Skyline

It was a long day, several hours drive… Yes I had the SatNav on, how else could I drive around the great lakes, but still not entirely sure. So I googled, “where am I?” In less than 0.136 secs google had the answer Latitude :: 41.03916091992087, Longitude :: -85.24132144166595…turns out I was close to Dearborn, Michigan, about an hour from Detroit. Started from Chicago, two days earlier. I was invited by the American Association of Neurological Surgeons (AANS) to give three talks on brain mapping and surgical techniques in excising tumours from eloquent parts of the brain…the only one from the UK, quite an honour for such a prestigious meeting.

The meeting was in an enormous venue, McCormick convention centre, that could accommodate thousands of people, and that was McCormick West only…AANS conferecnces are always great success, delegates arrive from all parts of the world. There are so many topics and themes that lectures are broken down to the many conference rooms, and usually meet at the escalators or coffee breaks. The most junior delegates (and some senior ones) are “chicken-heads”… :-) looking constantly right and left to identify people they know, common sight in these conferences…you always give value to people you look at…and always get value when people look at you…one of society’s unwritten rules…

On Friday there was the first international brain mapping course with honoured guest George Ojeman, now retired, Professor of Neurosurgery in Seattle who popularised the concept of cortical mapping during awake surgery in epilepsy surgery. Mitchel Berger, now Chairman at the university of California in San Francisco spent many years in the faculty with the aim to transfer these skills to tumour surgery. Hughes Duffau from Montpellier also visited Ojeman and subsequent Berger starting a movement to removed tumours in eloquent parts of the brain previously thought to be inoperable and untouchable.

So this all was in honour of Ojeman, his intellectual “children”. That was the first time I saw him and shook his hand, humble and pleasant like all great men. In the morning there was a “How I do it” session, 10 neurosurgeons with expertise and experience in awake surgery and removal of tumours from eloquent parts of the  brain, including 5 surgeons from USA, 3 from Europe, one from China, and one from the UK (me!).

At the main meeting, during the oncology sessions there were discussions on Buckner’s paper on effect of adding chemotherapy to radiotherapy in the treatment of low grade gliomas (LGGs). Buckner showed that survival is increased by several years when adding PCV (a chemotherapy cocktail) on radiotherapy…however the responses by the many oncologists were underwhelming…they felt that they would add PCV only when radiotherapy is indicated (which in LGGs is rare)…which means safe radical resection is still the gold standard in these challenging tumours. There were many discussion on tumour vaccines, immunotherapies and vaccines is the way that treatment is going…

During the international reception at Chicago’s cultural centre met with old friends and made new ones. Evey year I always bump to Kwang Tu, current president of the World Federation of Neurosurgical Societies (WFNS), the organisation of all neurosurgical organisations of the world. Kwang is a smart leader and already contributed many positive changes to the WFNS, always great fun to meet him. This time invited me to visit him in Taiwan…yes, will do! And talking about WFNS, the 2017 host, Ugur Ture invited me to speak in Istanbul in September next year, this is the biggest event for any neurosurgeon. I met Ugur in Antalya, middle of April when invited to speak to the Turkish Neurosurgical Society meeting. What a great meeting and an oportunity to see again Yasargil, just turned 90!, running up and down like a teenager.

He said how when he was a young surgeon travelled to see the legends of his time, to see how they operate, how they move their hands, how they move their feet…never heard this before, looking at how surgeons move their feet…! not a lot for a start! but I guess energy flows in the body in the same manner, arms, trunk feet…balance, composure, intensity, focus is the same everywhere…I took a 10 secs phone-video of him talking, capture a great man talking in his own language…

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Arriving at Antalya’s airport 12 April 2016, an advert of the Annaul Neurosurgical Conference in one of the terminals.

