Shadowing Practice: Leaders of Neurosurgery: Jacques Morcos, MD, FAANS, FACS interviewed by Gregory Zipfel, MD, FAANS - Learn English Speaking with Video
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Welcome to this very special event designed and sponsored by the AANS.
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These events are designed to be a 30 -minute interview with some of the most important neurosurgical luminaries in our field.
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Today's guest is Jacques -Jean Morkos.
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Today is April 24th, 2023.
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I'm Greg Zipfel.
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I'm the professor and chair of neurosurgery at Washington University in St. Louis.
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Today is a very special day for me to have this interview with Jacques, who I've known for well over a decade.
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I first met Jacques when he was an outgoing fellow at the University of Florida with Dr. Art Day,
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and I was an incoming intern at the University of Florida as a neurosurgical resident.
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Later, I worked directly for Dr. Morcos
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and Dr. Haros at the University of Miami
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when I proudly served as their cerebrovascular and skull base fellow from 2003 to 2004.
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I went there to polish my complex surgical skills, but I left there with so much more.
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I was provided amazing mentorship, learning much more than surgical anatomy and technique,
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and made lifelong friends with Dr. Haros and Dr. Morkos.
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Jacques has also played an outsized role in my career in organized neurosurgery.
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He really was the first to open doors for me in the joint cerebrovascular section, which was my first entree into organized neurosurgery.
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So Jacques has had an incredible impact on my career, all stemming from my one year as his fellow in 2003 and 2004.
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So thank you, Jacques, for being here with us.
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And it's an honor to speak with you today.
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Thank you, Greg.
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And I'm delighted to be sitting here with you and to carry on your story.
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You've made me so proud, not that I'm the reason behind your success, but it was very clear from your days as our fellow
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that you will be the superstar that you are today leading this spectacular department at WashU.
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Thank you, Jacques.
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That means a lot to me.
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So to continue the introduction, Jacques Morkos is the professor and co -chair at the University of Miami in the Department of Neurosurgery.
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He's the director of skull base, endoscopic, and cereavascular surgery there.
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He's also the division chief of the Cranial Service.
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He's the past chair or president of numerous organized neurosurgical organizations, including the CV section, the North American Skull Base Society,
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the Society of University Neurosurgeons, the World Association of Lebanese Neurosurgeons, and most recently served as vice president for the AANS.
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Outside of those titles and roles that Jacques has played, to me, he's the following.
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He's an exacting anatomist.
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He is an otherworldly technical neurosurgeon tackling some of the most difficult cranial surgical diseases that we face.
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He's an absolute dedicated educator and mentor.
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He's a national and international leader in neurosurgery.
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He's a humanist in the field of neurosurgery with an uncommon eloquence and ethics.
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And I really think he's become really our global ambassador of neurosurgery
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and a role that I know he embraces and something
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that we very much need from him as we are working to connect the entire world of neurosurgery.
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And he's a very big and important player in that field.
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So with that, you're not from the United States.
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You had kind of a circuitous journey to where you stand today.
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I thought we'd start with you explaining your journey to the United States and your journey to American neurosurgery Absolutely
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I was born in Latakia Syria, but my parents moved when I was four years old to Beirut Lebanon My mom is Lebanese.
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My father was Syrian and I grew up essentially in the middle of the Lebanese war
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That was from 1975 to 1990 My early influences regarding neurosurgery is Fouad Sami Haddad,
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who is one of the first neurosurgeons in the Middle East and who was larger than life figure, certainly in Lebanon,
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and was an enormous influence on me as I went through my medical school at the American University of Beirut.
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But clearly from those days, America, as we called it, the United States,
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was a dream for all of us young people who wanted to escape the tragedies of the war
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and carry on our education elsewhere.
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And that's what I tried to do as far back as 1984, when I went through what was then probably,
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I think, the second year of the MATCH program in neurosurgery.
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I think it started in 1983.
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I did not make it in 1984 when I tried to go through the match.
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Appropriately, I certainly did not compare at all with the quality of the wonderful US graduates.
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And then I decided to go to England, which is where I spent four years, from 86 to 1990.
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I tried again in 1989, the match program, and that year I was offered three positions outside the match,
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including Roberto Heros, who was then the chair at the University of Minnesota, and I jumped on it.
