Samuel Morganover 2 years ago
With great anticipation we have our esteemed mentor and Surgia affiliate Dr Chris Schwindack in the hot seat this week.
What an exciting journey he has taken from his beginning in Africa to the highlights of neurosurgery here on the Gold Coast.
We hope you enjoy.
Where did it all begin for you – what started your interest in surgery?
I grew up in a medical family on a missionary station. I used to sleep on a blanket in theatre while my parents were operating, so I guess it’s in my blood. I love doing things with my hands and I’m intrigued by the human nervous system. The combination of those things inevitably leads to neurosurgery.
Can you tell us a bit more about your pathway after you finished your tertiary studies, where did you spend time working and sharpening your skills?
I worked in rural Africa, Scotland, England, Australia. It is crucial to go and see what’s behind the horizon and to realise that there are many ways to skin the proverbial cat. It’s very important to realise that other people, in other places might do things very differently than you are used to but do just as well by their patients. I find dogmatic surgeons (or any doctor for that matter) very dangerous.
Talking laterally for a moment, what are some invaluable skills and experiences outside of medicine that have made you the surgeon you are today?
In secondary school me and some mates went on a few survival excursions through the African desert.
Picture from Wikipedia here: https://www.google.com.au/imgres?imgurl=https://upload.wikimedia.org/wikipedia/commons/thumb/4/48/NamibDesert01.jpg/377px-NamibDesert01.jpg&imgrefurl=https://en.wikipedia.org/wiki/Namib&h=240&w=377&tbnid=owLmUduNM0SsmM:&tbnh=160&tbnw=251&usg=__WRuAMpueYJLdVciDMpeP2P6G1kw=&vet=1&docid=0QCu4QWx3_mkqM&itg=1&sa=X&ved=0ahUKEwj9lZLj2ZnVAhXBErwKHROxC-gQ_B0IiAEwDg
The desert reminds you of your own insignificance in the bigger scheme of things. You learn to tough it out, cope with others under duress (without killing them) and learn about your capacity to function under extreme physical and mental stress. I’m certainly a better person for the experience. Kokoda anybody ?
When times got tough during the long rotations, what was the drive that kept you going?
Visualising my goal: becoming a neurosurgeon
Who or what was your biggest support during your training years?
My wife (I just had to say that – didn’t I ;)
There very a few teachers and mentors who really believed in me and convinced me that I had the skills to succeed.
What do you wish you knew before you entered into the surgical pathway and your specific field?
It’s good thing I didn’t know it was going to be so tough: it would have put me off.
What advice can you give to the next generation of budding surgeons as they prepare in their penultimate or ultimate years study?
Get into clinic and theatre as much as you can, speak to surgeons and see if you like them and what they do. Ultimately, it was the impression some great surgeons made on me that made me stick to it.
A hypothetical: You’re a registrar on call over the weekend and an emergency neurosurg. case has just presented to the hospital. You’re the most senior surgeon in the field available and you are about to scrub in after a long day or intense surgery. How do you mentally and physically prepare yourself for what is coming next?
We train for years and it’s well-rehearsed: what’s the problem, how am I going to solve it (you run the film of how you are going to do the case through your head), am I missing something ?
Neurosurgery, like all surgical skills is on the brink of what some see as a huge technological advancement. Some say that robotics can only benefit today’s surgeons by making their movements more precise. What are you views on these thoughts? Where do you see robotics or technology developing in your field over the next 10-15years?
The art of surgery does not lie in dexterity, it lies in the decision making. No robot can ever do that over. Robotics might improve the surgical accuracy but will not influence the fundamentals of surgical decision making. I believe the paradigm shift will occur in our understanding of the genomics and biochemistry of disease. Ultimately, we will not cure cancers and chronic degenerative disease with surgery but by manipulation the biochemical pathways underlying these diseases.
Today, our understanding of the brain compared to other skeletal structures is arguably decades behind. In Psychiatry, for example, schizophrenia management is based on observed changes to the patient rather than well understood pathophysiologic pathways. As more evidence and information is researched and the pathways of these conditions are understood more completely, will your scope increase/decrease or change in what ways?
I don’t have a crystal ball ! (but see above)
We will be doing things in a number of years we are not even dreaming of now. You guys will laugh at the stupid things we used to do. Change is inevitable and good surgeons will adapt to that. Surgery will always remain !