WEBVTT 00:15.400 --> 00:19.720 Before there were hospitals, prescriptions, or medicine as a science, 00:20.020 --> 00:25.300 it was a calling, a promise to heal, to question, and to understand the human 00:25.300 --> 00:30.340 body. Every discovery began with curiosity, and every breakthrough began 00:30.340 --> 00:00:33.536 with someone asking, why? From ancient remedies 00:00:33.536 --> 00:35.780 to artificial intelligence, this 00:35.780 --> 00:00:38.777 is where science meets compassion. Welcome 00:00:38.777 --> 00:41.560 to the Aesculapian Society. Today, I'm 00:41.560 --> 00:00:44.133 honored to welcome Dr. Donald Whiting, a distinguished 00:00:44.133 --> 00:45.420 neurosurgeon who serves as 00:45.420 --> 00:50.400 System Chair of the AHN Neuroscience Institute and Department of Neurosurgery. 00:50.400 --> 00:00:53.290 Dr. Whiting is nationally recognized for his 00:00:53.290 --> 00:55.720 expertise in deep brain stimulation, 00:56.060 --> 00:59.560 particularly in treating Parkinson's disease and other movement disorders. 00:59.880 --> 00:01:02.734 We're excited to hear about his path into medicine, 00:01:02.734 --> 01:04.580 his experiences in neurosurgery, 01:04.740 --> 00:01:07.079 and his perspective on the future of patient 00:01:07.079 --> 01:08.940 care. Welcome, Dr. Whiting. Thanks 01:08.940 --> 00:01:11.900 for being on the show. Thank you, Dhruv. It's 00:01:11.900 --> 01:14.400 a pleasure. So, let's move on to your 01:14.400 --> 00:01:18.096 personal motivation and background. What inspired 00:01:18.096 --> 01:20.660 you to become a doctor? My family 01:20.660 --> 00:01:23.694 was in the appliance business. We had appliance 00:01:23.694 --> 01:25.760 stores, and I was not very good 01:25.760 --> 01:31.360 at selling appliances. But I was good at science, and then I started in school 01:31.360 --> 01:37.520 getting more and more interested in it. And in college, my psychology major 01:37.520 --> 00:01:41.030 involved a lot of rat and cat animal brain 00:01:41.030 --> 01:44.540 surgery. So, I started liking doing that, 01:44.880 --> 00:01:47.118 understanding the brain, and then that's 00:01:47.118 --> 01:49.300 what drove me to go into neurosurgery. 01:49.660 --> 00:01:52.259 Okay. So, I read an article about you online, 00:01:52.259 --> 01:54.280 and it said that your mother was a 01:54.280 --> 00:01:57.260 nurse. How important was parental guidance 00:01:57.260 --> 02:00.240 in you becoming a doctor? My mother was a 02:00.240 --> 00:02:03.572 nurse, and she really did have a strong influence 00:02:03.572 --> 02:05.680 in me, particularly now that I 02:05.680 --> 00:02:08.463 am a doctor, understanding the role of the 00:02:08.463 --> 02:11.180 nurse in healthcare and how we're really 02:11.180 --> 00:02:14.490 one big team. So, it really makes me much 00:02:14.490 --> 02:17.720 more compassionate and understanding of 02:17.720 --> 00:02:21.812 everybody else's role that makes my job successful. 00:02:21.812 --> 02:24.300 Okay. So, how did your friends 02:24.300 --> 02:27.560 and family react when you told them you wanted to be a doctor, especially your 02:27.560 --> 02:31.540 mother? Well, as I told you, I was not good at selling appliances. My dad was 02:31.540 --> 00:02:33.858 ecstatic that I was not going to be in the 00:02:33.858 --> 02:36.120 family business. Yes. But they were also 02:36.120 --> 02:41.200 very proud of me. Okay. So, what was your high school life like relating to 02:41.200 --> 00:02:45.900 medicine? I was a little nerdy in sports, 00:02:45.900 --> 02:50.600 but also studied a lot. I had, you know, 02:50.680 --> 00:02:54.102 advanced classes and different things in high 00:02:54.102 --> 02:56.840 school. And it was really, it was a 02:56.840 --> 00:02:59.426 good well-rounded experience for me. Did you 00:02:59.426 --> 03:01.600 do any volunteer extracurriculars to 03:01.600 --> 00:03:04.628 help boost your application? Yes. I worked at 00:03:04.628 --> 03:07.320 the Easter Seals Society in the summers 03:07.320 --> 00:03:10.905 as an aide and as an assistant during high 00:03:10.905 --> 03:14.320 school most of the time. Okay. So, on a 03:14.320 --> 00:03:16.739 fun note, what would you be doing right now 00:03:16.739 --> 03:18.820 if you hadn't chosen medicine? So, I 03:18.820 --> 00:03:21.529 really, when I was growing up, I liked the 00:03:21.529 --> 03:23.980 idea of a milkman because they get up 03:23.980 --> 00:03:26.500 early, get done by noon, and then have the 00:03:26.500 --> 03:29.020 rest of the day. So, thinking about that. 03:29.220 --> 00:03:31.127 But seriously, I probably would have been in 00:03:31.127 --> 03:32.860 the family business selling appliances. 