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So can you tell me, you mentioned a couple of people who really mentored you and influenced you earlier in your career.
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Can you tell me a little bit more about each of those and others that may have influenced your career early on?
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Yeah.
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So Fuad Haddad was the first one.
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An exacting polymath, I mean, just created the field of neurosurgery in Lebanon.
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We would rotate he'll be he'll come to round very early
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like 5 a .m on the dot just such such a
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revered figure that's what he was the first the second one
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I must thank for again as all of us go through we have people opening doors for us
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which is why mentorship is so important in my life on the receiving end and on the giving end as well.
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Alain Crocard in the UK, again spectacularly elegant surgeon,
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he took me as what they call over there his registrar for 10 months
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and just from
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that 10 -month experience he then opened the doors for me to the United States by writing to people
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when I applied for a second time
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and of course the biggest influence in my life in neurosurgery
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is unquestionably Roberto Heros who I've known now since 1989 who
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I've had the pleasure of interviewing I was in your seat
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interviewing him not too long ago as a here as a
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giant of neurosurgery really has become my my big brother having been my mentor, my teacher.
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Then the fellowships, you mentioned I had art day, art certainly, I'd only spent six months with art in Gainesville.
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I've learned many things from art.
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He's a superb educator, but he certainly taught me how to think, for example, of aneurysms in 3D,
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how you clip them and made me think properly about surgical technique, particularly for aneurysms.
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And then I spent my year with Robert Spetzler
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and Robert is of course spectacular technician and judgment and
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so I mean I can go on big
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but those are the formative mentors that I've had
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and again very important to mention that and
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if there are young people watching this mentorship does not stop
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with your fellowship I mean I've I've learned enormous amount from people well into my faculty years,
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Juha Hernes -Nami, Evandro Di Oliveira, Fred Gentile, and others.
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You keep picking things, not only technical things, but just the different ways of approaching our complex field.
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Maybe continuing on the discussion of mentorship, You know, I've always viewed you as a mentor, obviously, and a mentor to many,
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but really a dedicated educator,
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someone who spends a lot of time in your local roles running the skull base and through vascular program,
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running the cranial service, running the cadaver lab,
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and running your fellowship, but also nationally organizing and serving courses and the like.
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Tell me a little bit about what drives that passion for education and teaching the next generation.
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Yeah, it is one of the main sources of pleasure that I derive is to contribute to somebody's education.
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When I think back where that comes from, it's certain nobody's born with that desire to do it.
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I think those role models that I've mentioned, but particularly Roberto Heros, I mean,
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his style of teaching, and I think I'm emulating part of what he does, his dedication.
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I remember those 7 a .m rounds, almost a Socratic method of teaching, the way he coached, he coaches in surgery,
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very patient man, he would sit next to you and he'll watch you on the microscope and say, you know, I wouldn't do that, let me show you, then he'll show you,
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then he'll give you the seat back that's very uncommon perhaps I'm not as patient as he is
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but I certainly picked up I think that love of imparting whatever I think I have to to the other generation
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and to have you know whatever emails or letters or people coming to you in the conference say
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dr morcos oh you know this thing and thank you for i learned how this and this from that from you
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gives you pleasure sure sure uh if you look back uh you know on your career uh thus far uh
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maybe name a couple of things and that you really are proud of
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or things that you've contributed uh are there things
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that come to mind in
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that area yeah i mean on different levels probably in organized
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neurosurgery you mentioned the various roles I loved I mean thank
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you for using the word I think user was ambassador yeah
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I do think of myself an ambassador not for the title
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but for my ability to create bridges in this flat world of ours
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and I think this is the role
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that I cherish the most is learning from other parts of
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the world we cannot be we cannot be very US centric we should be open for two -way communication
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and collaboration and that's what I will certainly continue to do I'm very proud
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that yesterday I was elected present -elect of this spectacular organization
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and that probably will be the theme of my messaging in the year that I'm there is the importance of being global.
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Mentioning organized neurosurgery and congratulations on president -elect of the AANS
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and in all your past roles really has been inspirational for many of us who are in that space.
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What drove you to participate in organized neurosurgery?
