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Interview: There is an urgent need to increase the neurosurgery workforce — Dr V S Mehta

Dr V S Mehta is an eminent neurosurgeon and one of the few doctors who have received awards like the Padma Shree and the Life Time Achievement Award. Previously, he served as the head of neurosurgery and chief of the neurosciences centre at the All India Institute of Medical Sciences (AIIMS), New Delhi. Currently, he is director and chief of neurosciences at Paras Hospitals, Gurgaon.

Dr V S Mehta
Dr V S Mehta

Dr Mehta is an inspiration to many young doctors in the field of neurology and neurosurgery. In order to know more about him and keep the Indian doctors inspired, India Medical Times took an opportunity to interview this wonderful doctor. Here’s what we learned:

Doctor, everywhere I search for your name, I get information about your career as an eminent neurosurgeon, a Padma Shree awardee and now a life time achievement awardee! But can we start this interview by knowing a little more about you as a person, as a doctor? Like where you were born, where did you grow, what made you a doctor, why did you choose neurosurgery of all these specialties?

I was born in Bikaner, a district in Rajasthan. Since my father was on a transferrable job, my initial schooling happened in Ganganagar, Bhilwara and Udaipur and later was in Jaipur. Back in those years, Arts/Commerce and Medical were the only fields of choices to choose for higher education. I chose medical, it being a noble profession.

While studying medicine, I strived to work upon the field, which was neglected by others and achieve excellence in it. One such field was Neurosurgery. Owing to the high mortality and morbidity attached to the field, not many people opted for it as neurosurgery had gained a bad reputation. Therefore, I decided to pursue my study in the field and took admission in the department of neurosurgery at AIIMS. In 1982, I was appointed as a faculty in the department of neurosurgery at AIIMS even before completing my tenure of senior residency. Then, with regular promotions, I became professor of neurosurgery in 1992, head of the department in 1994 and chief of neurosciences in 2001 at AIIMS.

It was in 2006 that I took voluntary retirement and joined Paras Hospital, Gurgaon, where I was able to give among the private hospitals one of the best neurosciences department in Delhi/NCR (National Capital Region).

You’ve got a reputation across the world, what do you think is the state of neurosurgery in India?

Neurosurgery, as a field, has gained popularity in India in the recent times. Accordingly, neurosurgery also emerged as a specialty in the last few years. However, looking at the size of the country and population, the number of neurosurgeons is very less when compared to that in developed countries. I feel, neurosurgery, as a field, offers a lot of scope and opportunity for development and exploration. There is a need for medical professionals to incline their interest towards the field and choose it for their expertise. Today, the status of neurosurgery in many metro cities is comparable to any of the best centres in the West; however, most of small towns or villages are still devoid of adequate neurological facilities.

There is a young medical student who just finished his residency unaware of which specialty to choose. There is another student who has been aspiring to take neurology or neurosurgery. As a senior doctor what would be your advice to them?

While it is very important for a student to choose the field of his/her interest it is more important to excel in that field. To talk about students willing to take up neurology, I would suggest that the field is still unexplored and requires full time dedication to achieve excellence. Therefore, they should select for the field only if they are ready to put in that much of effort and dedication.

Tell us about your research works in this field. What are the scopes of research in neurology in future?

Neuroscience offers a wide scope for more research and development. While the present technological advancements have given us a better understanding of neurological diseases and effective treatments, a lot more needs to be done. However, the first requirement is increase in neurology workforce as well as more and more research in the field to know more about the specialty, which is still not known or not well understood.

As far as my research work or my specialization is concerned, the principle has been to develop the field where others are not doing it. Some of these fields are surgery for brachial plexus injuries, surgery for giant intracranial aneurysm, brainstem gliomas, and insular gliomas. Most neurosurgeons avoid operating on these lesions, where I have been able to produce good result.

Diagnostics and technology in the field of neurosurgery, what’s your opinion about them? What are the latest techniques available?

