Shadowing Practice: Professional Interview: Dr. Gregory Zipfel & Dr. Chad Washington | Neurosurgery Insights - Learn English Speaking with Video

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Afternoon.

It's good to be here.

I'm Chad Washington.

I'm the Chair of the Department of Neurosurgery at the University of Mississippi Medical Center in Jackson, Mississippi, and I'm here today with Dr. Greg Zipfel, one of my good friends, who's the current Ralph G.

Dacey Distinguished Chair of Neurosurgery at Washington University in St. Louis.

Greg, great to be here.

Thanks for joining today for this interview for the AANS.

Thanks for doing this for me, Chad.

I appreciate it, and welcome back to St. Louis.

Good to be here.

Greg, so you're from Peoria, Illinois, went to the University of Illinois,

then transitioned to Northwestern University for medical school, and then the University of Florida for residency,

and then fellowship at Miami, correct?

And then when you did a, during your residency though, you had a connection with Washute and a fellowship in research, correct?

Yeah.

So basically I'm an Illinois Midwest guy at heart.

I grew up in Peoria, Illinois, and my dad grew up in a tiny, tiny town in Southern Illinois.

And so my entire life was kind of in those two spaces.

and I went to University of Illinois for undergrad and Northwestern for medical school.

So I was definitely an Illinois guy.

And then I kind of broke out for residency at the University of Florida in Gainesville and trained under Dr. Roden, Dr. Day, and Dr. Friedman.

And those were what turned out to be almost about eight wonderful years.

I met my wife there and made some really great friends and thought I got wonderful training.

During residency, though, I really got turned on to the idea of pursuing an academic career,

and in particular, a laboratory research career.

And my area of interest at the time, and still is, is vascular.

And it just turns out

that the options for me at the University of Florida at the time really didn't seem to be there.

And I got great advice from Dr. Day, one of my mentors, and another mentor who was actually a fellow at the time,

Dr. Dong Kim, to start looking outside of Gainesville and look for just the best lab,

best world -class experience in terms of research that I could find.

And that landed me here at Washington University in St. Louis in the Department of Neurology, actually, with the chair at the time,

Dennis Choi, who at the time was just world renowned for his work with ischemic brain injury, pathophysiology, excitotoxicity.

And so I joined that lab in 1998 and was here for two years, and I did peer research for two years.

I didn't touch the OR.

I went to neurosurgery conferences and actually opened some doors with Dr. Dacey, who was the chair at the time,

and a few other faculty and residents that I got to know in the neurosurgery department.

But primarily, I was doing research in neurology.

Then I went back to finish my clinical training at University of Florida,

did a year fellowship, open vascular and skull base fellowship with Dr. Morcos and Dr. Haros at the University of Miami.

And then I started looking for jobs.

And then this job here came open.

And for me, it was a dream job for me.

Close to my home, world -class institution, strong history of surgeons, scientists, and academics, and a wonderful chair,

Dr. Dacey, who recruited me back.

So it was a very natural fit for me to come back here to start my my faculty career

so growing up in peoria um how was

that transition from peoria illinois to neurosurgery what loop is there a natural evolution to

that how was it no so my parents were teachers um

and i don't have anybody in my family who's a doctor

or really you know beyond college uh kind of advanced degrees

and things of that nature that's just not part of my family history, really.

And so what's interesting is that I ultimately went into medicine.

I have two sisters.

One became a nurse anesthetist and the other one became a speech pathologist.

So despite no medicine in our family history, all three of us wound up in medicine, basically in healthcare.

And we have talked about that.

And I think it really related back probably mostly to my mom, who I remember sitting us down in front of PBS shows,

you know, about medicine or healthcare or surgery or,

you know, she just had an interest in medicine or interest in science that she exposed us to.

And then my grade school turned out, they were serious about science fairs and things like that.

And I think those two influences got me thinking about science.

But to be honest, it's a long road, as you know.

And at that time in my life, I just was not at all prepared or thinking that I was kind of up for that type of length of training.

So I started out in engineering at the University of Illinois, well -known engineering school, and I was good at math and science.

Thought maybe that might be a route for me that would not require as many years of training.

But after two years of that, I realized that that was just not my passion.

And I made a commitment to go to medical school, then changed my major and went pre -med and just went took that route.

And then the same thing happened to me in medical school.

I got to medical school.

I was drawn to cardiac surgery and I was drawn to neurosurgery.

But it was the length of training

that I just hadn't had any kind of context for with my family and personal relationships.

So that intimidated me.

And I spent my first two years looking for something else that I might like that was shorter in terms of training.

But then after a couple of years, a lot of people started making these decisions.

And I just kind of got kind of indoctrinated to the culture of subspecialty surgical training.

And I made a commitment to neurosurgery.

And that was off to the races then.

I really, once I made that decision, I realized I want to get to the best program to get trained well.

And I want to be competitive to get the best job coming out of training, which I knew for me when I wanted to be at a university setting, mainly because I felt like it was,

that's where the best go is to the university.

The research for me was not on my mind

that much until I started understanding what it meant to get a university neurosurgery job.

And then I started pursuing the research at that point.

So you went from avoiding the lengthy training to neurosurgery plus extra research time plus skull -based fellowship.

Yes.

So my My co -resident at the time, Kelly Foote, who's a very well -known functional neurosurgeon at the University of Florida.

So he and I were co -residents.

We started out together as co -residents.

