Video: Four things to know before specializing in neurosurgery

Neurosurgery is one of the most innovative and constantly evolving medical specializations. This is one of the things that attracted Dr. Amit Persad, a neurosurgery resident in Saskatchewan, to the field. Looking back at his career now, he gives us some insight into what he wished he had known about the job when he was just starting out. Also: In videos, he looks at: Five reasons to love neurosurgery and five ways to navigate the emotional weight of neurosurgery. Also see: Video: 4 ways to take time off as a physician Transcript: Five reasons to love neurosurgery Dr. Persad speaking: I’m Amit Persad, I'm a fifth year resident at the neurosurgery program at the University of Saskatchewan. Text on page: Five reasons to love neurosurgery Text on page: 1. It’s addicting Dr. Persad speaking: They're, they're fun, but also, in a way that's somewhat to a personality like mine, addictive, like, you know you're doing something but you could make it better every single time you do it, you can just change a little thing, learn something and get better. Like it's addictive to, like, study the art of self improvement in neurosurgery. And that makes you feel like you know, the same basic procedure that somebody else might get bored with, I still love doing because I could find just a little way to change it up a little bit, make it a little better. Text on page: 2. You can keep learning and studying Dr. Persad speaking: Right, and then you can study it. So like I'm a Research guy, you can collect your outcomes, do research on things and then also kind of find out more things about neurosurgery so that you get an idea of what to look for, how to make your decisions, how to change your operations. Text on page: 3. Procedures are challenging and engaging Dr. Persad speaking: It's incredibly challenging and engaging. So like, I'm actually a bit of an ADHD type personality, I have a hard time sitting down and focusing on something for any length of time, except for operating. I can operate for like 16 hours. And that's fine. Because it's super engaging and it just demands your focus. Text on page: 4. The nervous system is fascinating Dr. Persad speaking: And then there's the rest of it like that. It's the nervous system. What's more interesting than the nervous system? Space, I don't think so. Like, I literally did most of my bachelor's in quantum mechanics, and you can't tell me that's interesting, because I chose this. It's super cool. Like, we don't know anything about the central nervous system, we know only like the bare bones details. And we're essentially, like, the equation I would make is, you know, Neurosurgery is arguably the most diligent at least part of the most delicate things that are done in human medicine, in any medicine, almost in any technical field. Text on page: 5. You make a tangible difference in people’s lives Dr. Persad speaking: It's just that the potential is unlimited. And then like all that comes together to just make a difference for people like, you know, this is like one of the differences between doctors, medical doctors are good at looking for long term outcomes and small changes. As surgeons, we like to make big differences. We like to look at pretty pictures. We like to have patients happy with their results. And you know, the more we get better at doing our job and make her feel better, the more we can make a good difference for patients and all of this equates like all of the science stuff that sort of isn't the difference maker the difference maker because at the end of the day, that happy patient with the life you've saved. Transcript: Four things to know before specializing in neurosurgery Dr. Persad speaking: I became interested in neurosurgery around my second year of medical school towards the end. And that happened. I was initially interested in radiology. And I was interested in a case that was being done in the interventional suite and had to go to the ER so I followed that case to be a war. And the surgeon invited me to scrub in. And I thought it was really cool. So I spent a lot of time in the neurosurgical wars after that with the pediatric neurosurgeons in Edmonton, and I got really interested in neurosurgery after that. Text on page: Four things to know before specializing in neurosurgery Text on page: 1. The life-threatening nature of the problems Dr. Persad speaking: The first and foremost thing is the gravity of the problem. So all of medicine has problems that where there's a threat to life in at least one way like for every discipline has at least one problem that is a threat to life for them or functioning neurosurgery pretty much every problem is a threat to life, limb or functioning. Whether it's like our lowest grade problems or involving severe disability, like a process from a subdural hematoma, which we operate to fix it is simple. But the problem is, that it is of great gravity to the patient, or disabling chronic pain. Text on page: 2. You can’t always save people Dr. Persad speaking: What neurosurgery leads