There has been significant advancement in diagnostics and technology in the field of neurosurgery. These developments have helped in getting a better understanding of the brain and its functioning as compared to in the past. However, there remains a lot of scope and many aspects of brain yet to be understood. Although, there are researches going on all over the world in this regard, we expect many more advances in technology and diagnostics.

To name some of the diagnostic equipment which have changed the understanding of the brain and improved the surgical results includes CT Scan, MRI with facilities of functional MRI and Tractography, DSA machines; among the technological advancement which has improved the surgical results includes latest microscopes with the facilities of ALA, image guidance etc.

There has been a common notion among general public that if a disease or injury involves the brain, you can start counting your days. Has the scenario changed now?

This is something of past, I would say. With the help of the advancement in diagnostics and technology, there has been an improvement in identifying the diseases much before they can cause harm and affect the body; while operating on brain normally one should not develop any new neurological deficits. However, the fact remains that in the case of permanent damage of a brain cell, none of the latest technology can revive it. Hence, we insist on early diagnosis so that we can prevent the permanent damage.

Therefore, it becomes the responsibility of the neurologist and neurosurgeon to use these advancements in diagnostics and technology to provide appropriate treatment to the patient well in time.

If there is some neurological lesions identified by a general physician or a duty doctor, what are the steps that the doctor is supposed to do before referring to a neurosurgeon?

In such a case, it is advisable for the doctor to give the patient symptomatic treatment where the medicines and cures would provide ease from the symptoms, however, would not cure the cause. In order to cure the cause, the general physician should immediately refer the patient to a neurosurgeon.

How did you feel when you received the Padma Shree and the Life Time Achievement Award?

The feeling was very overwhelming. In my life, I have strived to achieve excellence and have worked to my best of the ability to attain it. I suppose, this is what everybody wants. When I took neurology, I wished to attain the best in the field. Receiving Padma Shree and Lifetime Achievement Award was the honour that was bestowed on me for my efforts and hard work. Additionally, the rewards also remind me of my responsibility that I have as a neurosurgeon.

Are neurosurgery and psychiatry related to each other? What’s your opinion?

The only term in which neurosurgery and psychiatry are related is that both the fields deal with the brain. Besides, both of them are completely different. Despite dealing with brain, both the fields have entirely different approach. While neurologists focus on brain disorders and diseases such as stroke, multiple sclerosis, Parkinson’s and other, psychiatrists treat for abnormalities such as disorders of mood and thought associated with no physical signs found in the neurological examination and issues such as schizophrenia, depression, anxiety disorders and others whereas a neurosurgeon deals with surgical aspects of brain, spine, peripheral cases including trauma.

How do you think the children with the cerebral palsy, mental retardation, microcephaly and similar conditions should be managed?

It is very unfortunate to see children with conditions such as cerebral palsy, mental retardation and microcephaly. It is beyond our capacity to even understand the pain and difficulty they suffer from. Since these conditions separate them from the rest, such children demand more attention, care and alertness.

These problems are complex in nature and are developmental, therefore, it is very essential to ensure that they receive all the necessary treatments, resources, services and supports required to thrive. Parents and guardians should be attentive enough to notice the house and vehicle modification that may be required in some cases.

It is important to ensure that such children are not bereft of basics that are sustenance, shelter, security, stability, family, education and health.

What’s your message to our readers and all the young doctors out there?

India is suffering from a dearth of medical professionals. Currently, there is only one doctor for every 1,700 people, which is much below the criteria set of one doctor against 1,000 people set by the WHO. Therefore, we need many more doctors and medical professionals, we need them to be dedicated.

While any student can take up different fields of medicines, neurology is still neglected due to the complexities involved. However, it is important to understand that the field requires more participation for more exploration. Only more exploration would make the complexities simpler. However, to begin with, there is an urgent need to increase the neurology/neurosurgery workforce.

by Usha Nandini

One Comment

  1. Dr Rakesh Gupta Dr Rakesh Gupta Saturday, April 2, 2016

    I agree with you Dr. Mehta. Neurosurgery requires lot of hard work, sincerety and dedication .
    Neurosurgeon now have to remain updated about the newer developments.

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