He finished a couple years ahead of me because he didn't do this extra stuff that I did.

But my parting gift when I finally finished was a flask that said PGY -9.

So I had nine years of training before I started as a faculty member.

So you decided to neurosurgery.

Yeah.

You committed to the training um you know there's any number

of specialties within neurosurgery skull base itself there are people who commit to their lives

and that's yeah that's what they do yeah

but you decided to do strep of vascular skull base plus run a lab dedicated to strep of acid

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so where in your training did you make

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that decision like okay i've decided neurosurgery

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but it's going to be this very particular aspect of neurosurgery

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so that was easy for me um because i trained University of Florida and Art Day was like my, you know, I wanted a career like Art Day.

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I wanted to be Art Day.

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And he was a very well -known, open vascular, you know, highly skilled microsurgeon who also did some skull base and some other things.

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But I wanted to be like him.

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He was the best, from my perspective, the best microsurgeon at the University of Florida, nationally known, making contributions to the specialty,

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advancing the surgical management of aneurysms, and I really wanted to be like him.

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So PGY2, met him, got to know him, was on his service, and I really wanted to be a vascular neurosurgeon.

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And I also, like I said earlier, really wanted to land or be competitive for a top job at a university.

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And by then, I had now understood through him, through Dong Kim, who was his fellow, and through some other mentors at at Florida,

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that for that type of job, oftentimes that means getting deep into research, which can really open some doors.

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And so that's when I really started thinking about research as a component of my career.

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I wanted to do vascular stroke -oriented research.

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That led me to the decision to leave Florida to go to Washington University with this world -winning scientist, Dennis Joy.

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And so I got into it from that perspective.

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And then it turns out I really like research.

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And I really got turned on to it during those two years.

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I met a great postdoc fellow, a neurologist named Jin Mu Lee at the time.

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And it turns out our careers have kind of intertwined over the years since that initial introduction.

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And he currently is the chair of neurology at Washington University while I'm the chair of neurosurgery at Washington University.

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So that started during those two formative years of research.

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But I just loved it.

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I thought the creativity of it, the discovery of something new, the possibility that perhaps we could stumble upon something

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that might actually be leveraged into new therapy to help patients to a better degree than we currently had.

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All that really, really, you know, kind of rang true to me and something I wanted to incorporate into my career long term.

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So I went back to training at University of Florida to finish up my clinical training.

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But then I started to make some decisions.

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And one of those decisions, because at this time of vascular neurosurgeons, especially, people were just starting to get into endovascular.

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And so I had to make a decision at

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that point whether I was going to get endovascularly trained as well as open vascular trained.

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And so I had lots of discussions with my mentors there.

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And ultimately, I felt that what I was being told

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and what I felt internally was that trying to be a really top -tier open vascular surgeon,

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top -tier endovascular neurosurgeon, and run a serious NIH -funded laboratory.

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Those are three distinct skill sets in some way.

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And trying to do all three of those things really well, I was told and I really believed at the time that that would be very difficult.

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And so I chose to do open vascular and lab

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and thinking that I could tackle two of those three things and do that very well.

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So that was a choice I made a long time ago, and I think it served me really, really well.

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But nowadays, you look around and there are people who are open vascular trained, endovascular trained, and can do serious research like you have and others.

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So I'm not sure if that was accurate at the time, but that was my thinking when I made that decision.

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So I kind of made a conscious decision not to do endovascular, to make sure my, really to make sure the lab became well,

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you know, well -founded and would prosper for years to come.

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So that was just a conscious decision I made at the time.

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So you spoke about Dr. Day.

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Yeah.

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But over the course of your career, you've either been trained or led by, I mean, a number of giants within the field.

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Dr. Day, Dr. Rogan, Dr. Friedman, Dr. Morcos, Dr. Harris, Dr. Dacey.

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Yeah.

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So you want to take an opportunity

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and a little bit of time to talk about those mentorships and how they impacted your career over,

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you know, from young resident to new faculty now as the chair of a department and leader of a, you know, top tier program in the country.

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Sure.

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Yeah.

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Well, I just feel blessed, one, to have the kind of mentorship that I've had.

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I have found in my career, especially when I was a program director and as a chair,

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there are certain people, trainees or junior faculty who are really drawn to mentors,

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and they really seek it out and something that they really embrace.

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And there's another small group of residents and some junior faculty who, no matter what you do, they don't seem to recognize the importance of mentorship.

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And then there's another group in the middle where, I think they understand it, but if you can foster it and prioritize it within your department or in your residency,

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I think they will take it seriously.

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But undeniably, mentors will pave the way for you.

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You will make less mistakes and you'll make better decisions if you really lean into mentorship.

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And I just, for whatever it is inside me, I've always leaned into it.

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So for me, my really, in neurosurgeon, my first real true mentor was Art Day for sure.

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You know, I wanted to be like him.

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He took me under his wing.

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He allowed me to use his office, you know, when I didn't, you know, when the resident, as a resident, I didn't have an office and needed to work on projects.

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He had, he and his wife, Dana, were wonderful about having residents over to his house.

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And you just really felt like you were part of his life inside and outside of neurosurgery.

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That meant something.

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It really meant, you know, like I was accepted in some sort of way.

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And then he was a tremendous, you know, surgical mentor.

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And then he was really had a lot of forethought into what I might need to get research training

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so I could do what I wanted to do long time

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and supported my decision to leave Gainesville for two years and seek research opportunities elsewhere, which I really am indebted to him for that.

