Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

And um so it's a pleasure to be invited to chair this session. I'm Catherine White House. I have with me, Nick Patel and this session is going to be a continuation of the last one. So we're starting with Madison and we're going to go through to uh prof tore steen and then we're gonna have coffee break after that just so, you know where we are. So, thank you. Thank you. It's very much a pleasure uh to be back in Bristol amongst colleagues. It's unbelievable to see. Uh This unit has reached the 75th the age of 75 and it's absolutely wonderful for us to all be a part of that. I first do want to tell all of my mentors. Thank you very much from the bottom of my heart. I will go through some individual things in the slides, but this is more of a programmatic thing. I almost feel like that we should pay your royalties because we ripped you guys off and we do all the stuff that you do in the United States. Um So thank you. Thank you. Um It's obviously we're enamored with this department. I mean, the visits through the years, the communications, I mean, obviously we send our residents over but really, uh, much more than an individual basis. Uh, we are indebted to your department. There are many parallels. Um, and they're really the most appropriate way to express that is through a family tree. So I'll tell all the younger people in the audience history is absolutely everything. You don't know where you're going unless you know where you're, you've been. And for me, I know a lot about this department and I know a lot about the times when I was there and I know a lot about the times that have occurred after that, but I really didn't know a lot before that until I had to get this talk together. I'm very thankful because again, I feel like the synergy between Memphis and Bristol is the reason that our unit exists next slide. So family tree. So this is my mother put this together when I was a little kid. I remember her putting this um together on a card table and you can see the very, very beginning. Um I definitely have British roots and then the tree kind of branches. And ultimately, it gets to that far end where you see uh my name on it. And as a little kid, I didn't really understand what this meant. I thought it was just art something to kind of smear something on, but actually, it really means a lot to our family in that a lot of the things that I do, the reason I do them is because of the people that come before me. So I feel like I do a lot of things on an individual basis that I'm doing things that are above average, let's say. Um but the reality of it is is I have taken everything from those people before us next slide. And so, you know, when you talk about this Memphis thing and Bristol, it does seem a little awkward. I mean, where did it come from? How did it start? Some people have alluded to it, but it's a real interesting kind of deal when you, when you kind of uh put a little magnification glass on the characters next slide. So Hugh Griffith and Jt Robertson, I would challenge that if you had to other people just randomly picked out and said, you know, let's make this work going forward. We wouldn't all be here. Uh It was really these two individuals that really chartered are course going forward. So you have Hugh Griffith and I love hearing the stories about him. I never met him personally. Um But it really giant of British neurosurgery. You heard this morning, the connection to Cushing. Uh If you look at Jt Robertson, exactly the same Eustace Sims was one of the residents for Harvey Cushing, uh came to Memphis. Uh Francis Murphy joined him and then ultimately became the Sims Murphy clinic and then you have JT Robertson that was one of their early residents and he was a giant of American neurosurgery. I mean, really on par. I mean, to kind of call them alpha males that were out there, they really did their, their entire careers in one place. Very unusual. I mean, even, uh, I will tell you in the States, uh, there's a lot of moving around as you go through a career, but these people really spent the large majority of their time at one institution. They had similar practices. I mean, they did a little bit of everything but they believed in sub specialisation. Um So you see that they did acoustics and pituitary's, but they also the interest in lumbar disks and the light. Uh they were great teachers and thought leaders. Um It sounds like Hugh Griffith was, you know, quite inquisitive, um very much uh the authoritarian on, on various things. Uh Jt Robertson was exactly the same, a wonderful teacher. Uh most of us learned from him by fear um more than uh by anything else but whatever you got to do to get it done. Um And he was a thought leader. I mean, you, you heard all the things about uh Mr Griffith uh basically ICP stuff and neuro endoscopes. Uh JT Robertson was that the real forefront of subarachnoid hemorrhage, brain tumor's extracranial vascular disease, really define these fields. And ultimately was one of the founders of what I do today, which is skull base charismatic. I mean, I think the queen would give her crown to each one of these people. Um They could take over a room when they had the chance. They were political forces and they were able to bring people together. Uh They were early adopters of microsurgery. I know we all take that for granted these days. But back then it goes back to what Nick Theodore was talking about. I mean, I remember uh reading articles where they brought the microscope out and people would criticize saying, are your eyes not good enough, you know, why don't you know the anatomy? So it was a real kind of tour de force to take on that kind of crowd. But these people were absolutely behind the microscope and then I went over subspecialty development. That's something that, that again, we should pay royalties. I'll say that again and again and again. But the both Mr Griffith and, and, and uh Dr Robertson really believed in developing subspecialties within a group. So if you go around the United States and look at all departments, that's really not the case from place to place. It's a very select group of people that really bought into that. And then the multidisciplinary approach which I really, really believe in uh Mr Griffith was much more uh political in that regard and I think did work very well together. I think Mr Doctor Robertson tried. Um I don't think he was as good at it. Uh He liked the dictatorial world and uh but he did believe in other people should