Neurosurgeon: It all started with mom’s passion for science.

I spent my first 28 years in western New York between Buffalo and Rochester. I grew up in Buffalo, studied at the University of Rochester for my undergraduate degree, and stayed for medical school. In my late 20s I left New York for North Carolina and my residency at Duke. It turns out there are a lot of people here from Buffalo. You see bumper stickers for Buffalo Bills fans everywhere.

As far back as I can remember, I had a very strong interest in anatomy and physiology. There are no medical professionals in my family, but my mom was a sixth-grade science teacher. I had an innate interest in the structure of the human body and my mom fostered that from the time I was young.

My first interest was cardiothoracic or heart surgery. But when I arrived at medical school, it was clear the landscape in medicine was changing. Cardiologists were starting to use stents frequently and the days of everybody getting bypass surgery were fading. Some of my mentors cautioned that by the time I completed my training, there wouldn’t be nearly the same need for cardiothoracic surgeons.

I connected with a neurosurgeon at the University of Rochester’s Strong Memorial Hospital and got hooked. That was my first exposure to being in the operating room. By my first year of medical school, I knew neurosurgery was what I wanted to do. I enjoyed the complexity of it, the delicate technical details. When I work on the spine, I'll use drills and screws, but there's still a finesse to it, which I found very attractive.

Neurological surgery includes cranial and spine surgeries. Cranial surgery involves tumors, aneurysms, and other serious conditions affecting the brain or skull. Novant Health in Charlotte is a Level II trauma center. We do a great deal of trauma-related surgery for head injuries from car accidents or falls. When I'm on call, I respond to those emergencies. They can be life-or-death situations.

Almost all the elective surgery I do is focused on the spine. I consult primarily on degenerative conditions which can occur with aging. One common condition I treat with surgery is a disc herniation. As we age the discs and joints wear down, creating mechanical back pain. Some people have pain when they're standing, bending, twisting or lifting heavy things. When the disc herniation is in the low back, it triggers an acute, sharp pain down the leg.

The typical age range is 50s to 70s, but I’ve had disc herniation patients as young as their late teens. We suspect the condition may be genetic. Researchers haven’t identified specific genes for it, but we see it run in families where mom, dad or siblings had a problem.

For most patients, the underlying cause is wear-and-tear over time. They may develop degenerative osteoarthritis which affects the joints and spine, causing pain and limiting movement.

Our treatment is designed to improve quality of life. If it's a disc herniation, we can usually fix the problem. A herniated disc hits a nerve, which is what causes the pain. Through surgery we take the pressure off the nerve. The more chronic, degenerative conditions are more of a challenge. We can usually get patients feeling much better and improve the body’s ability to function.

Probably 10 to 15% of patients will need some additional surgery at some point because the same underlying process continues to work in other areas of the body. A patient might have her right hip replaced due to degenerative arthritis, for example, and five years later needs to get her left hip replaced. The majority of patients have one surgery and don't require more.

It’s always a great day when you get to sit down with patients and hear about the improvement they've had in their lives. Sometimes people write nice cards or a note about how they’re doing. It's probably the most rewarding part of the job. I’ve had patients who started to lose function in their hands, their ability to walk, sometimes in the use and control of their bowel or bladder. You can really step in and make a difference in their quality of life.

Patients will ask me, “How can I keep things from getting worse?” What’s good for your heart is also good for your back. Try to maintain a healthy weight, eat a healthy diet, control your blood sugars if you’re a diabetic, move throughout the day. Take a 30-minute walk at least three times a week. Try to build up the muscles in your body, especially around your core and back, that help support the spine. That becomes really important as we age because we naturally lose muscle mass. If you do these things in your 40s through 60s, it will really help prevent a lot of this disabling pain as you get older.

Even though the general pathology in patients might be similar, everybody's experience with it is different. I can see two identical MRIs on two different patients. One may be in severe pain. The other might have gotten the MRI for another reason and discovered a back disorder incidentally. I try to treat everybody as an individual, listen to their story, and treat them based on what they uniquely need.

We've set up our practice so that we have time to sit down, talk with each patient, and give them that individualized care. There are external factors and pressure on us to see more patients, do things more quickly, and get people out of the hospital faster. Those pressures exist, but we are trying hard to push back appropriately and advocate for our patients.

Medical events have influenced my own life in unexpected ways. My wife Melanie and I had a COVID wedding. We were supposed to get married in New Orleans in April 2020 and three weeks out, everything got canceled. So we went to the courthouse, got the marriage license, found a justice of the peace, and got married at a local apartment complex with two witnesses we didn't know. They held their phones so our parents could see it over FaceTime. Two years later, we hosted our wedding in New Orleans, almost two years to the day of our COVID marriage ceremony.