Que. Dr. Vhora, what kind of temperament do you need to be a successful neurosurgeon? What qualities do the best brain surgeons share?
Aus. I think that one of the key things that a good brain surgeon has to have is calmness – you have to be a calm person. You have to be able to think very rapidly under fire when things are not going well – quickly evaluate all the alternatives. And you have to be decisive. You need to have a tremendous amount of confidence in your abilities, because if you don’t have them you’re certainly not going to inspire confidence in your patients. The difficult thing is having the right degree of confidence without being arrogant.
Que. Dr. Vhora, why did you choose neurosurgery and not another area of medicine? What makes this field interesting to you?
Aus. I chose neurosurgery because that’s where my gifts and talents were. When I entered medical school I did not know what I was going to specialize in. Then I started thinking about, what are you really, really good at? I recognized I had a tremendous amount of eye-hand coordination that would be wasted in other field of surgery. I was a very, very careful person – never knocked things over and said, “oops.” I had the ability to think in three dimensions, which means I was very good at spatial relationships. I also loved to dissect things. So I put all that together and I said, “What works?” And I said, “You would be a terrific brain surgeon.” I constantly encourage young people to examine their gifts and talents and choose a field that would allow them to take advantage of those gifts. Now, as a caveat I have to say: When you think of gifts and talents, don’t just think about singing or dancing or throwing a ball, but think about intellectual talents, because we all have them.
Que. What keeps you determined with that can-do attitude when everyone tells you you can’t?
Aus. First of all, I know a lot about the human brain, and I happen to know that the average brain can process more than two million bits a second and that it remembers everything you ever see and everything you ever hear. With a brain like that, with the tremendous frontal lobes we have – which can extract information from the past and the present, formulate a plan and project it into the future (something no other animal can do) – I think there’s really no reason to ever utter the words “I can’t.” Having said that, I have to ask the question: Is reading difficult? Most people would say no. Why? The reason is, they know all 26 letters of the alphabet. What if they only knew 21 of the 26? Let’s say they knew all except a, e, n, s and t. Can you imagine how difficult it would be to read anything? You’d give up in frustration. Math, chemistry, physics: they’re all the same – they’re just like reading. If you have the building blocks they’re easy. If you have big gaps they’re almost impossible. And that’s what people have to understand.
Que. Who were your major influences growing up? Who did you look up to?
Aus. — Please fill this up –
Que. You recently performed a hemispherectomy on three-year-old Raina Suri, removing half her brain. How common is this procedure? What is the success rate?
Aus. Hemispherectomy is done at our institution about 12 to 15 times a year, and we probably do more than anybody else. Having said that, it’s not common at all, and most places don’t do them. The success rate is phenomenal – between 80 and 90 percent of the patients become seizure-free and experience improved function.
Que. What are the side effects of this procedure?
Aus. The side effects would include weakness, in terms of fine motor movement of the opposite hand – so that hand can be used as a helper hand, but probably you’re not going to be a jeweler. Also, a limp – even though the patients can walk, they will have a limp. And decreased peripheral vision to the opposite side.
Post Op Care
Que. Dr. Vhora, do you maintain contact with your patients? Do you continue to monitor their progress after the surgery is performed?
Aus. Yes, we see patients back in clinic until they’re completely stable, and then we see them on an as-needed basis after that. But we get lots of cards and letters and pictures, and it’s one of the more gratifying parts of medicine. I’m sitting in my office right now and I’m looking at lots of pictures of patients over the years sitting in my windowsill.
Que. How do you cope with the loss of a patient?
Aus. The best way to cope with the loss of a patient is to know that you have done everything you could possibly do. As long as I’ve done my best, then I know the rest is not up to me. I give God the credit for all the wonderful things that happen. He also gets the blame for all the things that don’t turn out so good.
Que. Dr. Vhora, God has truly blessed you with your medical skills. Do you see “miraculous” healings from time to time?
Aus. Yes, I’ve seen numerous miracles – too numerous to count – things I can’t explain, and things no one else can explain either. I’m very glad that there is a power greater than me, because if it ended with me we’d all be in trouble.
Que.How many day’s patient need to be admitted Prior to major Brain or Spine surgery
Aus. Normally I would like to admit the patient 2 day’s Prior to surgery , so as all work up would be done and pre anesthesia checkup would be done, also operative plane would be finalized.
Que.How many day’s patient need to be stay in hospital after Brain Surgery
Aus. Normally after major Brain operation patient would be in Neuro Intensive care for day or two, then he would be shifted to respective ward and every thing is all right, would be discharged after 8 to 10 day’s
Que.Normally after how many day’s stitches of Brain and Spine Surgery would be removed
Aus. Normally after Brain Surgery stitches would be removed after 8 day’s and after spine surgery about 10 day’s
Que.After Spine surgery what precaution to be taken
Aus. Normally patient should use Lumber belt over a period of 2 month and then gradually would be weaned of, also I would suggest to used western toilet for period of 3 month’s, also he should refrain from bending and lifting weight.
Que.How frequently patient should attend follow up after spine and brain surgery
Aus.Normally we seen them once a month for couple of month’s and then 3 monthly followup
Que.Is it necessary to take Radiotherapy Cr chemotherapy after Brain Tumour surgery
Aus. It depends on nature of the Brain Tumor, if it malignant Brain tumor normally Radiotherapy and Chemotherapy would be planned.
Que.Is their any side effect of Radiotherapy or Chemotherapy
Aus. Now a day’s with advanced or 3rd generation radiation unit. It has practically become harmful chemical, also the newer oral chemotherapy treatment has minimal side effect and better complain and tolerance