03:33.740 --> 03:39.220 Okay. So, thanks for your background. So, moving on to the path to becoming a 03:39.220 --> 00:03:41.370 doctor. What was your process to becoming 00:03:41.370 --> 03:43.520 a neurosurgeon starting all the way from 03:43.520 --> 00:03:46.253 high school and starting to practice? So, 00:03:46.253 --> 03:48.920 being from a family that was already in 03:48.920 --> 00:03:51.736 medicine, I didn't really know what it took, 00:03:51.736 --> 03:54.040 the steps to do it, besides working 03:54.040 --> 04:00.260 hard in school. So, for me, it was learning a lot about the different things 04:00.260 --> 04:04.660 you need to do to boost your application and to apply to the right places and 04:04.660 --> 04:09.340 things like that. So, that in college was helpful. And then I actually went to 04:09.340 --> 00:04:11.940 graduate school and got a master's so I could 00:04:11.940 --> 04:14.020 learn more about the process before 04:14.020 --> 04:15.060 going to medical school. 04:18.040 --> 04:22.020 So, you went to Thomas Jefferson University, right? For medical school, 04:22.120 --> 00:04:24.207 yes. For medical school. So, what do you do 00:04:24.207 --> 04:26.100 after, like, medical school? Do you go 04:26.100 --> 00:04:29.437 to residency? Yes. So, typically, after medical 00:04:29.437 --> 04:31.780 school, you end up what's called 04:31.780 --> 04:38.100 matching into a residency. So, the way that works is you apply to different 04:38.100 --> 00:04:40.637 residency programs in the specialty that you're 00:04:40.637 --> 04:42.580 interested in, whether it's primary 04:42.580 --> 00:04:45.640 care, family medicine, emergency medicine, 00:04:45.640 --> 04:48.700 or neurosurgery, or any of them. And then 04:48.700 --> 04:54.380 you get interviews. And when you interview, then you make a list, and the 04:54.380 --> 00:04:57.460 places you interview make a list, and it's 00:04:57.460 --> 05:00.540 called the match. So, we'll rank 1 to 30, 05:00.540 --> 00:05:04.298 the people we interviewed that we want to have 00:05:04.298 --> 05:07.320 come here. And we pick 3 a year. The 05:07.320 --> 00:05:09.857 student will rank all of the places they interviewed 00:05:09.857 --> 05:11.320 in the order they want to go. 05:11.720 --> 00:05:14.946 And then there's a big computer somewhere that 00:05:14.946 --> 05:17.540 matches up their highest choice with 05:17.540 --> 00:05:20.015 our highest choice. And that's what's called 00:05:20.015 --> 05:22.040 the match. So, it's a big surprise, 05:22.040 --> 05:27.720 usually, in March. On a Friday, it's called Match Day. We get an envelope that 05:27.720 --> 00:05:30.474 says we're going to spend the next 3 to 7 years, 00:05:30.474 --> 05:32.540 and that's where you go after that. 05:33.420 --> 00:05:36.589 So, you spent 7 years in residency, right? So, 00:05:36.589 --> 05:39.620 when I did, it was 6. Oh. It moved to seven 05:39.620 --> 00:05:42.485 about 10 years ago. So, long-term, does going 00:05:42.485 --> 05:44.840 to a prestigious medical school like 05:44.840 --> 00:05:49.177 Harvard or Yale matter to a non-elite university? 00:05:49.177 --> 05:51.920 So, I went to a college called 05:51.920 --> 00:05:55.035 Grinnell, which is 1,200 people in Iowa, which 00:05:55.035 --> 05:57.540 then got me into medical school with 05:57.540 --> 00:06:02.190 Thomas Jefferson. I think, in the end, where 00:06:02.190 --> 06:06.100 you go depends on what you learn and 06:06.100 --> 00:06:09.853 how you do. The name matters a little bit, 00:06:09.853 --> 06:13.160 but it's mostly how you individually 06:13.160 --> 00:06:15.430 perform. So, it doesn't matter as much as 00:06:15.430 --> 06:17.700 people make it out to be. Right. Because 06:17.700 --> 06:23.440 there's different skill sets along the way. In medical school, in high school, 06:23.660 --> 00:06:26.542 college, and medical school, it's really about 00:06:26.542 --> 06:28.860 doing the best you individually can. 06:29.280 --> 06:33.200 But when you pick people to be in our residency programs, it's more about 06:33.200 --> 00:06:35.306 teamwork. So, some people are really good 00:06:35.306 --> 06:37.360 individual workers, but not necessarily 06:37.360 --> 06:42.040 good team workers. So, really, where people go for school through those years 06:42.040 --> 00:06:45.115 matters this much because it shows that they're 00:06:45.115 --> 06:47.340 smart, but it doesn't really tell 06:47.340 --> 06:51.780 us the whole story. So, on one of the parts of the application, you have to do 06:51.780 --> 00:06:54.332 the MCAT, right? How did you prepare for 00:06:54.332 --> 06:56.820 it? So, I did all the things everybody 06:56.820 --> 07:04.360 does. I got the exam books to practice from. I took the courses. I did all the 07:04.360 --> 00:07:07.214 things to get the best score I could get. 00:07:07.214 --> 07:09.860 So, for you, what