to the highest highs and lowest lows, the reality is that you can't always help people. Because either the solution is too dangerous or the problem is too far gone or something goes wrong despite what appears to be a technically perfectly executed procedure. But sometimes you take people from the brink of death to having a normal life. And sometimes people go from being okay, but on a downward trajectory to being miserable and being ventilator dependent on a trach. Text on page: 3. You will continue to face imposter syndrome Dr. Persad speaking: There's a really high chance unless you're just the kind of person who's naturally overconfident which is its own problem. There's a really good chance that going through neurosurgical training, you're going to find yourself facing imposter syndrome more often than not like, you're gonna find yourself thinking like, Hmm, I didn't know I could do that or worse, like going into something and being like, I’m nervous about this one. Man, it doesn't matter how much you practice, like eventually you have to do it by yourself and your faculty. But, you know, you will run into that it's hard. Everyone knows it's hard but it's really hard. Text on page: 4. Some parts never get easier Dr. Persad speaking: The thing that never gets easier is having a conversation with patients or with patients' families in the worst scenario in neurosurgery, which is actually when you can't operate. So again, in the trauma bay with a young person who was in a motor vehicle collision, they have a giant bleed and they're not salvageable essentially. Brain dead you can't declare that because you need two different exams to do it. But you know, they have no salvageable neurological function, there's no point in doing an operation and you're not willing to offer an operation and having to have that conversation with tearful parents about their 25 year old son where you're saying there's nothing that can be done the conversation never really gets easier? Transcript: Five ways to navigate the emotional weight of neurosurgery Dr. Persad speaking: To put it short, surely they're having the worst time of their life like people who are having neurosurgery are generally having the worst day of their life when you see them. And I thought it was a privilege to be involved in their care. Text on page: Five ways to navigate the emotional weight of neurosurgery Text on page: 1. You have to depersonalize some aspects of the job Dr. Persad speaking: You have to some extent, although it might sound insensitive, you have to depersonalize it. Like you can't live the pain and suffering and like the individualized life of every individual patient. You just can't, it's not realistic, you'll burn yourself out so fast that you will not last more than a couple of days in this discipline. Text on page: 2. Develop mentorship relationships at work Dr. Persad speaking: I find that there's a lot of value in developing close mentorship relationships with the supervisors and then talking over or debriefing cases as they happen as well. Like I personally seek feedback after every operation. Text on page: 3. Build friendships at work Dr. Persad speaking: Having people kind of be close to you personally at work, like having your work colleagues be also out of work friends, or mentors allows you to breach just the professional boundaries of what you would usually talk about, and sort of open up to those people, which I find to be incredibly helpful at work. Text on page: 4. Maintain your friendships outside of your field Dr. Persad speaking: I guess it's all about maintaining friendships with people outside of the field. Like, you know, if you only talk to neurosurgeons and neurosurgery residents and that kind of thing. It's easy to forget your like non neurosurgery persona. But even other doctors, people who are not in medicine, like I have all sorts of friends that I talked to who like many of them are in medical school but they're not in neurosurgery. So you know, talk about different things. My best friends are cardiology fellows. I'm dating a nurse like all sorts of different people who are sort of understanding of the field that's important like being able to comprehend the gravity of things but not being bogged down in the field itself. But then also like some of my closest friends are still like my high school classmates only one of them is in medicine the rest of them or not in medicine. Text on page: 5. Take a break from your work Dr. Persad speaking: It's good to sometimes just watch a TV show, or go to the movies not so much right now. COVID You know, like, do something else, play board games with friends. I like to carve wood, I like to play the drums. I can't right now because I live in an apartment. But like, those sort of things, getting your mind off of things. And then like just you mentioned being a person. Hobbies is how you are a person you're doing something that has nothing to do with your chosen field.

Video: Four things to know before specializing in neurosurgery

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