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What's the impact of you and others being involved in organized neurosurgery
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and do you have suggestions or advice for young folks who might be interested in following
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that path yeah I don't know that everybody needs to do it
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but it's certainly been an immense pleasure personally in my life
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to see other people rise to emulate them we need to better our specialty
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and that is the way to do it it's not simply technical things
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or basic or clinical science research things by organized neurosurgery you discover things
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that you didn't know existed you discover the way to promote
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people who will benefit the field it's this is not politics
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it should not be should not be confused with trying to
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be a politician simply to add another title to your CV it's it's an opportunity to have an impact
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and I certainly the doors were open to me again by my mentors
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but primarily Roberto Harris
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so as a youngster who didn't deserve to be on any of those committees he would plug me
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and say you know this guy is great you need to start
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so I started my life in cerebrovascular like you did in joint section
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and you know and that's what I tried to do for people
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that I think have potential in impacting our field and as you well know from your own extensive
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experience organizing the surgery it just it enriches us personally
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and enriches the field
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if we put the right people in the right positions yeah I find it we all want to have impact
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and that impact can be different for different people with different skill sets
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and different kind of aspirations And some of that can be local
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and very individual to patients and families and things of that nature.
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And some of it can be broader impact.
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And it seems like organized neurosurgery for you is one of those areas looking for broader impact.
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Yes.
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Yes, indeed.
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I agree.
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Yeah.
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So we'll shift gears a bit.
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You're relatively new but very active on Twitter.
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I think we all enjoy the Morcos challenges and other kind of thought -provoking things that you put on social media.
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Why did you enter this space?
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And do you have any advice for those neurosurgeons
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that may be considering and may be a bit intimidated to enter that space?
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Oh, wow.
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No, I certainly don't consider myself as an expert.
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But the reason I entered the space is you have to thank the wretched pandemic of COVID
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that forced us to become virtual, as you know.
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It paralyzed travel and education.
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And so it was a very good way to reach people.
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I certainly had no intention to get into social media, but then COVID really.
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And then I saw what other people were doing and I said, wow, we can actually have an impact.
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We can teach, we can.
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And that's why I got into it.
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You know, it certainly was no attempt to advertise anything.
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And what I, as you just mentioned it, I think last July.
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I started when I've had kind of a reasonable amount of followers.
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I said, well, let's let's make it keep it interesting.
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So I started this work of challenge where, you know, I we put in a clinical case every day and get input again,
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not certainly not to show off anything.
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And actually we've we've shown several complications, but it's educate.
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It's just reaching out for everybody.
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So, Jacques, I've had the pleasure of getting to know you really well over a long period of time
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and your wonderful wife, Fiona.
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I know you have three kids, Isabella, John, and Christina, and you're very proud and close to them.
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You're also a very high volume surgeon in a complex field with a lot of other local and national and international responsibilities.
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So maybe you could talk a little bit about how you make all that work
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and any advice for younger folks as it relates to work -life harmony yeah there certainly is no single formula that works
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and i think each one of us should figure out what
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works for them in their specific circumstances um one thing
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that again i'm i'm certain and
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if fiona was here probably he certainly would say he's not perfect
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and i i clearly i'm not
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but what one thing i do is i don't bring work
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home what do I mean it doesn't mean I don't do neurosurgical work at home
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but when I come home I don't usually talk about the day
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because that precious time that I have with
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that with my family in the evening certainly
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when they were young now they're all out of the home
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but it's Fiona and I only
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but even from you know the earlier years there's no neurosurgery
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talk Fiona is a nurse I could have easily discussed with
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her my day that's the last thing on my mind to do
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when I got home and certainly not with the kids and
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so and and you know weekends as well of course
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when the kids were growing up trying to be involved in all their activities
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but I did travel as I continue to travel quite a bit
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but that's kind of unavoidable if you are in organized neurosurgery you are in global education.
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We will be out of the house for quite a while, and I don't know how to change that in retrospect.
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Tell us about your hobbies.
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You have a lot of things that you like to do.
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I know about skiing and cycling, math and traveling.