was harder, passing 07:09.860 --> 00:07:12.868 medical school itself or getting accepted? Into 00:07:12.868 --> 07:15.300 medical school, getting accepted. So, 07:15.320 --> 07:20.900 what made getting accepted harder? I didn't come from a medical family. My 07:20.900 --> 00:07:23.724 family was in sales. So, there's a lot of 00:07:23.724 --> 07:26.480 nuances you learn from a medical family 07:26.480 --> 07:32.800 about how to be prepared with your application and everything else. All the 07:32.800 --> 00:07:35.330 check marks that they look for in medical 00:07:35.330 --> 07:37.860 school. So, that's what made it hard for 07:37.860 --> 00:07:40.625 me. I didn't have the background going into 00:07:40.625 --> 07:42.940 it. Looking back, is there anything 07:42.940 --> 00:07:45.833 you wish you had done differently in your pre-med 00:07:45.833 --> 07:47.840 years? No. I had a great time and 07:47.840 --> 00:07:50.219 I learned a lot and made a lot of good friends. 00:07:50.219 --> 07:51.940 And in the end, life's a journey. 07:52.560 --> 00:07:54.440 So, you might as well enjoy that. It's not 00:07:54.440 --> 07:56.320 about the end result so much as the ride. 07:56.760 --> 08:00.980 So, you said you had friends before. How did you manage stress and maintain a 08:00.980 --> 00:08:04.989 social life during medical school? Well, the 00:08:04.989 --> 08:08.360 one thing that I've learned over the 08:08.360 --> 08:14.540 years is that if you're so focused on one thing, you lose balance in life. So, 08:14.700 --> 00:08:18.101 keeping balance between social and family 00:08:18.101 --> 08:21.420 and work and exercise is what makes you 08:21.420 --> 08:26.580 very successful. So, where I went to medical school, it was very much built 08:26.580 --> 00:08:30.043 around having balance in life. So, they fostered 00:08:30.043 --> 08:32.280 that to help make you a better 08:32.280 --> 00:08:35.283 student. So, this time when you went to medical 00:08:35.283 --> 08:37.520 school, you were healthy? Oh, yes. 08:37.680 --> 00:08:40.324 Okay. Yeah, we had flag football teams. We 00:08:40.324 --> 08:42.780 had basketball leagues. We did all the 08:42.780 --> 00:08:45.650 physical, you know, things as a group for 00:08:45.650 --> 08:48.380 team building. We had, you know, study 08:48.380 --> 08:53.580 groups. We had all the things to keep it balanced. Okay. So, when you were 08:53.580 --> 00:08:57.169 studying, was AI ever incorporated into medicine? 00:08:57.169 --> 08:59.440 Those two letters weren't part 08:59.440 --> 09:05.200 of my training when I was in school because that was in the mid-80s. Oh, okay. 09:06.180 --> 00:09:09.272 You say that like I'm 400 years old. But... 00:09:09.272 --> 09:12.220 Oh, I'm sorry. But no, I mean, that just 09:12.220 --> 00:09:15.928 wasn't part of what we had back then. No, I'm 00:09:15.928 --> 09:19.060 sorry. No, I'm joking. Thank you. And 09:19.060 --> 00:09:21.390 so, move on to the day-to-day life of your 00:09:21.390 --> 09:23.720 neurosurgeon. So, what do you actually do 09:23.720 --> 00:09:25.810 normally for every day? You know, my wife 00:09:25.810 --> 09:27.900 asks me that every day, but I'm kidding. 09:28.560 --> 00:09:31.646 So, usually get up early, come in, make rounds 00:09:31.646 --> 09:33.860 on the patients that we've taken 09:33.860 --> 09:39.300 care of, either operated on or whatever, early in the morning to get ready for 09:39.300 --> 00:09:42.201 surgery, which usually starts around 645. 00:09:42.201 --> 09:44.960 Or clinic, which usually starts around 09:44.960 --> 00:09:47.734 730, where we see patients. And then do that 00:09:47.734 --> 09:49.940 through the day. And at the end of 09:49.940 --> 09:54.180 the day, round on the patients we've taken care of, check on everybody. And 09:54.180 --> 00:09:56.374 throughout the day, during the day, teach 00:09:56.374 --> 09:58.460 the residents and the medical students 09:58.460 --> 10:02.820 that are with us along the way. So, there's teaching. There's taking care of 10:02.820 --> 10:06.340 the patients. There's doing the business of filling out the paperwork and 10:06.340 --> 10:11.020 everything. Okay. So, can you walk me through, like, a common case you take on 10:11.020 --> 00:10:14.177 during or about surgery? Sure. I do a couple 00:10:14.177 --> 10:16.760 of things specifically. One is deep 10:16.760 --> 00:10:19.727 brain stimulator surgery. So, what deep brain 00:10:19.727 --> 10:22.100 stimulator surgery is, is minimally 10:22.100 --> 00:10:25.433 invasive brain surgery. Where we make a small 00:10:25.433 --> 10:28.100 little opening in the skull and put 10:28.100 --> 00:10:30.782 an electrode that's about two millimeters in 00:10:30.782 --> 10:33.220 diameter deep into the brain to a relay 10:33.220 --> 00:10:36.437 center that helps control symptoms that are 00:10:36.437 --> 10:39.280 out of control. So, specifically, for 10:39.280 --> 10:44.900 example, Parkinson's disease is a disruption of different circuits in the 10:44.900 --> 10:49.120 brain that control the smoothness of movements. It makes tremor and it makes 10:49.120 --> 00:10:52.232 rigidity. That's because the circuits are out 00:10:52.232 --> 10:54.860 of sync. There's a relay center where 10:54.860 --> 00:10:57.956 those circuits interplay to keep that synchrony. 