Blogging Again

Returning Home
Leslie K. Price

It has been nearly a month since I last blogged and for the month prior to that, had found myself with less time to devote to this pursuit than I would like.  In the ebb and flow of life-between the challenges of work, family, and personal needs-somethings rise up and others fall to the back by necessity.  Once the pause happened, I felt that I would only return when I felt I could potentially return to regular entries.  I am hopeful that I now can.  How did I feel when I wasn't immersed in the blogosphere?  I missed the outlet for the "connections" I made while seeing patients and carried on my day to day clinical practice.  I dearly missed writing and the reward that comes from completing a creative endeavor.  I felt I had set aside some good friends, even though these are friends I know only from their writing and their "profiles".  On some levels, I felt unburdened of the "deadlines" I had set for myself for writing and I realized (AGAIN) that the blog is for me-an outlet, a connection- and not an obligation!
So I return.  Hopefully stronger than before, with renewed vigor and interest.  I hope you are still out there reading...

All my Lovin'

To all my family and dear friends,

While Hallmark and Hershey's have tried to drag Valentine's Day over the edge (I won't even mention Victoria's Secret), I still think of today as a day to smile and give thanks for all those I love.  Today, I send out special love to one dear friend in particular-Glenda, this is for you.

Forgive me, I should have called sooner

There is no excuse, no rational cause

You were on my mind, I sensed you in need

And I always tell others-now, do it now!

I wish you were nearer, I would be of more use

I would love to bring you soup

Rub your back, brush your hair

Or just sit by quietly at your side

There are no words I know I can say

You have paid your dues twice and again and again

You deserve better after all you have given others

Just know we are here, will do all we can

Be proud of all you have done and will do

One has grown tall and will make you so overjoyed

Another has stood by your side, with love you share

And countless who have gazed at your historical visions

For me, I can say you no better friend there is

From days long ago in the lab to right now

We have shared our hopes, fears and struggles

I am honored to call you dear friend.

Edgar Tafel and Me

Edgar Tafel 1912-2011

I learned this week of the death of Edgar Tafel-a noted architect and also Frank Lloyd Wright (FLW) Fellow and Historian.  I am connected to Edgar because I live in the first house he ever designed and built (after he left the FLW Fellowship).  After we moved in to this unique and special home, we contacted Edgar who graciously came to visit us-beginning a friendship of many years.  Over a rainy-day lunch, he regaled us with talk of building this home for his parents, architectural history, stories of FLW, and his own personal history of loves, careers, and more.  Later, we had him return to deliver an aspiring lecture at our library on FLW followed by a reception in our backyard.  We also had the privilege of visiting him in his townhouse in NYC on several occasions.  Quite by chance, when we bought a small apartment in NYC, it was less than two blocks from his home, to which he had returned full-time.  I last saw him just a few weeks ago-stopping in on a whim while walking my dog.  Last week, I again passed his door with on a canine walk and realized he had died-I can't tell you how but I did.  I returned to my apartment and furiously "googled" him without finding any news.  But just days later, the obituaries appeared.  He was 98! He had lived long and large-seeing so much of modern architecture, art and music-all things he loved dearly.  While he is not a household name, his impact on how homes, places of worship, and college campuses are built will long outlive him.  His gracious and generous endowment to Cornell University will also assure his remarkable legacy.  Tonight I will say Kadish for Edgar Tafel.

The Albert House

First Presby Church NYC (Village)

Coming Soon

Been traveling and teaching for two weeks then the requisite hell week catching up on return but have some wonderful things to share and know that life has begun to return to a "normal" rhythm so the blogs will soon flow again.  Look for:
Travels with Mom I: Roots in Polish villages
Travels with Mom II: A Sobering Visit to Auschwitz-Birkenau
Return of the children: It's summer and the kids are back in town

Worldwide medical community: the beauty of coming together

MarianPlatz, Munich June 2010

Loss

Grief in Philadelphia

I saw him for the first time since
Had to be sad coming to where her light had formerly shone so bright
Too many memories crowding in
No place to hide
I knew the sadness in his eyes.

He asked if I had seen the art
I knew he needed to get away from the crowds
I took his arm and walked him through
His eyes missed Van Gogh, Matisse and more
Not as much as his heart missed her.

To my dear friend-if you read, know you are not alone and know too that it takes time and that I and others are here if you want us.

Winning with WINS

Just back from our neurosurgery meeting in Philadelphia.  The big news was our first every paperless meeting-everything was loaded onto an iTouch and I thought it was great and dug the "green" concept.  As usual, the highlight of the meeting was seeing my good friends and colleagues-particularly the women who have served as my close network for more than 25 years.

This year, WINS (Women in Neurosurgery) hosted Dr. Mary Sue Coleman, President of University Michigan who gave an inspiring talk on why diversity matters in college and beyond.  She has long been a proponent of this concept, being a driving force in her University taking affirmative action all the way to the Supreme Court.  What was most impressive, however, was how she used this theme as a foundation but then carefully and specifically related it to neurosurgery.  She also echoed the theme of Dr. Karin Muraszko's essay in Heart of a Lion, Hands of  Woman: What Women Neurosurgeons Do in stressing It Matters!!! 

