Why They Chose Spine Surgery and Patients Who Inspire Them

Why They Chose Spine Surgery and Patients Who Inspire Them

The real story is not always about where you are today, what you’re doing, but how you got there and what keeps you moving forward. That’s the essence of this article about 12 spine surgeons who, at this point in their lives, have already made significant contributions to the treatment of spinal disorders improving patient care.

Scroll through this article to read about each doctor's history, their interests, motivations, and some amazing patient stories! The following spine surgeons are featured: Joshua Ammerman, Neel Anand, Steven Garfin, Gerard Girasole, Jeffrey Goldstein, Richard Guyer, James Harrop, Reginald Knight, Lali Sekhon, Isador Lieberman, Khoi Than, and Dwight Tyndall.

Joshua M. Ammerman, MD, is Chief of the Neurosurgery Section and Chairman, Department of Surgery at Sibley Memorial Hospital. Academically he’s an Assistant Professor at the George Washington University School of Medicine and an Adjunct Assistant Clinical Professor of Neurosurgery at the Johns Hopkins School of Medicine.

He’s a third-generation Neurosurgeon and told SpineUniverse, “I come from a family of neurosurgeons, preceded by my grandfather, Harvey Ammerman and father, Bruce Ammerman. One of my partners is my brother, Matthew Ammerman. So, I guess you could say it is "in my blood!"

When asked, why did you specialize in spine, he replied, “Spine disease touches a diverse cross-section of individuals, old and young, men and women, and gives its practitioners a broad range of operative and non-operative interventions to offer. All these features appealed to me as a medical trainee looking for a specialty.” Furthermore, Dr. Ammerman commented, “Its interesting, most often I draw inspiration not from a patient’s medical challenges but from learning about their lives outside our spine care relationship. If you take the time to develop meaningful relationship with your patients, you are lifted by their professional and family successes and hardships.”

Neel Anand, MD, Professor of Orthopaedic Surgery and Director of Spine Trauma at Cedars-Sinai Spine Center in Los Angeles told SpineUniverse, “The challenge of making the right clinical diagnosis, choosing the right patients, determining the right treatment plan and precise execution all elevate treating spinal disorders to the ultimate pinnacle.”

Dr. Anand expressedthankfulness for his patients—"I am inspired everyday by their perseverance and determination to beat the condition that afflicts them. I am inspired by their smiling faces, receiving a big hug when they come in for their follow-up, to hear their lives have significantly changed for the better because of what we did to treat them. It is hearing my patients discuss how excited they are to regain a life they once thought was lost forever, seeing them walking better, receiving pictures of them on hikes or making that international trip they dreamed about, but never thought possible. And what really tugs at my heartstrings is hearing their joy in describing how they are now able to play with their grandchildren. I thank my patients every day because they have impacted my life far more than I could ever impact theirs.”

Steven R. Garfin, MD, the Distinguished Professor and Chair of the Department of Orthopaedics at the University of California, San Diego (UCSD) related how he came to specialize in spine.

“I spent one year during my residency in the UCSD Orthopaedic Research Labs. It was a very productive time leading to many papers and presentations. I loved the excitement of being in an academic position. Nearing graduation I asked my Chair, Wayne Akeson, MD, what specialties he thought were the most challenging and least served academically. He pointed me to spine. At the time, there were three fellowships he thought were outstanding. I was FORTUNATE to be selected by Richard Rothman, MD, PhD, for his great fellowship. His focus on patient care, learning, and teaching set the stage for me. I was into spine from then on—and oh so glad. When done right, we can really help people.”

Gerard J. Girasole, MD, is an Orthopaedic Surgeon and Adjunct Clinical Professor at the Frank H. Netter MD School of Medicine at Quinnipiac University. Dr. Girasole told SpineUniverse, “From a very young age, I was always intrigued and interested not only to become a doctor but to become a surgeon. I worked in hospitals as a teenager, I even worked in doctor's offices seeing patients with the surgeons and going to the operating room to observe surgery. I felt that I was never happier than when being in an operating room and the amazement of the human body and was fascinated by the operative procedures.”

Furthermore, he stated, “When I was a resident, I was going to become an oncology surgeon, but I worked with neurosurgeons during my residency, and I became intrigued with the instrumentation, complexity of the surgery and the ability to make a real difference in someone's life by either correcting a deformity or neurological function. It is for this reason that the best field for me would be spinal disorders.”

How do Dr. Girasole’s patients inspire him? He answered, “As a spinal surgeon, I see patients who are suffering with significant morbidity, whether it is intractable leg or back pain that really affects their quality of life. A lot of these patients feel lost because they believe they will never regain normal functionality. I'm inspired by my patients who come back after surgery and tell me that I've given back their quality of life—which I think is no better a feeling than helping another person and giving them back what they cherish most.”

“I have been blessed to be touched by many patients, but one patient still resonates in my mind. She was a 58-year-old female with metastatic breast cancer. She required a very extensive operation, which is known as an anterior/posterior procedure to reconstruct her spine. Post-operatively, she could function and according to her, I gave back her quality of life, albeit for a short period of time. She was able to live a normal life, but unfortunately passed away from cancer. Before her death, she sent me a cherub with my name on it; the scars of her surgery are on the cherub’s wings. That cherub sits on my bookcase overlooking me, and I feel that it is an angel whom she has sent down to watch over me.”