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And lastly, and I've told him this, I've mentioned this in numerous scenarios when I talk about how to be successful as a surgeon scientist,

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he also allowed me to recognize or impressed upon me the need to recognize that early in your career,

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you really need to focus your clinical practice into a modest but focused practice on your area of expertise,

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for me, vascular, to free up time

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so you could be successful as a scientist and running a lab

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and so and you need to make

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that decision early as early as possible in my mind

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and be emotionally ready so

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when you become a junior faculty you can make strategic decisions to to be successful in

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that area what does

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that mean well you go through nine years of training for me most seven

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or eight years you really want to operate you feel like you've put a lot of time

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and effort into learning the skills to having developing that skill set

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and you want to apply it you want to you know and want to take care of patients.

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And I think that's good.

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But early on in your research career, modest, focused practice on an area

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that you're going to really kind of become known in would be the advice I would give, the advice I was given by Dr. Day.

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And he would say things like, you know, once you develop a clinical practice, it takes on a life of its own.

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So early on, you need to make strategic decisions and say no and do things so you can create that time.

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So when I started as faculty, I was prepared for that emotionally to say no

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and accept a smaller footprint in terms of my surgical practice

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and accept that really probably I'd make a little less money early on as I got things established from my academic career.

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And I really credit Dr. Day a lot for that.

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In addition to Dr. Day at Florida, I was very much influenced by Don Kim, who was his fellow and had become a long -term friend of mine, because he really took me under his wing as well

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and helped me make these decisions about what to do from a research perspective.

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And I always looked up to Dr. Roten, who had an amazing influence at Florida and on me,

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attention to detail, deep understanding of microsurgical anatomy, caring and empathy for his patients that I like to,

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you know, take forward in terms of my own clinical practice.

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And Dr. Friedman, who really, really cares deeply about his residents at the time when I was in training and to this day.

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And, you know, in terms of hardworking, doing the right thing, trying to do the right thing for his patients and for his people at all times, it really meant a lot to me.

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So that kind of combination of mentors led by Dr. day was really impactful.

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Then I had a wonderful experience this one year at Miami.

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I kind of went there in my mind to hone my skills

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and polish what I had learned as an open vascular surgeon at Florida.

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And I got a lot more than that.

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I got that, but I got way more than that,

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especially from Dr. Haros, who really was kind of an inspirational kind of academic in the truest sense of the word.

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And I really felt like his intellectual honesty and his approach to complications,

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his approach to mentorship and dedication to his residence and training was just laudable.

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And I kind of came away from that like, wow, I'd like to incorporate that aspect into my career.

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And Jacques Morgos is just a wonderful, wonderful man, an unbelievable technical surgeon.

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And I learned just a ton of skull base, a lot of skull base sent some basket from him that I just,

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to this day, I utilize as I'm operating and as I'm taking care of patients.

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And he is another one who was just an attention to microsurgical anatomy

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and detail and making an operation perfect so the patient can do, has the best chance of doing well.

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So I took that away.

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So that was my training mentorship group.

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A lot of great influences that I was lucky to have.

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And then I landed at WashU with, you know, what turned out to be the most impactful mentor in my life, Dr. Dacey, who, as you know,

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since he trained here, is an amazing man, true academic, dedicated to his residency,

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dedicated to the department, dedicated to St. Louis and Washington University.

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And I just wanted to make him proud.

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And, you know, I first got here, I remember, like I wanted to be in my office before he got here

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and I didn't want to leave my office until he had already left

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because I wanted to because I really wanted him to think

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that I was working hard taking this wonderful opportunity he gave me

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and and making good on the promise I made

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that I was going to make something of myself and and

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and contribute to you know the academic environment here at wash

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you you you get here to wash you you're sort of tasked with starting the lab getting it up

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and going um you know developing your practice uh in skull base and vascular

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oh over that you know a time frame of from where you first got here until now of becoming the chair

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is there a moment to where you you felt

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that transition of this is my my goal or was it something

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that you had started with from the beginning of like this was your aspiration

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or did you evolve into i want to be the chair of washing

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or surgery after you know this experience is there anything

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that led you to yeah i i would say that um when i first got here i just wanted to you know, take good care of patients,

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do a good job as an open vascular surgeon.

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I really wanted to get my lab going and, you know, and get that off the ground and have a chance of success for a long -term scientific career.

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I mean, early on the first couple of years, I was mainly focused on that.

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After that started going fairly well, I started really.. thinking, well, what do I wanna do long -term?

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And being a professor and chair had been kind of ingrained in me by many, but especially Dr. Dacey as kind of,

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you know, the pinnacle in some ways of an academic career for some people

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and certainly for Ralph and something I took to heart and ultimately became a goal of mine early on in my career.

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I never dreamed of being the chair at Wash U, frankly.

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I was hoping that I would be successful enough

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that i could get a chair job anywhere um

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and um maybe a place that you know was good

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and i could make it better or maybe maybe even make it great um

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but certainly didn't think that i would be the kind of person

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that would be competitive for what i consider one of the top jobs in the country

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until i got into about year 12

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or 13 year of my faculty time here and then

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that was a time where dr daisy's horizon in terms of

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when he was going to step down started to become clear you know and you know, it was two or three years away.

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And, and, um, I had interviewed for a few chair jobs and, and had turned one down.