Drs. Lauren Schwartz  and Susan Hemley

Drs. Ko, Nelson, Mazzolla and Zusman

Congratulations to all those involved in making this such an inspiring event.

Members and guests

It Doesn't Get any Better

After more than two years of soliciting contributions, writing, editing, re-writing, re-editing and then publishing, I am thrilled to announce that Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do (Donning Press) got an outstanding review in JAMA. I am including the entire review (it is short, no worries) along with the stunning painting by Dr. K. Ko (who contributed the art to the front of the book as well.
Books are still available through the AANS Marketplace.

Blogging for Fun

Have read a handful of posts lately apologizing for being "absent" from the blogosphere for one reason or another. Certainly there are individuals who blog for a living but otherwise I think our blogs should not bind us or add guilt to our lives (most of us already significantly juggle plenty of things to need that). It reminds me of all my friends and family who regularly swear they will start to keep a regular journal and start up very diligently (ofter just after January 1 or their birthday) only to see it fade away quickly because in the end, there were other things.
I have enjoyed my blog enormously and after a slow start did realize that making a commitment to regular entries was the only way to engender value and reward for me (and potentially my readers).  That strategy has worked well in providing both structure and limitation of guilt. But like the working mother who won't apologize to her children for working, I vow never to apologize for allowing other components of my life to take priority over blogging if that is necessary.
Hope you are all enjoying the remarkable spring that we are seeing here in New York (pictures to follow soon).

New Family Member

Friday, April 2, 2010 we welcomed a new addition to the family.  Zev arrived after nearly 5 1/2 hours of labor (awake at 5:15 am, left home 5:45 am, arrived back home 11:30 am).  He is just 8 weeks old, a bundle of energy and antics.  So far, the transition has been smooth.  He did cry nearly the entire car ride home but that is to be expected.  Big brother Ezra is very tolerant of his youthful energy and intrusions.  My husband and I are more tired than usual but holding up well.  As is always the case, we take far too many photos and think you all will enjoy them as much as we do...I will try not to overwhelm you with cuteness too often.

Mixed Musings

Everyone is busy. I make no excuses. Everyone has times when all the hats they must wear need attention at the same time.  This has been such a time for me.  The confluence of this week included a higher than usual surgical quota, a similar load of consults and office responsibilities, both kids home from college (one with a crisis of intense proportions), a dog having surgery and a new puppy on the way, and multiple regional and national executive board meetings while health care reform reached fever pitch (with no real relief from the SGR)!
Why should anyone care about what happens in my small orbit? The easy answer is, you don't and you shouldn't.  You all have your own challenges and probably don't have the time to waste reading a long diatribe.
But in the midst of this, I was struck again by a few things.

• Talking to a close colleague he said, "I am not trying to blow smoke up your a...but it has to be so much harder for you as a mother and full time neurosurgeon to deal with the challenges of kids" (this after a prolonged discussion about a number of clinical matters and then his own crisis kids!).  It is 2010 and yet being a mother is considered unique from being a parent and I have to shake my head and think, we've come a long way but...
• Being a parent is far  more difficult than being a neurosurgeon 
• During a crisis, trying to be a good parent can distract from the unending work of being a neurosurgeon
• My patients remain remarkably supportive of me as a person-respectful of my multi-dimensional needs (in fact, sometimes I sense they like me more because I am not JUST a neurosurgeon)
• Isolating myself as a doctor excluded from the socioeconomic aspects of medicine will never be fulfilling
• Thank goodness for dogs, their love is unconditional
• My husband is a saint, I couldn't be without him

Is there a lesson? Sure, always have a Plan B, always be seeking new opportunities, making new connections, exploring new avenues.

Frank Lloyd Wright: The present is the ever moving shadow that divides yesterday from tomorrow. In that lies hope.
Walt Disney: We keep moving forward, opening new doors, and doing new things, because we're curious and curiosity keeps leading us down new paths.


Coming soon: adorable puppy pictures!

Lost Friends

Recently, I and all of neurosurgery lost two friends.  No death is ever easy but some losses are felt more acutely and for me this is true for the deaths of both Robert Ojemann, MD and Ilona Quest.  

