Reason

I find that this exercise of thanking and expressing gratitude makes my journey to the land of the unknown joyful. I thought I should do this when I have a clear mind and good health. I am teaching the residents now to understand its value. I am writing this now so that I am not too late to thank all those who helped transform my life. I want to show my appreciation to these men and women who helped me by educating me and helped me to be a better person by showing their love with an attitude of compassionate caring.

A desire

I was ten years old when I told my grandfather, who was a family doctor, that I wanted to be a brain surgeon. We were lying on a mat on the grass outside our house and looking at the clouds. I asked him where the clouds went. He said that some were greedy and heavy and became rain and some others were high up and traveled to distant lands. I told him that I wanted to be the latter. After graduating from medical school, I went to work with Dr. P.N. Tandon at All India Institute of Medical Science, in New Delhi. He accepted me but told me that I would have to work for free for a year because I was a candidate from out of state and, though I was qualified, he could only pay the candidate from the state. I accepted the offer and told him that I would be going to Louisville the following year. Dr. Tandon taught me the discipline I needed to be a neurosurgeon.

Fulfillment

I came to the U.S. in 1967 with the intention of becoming a neurosurgeon. I read a book by Dr. Glen Spurling, “Practical Neurological Diagnosis,” and then communicated with him by mail, as was available those days. Those days mail took a long time to travel. By the time I arrived in the U.S. to be an intern at St. Joseph Infirmary at Louisville, Kentucky, the doctor had already retired. But my good fortune helped me to find Dr. Richard Roth, a professor of neurology. He was most kind to me and was generous with his time. Almost every night he let me sit next to him in the EEG room while he dictated into a machine while flipping through a massive number of pages very fast. He taught me how to distinguish different patterns of brain waves. Once he learned that I wanted to be a neurosurgeon he drove me every week to Lexington so we could attend combined grand rounds with neurosurgeons and neurologists. He introduced me to Dr. Charles Wilson, chair of neurosurgery at University of Kentucky. In Louisville I worked with Dr. Frank Jelsma.

Dr. Wilson, upon learning of my intent, arranged my interview with Dr. Horace Norrell and a couple of other neurosurgeons. Dr. Wilson accepted a job at UCSF and then he arranged my interview with Drs. Boldrey, whose work with Dr. Penfield I knew about, Hoyt, whose book with Walsh I knew about, Hosobuchi, who was working with enkephalin, and another person, after which he accepted me in his program. He was very kind to me. One day in a neurosurgical gathering I had made some comment about a politician and Dr. Wilson told me that I should not express any opinion about any subject unless I knew a lot about that subject. At that moment I knew that he loved me, and that advice he gave me has stuck with me till today.

I needed to prove to myself that I was worthy and so I called Dr. Colin McCarty at Mayo Clinic for an interview. He had me meet three other members of the Mayo faculty and then accepted me. I knew about his introduction of the fronto-zygomatic burr hole, and I also read about Dr. Adson’s work before arriving for the interview. He asked me to sign a paper saying that I would join his program, but I asked him if he would kindly call Dr. Wilson from his office and let me talk to him. He was surprised but he did make the call. Dr. Wilson told me not to sign anything. Dr. McCarty was most gracious and to me, a boy from India, he looked like a holy man with beautiful white hair. I just wanted to know about these giants of neurosurgery.

However, not long after, the chair of the UCLA program notified Dr. Wilson that he would not be allowed to train me fully because I was foreign born, a foreign medical graduate. I never forgot Dr. Wilson’s face when he told me that news. He was most sad. He wanted to help me. So I requested him to call Dr. W. E. Hunt in Columbus, Ohio. Dr. Wilson wrote me a letter that I saved for fifty years and read every Christmas because it brought me joy to think that Dr. Wilson cared for me so much that he shared his feelings of disappointment with me and wrote me about it. For many years, instead of taking a vacation, I took a week or two to spend time with Dr. Wilson at Moffett Hospital in San Francisco to watch him and Dr. Hosobuchi performing operations on the brain. At times I called him from Louisville or sent him X-rays to discuss some cases for his opinion. He was always most helpful.

I remember that I saw a young girl for a second opinion who was scheduled for surgery for a dural graft because of a presumed CSF leak after being in a motorcycle accident and sustaining a Le Fort II fracture. The fluid dripped from her nose always when she went out on a date. After discussing with Dr. Wilson, we tried a small dose of atropine drop in the nose and I told her not to eat jalapenos in pizza when she went out. Her alleged CSF leak got cured.

I met Drs. John Meagher, Pete Sayers, and George Bingham and some other members of the team at the OSU interview. Dr. Meagher, my first interviewer, said, “I am a SOB and I am going to treat you like one for the next few years,” and asked if I was OK with it. I remember telling him that everyone treated me that way because I was born in a foreign land. Never have I met a kinder and more loving man than Dr. Meagher. I often ran out of money for grocery, and he always gave me what I needed till I got a night job, on the nights when I was off after being on call every other night. Dr. Sayers thought I could read Matson’s book of pediatric neurosurgery over the weekend, and he could talk to me the following Monday. Residency began soon after. It was the most wonderful journey of my lifetime. During the second year of residency, I decided to go to night school and get a degree in anatomy. So, after I was accepted in graduate school, I talked with Dr. Hunt and asked if he could pay for my school since I didn’t have any money. He paid for my school. He helped me become a man. After I got the master’s from the Ohio State University, I felt I was able to remove the stain of inferiority imparted upon me by the UCLA professor. Dr. Hunt’s bedside manners and surgical skills were impeccable. He knew I wanted to be an international volunteer and so he asked me to use hand drills, Adson’s rongeur for posterior fossa, Keith needle and Gigli saw as much as possible. He instructed us on our posture during operations. He didn’t like the “monkeys fixing watches” posture because he thought that would cause fatigue and back pain. He taught us to learn to view the anatomy of the bottom of the brain with eyes shut before going to the OR.