00:10:57.956 --> 11:00.020 We put that electrode into that 11:00.020 --> 00:11:03.360 relay center and adjust the electricity to 00:11:03.360 --> 11:06.700 re-synchronize the circuitry, almost like 11:06.700 --> 11:09.980 you adjust the thermostat in your house to get the right temperature from your 11:09.980 --> 11:14.860 furnace. We can do that with the electrodes. To get that electrode into the 11:14.860 --> 11:18.720 right area, we have to be within one millimeter of accuracy where we put it. 11:18.720 --> 00:11:21.940 It's a very narrow area we're going for. 00:11:21.940 --> 11:25.080 So, we have MRIs and CAT scans that we 11:25.080 --> 00:11:27.673 take the data and put it into a computer. The 00:11:27.673 --> 11:29.920 computer then gives us the information 11:29.920 --> 00:11:33.146 we need and it's almost like GPS for the brain. 00:11:33.146 --> 11:35.480 That gives us a 3D reconstruction 11:35.480 --> 00:11:37.750 of the brain and we can get in there right 00:11:37.750 --> 11:40.020 where we want to be. Then we do it awake. 11:40.400 --> 00:11:43.240 The surgery is awake so we can test it and 00:11:43.240 --> 11:46.080 see the improvement of the motor function 11:46.080 --> 00:11:48.165 right away and we know we're in the right 00:11:48.165 --> 11:50.200 spot. Then we just put a little plastic 11:50.200 --> 00:11:53.104 cap that locks that down. Close up the incisions 00:11:53.104 --> 11:55.100 and they go to the recovery room 11:55.100 --> 00:11:58.100 and then get CAT scan, go home the next day 00:11:58.100 --> 12:00.820 and we bring them back a week later to 12:00.820 --> 00:12:03.036 hook that electrode up to a little battery 00:12:03.036 --> 12:05.200 pack like a pacemaker on the collarbone. 12:05.340 --> 12:10.220 Then that has about 70,000 different settings we can set to adjust the 12:10.220 --> 00:12:13.059 electrical activity around that to give us 00:12:13.059 --> 12:15.560 the different adjustments we need to 12:15.560 --> 00:12:19.570 realign that circuitry. So, it's very precise 00:12:19.570 --> 12:22.600 minimally invasive surgery to get 12:22.600 --> 12:25.960 back the control of somebody's motor function when they lost it with the 12:25.960 --> 12:32.360 disease. Okay. So, I'm sure like there sometimes are complications. So, how do 12:32.360 --> 12:37.180 you deal with complications or worst case losing a patient? That's a very good 12:37.180 --> 00:12:39.576 question. I think, you know, with anything 00:12:39.576 --> 12:41.800 we do to try to help function, there's 12:41.800 --> 00:12:44.426 always some risk. We talk to the patients 00:12:44.426 --> 12:46.860 ahead of time when we're planning the 12:46.860 --> 00:12:49.603 surgery about what the risks are versus the 00:12:49.603 --> 12:51.900 benefits. And generally, we like to 12:51.900 --> 12:56.760 have a significant difference between benefit being the highest number, risk 12:56.760 --> 00:12:59.618 being as low as possible. Given that, when 00:12:59.618 --> 13:02.340 we do have some situations occasionally 13:02.340 --> 00:13:04.801 where there are complications, you know, 00:13:04.801 --> 13:07.200 we work to improve that, help them get 13:07.200 --> 00:13:09.880 through that, help them work with them and 00:13:09.880 --> 13:12.560 their family to get them back to the best 13:12.560 --> 00:13:15.341 function we can afterwards. Okay. So, by the 00:13:15.341 --> 13:17.680 contrast from above, what's the most 13:17.680 --> 13:21.620 rewarding moment you've had in your career? The most rewarding moments are 13:21.620 --> 00:13:23.892 giving people the control of their life back. 00:13:23.892 --> 13:25.760 So, for example, there's a story not 13:25.760 --> 00:13:30.120 too long ago about a 17- or 18-year-old girl 00:13:30.120 --> 13:34.380 who had Tourette's syndrome. So, since the 13:34.380 --> 13:40.900 age of 2, she was not able to be out in public school systems or in activities 13:40.900 --> 00:13:45.313 because the tics, the abnormal reactions that 00:13:45.313 --> 13:49.040 happen spontaneously like tremors and 13:49.040 --> 13:54.800 twitches and things kept her from being able to be in a classroom. We did the 13:54.800 --> 00:13:57.859 surgery and she got essentially rid of all 00:13:57.859 --> 14:00.700 of those