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TEDx Talks
Published: 2015-01-06
Source: https://www.youtube.com/watch?v=hVhEpTDNPic
so what is nurse surgery and I think we always use that as the brain surgery express and about what is it that we actually do and no surgery is the study of the anatomy physiology and learning of the operative skills in the patient care skills to take care of peace and that of anything wrong with their nervous system be that the brain the spinal cord or
any of the nerves so I've for those in the audience that I'm fortunate enough to have yourself a family member see a neurosurgeon we do some serious things like brain tumors and aneurysms and we really have a unique experience with patients because we form this bond %HESITATION you know because we operate on the thing that makes you you %HESITATION gives you the ability to walk and
talk so once we meet a pace and you know we say we're married to them for life because you know this is such a bond between patient and doctor I will also take care of brain abnormalities that people are born with %HESITATION my specialty is functional in their surgery which is near surgery to restore the quality of life so I take care of patients with Parkinson's
disease and other degenerative disorders %HESITATION well sourced by insurgence of you have a herniated disc arthritis that's us we do carpal tunnel as well sell a little bit about Parkinson's disease you know I think it's been great that Michael J. fox has brought so much attention to Parkinson's disease and I'm there is about one in nine people once you hit your eighties that are gonna develop
signs of Parkinson's this is a video of one of my patients and you can say head he has movement on the left hand and he actually has Parkinson's on both sides it's very calm and that it affects one side more than the other and so he'd been on medication for years and medication to the point of taking meds every two hours and you know this is
really debilitating because you're unsure are you know how you're going to be easy stay at home %HESITATION it really affects your ability to work to have a relationship you fall into a carry care giver wall with your loved ones and this can be quite awful and %HESITATION fortunately I have the ability to perform deep brain stimulation which is used when medication fails in order to treat
symptoms and restore people's quality and in fact we can get people off about fifty percent of their medications and a lot of cases and while selected patients so here he still chattering your noting that left hand side and we're gonna turn on the device which controls both the right side in the last side this is the neurologist I worked with doctor Ramirez the more I and
what you'll say as that we have taken him who is unable to write attacker feed himself or drank %HESITATION or hug his wife says somebody that has their drummer removed so in order to do that's what we basically do is make a small opening in the skull about the size of a nickel and we throw at a piece of wire down into the skull about the
size of a piece of spaghetti and connect that to a battery in the task that looks very much like a pacemaker battery %HESITATION then we do a series of visits back and forth a program that electrical device and that pacemaker to give the right signals to get him to American so this is the surgery and what that frame is that looks like something a building a
basement but really is much more expensive than that as a GPS for the brain giving us the axe wise the coordinates of the brain and we can get within a millimeter of where we want to go just let that information so here were making that entry point for where we're going to drill that small hole in the skull and then to get further accuracy than that
one millimeter because that's based on information from you know a couple of patients right before hand what we next do is we actually listened to the individual neurons on the patient so and if you can hear that sound when moving the arm we're looking at the brain activity and every time we move the army it's embarrassing things so we go one two three can hear that
represent and that's how we know where in the right spot and that this device is going to work for the the nurse surgery is really cool and I love what I do know and I'm eager to get more people to want to do it %HESITATION at because you really can make such a great difference in people's lives so what does it take lots lots school so
get out you didn't have to get your bachelor's degree %HESITATION it during that time you know I served on an admissions committee and people always say doesn't matter what school I go to where what my major is now you know that they're there has to be a way to separate people so well you need to concentrate on your GPA and your medical admission your I'm cat
scores and then you look at things like extra curricular areas are your relationship with your professor is in terms of getting ladder is then %HESITATION interviewing well I to help differentiate yourself and then in medical school medical schools for years to years of Bucks two years on the floor spend that time in our surgery people I say the like anything else do that instead of the
long road you want to make sure you allow that %HESITATION before you pursue it residency is seven years and you know you eagle from not knowing where the operating room is to basically being able to carry out an operation with minimal supervision at the end of residency and that if you're still a glutton for punishment like I was %HESITATION another fellowship so I and so I
did my fellowship and functional neurosurgery so residency we've all seen E. R. and greys anatomy and it's not really like that %HESITATION this out again we show you where the hour is your first that you don't have to figure this all out you may assist with you know positioning the patient and it's a a series of great and responsibilities with feedback and with attending this president
%HESITATION itself let you know that you're doing the right or the wrong thing and then once you master one step you move on to the next step so when I thought about not only in the long road of neurosurgery but also the intangibles that make the best neurosurgeons I now about five qualities the first being dedication %HESITATION and you know I think that again to go
through twenty eight years of school that ID be there for your patience I'm like any physician is but I have this bond you need to be dedicated it's not it's not easy %HESITATION there are times when it's easier than other areas and you need to make sure that you work hard and keep that determination you need to have skills not only in the box world the
bag in the O. R. and then most especially at the bedside again because of the intimacy of this relationship probably the number one thing you need is resilience you will fall and you need to get back out and when you fall you'll fall big because you can really hurt people %HESITATION by doing this not intentionally but just sometimes things are you know don't work out any
any you need to be able to get back up on the horse then be resilient and this is probably the secret to success in any field and you need to be a leader %HESITATION this is a team and you need to be that captain of the team and surgeons don't in general have a problem remembering that the captain they have a problem remembering that they're part