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Maybe expound on that a little bit, and are there any particular synergies or any kind of things
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that you see connect with your professional neurosurgical life well you've mentioned the things
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that probably I barely have time to do outside my my
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professional life yeah I love my peloton at home I cycle more on my peloton than I cycle outside
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but that's maybe I should change that
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but I love the skiing yeah I do read I love to read you know various things
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but I'm still probably a partial geek inside I've always loved math
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and physics and probably
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if I hadn't gone into medicine neurosurgery I just love the purity of of those disciplines not
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that I can keep up with what's going on
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but just seeing the beauty of those things I like to read about them
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and still to this day
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when it relaxes me I have no idea why I'm certainly
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not a professional in those fields it just it gives me perhaps this
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window into a certain beauty of of nature and of the human mind
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and the human creativity it's a nice change from neurosurgery
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but you did talk about synergy people might think well nothing
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do with each other also no no this exactness the way
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math makes you think about a problem it applies very much
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to what we do I probably drive my residents crazy talking about geometry and how it applies to surgery you know
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simple things like the keyhole concept and the angle and the cone
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and why do you open the Dura in a certain way you know lots of math in there not advanced math, but lots of good math.
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Yeah, I'm glad you brought that up.
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If you didn't, I was going to.
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That was the synergy that I identified was your love of math
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and exacting science and the way you approach anatomy where it's precise.
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And I think that really impacts your teaching, the outcomes that you have.
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But I saw that synergy a little bit, so I'm glad you brought that up.
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You're an avid reader.
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You mentioned that.
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Anything You recently read that it has impacted you that you might want to share?
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I read it a while back, but it impacted me quite a bit, the book Flow, F -L -O -W,
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written by Mihaly with an unpronounceable last name.
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He's a Hungarian psychologist, one of those names with full of consonants.
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I'm sure somebody will need to teach me how to pronounce it, but I call him Mihaly.
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I actually give
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that book to many of our my interested residents very briefly
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he talked about he's actually did survey among happy professionals
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and figured out what makes what creates happiness in the life of professionals
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and I'm not gonna go through the whole thing
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but there are nine factors and as I read this thing
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and I said gee I understand why I'm a happy guy
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because I am I'm a happy guy
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and he got it beautifully I mean he figured it out
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so I that's a book that stands out
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if you've heard some of my talks I often put in
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that book in some aspect of the talk if it's relevant yeah All right.
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Well, thanks for sharing that.
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Just a couple more questions here as we close.
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You've kind of, I think, begun to enter a more senior stage of your career.
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And one of you have thoughts about that stage that you're in and what the future may hold.
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And then in particular, do you have thoughts for younger neurosurgeons, you know, about, you know, thinking intentionally about this is the early stage of my career
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and now I'm an established and what are the opportunities and priorities at that stage?
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And now I'm entering a senior, you know, and beyond a stage and maybe tailoring your professional and maybe personal activities related to that.
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Have you thought about stages of career, where you are now and things of
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that nature? yeah actually i have not you would think
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that somebody like me who's very deliberate and precise
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and is mathematically minded would have charted early on how i'm gonna do things
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and i so i'm probably useless at teaching people that
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because i didn't do it myself i i went with the flow in
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that sense i did i certainly never planned well i'm gonna enter this section and from this section Maybe I'll be this.
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It may look like my life has been premeditated, professionally I mean, but it actually hasn't at all.
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Again, I've had the good fortune of having good mentors.
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So I, no, I don't, I don't, I don't have a specific plan.
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I certainly, yes, I am senior, happy to be senior, but still with deep passion for what I do and health permitting,
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I certainly plan to practice beyond 10 years from today.
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And we'll see if that will be possible.
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But you did bring up a very important point, is at some point in all of our lives as educators
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and neurosurgeons you will get the feeling well it's not about me anymore it's about
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raising other people the younger faculty and i've certainly arrived at
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that stage a while back now
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so that's what i intend to do during my remaining years besides the remaining very active surgically
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and on the international scene is help elevate other people.
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That's great.
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Maybe we can go back to the flow just for a little bit.
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And this may or may not be related, but I think it might.
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One thing I was struck by,
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and I speak highly of you in terms of a surgical quality outside of technical prowess and deep understanding of anatomy,
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me, but it's this equanimitas that you have throughout the day,
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especially in the evenings for longer complicated cases and when complications occur and things of that nature.