symptoms and ended up getting 14:00.700 --> 00:14:03.460 engaged, getting married, taking classes in 00:14:03.460 --> 14:05.900 a classroom, sitting in the front row 14:05.900 --> 00:14:08.470 and doing presentations, which her whole 00:14:08.470 --> 14:11.040 life she hadn't been able to do and now 14:11.040 --> 14:16.640 she could. Okay. So, during these surgeries, is AI and robotics currently 14:16.640 --> 14:23.480 integrated into them? So, AI robotics is part of spine surgery, part of brain 14:23.480 --> 00:14:26.570 surgery in some situations. So, yes, it is 00:14:26.570 --> 14:29.660 getting integrated into it. And, in fact, 14:29.820 --> 14:35.780 what we do with brain surgery, as I mentioned, with realigning some of the 14:35.780 --> 00:14:40.077 circuits with the electrodes, big data analysis, 00:14:40.077 --> 14:43.300 AI and miniaturization of computers 14:43.300 --> 00:14:46.380 is allowing us to start developing closed 00:14:46.380 --> 14:49.460 -loop systems, which means we don't have 14:49.460 --> 00:14:52.270 to do any adjustments. It senses it in the 00:14:52.270 --> 14:55.080 brain, the computer analyzes it, and then 14:55.080 --> 15:01.040 it sends a signal to avert or fix that behavior, all from a device that's 15:01.040 --> 00:15:03.571 implanted on the skull and into the brain. 00:15:03.571 --> 15:05.800 So, that's just the beginning of the 15:05.800 --> 00:15:08.583 advancement. The future is very bright for 00:15:08.583 --> 15:11.100 this kind of thing. Okay. And, again, 15:11.180 --> 15:14.340 another fun question. What's something about being a neurosurgeon that would 15:14.340 --> 00:15:18.310 surprise most people in their daily life? 00:15:18.310 --> 15:22.280 I think, you know, being a brain surgeon 15:22.280 --> 00:15:26.884 isn't rocket science, as they say. Anyway, 00:15:26.884 --> 15:31.160 it's really a very – it's a great job. 15:31.480 --> 15:40.700 It's a fun job. And when you're well -trained, you know, it's a job that, like 15:40.700 --> 15:45.040 I said, is very rewarding. But I think people have the idea that the brain is 15:45.040 --> 15:50.340 very complex and how would you be able to figure all that out? It's very much 15:50.340 --> 00:15:52.567 understandable and very much controllable 00:15:52.567 --> 15:54.740 with the right training and experience. 15:55.620 --> 00:15:58.496 Okay. So, that actually leads right into the 00:15:58.496 --> 16:00.980 next topic, qualities and skills. So, 16:01.540 --> 16:04.580 just like you said, it isn't rocket science. The quote, this isn't brain 16:04.580 --> 00:16:06.866 surgery. It's also sometimes said. With you 00:16:06.866 --> 16:08.940 actively practicing brain surgery, how 16:08.940 --> 00:16:12.359 much of it is academics and how much is communication 00:16:12.359 --> 16:14.100 skills? Wow. That's a very 16:14.100 --> 16:21.160 deep and smart question. You have to be very well-versed in the anatomy and 16:21.160 --> 16:26.760 physiology because, you 16:26.760 --> 00:16:29.319 know, as they say, it's very expensive real 00:16:29.319 --> 16:31.520 estate in the brain. There's no room 16:31.520 --> 16:37.200 for error with not knowing your anatomy. So, academics is very important, 16:37.200 --> 00:16:41.677 understanding all of that. But also, you know, 00:16:41.677 --> 16:45.180 your physical dexterity, your skill 16:45.180 --> 16:51.240 set is very important. But communication is so important because it's not you 16:51.240 --> 16:56.800 alone. It's your team. So, there's anesthesia. There's the circulating nurse. 16:56.920 --> 17:00.920 There's the scrub nurse. There's people from the device company. There's the 17:00.920 --> 00:17:03.310 residents and the students. And everybody 00:17:03.310 --> 17:05.700 has to really work in a very coordinated 17:05.700 --> 00:17:08.538 dance type way. And you can't really be out 00:17:08.538 --> 17:10.980 of sync. And then, as you mentioned, 17:11.140 --> 00:17:13.960 when something goes awry, you can't panic 00:17:13.960 --> 17:16.780 about it. Everybody has to come together 17:16.780 --> 00:17:21.247 in an organized way. And that's all about communication. 00:17:21.247 --> 17:23.480 Okay. So, what qualities do 17:23.480 --> 17:28.020 you think are useful for being a neurosurgeon? Certainly, honesty and 17:28.020 --> 17:35.800 integrity are number one. Being intelligent. But also, as you mentioned, 17:35.960 --> 17:41.460 being able to communicate. Being able to be, being able to take charge of a 17:41.460 --> 17:48.200 situation calmly and authoritatively. But get the team to work with you. So, 17:48.480 --> 00:17:50.653 collaboration is very important, I think. 