People don’t care what you know until they know you care.
Corrie Pitzer
Like Warren Buffett I believe that basically, ‘risk comes from not knowing what you are doing’. Indeed knowledge is the key requirement for safe and effective surgery. This is why I dedicate a considerable amount of time and effort to studying and teaching anatomy and physiology of the brain and its surroundings. Of course, one also needs skill. This comes with practice, both when carrying out surgery, but also in the laboratory setting and this is why I take part in numerous ‘hands on’, laboratory based training events in the UK and around the world. Above all, a surgeon must care about his/her patient. This ensures effective communication and understanding of patient problems and priorities, thus allowing to formulate the optimum management plan. Caring is a powerful motivator and the best guide in decision making at surgery.
My current role
As a consultant neurosurgeon I lead teams treating patients with tumours in and around the brain. There are more types of tumours affecting the central nervous system than any other organ in the body – nearly 150 types. I also deal with ‘lesions’ that look like tumours or require resection (surgical removal) that is best performed by a surgeon with experience in brain tumour surgery. These include colloid cysts of the third ventricle, pineal cysts and cavernous malformations (cavernomas).
Some brain tumours can be treated and even cured by surgery alone, but many will require other treatments such as chemo- and radiotherapy. I work closely with neurologists, neuro-oncologists, neuro-pathologists, neuro-radiologists, neuro-endocrinologists, neuro-ophthalmologists, neuro-physiologists, neuro-psychologists, neuro-anaesthetists, neuro-intensivists and ENT surgeons, both in paediatric and adult settings.
The most common tumours I treat are meningiomas, metastases, pituitary adenomas and gliomas (low-grade gliomas, such as oligodendrogliomas and astrocytomas, and glioblastomas). We use the most advanced techniques and equipment to maximise effectiveness and safety of surgery. Where appropriate we use brain mapping techniques, both in the context of asleep and awake surgery. Such an operation requires an experienced team consisting of a neuro-anaesthetist with special interest in awake surgeries, and a neuro-physiologist who carries out monitoring and helps with mapping of the brain.
Pituitary adenoma surgery and a number of other anterior cranial fossa tumours (Rathke’s cleft cyst, craniopharyngioma, meningioma), when appropriate, are carried out by a team consisting of an ENT- and neuro-surgeon. These surgeries are done through the nose using endoscopic techniques. Patient preparation, post-operative care in the hospital and outpatient care is carried out in the multidisciplinary setting in close collaboration with endocrinology specialists at CUH and other hospitals in the region, including hospitals in Bedford, Great Yarmouth Hinchingbrooke, Ipswich, Luton, King’s Lynn, Norwich, Peterborough, Stevenage, amongst others.
Prior to surgery our patients will undergo series of detailed assessments, depending on the type and location of their tumour, their symptoms and general medical condition. These include assessments by the following teams: neuro-anaesthesia, neuropsychology, neuro-ophthalmology, neuro-endocrinology.
In addition, I take part in an on-call rota for emergency neurosurgery, when I deal with traumatic brain injury and other acute conditions, including intracranial haemorrhages, hydrocephalus and intracranial sepsis.
Previous history
Before becoming a consultant, I completed neurosurgical training in Cambridge. I also gained additional experience at the Massachusetts General Hospital, Brigham and Women’s and Children’s Hospitals in Boston, Atkinson Morley Hospital in Wimbledon, the University of California in San Francisco (UCSF), Montpellier (France), Milan (Italy) and the Hospital for Sick Children in London. I received basic and clinical science training at Peter Black’s Lab at Harvard and completed a PhD in cancer genetics under the supervision of Sir Michael Stratton at the Sanger Institute. I do the best I can to balance research with my clinical work.
Membership / accreditations
- Royal College of Surgeons of England
- Society of British Neurological Surgeons
- World Academy of Neurological Surgery
- Anatomical Committee of the World Federation of Neurosurgical Societies
- Meningioma and Metastasis Group, National Cancer Research Institute, member (past Chairman)
- British-Irish Meningioma Society, President
- European Academy of Neurosurgical Societies
Personal interests
When not at work I enjoy sports (football, tennis, cycling, skiing, kayaking etc), hiking and learning about cultures by travelling and reading. I guess I am also an amateur linguist.