Lessons from the OR: How this brain surgeon rose to the top

Since I was a child growing up in Puerto Rico, I always wanted to be a doctor. My father, an anesthesiologist, would take me to the hospital on weekend rounds. I felt that working in a hospital was special because you could make a huge impact in people's lives.

Dr. Ortiz at Lenox Hill Hospital in New York.
Source: Lenox Hill Hospital
Dr. Ortiz at Lenox Hill Hospital in New York.

When I graduated from high school it was a clear decision that I would go to medical school. At that time I thought I wanted to be an orthopedic surgeon because I was a big sports fan and I was playing baseball, basketball and running on the high school track team. It was not until I was in medical school that I made a decision to train in a field related to neurosciences.

My favorite class during my first year of medical school was a neuroanatomy class. I found it challenging and fascinating that one could localize a lesion of the brain and spinal cord just by doing a clinical exam, looking at someone's pupils and seeing someone walking on a straight line.

"I have learned about the importance of faith, collaboration, professionalism, determination and family when dealing with difficult health challenges in life."

During that period of time, my grandmother was suffering from a neurodegenerative condition. Seeing her clinical deterioration was devastating to everyone around her. She was a strong, fun and smart woman who lost her memory and got progressively weaker. Those were twenty very difficult years for everyone in the family and the experience made me even more attracted to the neurosciences, where I felt I could have an impact on suffering patients and their families.

I moved to Philadelphia to complete a residency in neurology. My preconceived notion of the fascinating aspect of localizing a lesion with a neurological evaluation was true, but I realized that I needed to continue to train and expand my knowledge in a different field so I could fix acute problems with procedures and not just diagnose the problems and treat them with medications.

The chief resident of neurosurgery told me about a field of medicine that was relatively new at the time. It was exciting, procedure based, and utilized the latest technology to make an enormous impact at the time of treating a patient.

That is when I discovered neuro-endovascular surgery, where we navigate catheters through arteries of the leg, brain and spinal cord to treat brain aneurysms, strokes and brain tumors without the need to do open head surgery. The surgeon that was the leader of the program in my hospital had a superb reputation. I spent several months rotating with him and since the first case I saw him perform I decided that I wanted my future and career to be in this field.

I had the amazing opportunity to train in New York City with the pioneer of Neuro-Endovascular Surgery and Interventional Neuroradiology in the United States, Alejandro Berenstein, MD.

I learned about being extremely meticulous while paying attention to details in order to prevent complications in the procedure room. I learned about navigating catheters from the arteries and veins of the leg to the arteries and veins of the brain to treat problems like tumors, aneurysms, strokes and vascular malformations in adult and children using the most advanced X-ray technology.

After completing the fellowship he invited me to be his partner and I spent six years working with him. That time of my life was a stage of exponential professional and personal growth.

During that time I met Emille on a blind date. She is a smart, talented and beautiful pediatric dentist originally from Puerto Rico who was living in New York City while establishing her private practice. We have been together every day since and she is now my wife.

In 2012, I had the opportunity to join my partner, David Langer, MD, to create a new department of neurosurgery at Lenox Hill Hospital in New York City. It was the opportunity of a lifetime, starting a neurosciences program in Manhattan at a hospital with a tradition of more than 150 years.

It has been a rewarding and challenging adventure. We had to create a safe environment in order to perform the most advanced types of procedures for the brain and spinal cord. We were fortunate to be able to hire the most talented individuals that we had met during our years of practicing in New York City. We have the most comprehensive and collaborative program of Neuro-Endovascular and Cerebrovascular Surgery for the management of the most complex neurovascular diagnosis.

During my career I have had the opportunity to travel to different countries to lecture and do procedures. I have met luminaries in the neurosciences. I have learned about the importance of faith, collaboration, professionalism, determination and family when dealing with difficult health challenges in life. But more importantly, I have been able to acquire and develop the procedural and personal skills to help and cure adults and children with neurovascular conditions.

Commentary by Rafael A. Ortiz, M.D., chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital. He is also an assistant professor of neurosurgery, neurology, and radiology at the Hofstra Northwell School of Medicine. He is a member of the Board of Directors of the American Heart and Stroke Association and the co-chair of Tu Corazon Latino. He recently received the LatinTRENDS 2016 Latino Trendsetter Award. Follow him on Twitter @RafaelOrtizMD.

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