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I just was always struck by how you were able to keep calm
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and kind of continue to go about your business in an unhurried and respectful and effective way.
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Any thoughts about where that comes from or is that just natural or did you learn that from someone? Where did
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that come from there is not most of what we become
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is is not nothing we're born with I don't think I mean you know beyond the obvious genetic things
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that are the traits
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that you're recognizing people it it probably goes back to the
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war in Lebanon to be honest I lived in it 11 years it lasted 15 I lived 11 then went to England.
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And we lived every day as if we were going to die today.
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A bullet might hit you, a bomb might fall in.
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and you develop a thick skin if you're still alive you develop a thick skin
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and then you develop this sense that well if that i mean
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if i survive today well everything else will be
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so much less threatening
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so this is probably what makes me sail through i mean i make it sound very simple it's not
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but sail through what we consider our daunting tasks in neurosurgery
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I very often in my mind I'm in the middle of something
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and I think of the really terrible days of the Lebanese war
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and I say well this is nothing compared to what I lived through or lived through before
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it probably comes from there you reminded me of something too
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what I think about I used to think about is for example
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when my kids were young i would be in a tough
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part of a case i i might think of lebanum i
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might think well whatever's gonna happen at the end of today i'm gonna go home
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and christina or isabella or john
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but usually it's christina is the youngest she's gonna run to me
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and she's gonna say hey so those things that keep you going you know yeah that makes sense that's Great.
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Let me come back to Global Ambassador of Neurosurgery, which I really like that title, whether you accept it or not, but I like it, and I think it embodies who you are, especially at this stage.
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You mentioned it a little bit earlier, but maybe you could expound upon it a bit more.
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Why is that important?
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I know the WNS is leaning on you and others, but you especially, to make this push towards connectedness across the world.
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Why is that important?
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Do you think that's particularly important this in this era
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that we're living through right now in history and
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so forth unquestionably i just finished i'm finishing this week my one -year assignment by ann stroink
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of being the director of global strategy
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and i had a very nice committee of eight people to work with
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and we drafted it was approved by the wans board in
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november we drafted our suggested vision for what the AANS should do globally.
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It was, we never had, the AANS never really had an articulated vision.
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We certainly had lots of international initiatives.
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But this document we put together, I think, embodies what the AANS is all about.
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And, of course, you mentioned why do that.
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Again, the world is flat and we cannot live into our silo, even though our silo is pretty huge,
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AANS, North American Neurosurgery, the silo should not exist and there should be no borders to education,
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to mentorship and so many other things and by reaching out and learning and teaching,
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it's not just a one -way teaching of the rest of the world, we just enrich, going back to a theme we talked about earlier.
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It enriches us personally as neurosurgeons and human beings and it benefits the world.
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I mean, just think of what our less fortunate colleagues,
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neurosurgeons in some very underserved areas in Africa,
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I mean, what they would get from an open -door policy to what we in the AANS have to offer.
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Just one of many examples.
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Or the time is coming to a close
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and we've covered a lot of topics and and
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and heard a lot of your background and insights and how you contributed to to the field.
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Anything we haven't covered that you'd like to mention or just encouraging people who love neurosurgery,
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who know what they can bring to the field to get involved in organized neurosurgery are many ways to do it,
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committees, task forces.
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We all have individual gifts, talents, expertise, and please join.
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Don't live in your own silo.
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You will be surprised what you can bring as a gift of your own self to the rest of the field.
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But it does require
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that you have passion in your heart to be able to
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do it effectively don't do it just to do it do it if it gives you pleasure
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otherwise you will not be happy well jock thank you
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so much for spending the time with us today thank you for the impact
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that you've had on my career uh the impact you've had on through vascular
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and skull base surgery i think you're really a beacon for
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all of us to look up to thank you for your leadership within organized neurosurgery a platform
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that i think you've used to better the field and better the care of our patients.
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And thank you for your role as the global ambassador to neurosurgery.
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I can't think of anybody else who does it better.
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So it's been a pleasure speaking with you today and really hope
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that we have more opportunities to share and converse in the years to come.
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So thank you.
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Thank you so much, Greg, for doing this.
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Thank you.
