they can get inspired, make connections, further their career. I do want to give them opportunities I never had when I was a trainee. Do all trainees turn up to these lectures? Although I know that some they don’t, I am still surprised every single Thursday that they don’t! Have they go something better to do, someplace else to go? I stopped asking these questions to them (and to myself) quite sometime ago. And stopped trying to explain it. You can’t force anybody to learn or get inspired.

A legend in molecular biology in the 6th floor Seminar Room, Queen Square, looking fondly at the video of his pet project bidding for 1 billion euros!

Of course there are the keen trainees, pretty much the same croud every week, who absorb and enjoy (some of them take notes). You can always tell who is going to go up like a rocket and is going to take his/her time.  Its alright, everybody is different, but you can always tell. Back to Stephen  Beck, you could see his enthusiasm about genes and disease. He spoke about technology. What needed 15 years of hard work to decode the DNA, now it takes less than an hour. And what needed huge laboratories of more than 20 institutions now needs a device in the size of memory stick that costs less than $900. Stephen spoke about personalized medicine and a massive project at UCL bidding for 1 billion euros. In the photo you can see Stephen watching with pride his 5-mins promotional video. This project might change the way we practice medicine. That was the first time that he showed this exclusive video anywhere in the world! And still there were quite a few of our trainees who missed that. I shouldn’t come back to that, but still can’t get my head around it and never will!

On the other hand the whole world is within our reach, so people with the burning desire to learn can travel either through cooper wires or in the flesh, like the forty people who are coming to my course (www.advancedneurosurgery.moonfruit.com) from every corner of the earth. The initial 24 exclusive places disappeared within two days, so we created another 16 exclusive places but that’s all folks! Forty super lucky participants will be taught for two days by some of the best surgeons and scientists on the planet. And for the Saturday night dinner for delegates and faculty at a secret place :-) with stunning night views of the glorious Tower bridge and the Thames river in a summery London! What more can you ask for?

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One Response to Up in the air

  1. dr.prabhakar says:

    wow!! Ur blog is amazing…full of experiances n emotions..nd u do inspire me..nd dat song u mentiond by bebe….it shot me into d sky…wt else do u listen to??…i wud realy like to knw..

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