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It Is Brain Surgery with Dr. Ralph Dacey
Manage episode 434671055 series 3593612
It Is Brain Surgery with Neurosurgeon Dr. Ralph Dacey
Neurosurgery is one of the most demanding medical fields, with practically no margin for error when operating. One small miscalculation can have profound effects on the patient. As a neurosurgeon and former chair of the Washington University Department of Neurosurgery, today’s guest, Dr. Ralph Dacey, knows all about this pressure and responsibility. He begins the episode by outlining the demanding and competitive route into neurosurgery, including the surprisingly low attrition rate and how emergency care is incorporated into training. Sandy then asks Dr. Dacey how he deals with risk, and he points out that neurosurgeons don’t risk their own lives but those of their patients, meaning that the burden must be shared by establishing a relationship built on medical ethics.
Next, Dr. Dacey discusses the discipline of neurosurgery, including the state of current knowledge on the brain, the main sub-specialties, and the conditions that cannot yet be successfully treated. He also goes into detail on what happens in the operating room, describing the process of fixing an unruptured aneurysm, how neurosurgeons navigate inside the brain, and how forceful backup has become a more prominent part of the operating process. And finally, Dr. Dacey discusses the great highs and lows of being a neurosurgeon, emphasizing that it’s ultimately a very rewarding life, with the highs definitely outnumbering the lows.
The Finer Details of this Episode:
- The track to enter neurosurgery
- Sharing the burden of risk with the patient
- The discipline of neurosurgery
- What happens in the operating room
- The highs and lows of neurosurgery
Quotes:
“Neurosurgeons make up about 0.4% of all the physicians in the United States. So it’s a competitive process, but mostly what we’re looking for is people who are capable of working very hard and intensely. People who are capable of absorbing and processing a lot of technical and scientific information. We also want people that have fine character, like you’re looking for in the Navy, and to be astronauts.”
“There is a difference between people like you two and neurosurgeons with regard to how we deal with risk. When you did your risky and challenging things, you were risking your lives. It’s different for us because we don’t risk our lives, the patient is at risk. And we have to share the burden of that risk with the patient.”
“There’s some evidence that by very specific paradigms of stimulation of the brain, with minimally invasive, stimulating devices, that we may be able to improve memory and treat people with refractory depression. So we are working constantly with the neurologists on trying to expand our ability to take care of all the diseases that affect the brain. But you know, there are many that we can’t successfully treat now, like progressive supranuclear palsy.”
“The forceful backup is definitely something that’s much more prominent now, in the operating room and in any kind of medical situation. So any member of the team is encouraged to speak up if they don’t think something’s going properly or there’s a problem. And if someone does that, we basically stop and try to figure out what the problem is. And that has been a great improvement in the way we do things in surgery and in medical care in general.”
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