I couldn’t make it home, since I was operating when my wife delivered by herself in our apartment. Dr. Hunt went over and brought my wife and newborn child to the hospital. I remember that Dr. Hunt let me spend an extra six months in the lab because I had brain fog after being hit by a truck on the Pennsylvania turnpike on the way to attend a meeting in New York. He said, “It wouldn’t matter if I killed a rat or two.” Around 1987 I received a letter from Dr. Hunt when he called me a “Boston Brahmin.” That letter boosted my ego much. He was so gracious and humble when once I called him after performing my first medullary tractotomy, after talking to Dr. Ludwig Kempe and reading his book “Operative Neurosurgery.” He said that he wished that I had called him earlier so he could see it.

Dr. Robert Hess was a few years senior to me. I often talked to him about his publication about cerebral aneurysm. He was most humble and guided me to the process of gathering data. Dr. Richard Dewey, a colleague resident, met my wife in the hospital when she was having her second baby, while I was operating on a patient. Dr. Carole Miller, one year ahead of me, was most supportive. I understood her stress. Dr. Joan Venes from Michigan spent some time with us. Dr. Frances Conley’s “Walking Out on the Boys” was not conceived yet.

I want to thank Dr. Shelly Chou. He was the referee during my board examination. He had intervened when one of the examiners, he thought, was using up too much time on foramen rotundum. I had to answer a certain number of questions in a certain time period.

I want to thank Dr. Gordon Dugger for guiding me when I was a young faculty at Chapel Hill, NC. He rescued me once when I passed out while operating on a patient with tic douloureux under local anesthesia in a sitting position. The middle meningeal artery had gotten away from foramen spinosum and it squirted blood into my eye. Dr. Harris Pittman, chief resident, and my assistant called Dr. Dugger to finish the operation.

I want to thank Dr. Eben Alexander Jr. of Bowman Gray School of Medicine. He was most generous with his time with me on every occasion I called him for advice. He shared personal stories with me and helped me when I was doing some work with silastic. Dr. David Kelley helped me in many ways and also by complimenting me when I sent him one of my patients for follow-up who had moved to North Carolina, a patient from whom I had removed a deep AVM from the right fronto-parietal area, from Louisville.

I am grateful to Dr. Joseph Miller RAMD for doing me a favor. I was a commander in the naval reserve, and I didn’t want to waste my time by going for INACDUTRA one weekend every month when I was sitting around and doing nothing. I saw Dr. Miller at a meeting in Honolulu and asked him if he could move my base to Memphis so that I could go for ACDUTRA for two weeks once a year. By the time I came home I was transferred to the Memphis navy base, being more than 200 miles from my home, which meant that I only went to San Diego for my ACDUTRA. I told him that I could be a true volunteer in the military, but he said that would confuse the system and for me to get paid and donate at my wish.

Dr. William Mosberg, whom I always thought was a genius, was extremely kind with his time. He shared stories of his visit to India and the part he played in the program at Vellore and encouraged me to continue international work. He once gave me an opportunity to be on an international panel. He knew Drs. Chandi and Abraham at Vellore and helped develop the program in south India.

Drs. Hemmer and Colbert taught me general surgery and orthopedic surgery and kindness.

I want to express my gratitude to Dr. Marty Weiss, Dr. James Ausman, Dr. Laws, and Dr. William Meacham for talking to me and giving me supportive advice whenever I talked to them. I want to thank Dr. Tom Farmer, professor of neurology at UNC. He taught me gentleness and details of neurological examinations in progressive supranuclear palsy and fronto-temporal dementia. At my request he gave me a mock board examination. He wrote the preface to one of my books.

Dr. Sweet, Dr. Tew, and Dr. Spetzler were part of a team when we spent some time together in Moscow and Tashkent. I learned an enormous amount from them by just listening and observing.

I cannot overstate the influence Dr. Sean Mullen, Dr. Richard Schneider, and Dr. John Jane have had on my career. I met them on several occasions, and I know that I read just about everything they published. Dr. Schneider was the guest of our department during OSU-Michigan football games when they played at Columbus.

I want to thank Dr. Merwyn Bagan, Dr. Gail Rousseau, Dr. Salibi, Dr. Javid, and Dr. Peter Nakaji for being my friend. They assisted me whenever I called them and asked for help. My colleagues at University of Louisville have helped me immensely. I particularly want to thank Dr. Hiram Polk, past chair of surgery at University of Louisville. He wrote the introduction to one of my books.

I wanted to celebrate these men and women for making my dream come true of being an international volunteer neurosurgeon. I didn’t want to miss the opportunity of thanking them before my time arrived for the last dinner bell as in Revelation 3:20.

Addendum

Dr. Hunt got to see the galley proof of “Signs, Syndromes and Eponyms,” our legacy AANS publication, 1999. It is dedicated to him and my grandfather. There is a lecture at AANS to honor Drs. Wilson and Hunt every year.

I contribute to an annual lecture honoring Drs. Hunt and Meagher at the Ohio State University. There is a lecture to honor Dr. Richard Roth every year at University of Louisville. In the Kentucky school for the blind, two students get scholarship money every year in the name of Dr. Jelsma, the Jelsma award titled “To See Through Love.”

Timir Banerjee is a neurosurgeon.