HJAR May/Jun 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2020 43 THANKS to CT scans and MRIs, today we can identify and precisely map tumors prior to surgery. If a stroke patient experiences a small clot in the brain and they reach a doctor quickly, we can administer medication that begins to break down the clot immediately, so that the impact of the stroke becomes less significant. If a patient suffers a large clot in the brain, we can now take them into the an- gio suite and use a catheter, similar to what you would do for a heart cath, to fish the clot out and reestablish blood flow. The impact of such advancements cannot be overstated. While you may not be able to save every impacted area of the brain, the difference today means going from someone who could be completely paralyzed and un- able to talk, to someone who may have some residual weakness, but can still walk, talk, and engage with their families. That is what lies at the core of all our medical advancements in the field of neurosurgery. While the tech- nology and procedures have revolutionized treatment, the real impact is on the lives of our patients. Over the last 40-50 years, we have quite literally experienced a quantum leap in patient outcomes. Ahalf century ago, as many as 50 percent of neurosurgery patients would either die or not do well after surgery. One of my men- tors, Professor M.G. Yasargil, helped change that. He possessed a unique understanding of anatomy and how to navigate the brain. Through his work and leadership, outcomes for neurosurgery patients went from pre- dominantly negative, to 85–90 percent posi- tive outcomes. It revolutionized the field, and neurosurgery has gone from a subject pa- tients fear, to a point where we can conduct complex 18–19 hour surgeries, and the patient recovers so quickly that they are able to walk out of the hospital and go home two days later. The domino effect of this progress can be measured by so many patients living lon- ger, healthier, full lives with those they love. Despite all of these advancements, there remains much that we do not understand. When I began to study neurology and anat- omy as a medical student, I quickly realized how little we truly know about the nervous system and the brain. We know far, far more today, but that progress is still minute com- pared to our ignorance about how the brain functions, and how diseases occur. We have so much more work left to do. We still face brain cancers that are very difficult to manage. We can remove a tumor surgically and get a perfect post-operative MRI where the entire tumor is gone, but some of these tumors are elusive and still manage to come back. For all of our prog- ress, we remain in the dark about how the brain connects, how the brain functions, and the nature of its environment. This is why it is necessary that we never give up or stop trying to advance the field of neurosurgery. Even when a patient is told their condition is non-operable or cannot be treated, we must realize that each of those lives are invaluable to their families. Impossible does not exist. Only ignorance exists. Each case is an op- portunity to save someone’s life and expand our knowledge for the future. Imagine trying to explain our scientific and medical insights of today to someone 100 years ago. They would think you are crazy, but that just speaks to how far we have come. If we are to continue moving forward in the field of neurosurgery, we need to consistently put our ignorance aside and open our minds to the possibility of even greater advance- ments around the corner. Even the greatest challenges we face today can be overcome as long as we continue to push forward. We are fortunate to have somany bright minds in the field of neuroscience today, and I am sure the next 40–50 years hold even more progress, so long as we choose not to give up. n Ali Krisht, MD, FACS Director Arkansas Neuroscience Institute at CHI St. Vincent While the technology and procedures have revolutionized treatment, the real impact is on the lives of our patients. Over the last 40-50 years, we have quite literally experienced a quantum leap in patient outcomes.