do it. So his uh the people that he trained would carry on that tradition. But these are just two giants on both sides of the pond that met. And the, you heard Stephen talk about this a little bit earlier. I had to go back to a couple of people that are kind of towards the end of life to figure this out. But why, where did they meet? I mean, just by chance was there an invitation somewhere? But I found uh the nephew of JT Robertson who is now an adult. But when he was 10 years old, next slide, next life. But when he was 10 years old, his family moved over to Iran and uh next slide. So when's the last time that these three countries were under one, the same roof? It was the 2022 World Cup. And I can promise you the years before that, that was not the case because in 1979 the Iran really turned anti British anti American. But in 1975 next slide, Jt Robertson was invited by the Shah of Iran to come over to Bolivia University and they wanted to get started in their surgery departments. Well, at the same time, an invitation was given to uh Hugh Griffith and they both went over there for extended periods of time and uh that's where their early interaction and that's where they met. And of course, can you imagine those two people coming into a foreign land, everybody else around them from, from other countries? Um That just was right for conversation and they met, they got to know each other. And from that point forward, it was a distinct bond. I do know that the Chancellor of Palaver University at that time was actually from England, the first English Chancellor of that Medical University. So I always wonder if that's the reason that these people were invited over there. But nonetheless, Iran is where this all started. So I'm not sure America could ever say thank you Iran to any other situation. But right now, so next line, the going forward, I mean, it's really not a given, you know, there was no charted course. Uh JT went back to Memphis, of course, Mr Griffith came back to, to England, both running excellent departments growing them. Uh But this cross collaboration is something that's very, very constant and and really um is something that, that I think made our programs very similar. I mean, we, we have a situation where we develop leaders, we believe in an intellectual curiosity or academic productivity. Uh and we believe in surgical mastery. The one thing I love about being here is there's a lot of emotion that that goes into to surgery that talking about it, the mastery of it there's, there's a in it to win, it kind of feel over here. And that was the same thing that was taught to me during my residency. And I thought it came out of the blue, but I really do think it came from Mr Griffith. And so you had Stephen Johnson and, and Clarence Watcher come over in the 19 seventies. So they met in 75 Stephen came over in 76 and then 83 and then Clarence came over in 79. And of course, that's when you started to get that cross collaboration 1986. So they gave you both their stories um uh from when they were over there next slide. So Michael Mobile, our is all I can say is an interesting individual. So he is a tour de force, the hardest worker that I know. And he's a real giant on the state side and both peripheral nerve and pediatric spine. One of the authorities uh on our continent in both of those situations and so much like all of us with the JT situation. Uh Mike had a six week old child. JT says you need to go um to England. Uh Mike says I really can't go and he said you're going. And so the next thing you know, he's on a plane, he's going, that's just the way it worked out for a lot of us. And he came here and he worked with Mr Griffith. Mr Cummings uh prof Coke. Um, and then Mike Torrance as well. And when he got here, this is all from his point of view, but he got here and, and JT wanted him to be a peripheral nerve expert. And so, uh Cummings just gave him a roller dex. He told him to go through the roller decks, find all the peripheral nerve and do them all. Um, and don't include him if, if, if possible. Uh He also told him that he hated a CD. So he said as you're working through the roller decks, if you see an A CD, go ahead and knock that out too. So he did 2012, 2 sevens, I mean, hundreds of carpal tunnels and uh on our nerves and other complex peripheral nerve stuff and really was the start of his career. He went on to do training with David Cline, who's one of the premiere pro uh peripheral nerve guys on the States and really has gone to have a great career. We use hydrogen peroxide. So our trauma center unfortunately has uh you guys are kind over here. We have the gun and knife club in the States. And so what you see probably in a entire year, we see 10 to 15 of those a day. And so it's not a kind place but hydrogen peroxide is part of our training. I mean, we see this bomb go off in the head. I mean, next thing you know, a cotton ball goes in and then there's some sort of visual display that I think would make a kindergartener get excited. Uh He learned it here from Mr Griffith. He mixed it with gelfoam uh and it could stop any bleeding. Um Corey Plexus cauterization. I will tell you that this conversation was not a positive one from Mike Muhlbauer. Supposedly the kids come in or turn prone and then they get a cauterization. Uh And I think there was even CFF CSF exchange. So as we talk about limited hospital stay, I think you could probably drive up your entire uh length of stay by this one operation by description of Mike Ball about, I suppose that they were in the hospital for weeks to months on end. Um Torrance who I had not met before this uh meeting. He remembers whether this is true or not. The years do tend to add fabrication, but he very much enjoyed a couple of drinks before clipping aneurysms. And he said that he was one of the best technicians that he has ever seen. And just to give you a slice of life in the mid 19 eighties, myelomeningocele, we're not closed. They were sent home uh to die in GB M's were really not aggressively treated. So it's a very different era uh next life. And so we had the same thing coming back to Memphis. We were very fortunate. I remember when I was a resident, I met George very proper. Alex Sanford uh is his anti personality. I lovely technician. Wonderful at what he does but to guns in the air and customers flying off uh out in the air. So it's absolutely uh the most fun thing to see the two of them interact. I will tell you. Um And George was a wonderful visitor. Um I was not fortunate enough