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And, um, and then I kind of realized maybe I, maybe, maybe I could become the chair at WashU.

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And so I just kind of at that point just said, you know what, I'm, I'm not looking anywhere else.

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I'll play my, my cards and, uh, and see how it goes.

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And so I just stopped looking anywhere else and, and put my head down and prepared for, you know, when Ralph was going to step down

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and to be the best version of myself in hopes that I could be competitive for the washer chair job.

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And it worked out.

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And certainly that wasn't a design in any way when I first got here, that's for sure.

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Over that time period, you know, so obviously congratulations on becoming chair.

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That's a remarkable, you know, achievement for you.

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I think it's great for the department.

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But over that time period, are there some other accomplishments that you're, you know, proud of that you, that you see as moments in,

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um, your early practice or later on to the, or solidified you as a clinician, solidified you as a researcher?

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So kind of, you know, things in my career where I really felt proud or something I accomplished.

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Um, um, like you have an R01.

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Yeah.

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I mean, I think when I, when I, yeah, yeah, I got a K award in my, in my um at the end of my first year

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that was a proud moment um

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when i got my first r01 my first independent uh nh investigator award

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that was a proud moment um i think you know i think

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when i was promoted from assistant to associate professor with tenure that was a proud moment

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um when i became the uh the chair of the cv section

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which i put a lot of time

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and effort into for a number of years i was really proud of

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that um well over the course of

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while i was here yeah you we transitioned the department now

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in terms of the program director from oh yeah to you yeah

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which was a big deal at the time because he had been the program director

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yeah um and i know at the time um at least on their appearance you appeared very proud of that Yeah.

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Well, that was wonderful.

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And I think it gets back to my parents being teachers and loving that part of my job.

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And yeah, I would say Ralph was very incredibly open and understanding that that's something that I,

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you know, kind of aspired to.

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And I don't think it was something natural for him to give up, frankly, where he kind of grew up in a time where you're the professor chair and program director, like that was a natural thing.

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And lots of people did that.

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You know, when things evolved, the program got bigger and more complex, more rules and things.

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And so adding me in as an associate program director, I think, was a great opportunity for me.

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And then I think once I got into that role, I think he saw that I could bring some things to the table.

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And eventually he did ask me to be the program director.

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And that was great.

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In fact, I mean, the way I think of my career, I think from operating on a patient is great, and I feel wonderful, and you do a great operation,

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they come through it, they're grateful, they get back to their lives, and that brings immediate satisfaction every time you do it.

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It just feels great.

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But for me, I really wanted to do more than have that immediate satisfaction.

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I wanted to have broader impact beyond, you know, what I was doing for each patient that I took care of.

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And for me, I did that through science and I did

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that through being the program director now the chair

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but at the time science and the program director

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and I like building programs and I like doing science

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and I like discovering and trying to implement new things in the clinic.

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But if you ask me what I'm most proud of, it's really about when I was a residency program director

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and the people that we trained and the careers that they have gone on to have, they treat patients for 30 or 40 years after they leave here.

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And to me, that's broad impact and something I'm super proud of.

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And now as chair, you know, something similar, I still feel that pride with the residents, but I also feel that with the faculty and watching their careers will blossom in the contributions they make.

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Again, that's a way to have broad impact.

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And when you couple that with the immediate satisfaction of taking good care of patients, it's a wonderful life, it really is.

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So for the people that you're training and other young neurosurgeons,

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why would you suggest that they get involved in organized neurosurgery?

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Why is that important? and what's that impact on you in your career?

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Well, it gets back to what we were just talking about where broader impact.

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And you got to find out what you're passionate about, what you're good at.

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And not everybody wants to be a scientist or a translational researcher.

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Not everybody has the skill set to be certain things.

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But I think a fair number of people, one way you can have broader impact,

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one way you can contribute to your field that most of us are super passionate about is through organized neurosurgery.

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And so for me, getting involved there was an opportunity to have broader impact.

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And then as I got deeper into it and I got more senior in my career, I realized it's not only broader impact,

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but it's a way I feel like I can give back to a specialty that has been wonderful to me.

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So I view organized neurosurgery as a way to have a broad impact, but also how to give back to your specialty in a meaningful way.

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So I'll just mention two things from the give back perspective that I'm particularly proud of that I'm involved with that,

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I mean, I just absolutely love it.

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And that's the role I play with helping lead the K -12 career development program nationally for junior faculty.

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It's an NIH -supported grant.

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It's in its 12th year of existence.

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And I've been in leadership of it over the past seven and I'm the contact PI for it now.

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And we're absolutely dedicated to helping junior faculty achieve their goals of becoming independent investigators.

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And every time someone who is a scholar through that program gets an R01 or gets a new, you know, independent award from NIH and they email me

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and let me know that the K -12 program had something to do with it.

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I mean, those are some of the best days, you know, in my professional life is seeing people prosper like that.

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And so I feel like that's a way that I can help give back to

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organized neurosurgery or to academic neurosurgery to help the next generation achieve.

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Similarly, there's a program through the American Academy of Neurological Surgeons called the Emerging Investigator Program,

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EIP, Academy Emerging Investigative Program.

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And that was started by a group of us who were involved with the K -12, but realized only three to four people get the K -12 each year.

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And there's a bigger group of people who really can do this and would probably benefit from some mentoring and some guidance.

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So the Academy developed this new program, this Emerging Investigator Program, to help that group of people.

