What were you doing on Saturday night? Around midnight… where you out drinking with friends, sitting hypnotised in front of a screen panel, were you asleep? (that’s the worst!). As of me, I was looking down at the operating microscope, I was looking at an angry aneurysm, a weak spot at a brain vessel that could burst any second and kill my patient in front of my eyes. Have you ever looked at an angry aneurysm “face to face”? Have you ever felt a dark storm coming?
The operating theatre number three was dark. When I operate I like only the microscope’s light beam to cut through the dark room. Not because its more theatrical (that too!) but because I want to shut out everything outside my hands and my patient’s brain. It was midnight but I had two neurosurgical residents assisting me, two more junior trainees were also observing, two anaesthetic residents, one consultant anaesthetist, three theatre nurses. In my favourite theatre three at Queen Square, around midnight, with eleven people above a patient, you could hear a pin drop. I knew that the aneurysm could burst and cause catastrophic haemorrhage, all beautifully dissected vessels and nerves would be flooded with blood at a split second. Yes, I was ready for the battle, and no, I don’t panic, I never panic. And I have been through quite a lot life and death battles…If I panic my patient will die. But that moment, with eleven people in theatre and another ten million in London, when you are standing there starting your battle, everyone and everything fades away, its only you and your defenceless patient, you are standing there all alone, the loneliest person in London…
An hour later while my team was closing, I went to speak to my patient’s relatives. I got big, happy hugs! On Monday when I told the story to one of my residents she said “Ohhh Mr Samandouras…, I want to hug you too!” Bless! But no, I don’t save lives regularly every Saturday night. Last Saturday night for example we were at a very cool bar in London (read on!).
On a day like today, 5 June, couple of decades ago, something extraordinary happened in the life of a man. It was the morning after the Chinese army had violently removed protesters from Tiananmen Square in Beijing, China. The huge square was deserted from fear of violence and death. In the massive, empty roads a column of tanks are moving rapidly. Suddenly, a lone man with two grocery bags runs in the empty street and stands in front of the moving head tank. The tank and the entire column stops!!! After a few seconds the head tank tries to manoeuvre the man but again the man places himself in front of the tank. The tank stops again! The man then climbs on the tank and starts to talk to a crew member at the gunners hutch. Have a look at the YouTube video, its breathtaking! http://www.youtube.com/watch?v=9-nXT8lSnPQ How is it possible for an average man to do this?
Our brain is designed to protect us; to avoid danger; to obey to fear. Our brain will do anything to protect our lives: it will threaten us; it will lough at us; it will lie to us. How come, an average man can overcome his amygdala-evoking fear and can do something so exceptional? It is the same obstacles to overcome for people who dare to do what they dream of, what is right, what their heart desires… Cross the atlantic with a small boat, climb a remote mountain peak, speak up when everybody else put their heads down, move to a different country, make a brave fresh start… Nobody knows what happened to the tank-man with the two grocery bags, nobody knows his name. But he is my hero, well…, one of them, and If he is still alive I would looove to hang out with him one afternoon in some of Beijing’s hutnogs or Forbidden city’s courts.
On Wednesday I finished my operating theatre list a bit earlier for a reason. I was off to Sheffield. No, I wasn’t after some Sheffield steel for my surgical knifes. We had the biannual conference of the Society of British Neurosurgeons. My team was presenting our results on a difficult group of patients harboring a rare posterior fossa tumour called medulloblastoma. Never been to Sheffield before. Most people took the train. I prefer (love!) to drive. It took me just over couple of hours to get there. I was happy to see old friends and make some new ones. These days I am used to people who come to talk to me, trainees, students, new consultants. Thing is, I don’t know most of them, but they know me, and that’s fun. A couple of years ago trainees would come and ask me to sign their “Neurosurgeon’s Handbook” copy. It felt a bit unreal at the beginning but now is totally normal.
A medical student, intelligent face, purple shirt, black bow tie(!) came to talk to thank me and tell me proudly that this year his presentation did not raise any questions on the topics I asked him to improve a year ago. I had no idea what he was talking about, but an hour later it came to me. Some neurosurgeons from the audience try to be smart by cornering some inexperienced trainees or medical students. Morons! I usually say something good (they deserve it!) and try to make a suggestion or two so they can have their paper improved and possibly published. This medical student took seriously my 30-second suggestions a year earlier and worked on those and now came to thank me for my advice. What a splendid young man, I am sure he will do very, very well!
In Sheffield I was very proud to see one of my trainees taking the annual Norman Dott Gold Medal for acing in the British Neurosurgical Boards. I am not surprised, Harith possibly knew more than most of his examiners. About three and a half years ago, when I was starting my career as a Consultant Neurosurgeon, Harith was one of my first trainees. Although my practice was still developing back then, Harith was very enthusiastic for going to work for me, (you see, I remember things like that, they make all the difference in the world). We are lucky to have trainees like Harith at Queen Square, smart and polished and with a big smile on their face! I was teasing him that when he stands up to get the gold medal he should say to his acceptance speech that he got the Gold Medal all thanks to my book! which is true! :-) Well done Harith, you finally made it to my blog (and please don’t run around in bars and clubs wearing the gold medal on your chest with an unbuttoned shirt :-)
At the evenings of both conference days there were some social activities. The social program is always predictable. Black-tie dinner, repetitive toasts, dull chit-chat, neurosurgeons talking about neurosurgery even when holding a glass of champagne (really?!), reps getting drunk… Even when we went later to some bars in Sheffield, I was bored out of my head… Back in London I had to replace these memories :-) with something more trendy and fun. We went to a cool bar (one of my very favorites) at SW3, what a difference in style… But you know the rules! no personal stuff here…One of the songs was so fresh and summery so I shazamed it, here it is, “get lucky” from Pharell Williams. The lyrics is cheese but the tune is like… getting ready to go out to some beach town on a warm, summer evening…
And talking about summer, I am off to the international hydrocephalus conference in Athens in a couple of weeks. My team is presenting a series of rare endoscopic operations of intraventricular tumours. Despite being battered from unemployment and financial problems, Athens remains a charming grand city with cool places to hang out and wonderful people to talk to. The bars have style (nothing like Sheffield!!!) and people are beautifully dressed. I might even show you some photos next time!