Seeking Perfection

good morning everybody

my topic for today is seeking perfection

and how apt it could be but let me

ponder on this very first slide

you may have noticed that i have placed

sun

way up front we must all remember

that we are a son or a daughter to our

parents

a husband or a wife to our spouse

a father or a mother to our children

i have a son and a teacher which i put

on the same line

because we must give to the future and

unless we teach

we are not giving anything to the future

so therefore i prefer to call myself a

professor rather than a doctor

gratitude is the foremost virtue and i

must thank

people who are often taken for granted

first and foremost is my wife

anna paula she has not only helped me

with this presentation but also

with whatever i do even as a

neurosurgeon to become perfect

i should also like to mention a number

of friends but nadeem rice in particular

but i’d be failing in my duty if i did

not mention

two of my teachers of course all of them

matter from school from college

but two of my teachers who really helped

me to be where i am

professor das and professor rauth they

were heads of respective national

institutes of the country

perfection let’s try and look at it very

simply

it also means completeness you try and

do a job

and do it well done that’s all that is

required

for a small child when he learns his

first match

like for example two plus two is four

and he does that

time over and time over again precisely

the same answer

he is perfect at that so maturity

what is flawlessness not to make

mistakes that’s what neurosurgery is all

about

anyway supreme excellence

and when you have these under your belt

you’re often considered saintly

so they all have something in common

so let’s start with simple things if you

can do the simple things

there’s a good chance that you’ll be

able to do the more complicated things

and when you come across the more

complicated challenging things you break

them up

they’re like algorithms for the computer

they’re all broken up into small small

bits

so you achieve the small bits and then

you will be able to

achieve the bigger things so how do we

do the impossible

it’s not just to try you must try to do

your very best in the true sense of the

word

and you will succeed provided you have

no agenda

and we shall see that in the next few

minutes

there are many professions that demand

perfection the practice of medicine

is one such and neurosurgery is probably

at its top

let me share with you some true life

experiences

to indicate what we do on a daily basis

this is a young registrar’s mother

who was suffering from a massive

pituitary adenoma and she

lost her vision all of a sudden

i got a frantic call on a sunday morning

when i was at a busy cme

where i was in fact sharing the session

and i had to leave because

the registrar was frantic saying my

mother has lost vision

she was very diabetic as well she had

sugars to be controlled she was obese so

it was not

easy for us to just take the patient

and immediately operate so we had to

really prime this patient which took a

couple of days

it’s no point trying to save vision and

losing life

so i operated her in a couple of days

and here she is

with vision restored the last i heard

was she was going

with her daughter for a movie so these

are the things that you hear

from our patients in neurosurgery let’s

look at another case

a basilar tip aneurysm where i was

called in to operate because this

patient bled in the brain

and my student who had gone to baroda

requested me to come

so i flew i had to fly immediately which

means i had to take the evening flight

and operated through the night i had to

take my micro instruments

and this surgery is difficult even in

our own surrounding at the km hospital

but

i had to do this in an alien surrounding

i didn’t know the sister

so so many parameters that were not

within my control

but yet i planned this surgery in my

mind

took the clips that i needed for the

surgery did the job in fact i used four

clips for the surgery

and came back the next morning to

continue duty at the km hospital

the patient did well let’s look at the

other case now

this is a case i operated 12 years ago

she has a huge dominant dominant means

on the left side on the dominant

hemisphere of the brain

a mortar strip that’s around the motor

area of the brain

a large arterial venous malformation

whereas consultants had said that this

was an inoperable case

but i could see this girl she was living

in my building for a while

deteriorated in front of my eyes she

started having weakness on one side of

the body

and then she started developing

seizures multiple seizures in fact she

had four or five

seizures every day by the time she came

up for surgery or

she she was ready for surgery because

the relatives are very very scared

she was practically bedridden

i started the surgery at five in the

evening after my day’s work at km

hospital

and i finished at 5 am the next morning

it took me 12 hours to get rid of this

huge

ball of blood in vessels

and after i did the surgery i settled

the patient in the icu

spoke to the relatives the parents of

the kid and said that everything will be

fine

and went to play a cricket match in fact

a time shield which i had committed to

play

and we could save his life

19 years old and i have a lump in my

throat

how do we do what we do so there are

multiple steps involved

the first is proper learning and

education this is where most of us

are being a teacher i still continue

to learn because i teach people and they

ask me the most difficult questions to

answer

so most students are at this stage but

remember

learning and education must be vast

you must gain immense knowledge like the

base of the pyramid this is your

foundation then mentorship and guidance

it’s extremely important to have a good

mentor

he mustn’t be the one who says you can’t

do this or you won’t do this

he should be able to guide you through

and this is the person or these are the

people who are going to give you the

wisdom and the skill

which will develop on the education that

you’ve had

at home you have a similar person as

well

and she’s your she’s your wife so most

men call that nagging

nevertheless practice makes you perfect

this is what was highlighted many years

ago

but now it is known that that is not

exactly what it is

there is more to it than just that yes

practice makes you perfect when

probables

are more standard and the conditions are

stable

for example like tennis as a sport would

be

probably better off as you keep seeing

roger federer practices backhand for

example

but it’s not the same in medicine in

fact it’s not at all

and same with cricket in fact

let’s look at the next step you

have something called cross training so

for an athlete

a cricketer might play a bit of football

so he develops other skills

whereas for a surgeon like me i play the

piano

or i play cricket or i think around with

the car or do carpentry so it

develops other skills in your ever

expanding brain cells

they expand by networking they keep on

networking it’s like what

so many other softwares do for us that

we network and then we expand but what

is also important is you must be

analytical

and you must observe and these skills

develop

only if you are honest if you are not

honest

i’m sorry you will go the wrong path

this is what i managed to do on the

cricket field i played veterans cricket

for india early this year

and these are some of my exploits when

i’m not in the operating room

probably the most important but would

come at the end

is the mind and how do you trigger

how do you manage to have the attitude a

person

needs to become perfect you need the

courage

you need the discipline you need the

determination you need

the respect you need temperament

commitment

and focus let me give you a simple

example of respect

if i’m playing a match i’m playing a

cricket match and i don’t respect the

bowler or i don’t respect the ball

and i try to hit a ball which is meant

to really actually get me out i should

defend it

i will lose my wicket i won’t be able to

do what i need to do

and i will we won’t be batting perfectly

so this is a small example and

everything can be dissected in the same

manner

let’s look at the last point which is

also extremely important

is the spirit it is the belief that you

carry

it’s not the spirit that you use or that

you that you consume

in the bar and the restaurants this

spirit

makes you the spiritual person that you

are that allows you to reach

for most people beyond the realism

of what you see in day-to-day life

this is just a slide i put for people

who don’t understand what the mind is

remember that it is all powerful and

it depends on how you want to use it

so therefore it shows neurosurgery a

field that merits perfection

and for me to forgive is humane

and to air is inhuman we indians here

from a country where generations of

people

performed with perfection and no agenda

simply look at ajanta and alora look at

those rock

caves or look at the paintings they’re

perfect

and they continue to be done by

generations 3000 years ago

this is neurosurgery today this is a

young lady who worked with me as a

secretary for four years she’s married

and got a kid

she underwent two surgeries on either

side of the head where we had to open

into the brain

and clip multiple aneurysms so this is

just to tell you what neurosurgery is

today and how one can be perfect

in day-to-day life as well thank you

stay safe and stay healthy