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And so it's a two -year mentoring program.

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I run it.

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And we partner established investigators with junior faculty.

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It's a two -year mentoring program.

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And the same thing, you know, getting emails from an emerging investigator scholar who gets their first R01 is just some of the best,

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you know, the best days of my professional life to see that kind of thing.

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And again, you know, feeling like I had a little bit of an impact on someone's success means a lot.

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But I really feel like through those two programs, Other things, but those two programs in particular, I feel like I'm giving back,

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you know, and helping the field prosper for years to come, I hope.

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So you've been a champion of neurosurgical research and research being a component of training programs.

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But I think you just recently saw a paper that you authored about the decline in K awards, particularly in cerebrovascular neurosurgery.

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So any thoughts on that?

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And then in general, the future of neurosurgery and what do you see as the potential barriers to redirecting that?

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And what would you like to see happen?

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Sure.

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Well, when you take the biggest, broadest view of academic neurosurgery and science coming from neurosurgery departments

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or from neurosurgeons we're doing great we are doing great we

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have over the last five to ten years have had a

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pace of growth of nih funding as a barometer of overall success

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and contribution from the science perspective than the neurosurgery has ever had

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and we're outpacing all other surgical specialties and most other medical specialties over

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that period of time so neurosurgery really is doing outstanding in terms of growth of research and academics.

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And I feel really good about that.

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There's lots of reasons for that.

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Brain initiatives, advancement of NIH funding, and other things.

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But part of it is some of this infrastructure

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that over the last 10 years has been developed by organized neurosurgery in partnership with NIH.

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That's the K -12 career development award I mentioned, or career development program, the Academy Emerging Investigator Program.

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But it turns out the NIH has an R25 program to support neurosurgery residents.

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The Society of Neurological Surgeons now has a program called NSTP,

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Neurosurgeon Scientist Training Program, which is meant to help mentor and provide some funding for neurosurgery residents who are pursuing research careers.

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The spine section led by Zach Ray, one of our faculty here,

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has created an emerging investigator program specific for spine surgeons to get more spine surgeons doing federally funded rigorous science.

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And that community, all those programs have developed in the last really 10 to 12 years.

384

I think that has had some role in why neurosurgery as a field is doing so well in academics.

385

And that's because the field of organized neurosurgery has invested in programs to help develop new investigators over time.

386

And when you talk to people who came off at a time where they didn't have these programs, I was one of them, but even, you know, but others,

387

we just didn't have those kinds of mechanisms that this day and age we do have.

388

And I think that bodes well for especially long -term.

389

Now, the one part of your question was about vascular neurosurgery in particular, and as a vascular neurosurgeon yourself, and me as a vascular neurosurgeon,

390

I mean, I'm particularly interested and a little concerned about where that particular area of neurosurgery is going.

391

So a group of us, Bill Mack, who just now is the chair of USC, myself and a few others,

392

we looked at this and really came from a K -12 retreat where we were noticing

393

that a lot of tumor surgeons doing well academically, a lot of functional neurosurgeons doing well academically.

394

Turns out pediatrics is starting to do more and more in that area as well.

395

But we, as vascular neurosurgeons, were noticing that we didn't see as many vascular grants.

396

We didn't see as many neurosurgeons who were vascular neurosurgeons, you know, doing research.

397

So we did a little project to examine that and determine if our impressions were correct.

398

And it turns out they, in part they were, in part they weren't.

399

So it turns out when you look at vascular neurosurgery as a whole, again, we're doing really well with grants,

400

but it tends to be senior people who are doing well with grants and clinical trials and things like that.

401

But when you look at those who are applying for K awards, who are applying for NREF awards, that's where we saw softness,

402

where the newer generation in

403

that timeframe of their careers didn't seem to be putting in those grants nor getting those grants like they had,

404

you know, that was present earlier.

405

And we had some ideas on why that might be.

406

I mean, I think in part is nowadays to be a vascular neurosurgeon, you got to do both open and endovascular.

407

So you have two skill sets you have to develop and

408

that can be taxing and may take your focus away from research.

409

For example, as you know, as an endovascular neurosurgeon, thrombectomy call for large vessel occlusion stroke is a true emergency

410

and it's a growing burden it's an amazing opportunity to change people's lives

411

but it also is taxing on you personally and professionally we wonder

412

if that is impacting people's ability to also spend time with research and

413

so we did the paper to try to examine it we

414

saw we saw some softness we've talked to leaders of the CV section

415

and in other organizations of vascular neurosurgeons to bring this to their attention.

416

And they're starting to respond.

417

CV section now has, I don't remember the title of it,

418

but they have a specific grant mechanism for junior investigators who are vascular to help catalyze their academic careers.

419

And I think by shining a light on something

420

and is a way that we can influence it to make sure that vascular neurosurgeons remain true to science,

421

because that we all know that's an important part of how you can improve care for the future is

422

if you do the fundamental signs now um in your training

423

um i think at florida is where you met your wife married yeah so Tell us about the impact of your family,

424

and as we all know as neurosurgeons, there's another group of people who support us through our careers.

425

Yeah, so Mary Jo has been unbelievably supportive during all this.

426

We met when I was a resident at the University of Florida, and she was a medical student.

427

Turns out at Florida, if you are a neurology or neurosurgery resident and you're off service, you TA the neuroscience class.

428

And she was in that class.

429

And so that's where we met.