00:17:50.653 --> 17:52.720 So, when talking about surgery, you're 17:52.720 --> 18:00.520 like the boss, essentially? We would call the captain of the ship. Okay. And 18:00.520 --> 00:18:04.167 finally, do you think future doctors will have 00:18:04.167 --> 18:07.100 AI into their curriculum? I think AI 18:07.100 --> 00:18:10.470 is going to be a very integral part of all 00:18:10.470 --> 18:13.760 of medical education and treatment. And, 18:14.080 --> 00:18:18.502 in fact, now, just using AI to source information 00:18:18.502 --> 18:21.300 that would have taken hours or 18:21.300 --> 00:18:24.872 days to do not too long ago. And actually, you 00:18:24.872 --> 18:27.900 know, put together a meaningful action 18:27.900 --> 18:36.040 plan. AI is really revolutionizing that and making people that were average at 18:36.040 --> 00:18:38.590 finding information very, very good at it. 00:18:38.590 --> 18:41.080 So, I think it's really helping to bring 18:41.080 --> 00:18:43.668 things together to help people work on solutions 00:18:43.668 --> 18:45.340 rather than spending all their 18:45.340 --> 00:18:48.452 time working on getting the information. Okay. 00:18:48.452 --> 18:50.820 Well, thank you. And let's move on 18:50.820 --> 00:18:54.943 to your career and lifestyle. So, what percent 00:18:54.943 --> 18:57.900 of being a doctor is about money 18:57.900 --> 19:02.120 versus helping people, would you personally say? That's a really good 19:02.120 --> 19:08.660 question. It depends. I mean, it really should be about helping people because 19:08.660 --> 00:19:12.902 there's better ways to make lots of money. 00:19:12.902 --> 19:16.740 And I think if you go into it to make 19:16.740 --> 00:19:18.554 money, you're picking the wrong route and 00:19:18.554 --> 19:20.280 you're not going to be happy with your 19:20.280 --> 00:19:23.819 career. You know, working on Wall Street, 00:19:23.819 --> 19:27.100 being in banking, being in investing, 19:27.260 --> 00:19:30.094 things like that, definitely build around making 00:19:30.094 --> 19:32.220 money. Not about really a whole lot 19:32.220 --> 19:38.620 of other things, but making money. In medicine, the hours, the commitment, the 19:38.620 --> 00:19:41.980 personal investment really isn't worth any 00:19:41.980 --> 19:45.340 amount of money if you're not doing it to 19:45.340 --> 00:19:48.670 help people. Plus, the reward, in the end, 00:19:48.670 --> 19:52.000 isn't the money. It really is the feeling 19:52.000 --> 00:19:55.495 you get for helping people get their lives back 00:19:55.495 --> 19:58.320 or saving their lives or doing things 19:58.320 --> 00:20:01.476 that integrally help their lives. So, I don't 00:20:01.476 --> 20:03.860 think people that are in medicine 20:03.860 --> 20:09.360 for the right reason are in it for the money. Okay. So, what would you say are 20:09.360 --> 00:20:11.324 the biggest benefits of this career? Would 00:20:11.324 --> 20:13.100 you say it's like watching people get 20:13.100 --> 00:20:19.129 their motor skills back? So, the biggest benefit 00:20:19.129 --> 20:23.400 of being in medicine is you go to 20:23.400 --> 20:27.780 work and feel good about the fact that just going to work is going to make a 20:27.780 --> 20:34.380 difference in the world. And, too, it's a respected career. People, you know, 20:34.440 --> 00:20:37.713 respect you. It does give you a reliable income 00:20:37.713 --> 20:40.220 no matter what specialty you're in. 20:41.300 --> 20:49.980 And it helps you really then, in other ways, help the community because you're 20:49.980 --> 20:54.880 respected as a volunteer or a board member or things like that because of your 20:54.880 --> 00:20:58.869 knowledge. So, I think it's a good career 00:20:58.869 --> 21:02.760 for stability, for happiness and reward 21:02.760 --> 00:21:05.623 and for helping the world. So, if someone has 00:21:05.623 --> 21:08.040 a passion for medicine but they go to 21:08.040 --> 00:21:10.116 school and they get into debt, would you still 00:21:10.116 --> 21:11.740 say it's a good idea for them to go 21:11.740 --> 00:21:14.370 into it? So, you mean they get into school and 00:21:14.370 --> 21:16.600 then get in debt going to school? Yes. 21:16.600 --> 00:21:20.883 I think that's the nature of the business at 00:21:20.883 --> 21:24.680 this point is it does – it's expensive 21:24.680 --> 21:32.500 to go to medical school. But in the end, the government had some plans to help 21:32.500 --> 00:21:36.146 forgive debt over the years for certain specialties, 00:21:36.146 --> 21:38.180 which is really good. But in 21:38.180 --> 00:21:41.140 the end, the career will give you enough 00:21:41.140 --> 21:44.100 income to pay that debt off. I think if 21:44.100 --> 21:49.420 you quit with the debt without getting the career, you're kind of committed to 21:49.420 --> 00:21:52.299 finding that career that's going to pay that 00:21:52.299 --> 21:54.720 debt off, which may or may not be as 21:54.720 --> 00:21:58.000 lucrative to do that. So, I think getting 00:21:58.000 --> 22:01.120 a debt is part of the nature of it and 22:01.120 --> 22:06.200 sort of part of the end game. I was – frankly, I was about 50 when I paid off 22:06.200 --> 00:22:09.985 all my debts from school. So, where do you 00:22:09.985 --> 22:13.680 see yourself in 10 years? Still working, 22:13.800 --> 00:22:18.611 retiring? Hopefully alive. But I've been doing 00:22:18.611 --> 22:22.480 this now – I've been in neurosurgery 22:22.480 --> 00:22:26.960 since 1991 with six years before that in 00:22:26.960 --> 22:31.440 residency. So, probably another four or 22:31.440 --> 00:22:35.532 five years, I will retire. I have seven grandkids 00:22:35.532 --> 22:38.120 right now that I love spending 22:38.120 --> 00:22:41.533 time with and, you know, hopefully spend more 00:22:41.533 --> 22:44.340 time with them. Probably always be a 22:44.340 --> 00:22:46.314 little bit connected to this. I work with 00:22:46.314 --> 22:48.240 two of my sons in our department, and I 22:48.240 --> 22:52.500 have a really great group of young neurosurgeons that I hope to follow their 22:52.500 --> 00:22:55.749 careers and be helpful with them too. So, 00:22:55.749 --> 22:58.840 moving on to family and personal life, 22:59.140 --> 23:02.420 how's the work-life balance in neurosurgery? It's a career known for 23:02.420 --> 00:23:06.350 being especially demanding. So, work-life 00:23:06.350 --> 23:10.280 balance is variable over the years. When 23:10.280 --> 00:23:13.407 you're in your residency, the first couple 00:23:13.407 --> 23:16.460 of years of residency are pretty intense 23:16.460 --> 23:20.520 because you're getting all the basic knowledge there, patient care management, 23:20.800 --> 23:26.440 the ICU management, things like that. So, it's a time commitment. And with all 23:26.440 --> 23:30.580 residencies, there's an 80-hour work week. So, you can't work more than 80 23:30.580 --> 00:23:33.476 hours in a week, but also then there's study 00:23:33.476 --> 23:35.780 time and things like that. So, the 23:35.780 --> 00:23:38.230 first couple of years, it's a little bit 00:23:38.230 --> 23:40.680 harder to have a great balance. But the 23:40.680 --> 00:23:43.445 last five years, it's very balanced as far 00:23:43.445 --> 23:45.880 as work time and free time and other 23:45.880 --> 00:23:48.841 things that you do. And, in fact, a lot of 00:23:48.841 --> 23:51.520 our residents have a regular physical 23:51.520 --> 23:56.780 fitness regime that they do to stay physically fit. They do a lot of outside 23:56.780 --> 24:03.380 activities together and apart, and a lot of them have families. Once out of 24:03.380 --> 24:07.280 residency, again, the first couple of years, while you're building your name, 24:07.840 --> 00:24:10.164 building your practice, you're working pretty 00:24:10.164 --> 24:11.920 hard. You have debt that you want 24:11.920 --> 00:24:14.235 to pay off, so you're working pretty hard. 00:24:14.235 --> 24:16.440 Once you start having a family, usually 24:16.440 --> 00:24:19.700 you can work it out where you do have the 00:24:19.700 --> 24:22.800 opportunity to have work-life balance. 24:23.460 --> 00:24:25.744 That's where it becomes a personal choice. 00:24:25.744 --> 24:27.920 You have to decide you want to keep the 24:27.920 --> 00:24:30.749 balance between work and family, physical 00:24:30.749 --> 24:33.440 health and mental health and spiritual 24:33.440 --> 00:24:37.163 health. So, that's something that we train our 00:24:37.163 --> 24:40.320 residents to keep an eye on because if 24:40.320 --> 00:24:41.780 you don't pay attention to that, you can 00:24:41.780 --> 24:43.240 get down the rabbit hole of working too 24:43.240 --> 00:24:46.196 much. But there is the opportunity to have 00:24:46.196 --> 24:48.940 good balance. So, what are your hours? 24:49.180 --> 00:24:53.594 Like, what time do you come in and then leave? 00:24:53.594 --> 24:56.760 So, now I work probably about 10 24:56.760 --> 00:24:59.138 hours to 11 hours a day. I don't work so much 00:24:59.138 --> 25:01.040 on the weekends because I'm head of 25:01.040 --> 00:25:04.222 the department. Most of my people that are, 00:25:04.222 --> 25:06.960 my doctors that are earlier in their 25:06.960 --> 00:25:10.324 career, they probably work about, maybe about 00:25:10.324 --> 25:12.940 60 hours a week and then weekends. 