Jeffrey A. Goldstein, MD, is an Orthopaedic Spine Surgeon, Chief of the Spine Service and Director of the Spine Fellowship program at NYU Langone Health. Dr. Goldstein expressed, “The surgical treatment of patients with disorders of the spine provides the opportunity to directly improve someone's quality of life. Surgery often allows a patient to return to their normal activities and live with less pain and greater function.”

How do Dr. Goldstein’s patients inspire him?“My patients regularly inspire me by focusing on their recovery, so they can return to their families, friends and jobs with great enthusiasm and feeling better.”

Richard D Guyer, MD, is Co-founder of the Texas Back Institute (TBI), Director of their Spine Fellowship Program and Co-director for the Center for Disc Replacement at TBI. Dr. Guyer’s career aspirations started early in life. “As a young boy I used follow my father, who was a general surgeon, around in the office and on house calls. At the age of 12, I assisted him on an emergency appendectomy on a weekend. I was amazed at his skill and compassion, how he treated his patients and the gratitude they had towards him. He was a wonderful role model and from the age of 6 on the only thing I ever wanted to do was to become a doctor.”

Fast forward to TBI. “I always enjoyed spine but was discouraged early on by one of my mentors, so I choose total joints. Shortly thereafter, I was approached by my two original partners, Stephen Hochschuler, MD, and Ralph Rashbaum, MD, to join them as a third partner to start Texas Back Institute. The catch was that I had to do a spine fellowship. So off I went to work with Leon Wiltse, MD, and Henry Bohlman, MD, and never looked back."

“Spine surgery was one of the last frontiers. Over the last 30+ years there has been so much expansion of the field not only into numerous sub-specialties, but also in the tremendous advancement of technology, including biologics, motion preservation, minimally invasive surgery, and robotics. It has been an exciting and challenging ride that keeps on going!!!”

How do Dr. Guyer’s patients inspire him? “The positive feedback, whether through kind words in a handwritten note or letter, home-baked cakes or cookies, or a handmade gift that I get from grateful patients who I helped get back to their normal life is the fuel that keeps me going. It is the ability to improve a patient’s quality of life that makes this such a wonderful profession and avocation! There are so many wonderful stories are equally important that there is not enough room or time to tell them all.”

James S. Harrop, MD, is Professor, Departments of Neurological and Orthopedic Surgery; Director, Division of Spine and Peripheral Nerve Surgery at Thomas Jefferson University, and Neurosurgery Director of the Delaware Valley Spinal Cord Injury Center.

How do Dr. Harrop’s patients inspire him? “I’m inspired by all my patients in that it is truly the greatest to watch them overcome and adapt from their disabilities. The group I am most impressed with are the spinal cord injury patients—whether the patient has a chronic cervical myelopathy or an acute traumatic injury. To see them fight and struggle to do things that most of us do daily and take for granted is truly amazing.”

“One particular patient I recently operated on was a congenitally blind individual. He lived independently and was a writer. He had a cervical myelopathy and lost his ability to read braille. Despite this, he was one of the most upbeat and positive individuals I have ever met. We decompressed his spinal cord, and quite amazingly, he had a full return of sensation in his fingers, which is somewhat atypical. For him, this was an exceptional recovery in that it allowed him to continue his employment as well as live independently.”

Reginald Q. Knight, MD, is an Orthopaedic Spine Surgeon, Vice President of Medical Affairs at AO Fox Memorial Hospital, and Director of the Bassett Spine Care Institute and Imogene Bassett Medical Center.

“Becoming a doctor was a decision that morphed over several years and the circumstance of timing. As a young chemistry major in the early seventies, a recognized disparity in healthcare demographics was being addressed by the recruitment of qualified students of “color." My first ambition was to become a pediatrician. However, during third-year clerkships, I was introduced to William Bunnell, MD and Robert B. Cady, MD, prominent pediatric orthopaedic surgeons in my cadre of inspirational mentor educators. They introduced me to orthopaedics and the care of children with spinal deformity. As my training progressed, the complexity of spinal mechanics, anatomic variety associated with spinal procedures and overall diversity of spinal pathology solidified my decision to choose spinal surgery as my career avocation.”

How do patients inspire Dr. Knight?“Patients are why we are here. While the evolution of healthcare continues to stress the patient-physician relationship, it is this relationship that keeps me practicing. There is no one story but a multitude of experiences that drive most physicians to bring their “A” game to work every day. The vast majority of our outcomes are positive and remembered fondly. On those occasions when outcomes are not as expected, a course of introspection and reflection guides future choices. Patients are more than a computer number or survey questionnaire. When we forget that, our profession becomes no more than another job and that is not what patients want or our profession deserves.”

Isador Lieberman, MD, is an Orthopaedic and Spine Surgeon at the Texas Back Institute’s Scoliosis and Spine Tumors Center. For Dr. Lieberman, it just made sense for him to become an orthopaedic surgeon as his father was a carpenter and his mother a seamstress. “Treating spine pathology is unique in that no two spine problems are the same. Every case requires individual planning and precise execution,” he stated.