430

I met January of 1998, six months before I left Florida to go to come here to do research for two years.

431

And so I didn't tell her that originally until a couple of months into dating.

432

And then I told her and then we were apart for two years, which is a little hard.

433

But, you know, it either makes you stronger or not.

434

And for us, it made us stronger.

435

And we got engaged in the Forest Park here in St. Louis.

436

And she's been an amazing partner in life and extremely supportive of all my endeavors.

437

And now when we left here, I had a fellowship, research fellowship, and went back to Gainesville.

438

I don't think either of us really dreamed that we were coming back.

439

But we had the opportunity to come back.

440

And probably not her first choice as a Florida one and used to the beach and the sun to come to Midwest,

441

but she went with it and we've loved it here once we got here and she's been amazingly supportive.

442

I have three kids who are awesome and supportive.

443

I'm super proud of them.

444

None of them seem to be going into medicine as best I can tell at this page, but we'll see.

445

But they're doing amazing things and I'm super proud of them

446

and they're supportive of me as well and proud of some of the things that I've accomplished.

447

And I think that family support is really important, not only for me, but for faculty and trainees,

448

and we do everything we can in the department to include families as best we can.

449

So, we have all -inclusive events for faculty, trainees, and staff, and we always try to include those spouses at least,

450

and when we can, the kids, because we all know how important all those people are to our success

451

and our contributions and our ability to take care of patients.

452

And so I feel very privileged to have that kind of support.

453

And it all started in Gainesville, Florida.

454

So we were talking earlier today about neurosurgery and neurosurgery careers

455

and um you know it can be very tough

456

and very demanding um high intensity um operations long hours um what are some things

457

that you have done to uh disconnect to there's a lot of discussion now about work -life balance

458

and making sure that people have appropriate you know uh ways of disconnecting from, you know, the job.

459

So what do you do to enjoy outside of work?

460

Yeah.

461

So I have learned over time to do that better and better.

462

I didn't do it very well the first few years.

463

And in some ways, maybe I could have done a little bit better.

464

In other ways of looking at it, you're investing in a long -term future.

465

And maybe I needed to put that kind of time in the first few years of my faculty to make things possible.

466

But pretty quickly after a few years of

467

that i realized i needed to rebalance my life and uh

468

and made commitment um to my family um where i felt like i was committed

469

but i kind of recommitted a little bit um really what

470

i need to do is take care of myself better um which i wasn't doing um

471

so i got into fitness and you know eventually understood diet uh much better

472

and um and began running in the morning

473

or working out in the morning oftentimes with a neighbor who helped me and get started in this.

474

Later, my wife became my workout partner in the mornings, which really helps.

475

But that dedication to physical fitness and health really matters, you know, for the long term of anybody, but definitely people doing tougher things like,

476

you know, you and I do.

477

And then, you know, and then investing in your family and spending as much time with them as possible in their endeavors.

478

And so for me, that was supporting my older daughter with her dance and my middle son with golf

479

and my younger daughter with basketball.

480

And that time really centers you and, you know, realizes, you know, yes, things are important at work,

481

but there's other things that are more important.

482

So I think those are things that I've tried to do to balance myself.

483

And now that I'm more senior

484

and one child is out of the house and the others are much more independent than they used to be, you know, I'm kind of leaning into myself a little bit as well.

485

Things that I enjoy looking for new hobbies and new experiences that, you know, that I think balances because I think if you're balanced,

486

your work is better and more effective and you're just a better person if you can do that.

487

But it took a little time for me to figure that out.

488

And so I think you're going into your sixth year as chair?

489

Yeah.

490

So six years as chair of neurosurgery, weathered the storm of COVID,

491

now into a phase of growth.

492

So over that time, what's your proudest accomplishment for the department, not you personally, but for the department of neurosurgery during your tenure?

493

Yeah, my number one thing I'm most proud of probably is development of the Brain Tumor Center.

494

That was kind of my lead idea or initiative that I interviewed with.

495

And I just thought it was super important for a variety of reasons

496

that we take what had been building as a wonderful brain tumor program, but put it together in an organized way,

497

get it resourced and supported by the hospital and the school and,

498

and multiple departments and the cancer center in a way that would create something truly, truly special.

499

And I feel that for a variety of reasons.

500

One is I think are going to be one of the top or the top academic department in the country.

501

You have to have a very top tier brain tumor program.

502

That was important.

503

But really, I just think there's also a big need.

504

I mean, malignant brain tumors is a terrible disease.

505

Increment progress has been made, but it's very slow and very,

506

nothing transformative has happened in malignant brain tumor care for decades, really.

507

And I felt that the team we had here with adding some pieces

508

and organizing it in a serious way and leveraging strengths at Washington University

509

and at Siteman Cancer Center gave us the best chance

510

that we could be one of those centers that could really truly move the needle.

511

And I've seen it grow and I've had numerous conversations with our brain tumor leaders

512

and where we are here at Wash U, but where the field is more broadly.

513

And I truly, truly believe in the next couple of few years

514

that it's time for a true transformation and care of that terrible disease.

515

And I'm going to feel proud that we had something to do with it.

516

So I'm super proud of that.

517

I'm proud of a lot of other things that we've done.

518

We have a special area here in neurotechnology and neuromodulation.

519

led by Dr. Luthart, who's just an unbelievable world -class scientist and thought leader in the space.

520

And I thought that's something also we could build around and really make inroads and make a difference.

