HJAR May/Jun 2023

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2023 55 Ali Krisht, MD Director CHI St. Vincent Arkansas Neuroscience Institute and the nature of its environment. This is why it is necessary that we never give up or stop trying to advance the field of neu- rosurgery. Specialty neuroscience centers ex- ist to implement the latest knowledge and advancements and will not give up on patients, even when others tell them their condition is inoperable or cannot be treated. We do not play the statistics game because we realize that each of those lives are invaluable to their families. We also un- derstand that difficulty, as we often think of it, does not exist. Impossible does not exist. Only ignorance exists. Each case is an op- portunity to save someone’s life and expand our knowledge for the future. Imagine trying to explain our scientific and medical insights of today to some- one 100 years ago. They would think you were crazy, but that just speaks to how far we have come. If we are to continue mov- ing forward in the field of neurosurgery, we need to consistently put our ignorance aside and open our minds to the possibil- ity of even greater advancements around the corner. Even the greatest challenges we face today can be overcome as long as we continue to push forward. We’re fortunate to have so many bright minds in the field of neuroscience today, and I’m sure the next 40-50 years hold even more progress so long as we choose not to give up. n THANKS to CT scans and MRIs, today we can identify and preciselymap tumors prior to surgery. If a stroke patient experiences a small clot in the brain and they reach a doctor quickly, we can administer medica- tion that begins to break down the clot im- mediately so that the impact of the stroke becomes less significant. If a patient suffers a large clot in the brain, we can now take them into the angio suite and use a catheter, kind of like what you would do for a heart cath, to fish the clot out and reestablish blood flow. The impact of such advancements cannot be overstated. While you may not be able to save every impacted area of the brain, the difference today means going from some- one who could be completely paralyzed and unable to talk to someone who may have some residual weakness but can still walk, talk, and engage with their families. That’s what lies at the core of all our medical ad- vancements in the field of neurosurgery. While the technology and procedures have revolutionized treatment, the real impact is on the lives of our patients. Over the last 40-50 years, we have quite literally experi- enced a quantum leap in patient outcomes. A half-century ago, as many as 50% of neurosurgery patients would either die or not do well after surgery. One of my men- tors, Professor M.G. Yasargil, helped change that. He possessed a unique understanding of anatomy and how to navigate the brain. Through his work and leadership, out- comes for neurosurgery patients went from predominantly negative to 85-90% posi- tive outcomes. It revolutionized the field, and neurosurgery has gone from a subject patients would fear to a point where we can conduct complex 18- to 19-hour sur- geries and the patient will have recovered so quickly that they’re able to walk out of the hospital and go home two days later. The domino effect of this progress can be measured by somany patients living longer, healthier, full lives with those they love. Despite all of these advancements, though, there remains much that we do not understand. When I began to study neu- rology and anatomy as a medical student, I quickly realized how little we truly know about the nervous system and the brain. We know far, far more today, but that progress is still minute compared to our ignorance about how the brain functions and how dis- eases occur. We have so much more work left to do. We still face brain cancers that are very difficult to manage. We can remove a tumor surgically and get a perfect postoperative MRI where the entire tumor is gone, but some of these tumors are elusive and still manage to come back. For all of our prog- ress, we remain in the dark about how the brain connects, how the brain functions,