25:13.420 --> 25:16.740 And then they're on call. So, sometimes when you're on call, you're not 25:16.740 --> 00:25:18.642 necessarily working, but you have to take phone 00:25:18.642 --> 25:20.140 calls at night and things like that. 25:21.880 --> 25:26.100 So, yeah, referencing the same article I cited before, both of your sons are 25:26.100 --> 00:25:28.751 neurosurgeons. And now all three of you guys 00:25:28.751 --> 25:30.920 work together at AHN's Neuroscience 25:30.920 --> 00:25:34.167 Institute. What was it like the moment you 00:25:34.167 --> 25:37.260 found out they followed you? So, before 25:37.260 --> 00:25:40.140 that, when they went to college, I said, 00:25:40.140 --> 25:43.020 you guys have, and my daughter as well, 25:43.120 --> 00:25:45.280 who isn't a neurosurgeon, said, you have to 00:25:45.280 --> 25:47.340 pick the career that makes you happiest. 25:48.060 --> 25:52.380 Because no matter what you do, you can't go to work and hate it because you're 25:52.380 --> 00:25:54.408 going to take that home after work and it's 00:25:54.408 --> 25:56.200 not going to be a good life. So, pick 25:56.200 --> 00:25:59.783 whatever you want to do. And for a while, I 00:25:59.783 --> 26:03.200 wasn't sure what, they weren't sure what 26:03.200 --> 00:26:05.240 they wanted to do. And then it turned out they 00:26:05.240 --> 26:06.880 ended up going to medical school and 26:06.880 --> 00:26:11.922 then it turned out they ended up going to neurosurgery. 00:26:11.922 --> 26:14.580 So, it was, I was very proud 26:14.580 --> 26:19.660 because that's a good career. Happy because during their childhood, I didn't 26:19.660 --> 00:26:23.118 make it seem like a horrible life or they wouldn't 00:26:23.118 --> 26:25.400 have done it. And then also it's 26:25.400 --> 00:26:27.708 a responsibility because when you work with 00:26:27.708 --> 26:29.640 them, when you're working with your 26:29.640 --> 26:37.220 family, it's, it's, everybody has to elevate the ships. So, you can't have, I 26:37.220 --> 00:26:39.277 can't be bad at my job, they can't be bad at 00:26:39.277 --> 26:41.100 their job because we're all connected. 26:42.300 --> 26:45.580 But it's similar with all the other doctors in my department. They're all, 26:45.680 --> 26:50.780 we're all one big family. So, what's it like working alongside your own kids 26:50.780 --> 26:52.220 versus unrelated colleagues? 26:55.780 --> 00:26:58.853 So, at work, I really try to keep it the same 00:26:58.853 --> 27:01.380 with everybody. And I think I have a 27:01.380 --> 27:07.080 really good relationship with all of our doctors. At home, when we have family 27:07.080 --> 00:27:10.754 events, my wife made a rule that we can only 00:27:10.754 --> 27:13.760 talk about work for five minutes at 27:13.760 --> 27:17.680 any family event. Because if not, it becomes overwhelming to the rest of the 27:17.680 --> 27:23.080 family and it's not fair. So, we keep family, family, work, work. And it's, I 27:23.080 --> 27:27.240 try, I have a good relationship with all our doctors. Okay. So, your son, 27:27.360 --> 27:31.100 Alexander, said that you never missed a soccer practice. How did you actually 27:31.100 --> 27:37.580 manage that kind of balance with having this career? Volitional effort to be 27:37.580 --> 00:27:41.038 present during their childhood. So, I was very 00:27:41.038 --> 27:43.820 busy at the time operating and doing 27:43.820 --> 00:27:46.748 things like that. But I made my schedule such 00:27:46.748 --> 27:49.220 that I was there when they had events 27:49.220 --> 00:27:51.772 and I was there when they were growing up. 00:27:51.772 --> 27:54.080 And the final question. What piece of 27:54.080 --> 00:27:57.811 advice do you wish you had heard when you 00:27:57.811 --> 28:01.360 were an early kid or teen? I think the 28:01.360 --> 28:07.220 best, I had a lot of good mentors throughout. So, I got a lot of different 28:07.220 --> 28:13.740 advice along the way that was all good. I think everything 28:13.740 --> 00:28:16.510 worked out. And everything, every right turn 00:28:16.510 --> 28:18.840 and wrong turn happened for a reason 28:18.840 --> 00:28:22.205 that I learned from it. So, I think all the 00:28:22.205 --> 28:25.100 advice I got was good. Sometimes not 28:25.100 --> 00:28:28.329 necessarily timely. But I don't know that 00:28:28.329 --> 28:31.480 I would have done anything differently. 28:32.680 --> 00:28:35.370 Okay. Well, thank you so much for agreeing 00:28:35.370 --> 28:38.060 to be interviewed. I'm currently thinking 28:38.060 --> 28:41.980 of becoming either a neurosurgeon or a cardiothoracic surgeon. Leaning more 28:41.980 --> 00:28:43.943 toward the neurosurgeon side. And I really 00:28:43.943 --> 28:45.860 appreciate all of the information you've 28:45.860 --> 00:28:48.115 provided me. Thank you, Dhruv. And I can tell 00:28:48.115 --> 28:50.020 you neurosurgery is way more fun than 28:50.020 --> 00:28:52.650 cardiothoracic surgery. So, pick us. Okay. 00:28:52.650 --> 28:55.280 So, thank you very much. Yep. It's been a 28:55.280 --> 28:56.340 pleasure. Thank you.