to be there when Ian Ian came before me, but the stories about he was an absolutely wonderful technician, a great thought leader. And uh when I got here, I was very fortunate to cross paths with him and uh work with him next slide. So 1995 brought the end to the JT area. So that was the retirement. And I think, and I'm not, I haven't asked, but 1993 is when Mr Griffith past. And so that's really when the Bristol uh Memphis thing died down a little bit. Um But it was resurrected. So 1995 you can see the funny enough. Um I never understood this, but you can see uh Bactine there in the very front and then they're doing parsi in right here. And of course, I never understood why, but there are Iranians. So we continue to have Iranian trainees come over the United States and training with us up to the point that I started never understanding why until I went back and looked at the history and boom. There's the reason that we had Iran people within our residency. And so he retired and very similar to sounds like my descriptions of Hugh Griffith and uh JT could not stop. So he actually next slide, bought a flat in bath. Um and he was uh worked with Brian Cummins. Uh He actually was formally paid as a consultant by Medtronic. Um He had finished neurosurgery completely and he moved over here uh and stayed in Bath to work with the Bristol unit on developing this disk. And so the collaboration uh from JT and Hugh Griffith was then translated of course to Brian comings and it was wonderful. I was here. I don't know if y'all remember this, but I was here when this painting was unveiled. Um It was a bright sunny day, lots of great uh conversations about Brian Cummins, which I had, who had not met. And it was just really nice to see that uh continuity of excellence in neurosurgery at, at, at French. I mean, the mentors that I had during my time here were great, but it was awesome to see them talk the same as I would about them about Brian comings and Hugh Griffith. So now we kind of flash forward uh next slide and then double Ns mean. So, you know, I wouldn't say that that uh there was no activity in between the times that we were not rotating back and forth. I don't know if you remember this, but this is a double Ns meeting in 1998. I think Doctor John was a scientific chair for the meeting. And you could see the grin. I mean, uh you know, my father doesn't always look at me with pride, but when he has looked at me with pride, this is the look that he has. And I can tell you that he's looking with Doctor John who is his younger brother by 14 years, same mother and father. Uh but they grew up very, very different. And Dr Robertson, the younger one has been really my prime mentor on the state side throughout my entire career. JT. Once again, just looking at that photo, I kind of shake a little bit but uh but that's a great photo to show you the collaboration between our units next life. And so a re connection 2004, I go out to dinner classic JT style. I'm finishing up my last year. I told JT who had helped found skull base surgery. His brother certainly refined it and then I basically take my wine glass, turn it up. And the next thing you know, we're talking about what Madison Michael's gonna do next year, which I had a kid on the way. Not necessarily the way that conversation that I did not want the conversation to go that way, but I am so fortunate that I had a glass of wine up so that I couldn't talk at this moment. So I want to do a skull base. Er, Doctor John was basically saying he, you, I've taught you everything that you need to know. You don't need to do any extra training. And then the next sentence without your breath, you know, any air between the two sentences, you're going to England. And so the next thing you know, I'm talking to Ian Poeple about coming over to England. He was very, very gracious to help us set this back up. So you can, as we talked about the 93 95 around that area era, uh Hugh Griffith passes away JTS. Not in clinical practice, the relationship continues, but there's not a lot of transition back and forth next slide. And so here is the original uh email um lovely uh pol dot net, which is physicians online. It's out. Um It was on an A OL uh email driver. So I got the little being you got mail and here we got you go. Uh Ian was very, very for uh gracious to set up a rotation for me coming over here for a year. Uh They thought that I was a little bit uh too big in my britches may. Maybe my confidence was a little too high. So they made me take a freaking English test. You know, I thought, I thought, you know, I'm gonna, you know, here, bring it. And then the next thing, you know, I do horrible on the English test. So I barely got in to come over here to do this, this rotation. So you guys can sweat about visas, you can sweat about all this other stuff. I sweat about that English test. So uh next life. So a re connection we came over here. It was awesome to see Paul Grundy there. I took his uh car as well as his house, Walnut cottage and we lived in oldest own, you know, everybody that's coming over since my time actually is working in South Meet in Bristol. But the French aid unit, oldest son was, was closer. I did not spend much time in Bristol, but I spent a lot of time out in the countryside around Alverson, Thorne Baranova Liston. And uh I've never taken a bath before, but I took a bath for 365 days. And let me tell you when you're trying to get out the door, a bath is not quick. So you have to learn to draw the water and it was often in competition with my kids. So next slide, next line. And so French a hospital, I mean, it was just a lovely place. I mean, I felt a lot of hospitality. Please keep me on time. But uh so much hospitality I felt welcomed. Uh Nitin Patel was, was great as far as making my family welcome Mike Carter. Um I mean, everybody here was just absolutely gracious. I will tell you the hardest thing I have ever done in my life is finding apart in spite at that hospital that, that, that, that was, uh you know, you can be late to a lot of things but don't be late to French because you will not get a parking spot. But it was a wonderful place to train. And you know, there was just a feeling there that something excellent was going on. And when I heard World Class Center, uh I cannot say that enough. This is just a world class group of individuals next slide. So this was the re connection for me. Um I mean, just, I was telling somebody out in the thing, if you could just talk about whatever your favorite rock band is.