of a team and that's absolutely essential that the nor a you're involved at the nurses in the social workers and physical therapists and all the people to take care of the patient and the patient is part of that team of the most so what about women inner surgery I miss out there where about five percent of all neurosurgeons are women %HESITATION we come a long way
%HESITATION there were two in the nineteen sixties %HESITATION when we started our women are surgery organization and there were twenty three and now we're up to about two hundred and eighty %HESITATION so we've made some progress but when you talk about male dominated fields and women getting involved in them fifteen percent is supposed to be the magic number south we still have a long way to
go at fifteen percent it's when you stop seeing some of the biases and things are pretty neutral and that's the kind of the magic number for diverse city so how do we do this well first we have to attract people into neurosurgery but we also have to keep them there and %HESITATION we recently published a paper from our women and our surgery group showing that we
have a hard time doing that %HESITATION women are much more apt to quit and during residency and they can imagine not become bored it after twenty eight years of schooling so what would drive somebody to this and you know I think there's about that there's three factors involved set feedback in future so in terms of that I have been this person on the bottom row many
times where you're the only woman in this group and everybody else seems to have a little bit more in common at least on the surface than you do and that can be very uncomfortable when you don't feel like if it and %HESITATION I think we've all had that moment when you don't feel like if that and and imagine day in day out working eighty hours a
week not setting and that can be grueling and in fact that's not just a problem in the Senate or and %HESITATION surgical specialties but that's also a problem that we well diverse institutions like Harvard so this is taken from doctor Judith singer %HESITATION who is the vice provost at Harvard she publicists and their annual report two thousand thirteen and fourteen dryad had sent to the bottom
half of this slide talking about I feel that this is a good climate for women and forty three percent are equal to mail their male colleagues forty three percent of women said it was an equal and in fact twenty percent a man said it was an equal so this is a problem throughout and one we need to be aware of feedback I feel that I mean
not only giving feedback and receiving feedback but also just generally the way we communicate I mean men are from Mars women are from Venus communication is a problem at home it's a problem in the workplace and people communicate differently a confidence gap by Claire Shipman thinking I I catty Kay was published this year in the Atlantic and what that look that was how men and women
view their own performance so if I told you on this a tight rope men and women walk the same same they were equally as competent but this is how the woman perceives that she did where she was barely hanging on and that's how the man perceives that he did when he was a peacock and you know men Tenta over evaluate their performance while women tend under
evaluate their performance and there is a body of literature saying that in that one thought on one side right %HESITATION probably if we all met in the middle and that would be the best thing and you know that carries on so in cases where things go wrong women tend to say all guys that was because I didn't do something and men tend to say oh that's
because such and such happened and externalize that and again no and neither is right or wrong it's just a different perception men tend to excel in competitive environments women tend to like supportive environments that the where they develop relationships and we need to be aware of those differences in how this affects the way I educate my residence in my medical students %HESITATION I have this conversation
with my female residents out before my male residents on some things where they feel like they're you know hanging from that and they're doing yeah much better so we need to be aware and the future the future of society and the future of women's issues is not just based on what women do at the work place this is based on the perception outside the workplace of
men and women's roles Intel we all understand what I think is the most important job in the world which is are raising our children and child care in caring for elderly family members and supporting our family and realizing that that is the most important thing and that men and women should share that task equally %HESITATION I don't think women can move forward in the workplace because
they're burdened with a doing this all by themselves I love the sign to take a picture of it I was at the Westin waterfront in Boston first time I've ever seen this on a man's background so at least now we're giving men the tools to change things yeah and it again they showed this at Harvard as well so this isn't just you know our perception of
what's going on again from Judas thing here and if you look at the bottom graph on on the right hand side and this is assistant associate professor MD PhD is at Harvard and these are what people with working spouses men and women work the same number of hours at work but then you go home and women where twenty more hours a week until we change this
and make this equal women cannot do it it's necessary for women to excel in the workplace and in the home so what can we do now I think we need to be cognizant of the is that feedback and future %HESITATION in the ways we change things women need to see people on the podium that look like them that they can relate to and say Hey sis
doing this so I can do that and elementary school all even when kids read biographies they read it six biography is about man as for everyone on one it they need to that needs to be equitable young girls need to be motivated to know that they can do anything including male dominated fields we need mentors and sponsors %HESITATION this can't be understated you need to have
people that help you open the door to be at the table %HESITATION the you know Sheryl Sandberg says to lean in and you also need those people not only to help you lean in and be present but also to know what you bring to the table so that you can negotiate your possess and batter for instance female doctors get sued far less than male doctors so
if I was CEO of the hospital I'd wanna hire all female doctors but you know we don't use that to negotiate %HESITATION our skills and we need to be aware of all and organizations you know I think women are their own worst enemy in terms of some of these organizations because you don't want to be and I'm a feminist organization but this isn't about feminism and
you know I don't like that word this is about being with people that you relate to that you have things in common with that are going through similar things in you that can help support in Manchuria we have such a positive %HESITATION of %HESITATION nurse surgeons that are women but also neurosurgeons that have risen through the ranks we have not had any neurosurgeons lead our national
organizations we have one female chair of the neurosurgery department in the country out of a hundred and thirty programs we only have ten are surgeons that have reached the full professor level so we have a lot of work to go and what we've actually done is we've coupled with the medical device industry because they're going through similar things and the women in that field we work