Tales of two cities

I could see terminal 5 lit in the dark while driving to the long-term car park. It was still before six on a cold October morning. I was off to Paris for a day. After landing and following about an hour of heavy rain and strong wind the sky cleared. When I first moved to Paris in 2008 I was always surprised that the weather in Paris is not so much different from the weather in London. I finished my two meetings, time for a quick glance at the Eiffel tower (photo) and a stroll at Champs-Élysées dodging hordes of tourists. One of the coolest places to have coffee at the avenue (no, its not Hotel George V) is at the top of the Virgin store, best views and no tourists around! After you coffee you can sit on the marble stairs of the store, along with at least a couple of dozens other people, and read a whole comic book (what the Brits call graphic novels). French people absolutely love them (and so do I).

Does the world needs another photo of Eiffel tower? Yes it does, especially this one taken with my iPhone on a chilled October afternoon.

There is something in the air of Paris, the cobblestone streets and the little cafes, you do feel that writers, and poets, and film directors, philosophers and thinkers walked through the same streets and may have sat on the same chairs. I felt that long before I watched Woody Allen’s “Midnight in Paris”, where Gill (Owen Wilson) while vacating in Paris gets lost one night and around midnight goes into half real/half dream state of living that night, and a few other nights, adventures in the 1920s Paris. During these nights he meets a macho Ernest Hemingway and a dandy F. Scott Fitzgerald, gets his book reviewed by Gertrude Stein, talks to surrealist director Luis Bunuel, rides a taxi with T.S. Elliot and falls for Adriana (Pablo Picasso’s mistress) and together they go even further back in time, the 1890’s Belle Epoque, where they have a drink, at Maxim’s, with Paul Gauguin and Edgar Degas. All this time travel takes part in the nights of Paris and in the mornings he is going back to his normal life. He finally decides to leave his disinterested fiancee and live in Paris.

Parisian commuters late afternoon, thankfully not reading the Metro paper like their London counterparts!

Above ground Seine waits for you!

You feel more creative when in Paris, bit more laid back, possibly because everybody is laid back in Paris. Depends what you are looking for, to lay back or to do. There is no right or wrong, is whatever makes you happy. I give the nod to the latter, so time to go back to Orly airport taking the Parisian metro, quite smaller than London’s but overground for quite a bit (photos). Short trip on a plane, before you take off, you start preparing for landing. I left London in the dark, I am coming back in the dark. But the night London is lit, from the plane it’s an eye candy (photo).

Approaching London from air in the night; view through the window is stunning!

A few days earlier I had spent some time with another Frenchman, Hugues Duffau, Professor of Neurosurgery at Montpellier. I had invited Hugues on behalf of the Department of Neurosurgery at Queen Square to deliver the fourth Annual Victor Horsley Lecture. Victor Horsley was the world’s first neurosurgeon and the first person in history who was appointed as a “brain surgeon”, nearly forty years before neurosurgery started to branch off from general surgery in the 1920s and 1930s. There are very few operations that Horsley did not do for the first time in the world: ligation of a carotid artery for an aneurysm, transcranial approach for a pituitary tumour, division of the trigeminal nerve for trigeminal neuralgia, first epilepsy case, removal of a spinal cord tumour, invention of stereotactic frame and many others.

Our department which bears his name, organizes annual lectures to honor his memory. This year we invited Hugues Duffau, I have written about his work in tumours in eloquent parts of the brain in previous blogs. His lectures was streamed live through the web so people could log in and watch it live, no matter where they were. After the lecture I took Hugues out for a dinner. We talked about a lot while he was sipping his red wine (what else for a Frenchman!) and I was drinking my orange juice. No, I don’t drink wine (or alcohol or coffee or tea). People are joking, are you sure you are Greek? We never saw a Greek not drinking alcohol! Thing is, I haven’t drunk alcohol for, give or take, the last five years. When people ask me why I don’t drink, I tell them relaxed “lifestyle”. That’s true but I don’t go into details, as they usually ask me in a bar when everybody else around me drinks, so no need to challenge their reality.

The thing is, my brain is the most important part of me, (and the most important part of you), the cause for all I am and will be. I don’t want anything artificial to affect my reality, how I see the world, how I live my experiences. Yes, some experiences do not feel pleasant but so what, I want my brain to handle everything without an anesthetic. Isn’t this part of being alive, being able to feel? I don’t want to numb my brain with alcohol or give it a kick with caffeine, what a ridiculous idea! Yes, alcohol has been a social lubricant for centuries, but trust me, you don’t need alcohol to be sociable.

I do miss the taste sometimes, the elegant feeling of resting a heavy tumbler half-filled with a single malt on the soft arm of a leather chair, or I do rarely miss the aroma of a Haut-Médoc, but so what, nothing is more important than drinking the world around you with all your senses, that taste is the best!

Not long ago, two brothers came to my clinic. One was the patient, the other was the carer. The patient, a man in his late twenties came as an emergency a year ago with a big blood clot in his the left side of his brain. All this happened during a strenuous bodybuilding session. I was so happy to see him in his last clinic visit walking although his speech was still impaired. I had seen him a few times during the last year. He has done so well, it was time to discharge him from my care. While shaking my hands, tear came to their eyes. “We pray for you every single day” said his brother. When they left I felt a bit heavier. What a concept! people wishing good for you and praying without you having a clue. Do these prayers and wishes attach to yourself, become part of you and influence how you handle things?

Last week I received an email from a woman who had a very difficult operation a year ago. She had a small tumour in a very narrow and critical part of her brain called the third ventricle, anatomically in the centre of the brain. Here’s what she wrote a year after her operation: “Just wanted to say, thank you once again for all you did for me a year ago, this coming Friday.  I can vividly recall the night before I was due to come into hospital.  I had my bags packed, I read my bible the night before.  Woke early the morning of my admission to pray some more.  God was very good to me, for he blessed me with you as my surgeon.  I so cannot believe a year has nearly passed…….  I am back to work, enjoying life and have my health, and so much of this is due to your skill as a surgeon. Thank you.”

Man is matter and heart and spirit. Is spirituality part of the brain, a reflexion of cortical activity? I think not. I downloaded a book written by a Neurosurgeon, Eben Alexander, very well known in the neurosurgical community. This man had a near death experience after being in a coma after life threatening meningitis. At some stage his pupils were fixed and dilated waiting from brain stem stem tests. He did survive and what he describes is quite interesting. Have a look on Amazon.

UK’s most experienced pituitary surgeon, Michael Powell talks to our trainees for the last time before his retirement.

Every Thursday at 5:30 we have a neurosurgical lecture, usually geting a top neurosurgeon to give a lecture to our trainees. We have now started streaming it live on eBrain where it is all saved and can be viewed any time. So if you want to feel that you are at Queen Square, here’ the link (www.ebrainjnc.com, you need to be member of professional organization to log in). Two weeks ago we had a legend in pituitary surgery, Mr Michael Powell. Mick is retiring (early) this January, so that was his last lecture to our trainees. Mick is one of these people who makes everybody comfortable around them, and virtually has no “enemies”! I was a bit sad to see his last lecture but Mick is excited to continue traveling the world, or hanging out in his flat in Nice, enjoying the sun of the southern France. Yes, there is much more to life than Neurosurgery, the horizon is wide open, but if you had to do something, job-wise so you won’t get bored out of your head, or even better something that blows your mind, what else could someone do?

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