When asked what inspires him, Dr. Lieberman replied, “Patients inspire me with their smiles and hugs. That is all I need.” Well, he is certainly not lacking inspiration! Besides his US-based practice, he frequently travels to Uganda to provide free treatment to people with different spinal deformities. In a round-about way, that is how Jamila, a 13-year-old girl came from Tanzania to Texas to be in Dr. Lieberman’s care. She lived with debilitating scoliosis for 10 years. “Her overall health, bone quality, stature—everything was hindered by scoliosis. Jamila couldn’t walk or even digest enough food for nutrition. The pain was close to being unbearable,” Dr. Lieberman explained. Now, after extensive surgery (two rods, 16 screws) the curve is gone, she’s 4 inches taller, gained self-confidence and looking forward to running without pain and playing soccer when she returns home.

Visit Dr. Lieberman’s Uganda Spine Surgery Mission’s website to see photos, video and read some amazing stories!

Lali Sekhon, MD, is a Neurosurgeon and Adjunct Associate Professor, Department of Physiology and Cell Biology, at the University of Nevada, School of Medicine in Reno and Las Vegas. He told SpineUniverse, “I only ever wanted to be a doctor. My father was a general practitioner (“GP”) and I used to sit in his waiting room and watch him bring patients out. They would be smiling. He would have a twinkle in his eye. I could see the trust and responsibility they put in him, and I aspired to be that person. To me being a doctor is a huge responsibility, and the fact people put their trust in us is a very privileged position.”

Furthermore, Dr. Sekhon told us, “In residency, I had planned to be a cerebrovascular surgeon. As I looked at all the subspecialties, I saw spine was relatively undeveloped. Indications were not clear. Tools were limited. Outcomes poor. I saw that this was a part of neurosurgery that needed the most work, and I felt would explode beyond everything else.”

“I trained with hooks, wires, iliac bone graft and Cloward fusions (Ralph Bingham Cloward, MD) and have been so happy to ride this wave from the start. What I’ve been privileged to be a part of is the growth and explosion of spine surgery encompassing technology, indications and outcomes. Few areas of medicine give us this experience in a compressed 20 years. In short, specializing in spine allowed me to make a big difference in a short period of time.”

How do patients inspire Dr. Sekhon? “Coping with adversity is always humbling. In my fifth year of practice, I vividly remember a young man 25-years of age who dived off a pier into shallow water and sustained a high cervical complete cord injury. He had multiple surgeries, spent months in ICU on a ventilator and eventually went to rehab. Over time, he started coming to my outpatient clinic. Each time he’d come in his wheelchair, only able to shrug his shoulders, driving his wheelchair with a joystick that he controlled with his nose. Each time I asked him how he was he’d say, “Great!" No matter how bad a day I had, his positivity cut through me. This man had every reason to be angry, bitter, depressed and to complain bitterly, yet he chose not to. Every time I saw him, I realized how trivial my own concerns were. He was a better man than I’d ever be in how he handled himself.”

Khoi D. Than, MD, is a Neurosurgeon and Assistant Professor in the Department of Neurological Surgery at Oregon Health & Science University. Dr. Than told SpineUniverse, “I love helping patients with spinal disorders in part because of the decision-making that goes into the treatment of each individual. It’s not just a matter of fixing problems I see on imaging; I ask myself, does the imaging explain the patient’s symptoms? Do I perform a big surgery or a small surgery? Do I approach the spine from the front, back, side, or multiple routes? Can I even fix the problem at all? The diverse thought processes that go into helping a patient with a spinal disorder—and seeing their good outcome after surgery makes my job rewarding and fun, day in and day out.”

How do Dr. Than’s patients inspire him? “My patients inspire me through their ‘will’ to get better. People who are suffering from spine pain want to improve their quality of life—they will participate in physical therapy, undergo spinal injections, quit smoking, lose weight, and even undergo surgery to alleviate their symptoms.”

“The road for patients with spinal deformity can be long. One patient comes to mind. She underwent a front-back procedure, then a multi-level foraminotomy when her leg started to become weak, then an extension of her fusion when the initial procedure didn’t heal. Finally, after three surgeries over a course of two years, she is free of back pain.”

Dwight Tyndall, MD, is an Orthopaedic Spine Surgeon at Orthopaedic Specialists of Northwest Indiana's Spine Care Specialists. Dr. Tyndall told SpineUniverse, “I chose to become a doctor because I love helping people, I was a bright student, and I was drawn to the sciences—those 3 things made medicine a natural fit for me.” Furthermore, he explained, “At the end of my orthopaedic surgery residency, I felt that I had mastered all the subspecialties—except spine. I found it most challenging, so I decided to pursue it as a career.”

How do Dr. Tyndall’s patients inspire him?“I’m inspired when someone comes to me with a complex issue, and I can solve their problem. Watching a person go from a sense of hopelessness to watching them function again, being able to go back to their activities, and to regain their life is so very gratifying to me.”

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