Robert Ojemann
I only had the honor and privilege of interacting with Dr. Ojemann on a few occasions.  He was the quintessential gentleman, scholar and teacher.  During my training, his name was up there in the stratosphere. He was a master surgeon, researcher and administrator; one of the few to hold the top position in nearly all of neurosurgery's national organizations.  So when I encountered him,  I was prepared to be "brushed aside"-quite the contrary.  He went out of his way to comment on a recent talk he had heard me give and to compliment me!  It was obvious that he was still keenly interested in all that was neurosurgery and held respect for those who worked seriously and tirelessly to move the specialty forward to better help our patients.  For all his dedication, hard work, and enormous success, I showed me honest respect that helped propel me forward in my career. What a great role model. We will all miss his wisdom, intelligence and honesty.
Ilona Quest
No one I know that ever met Ilona Quest, the lovely and gracious wife of Donald Quest, MD (past-AANS president, ABNS, RRC, Senior Society, Professor Columbia), ever walked away feeling anything less than cherished. She was an amazing woman who provided the foundation that allowed her husband to flourish and succeed as a world class neurosurgeon.  But Ilona was more than just the woman behind the great man. She worked tirelessly to enrich our meetings in a multitude of ways.  I firmly believe she was also a great force behind her husbands unfailing support for women entering neurosurgery (for which he was recognized with the coveted "Friends of WINS Award" (Friends of WINS Award).  It was a cruel twist of fate that she succumbed to a neurosurgical emergency.  I last saw her in New Orleans-we hugged and talked while Don performed his jazz on-stage.  I was again struck by her ability to recount details about my family who she had never met and talk about the state of my career.  She made me feel very special-that is a great gift.  My thoughts and prayers are with her family and friends. Tonight I said Kaddish for her.

Medicare and the Neurosurgeon

Congress and the President decided to give physicians and the American citizens a month reprieve from the 20% Medicare cuts proposed.  This is a battle that has been waged for the last decade with the SGR (sustainable growth rate) equation being the focus of much debate.  Most years, Congress realizes such a cut will end medicine as Americans have known it and finds a way to reverse the cuts, and if we are "lucky" give doctors a 0.5-2% raise (still well below the annual increased cost of doing business).  Increasingly, specialists such as neurosurgeons are finding it impossible to provide Medicare patients with services at the reimbursements provided.  A close colleague, Dr. Ed Kornel, was recently interviewed by CNN and provides a concise, cogent discussion of the issues.  I encourage all to watch this piece-this is an increasing problem in our health care system that impacts ALL of us: physicians, patients, business.  With an increasing percentage of Americans over 65, this is not a problem that will go away.  If you are not over 65, I bet you know someone (parent, aunt, uncle, friend) who is!  Dr. Kornel on CNN
Dr. Kornel can also be heard weekly on his own radio show talking about the spectrum of back problems and the politics of medicine. http://backtalkonair.com/ and can be followed on his blog ezrielkornelmd.blogspot.com

First Ladies of Neurosurgery: Karin Muraszko

Helicoptering: she introduced me to that phrase and I have since realized there are few that do it better!  Karin holds a special place within neurosurgery-she was the first woman in the US to gain the position of Chair with an RRC approved residency training program  at the University of Michigan.  http://www.med.umich.edu/opm/newspage/2004/neurosurgerychair.htm

Her journey there has been anything but easy but at every step of her enormously successful journey she has literally and figuratively "risen above" and in doing so, gained the ultimate advantage of "helicoptering", the ability to see the whole picture, to better understand how the little pieces come together as a whole, and to avoid getting mired in the minutae of the moment.http://www.icyou.com/topics/medical-fields/neurology/harder-brain-surgery+

While her list of accomplishments are many, I would like to comment specifically on one.  Karin has dedicated herself tirelessly to mentoring.  She has taken enormous amounts of time to guide, nurture, and assist more women than any other neurosurgeon (she also mentors men regularly but for better or worse, men have a surfeit of mentors available).  She has guided me through many difficult moments and I know she has done this for others.  Somehow, she always has the time to help with a difficult clinical problem, put a job decision in perspective, see an answer to an organizational dilemna. 

For more than 15 years she has also donated her time and resources to Project Shunt.

Detailed career highlights:
Graduated Yale, 1977
Graduated Columbia Medical School, 1981
President, Women in Neurosurgery (WINS), 1991
Associate Professor, 1996
Assistant Professor, University of Michigan Neurosurgery, 1990
Associate Professo, University fo Michigan Neurosurgery, 2004
Chair, Department of Neurosurgery (First woman in US), 2005
Society of NS, member 2005
Nina Starr Braunwald Award (AWS), 2005
ABNS, Director (First woman), 2008

Patients, patient families, women doctors, women surgeons, neurosurgery, the disadvantaged, the disabled-and more-all have benefitted from the dedication, compassion and expertise of this amazing First Lady of Neurosurgery!

More Outstanding Art

Dr. K Ko contributed the several pieces in addition to her fab art on the cover.  This is another favorite.

Friends and Colleagues

Where would we be without friends? And when you are a minority (of any kind for any reason) so small that you are really more just an isolated individual rather than anything that approaches a "group" then friends are even more critical.  I have benefitted enormously over the years from my connections to some of the pioneering women in neurosurgery.  We met during the earliest days of WINS (Women in Neurosurgery) and though we have never lived in the same cities, our friendships have been invaluable.  Now we all realize how so important these connections have been and that finding some time to relax together during our very hectic meetings is priceless. If there is one thing that has helped me succeed in neurosurgery, it has been these connections. You can't wipe the smiles from our faces after one of our engaging, enjoyable dinners out.