521

And he's proven that idea right and has built a division of neurotechnology that I don't think anywhere,

522

nobody can match, I don't think.

523

And he's really, you know, change in the field, brain -computer interface for chronic stroke, looking on same kind of concept for pain.

524

Others in the division are looking to how you can augment memory, how you can treat patients with PTSD, how you can treat patients with medically refractory depression,

525

and a host of other diseases.

526

I really feel like that's an area that can make a big difference in patients' lives in the future.

527

And organizing that effort, helping organize that effort has been important.

528

And I'm proud that the department has gotten into the community.

529

We have made really strategic and intentional moves to get WashU expertise,

530

WashU neurosurgery expertise into the community.

531

We're now at six community hospitals taking care of patients in their own backyard.

532

And in part, you're providing expertise in the community.

533

But the other part of that's been very satisfying is as we did that,

534

we also made connections in the community of St. Louis that had been wonderful.

535

People who have run big businesses, they've had their own lives and had their own accomplishments.

536

And by connecting with the community of St. Louis, we've been able to learn from them.

537

We've become better at patient experience.

538

We've been better at clinical operations.

539

We've been better in many ways because of those connections we've made in the community.

540

And that's been really gratifying and satisfying effort that we've made over the past six years.

541

We built out the academics.

542

You know, we're now number five in NIH funding, and we think that's going to continue to grow.

543

And that's been a major push and effort of ours and something I'm really proud of.

544

And the NIH funding is just a metric, but it just shows how vibrant the research and discovery science that's going on here.

545

And what's really important for neurosurgery is we're really laser focused on trying to translate those discoveries into the clinic

546

and new novel therapies for clinical trial and beyond.

547

So that's been a wonderful event.

548

We're expanding the residency

549

and really doing a lot of intentional things to make sure

550

we're preparing unbelievable junior faculty coming out of this program that can make contributions for years to come.

551

I probably could keep going on and on, but I'm proud of what we've been able to accomplish in the last five and a half years.

552

And I have great team members who've helped do it with Dr. Ray and Dr. Kim, Dr. Luthard, Dr. Osband, Dr. Willie,

553

now Dr. Thompson, who just arrived.

554

Ralph Dacey remains a huge part of our department and continues to contribute in many ways.

555

And it's just been wonderful, more than I could have ever expected, really, in terms of becoming chair.

556

And it's just, I really feel a deep sense of purpose to measure up to the past chairs

557

and what they've been able to accomplish in neurosurgery here.

558

And I want to do my part.

559

Greg, always great to be here.

560

It always feels like coming back home.

561

The department looks great.

562

The institution is just blowing up, expanding.

563

It's remarkable what you all are doing here.

564

I commend you and the members of the department for, you know, the things that you're doing here.

565

And I suspect that it will continue to grow and flourish.

566

Thank you again.

567

And just look forward to seeing what else neurosurgery will do from WashU.

568

Chad, thanks for doing this for us.

569

And thanks for spending some time with me.

570

It's been great to go down memory lane a little bit.

571

And we're super proud of everything that you've accomplished.

572

And I know you have more to do and more to come at the University of Mississippi, but we are truly, truly proud of what you are as a neurosurgeon

573

and as a leader and look forward to what you're going to contribute in the years to come.

574

And again, thanks for doing this.

575

Thank you.

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Leaders of Neurosurgery: Jacques Morcos, MD, FAANS, FACS interviewed by Gregory Zipfel, MD, FAANS

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אוצר מילים והערות הגייה לשיעור הזה

שיעור הדיבור הזה ברמה C1 מבוסס על הסרטון “Professional Interview: Dr. Gregory Zipfel & Dr. Chad Washington”. בסרטון הזה יש 575 משפטים ו-8073 מילים לתרגול Shadowing. הדיבור נמשך 47:20. הדובר מדבר בקצב טבעי של כ-171 מילים בדקה, קרוב לשיחה יומיומית. 83% מהמילים נמצאות בין 3,000 המילים הנפוצות ביותר באנגלית; כדאי ללמוד את השאר לפני שמתחילים.

אוצר מילים מרכזי בסרטון הזה

15 המילים המתקדמות ביותר בסרטון, עם ההגייה והמשמעות שלהן:

מילה	הגייה	משמעות
mentor שם עצם	/ˈmɛn.tɔː/	מַנְחֶה, חוֹנֵךְ
investigator שם עצם	/ɪnˈvɛs.tɪˌɡeɪ̯.təː/	חוֹקֵר
fellowship שם עצם	/ˈfɛl.ə.ʃɪp/	חברותא
emerge פועל	/ɪˈmɝd͡ʒ/	צץ, התגלה
supportive שם תואר	/səˈpɔɹtɪv/	תומך, תומכת
accomplish פועל	/əˈkɑm.plɪʃ/	בִּצֵּעַ
spine שם עצם	/spaɪn/	עַמּוּד שִׁדְרָה
organize פועל	/ˈɔɹɡənaɪz/	ארגן
unbelievable שם תואר	/ˌʌnbɪˈliːvəbl̩/	לֹא יֵאָמֵן, לֹא יְאֻמַּן כִּי יְסֻפַּר
intentional שם תואר	/ɪnˈtɛnʃənəl/	בְּכַוָּנָה, מכוון
tenure שם עצם	/ˈtɛn.jʊə/	קביעות
anatomy שם עצם	/əˈnætəmi/	אנטומיה
dedication שם עצם	/ˌdɛdɪˈkeɪʃən/	הקדשה
modest שם תואר	/ˈmɑdəst/	צָנוּעַ
neighbour שם עצם	/ˈneɪbɚ/	שָׁכֵן, שְׁכֵנָה