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Vocabulary and speaking notes for this lesson
This video has 368 sentences and 4644 words to shadow. The speech runs for 30:04. The speaker talks at a natural 154 words per minute, close to everyday conversation. 83% of the words are among the 3,000 most common in English; the rest is worth studying before you start.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| mathematics noun | /mæθ(.ə)ˈmæt.ɪks/ | An abstract representational system studying numbers, shapes, structures, quantitative change and relationships between them. |
| mentor noun | /ˈmɛn.tɔː/ | A wise and trusted counselor or teacher. |
| ambassador noun | /æmˈbæs.ə.dɚ/ | A diplomat of the highest rank sent to a foreign court to represent there their sovereign or country. (Sometimes called ambassador-in-residence) |
| surgical adjective | /ˈsɝd͡ʒɪkəl/ | Of, relating to, used in, or resulting from surgery. |
| educator noun | /ˈɛd͡ʒəkeɪtɚ/ | A person distinguished for their educational work, a teacher. |
| passion noun | /ˈpæʃən/ | A true desire sustained or prolonged. |
| contribute verb | /kənˈtɹɪb.jut/ | To give something that is or becomes part of a larger whole. |
| spectacular adjective | /spɛkˈtæk.jə.lɚ/ | Amazing or worthy of special notice. |
| anatomy noun | /əˈnætəmi/ | The science that deals with the form and structure of organic bodies; anatomical structure or organization. |
| technique noun | /tɛkˈniːk/ | The practical aspects of a given art, occupation etc.; formal requirements. |
| thick adjective | /θɪk/ | Relatively great in extent from one surface to the opposite in its smallest solid dimension. |
| discover verb | /dɪˈskʌvə/ | To find or learn something for the first time. |
| connect verb | /kəˈnɛkt/ | To join (to another object): to attach, or to be intended to attach or capable of attaching, to another object. |
| faculty noun | /ˈfæk.əl.ti/ | The academic staff at schools, colleges, universities or not-for-profit research institutes, as opposed to the students or support staff. |
| enormous adjective | /ɪˈnɔː.məs/ | Extremely large; greatly exceeding the common size, extent, etc. |
Phrasal verbs you will hear
| Word | Meaning |
|---|---|
| go through verb | To travel from one end of something to the other. |
| go back to verb | To stem from; to originate in. |
| live through verb | To survive a difficult period or event |
| figure out verb | To come to understand; to discover or find a solution; to deduce. |
| grow up verb | To mature and become an adult. |
| bring up verb | To mention. |
| call over verb | To ask (someone) to come to one's location, especially when raising one's voice towards someone within earshot. |
| keep up with verb | To manage to remain beside or just behind someone or something that is moving away from one. |
Grammar in this video
The structures the speaker uses most, with the exact words from the video:
| Structure | In the video |
|---|---|
| Present perfect have/has + past participle — a past action that still matters now | I've known · has also played · has had |
| Passive voice be + past participle — the focus is on what happens, not who does it | are designed · was provided · was born |
| Relative clauses who / which + clause — extra information about a person or thing | section, which was · people who wanted · England, which is |
Pronunciation to watch
The speaker uses 104 contractions and reduced forms, such as I'm, I've, don't. Say them the short way, as you hear them.
- The “th” sounds: mathematics /mæθ(.ə)ˈmæt.ɪks/, thick /θɪk/, ethics /ˈɛθ.ɪks/, threaten /ˈθɹɛt.n̩/
- The “sh” and “zh” sounds: passion /ˈpæʃən/, fellowship /ˈfɛl.ə.ʃɪp/, essentially /ɪˈsɛnʃəli/, congratulations /kənˌɡɹæt͡ʃəˈleɪʃ(ə)nz/, initiative /ɪˈnɪʃ.ə.tɪv/
- Long words — get the stress right: mathematics /mæθ(.ə)ˈmæt.ɪks/, ambassador /æmˈbæs.ə.dɚ/, educator /ˈɛd͡ʒəkeɪtɚ/, spectacular /spɛkˈtæk.jə.lɚ/, anatomy /əˈnætəmi/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Start at 0.75× speed, shadow it sentence by sentence, then go back to normal speed once it feels easy.
- Record yourself and compare with the original, paying attention to words like mathematics, mentor, ambassador.
What is the Shadowing Technique?
Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.