 

 

 

 

 

 

 

 

 

 

 

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Yasargil on a shaky photo on my iPhone, standing in front of one of his slides, talking about the “ego of the neurosurgeon”. He spoke about techniques, skills, art, history and philosophy. He influenced more modern neurosurgeons than anyone else…

 

 

 

 

 

 

 

 

 

 

 

 

 

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Catching some of April’s sun in the hotel’s balcon

 

 

 

 

 

 

 

 

 

 

 

 

Back to Chicago, 29 April, was not sunny, at least not for the first 3 days. My umbrella that lasted all english winter broke in the first day, I had to throw it in the bin… when they say windy city it’s not a joke…but the next 3 days was (mostly) sunny. Chicago is supposed to have a good vide with jazz clubs, a sandy beach, cool neibourhoods…was good but did not get the vibe…surprised by how few people were on streets…Michigan avenue is the equivalent of Oxford Street in London…was nearly deserted after-hours, and not that busy daytime…Still the skyline was breathtaking, looking at some of the world’s tallest buildings at night is someting…interesting, the first 10-15 floors of most skyscrapers are car parks, how great would that be for London, that is until… London real estate agents convert them into cozy flats…

The AANS was productive, stimulating, large-scale event! I enjoyed it and of course was grateful for the invitation and the honour…every time I give a talk at the end people come to talk to me and ask me to spend time with me in my hospital or invite me to speak to more conferences and events…so got invites for New York, LA, and Cancun, Mexico…as far of Chicago might have to give it another chance some other summertime!

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Chicago river at a cloudy, wet night

Two days left to have some time off, so rented a car, (a silver mustang!), at the O’Hare Chicago airport and explored a bit of America, country roads, small towns, quite coffee shops. In one of them, somewhere in Indianapolis, a police car parked outside, a few bikers, families with children, couples in a car with windows rolled down so they can attach a tray with burgers and fries, all like taken out of a movie, but very genuine…

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Amazing coffee/burger/ice-cream shop somewhere in Indiana

Friends often ask me how I can drive in America, well with Sat Nav…they still think it is impossible…I have no idea what they are talking about! Driving is so easy, anywhere in the world (well, expect Mumbai…! its crazy there). You can’t feel a place unless you take the detour, drive to country roads, see people sitting at the porch, drinking lemonade, watching strangers walk by, talk to locals, make a bit of noise. Contrary to what you think, the best way to blend in is to stand out! People are the same all over the world, no matter where they live, how they look, what’s their wealth or poverty status, illiterate or highly educated, they all respond to the same things, to interesting (not boring!), genuine (not fake!) people…so don’t think too hard, avoid talking about the weather (or anything similarly boring) and act naturally, how they call it…let me think…yes! be yourself…!

Last week I left my iPhone at the reception of the intraoperative MRI, anything metal should stay away from strong magnets, then at the end of the day I could not find it… there is a “find my iPhone” app which I had activated, was hoping to tell me its under a pile of books in the reception office, turns out it tells you its in London…yea, great, I will now stop looking to find it in china…! I looked at my office, nothing…that’s a bummer…how can u live without a phone? well, looks like its not that difficult…most people text, so I get the messages on my macbook, or they come and find you in person…yes, I got another phone, not an iPhone this time, I got so bored about the same, year-in, year-out design and apps, and the non stop prompts to update the software, “do you want to update now or in the evening”, no I don’t want to update at all!…there was a time when apple was a cool rebel, now its a boring mainstream…so got a different phone and still playing with the new interface and apps…change is good for the brain…! and contacts easy to transfer from iMac to Google contacts and then to android phone even if you lost your iPhone. If I find it, will sell it for charity, no going back now…!

Okay, I know, its been a while, my blog was closed…why and where was I all this time?…I know you want to know… I got hundreds of emails from doctors, friends, patients, asking to grant them access…well, you will find out “why” in its own good time…my life and adventures carried on in the meantime…for now all you need to know is that I am back and will be writing frequently…I know you missed this blog , I missed writing it…! I can’t catch you up on what happened since my last blog, (October 2014, unbelievable!)…but will catch you up with what’s will be happening from now on. A few things coming up, talking to medical students in Sheffield, 11 June, preparing for my fifth annual world course in neurosurgical oncology (this would be a blast!) June 22-26, bigger and better than any previous years, and a week to relax under the July-hot, hot mediterranean sun…and, by the way, if you find somewhere a (slightly!) battered white iPhone, its mine!

 

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