Phrasal verbs שתשמעו

מילה	משמעות
come back פועל	שָׁב
blow up פועל	פוצץ, התפוצץ
give up פועל	וִתֵּר
go down פועל	ירד

משפטים שכדאי לחזור עליהם

משפטים קצרים ושלמים מהסרטון שאפשר להשתמש בהם בשיחה יומיומית:

That's a remarkable, you know, achievement for you.
I think it's great for the department.
I'm super proud of them.
Louis, we've been able to learn from them.
We've become better at patient experience.

דקדוק בסרטון הזה

המבנים שהדובר משתמש בהם הכי הרבה, עם המילים המדויקות מהסרטון:

מבנה	בסרטון
הווה מושלם (Present perfect) have/has + past participle — פעולה שקרתה בעבר ועדיין יש לה חשיבות או השפעה עכשיו	have talked · i've decided · I've had
סביל (Passive voice) be + past participle — הדגש הוא על מה שקורה, לא על מי שעושה את הפעולה	was drawn · be leveraged · being told
משפטי זיקה (Relative clauses) who / which + clause — מידע נוסף על אדם או דבר	people who commit · research, which can · people who are

הגייה ששווה לשים לב אליה

הדובר משתמש ב-117 קיצורים וצורות מקוצרות, כמו I'm, you're, didn't. אמרו אותם בצורה הקצרה, כפי שאתם שומעים אותם.

הצלילים של “sh” ו-“zh”: fellowship /ˈfɛl.ə.ʃɪp/, specialty /ˈspɛʃ.əl.ti/, accomplish /əˈkɑm.plɪʃ/, accomplishment /əˈkɑm.plɪʃ.mənt/, intentional /ɪnˈtɛnʃənəl/
מילים ארוכות — שימו לב להטעמה: investigator /ɪnˈvɛs.tɪˌɡeɪ̯.təː/, residency /ˈɹɛzɪdənsi/, neurology /n(j)ʊ(ə)ˈɹɒləd͡ʒi/, unbelievable /ˌʌnbɪˈliːvəbl̩/, academically /ˌæk.əˈdɛm.ɪk.ə.li/

צלילים שדוברי עברית מתקשים בהם:

/æ/ — פתוח יותר מה-“אֶ” העברית, לא כמו “a” ב-“cup”: vascular /ˈvæskjələ/, academically /ˌæk.əˈdɛm.ɪk.ə.li/, impactful /ˈɪmpæktfəl/, nationally /ˈnæʃənəli/, anatomy /əˈnætəmi/
/r/ — הלשון לא נוגעת בשום מקום, לא ה-“ר” הגרונית: residency /ˈɹɛzɪdənsi/, tumor /tuː.məɹ/, supportive /səˈpɔɹtɪv/, neurology /n(j)ʊ(ə)ˈɹɒləd͡ʒi/, prosper /ˈpɹɑspɚ/
עיצור קולי בסוף מילה — /b/, /d/, /g/, /z/, /v/ בלי להפוך אותם לאטומים: emerge /ɪˈmɝd͡ʒ/, supportive /səˈpɔɹtɪv/, expertise /ˌɛkspɜːˈtiːz/, organize /ˈɔɹɡənaɪz/, oftentimes /ˈɔf.ənˌtaɪmz/

איך לתרגל עם הסרטון הזה

הקשיבו לכל הסרטון פעם אחת בלי לדבר, ורשמו את המילים שאתם לא מכירים.
התחילו במהירות 0.75×, תרגלו Shadowing משפט אחר משפט, וחזרו למהירות רגילה כשזה מרגיש קל.
הקליטו את עצמכם והשוו למקור, תוך תשומת לב למילים כמו mentor, investigator, fellowship.

מהי טכניקת השאדואינג?

שאדואינג היא טכניקת למידת שפה מבוססת מדע שפותחה במקור להכשרת מתורגמנים מקצועיים ופופולרית על ידי הפוליגלוט ד"ר אלכסנדר ארגואלס. השיטה פשוטה אך עוצמתית: אתה מקשיב לאודיו באנגלית ילידית וחוזר עליו בקול רם מיד — כמו צל העוקב אחרי הדובר עם עיכוב של 1–2 שניות בלבד. בניגוד להאזנה פסיבית או תרגילי דקדוק, שאדואינג מכריח את המוח והשרירים בפה לעבד ולשחזר דפוסי דיבור אמיתיים בו זמנית. מחקרים מראים שזה משפר משמעותית את דיוק ההגייה, האינטונציה, הקצב, הדיבור המחובר, הבנת השמיעה ושטף הדיבור — מה שהופך אותו לאחת השיטות היעילות ביותר להכנה לIELTS Speaking ולתקשורת באנגלית בעולם האמיתי.

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אוצר מילים והערות הגייה לשיעור הזה

אוצר מילים מרכזי בסרטון הזה

Phrasal verbs שתשמעו

משפטים שכדאי לחזור עליהם

דקדוק בסרטון הזה

הגייה ששווה לשים לב אליה

איך לתרגל עם הסרטון הזה

מהי טכניקת השאדואינג?