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Pediatric neurosurgeon J. Wells regularly feels the urge to save a child from certain death – and sometimes the pain of failing to prevent it. He has performed operations on various parts of the pediatric central nervous system, including surgery on the spine of an in-ero fetus to correct spina bifida.
“Depending on the size of the fetus, [the spine] Can be really small, [like] Three grains of rice, “Wellness says.” We use our magnifying loops, these surgical loops, the magnifying glass that we wear, and then we turn on a headlight so we can see what we’re doing. “
Wellness, who hails from southern Mississippi, said he did not want to be a pediatric surgeon. When he first went to medical school, he imagined himself as a small-town family medicine doctor who could “occasionally pay for tomatoes and chickens.” But a gross anatomy lab where he learned about the spinal cord and nerves of the brachial plexus changed his path.
“I remember spending hours and hours dissecting it and absolutely getting through it. It was like McCormick,” Velons said. “It started when I realized that I could start with a great career in family medicine, which would be very fruitful, in a completely different career.”
Wellness’s memoirs reflect his experience as a pediatric surgeon, All that moves you. He says he has a large book of pictures and memorabilia of his patients that he pulls out whenever he needs to be lifted up or thrown to the ground.
“I would always pull out that file and just flip through it and just think, ‘That’s why we do what we do,'” he said. “Because it’s a deep night. It’s a lot of hours for the residents and for us on the field. But that amount of gratitude – I mean, I felt it as a patient. I felt it as a parent, and I experienced it as a surgeon.”
Penguin Random House
How Invert Rowe vs. Wade Will affect patients who have fetal neurological defects
I will tell you a story about my niece and my niece allowed me to talk about it. My niece … calls me one day after being a few weeks pregnant and says, ‘I’m with OB, we did our 13-week ultrasound and they say I have a brain problem and they say I want to come see you, Uncle J. ‘ And we take her to the fetal clinic, we do the ultrasound. I stay with them all the time – my niece, whom I have known since childhood, my kids walked to her wedding – and have this encephalosel. It’s a monster. And the whole brain is outside the skull and it’s kind of inverted. So now it’s also at the mercy of amniotic fluid, the caustic fluid that becomes more caustic over time, which is why fetal surgery makes a difference for spina bifida.
Susan Urmi / Penguin Random House
So in that scene, the choice is a child who is finally born, who is in constant pain, who does not have the ability to communicate or see or communicate with the world around them. They are in a wheelchair, the type of wheelchair that holds your neck. They are fed G-tubes and over time they do not grow from baby. They become adults who have the level of care they need. Earlier in such situations, with other patients, we talked about termination and with my niece we talked about this. …
We are now going to see many more of these and we as a society need to understand that we need to take care of these children. That is our job.
When performing in-vitro surgery to correct spina bifida on a fetus
Mom came into the operating room, she went to sleep, lines were laid, her stomach was prepared. And then there’s a whole team called MFM, the team for maternal fetal medicine. … So the abdomen is prepared, an incision is made, the uterus is exposed. It’s like an orange-pink football ball. And the team will do an ultrasound of the uterine dome, find a good place to open it, make an incision, reveal the inside of the uterus, where the fetus is. And so, all of a sudden, like 20 to 22 weeks, we’re looking down there at what has been rotated in place. And that’s the moment when we repair the back to stop it to reduce some long-term sequels that could happen from Spina Bifida.
Being a guardian and dealing with the deaths of his patients
I think you need to actively double when you’re in the middle of it, especially if you have children and you’re a pediatric neurosurgeon. It’s almost like I imagine myself pressing a clutch to turn that gear off. It’s not that easy. …
[I] There are places like this where I go that is out of my sight, and it’s a beautiful green field that I think of. I can take such memories and experiences [patients] And I can imagine putting them in a box. I don’t like to forget these kids. It’s just that it’s a place where we keep them. And I think it’s a common feeling among surgeons to deal with things like life and death.
On the importance of explicit communication with the families of his patients
As much as you want to punch, or as much as you don’t want to say it, or as much as you don’t think you can take it if you are told it, it’s still your job to make sure they know and they understand. That doesn’t mean you can’t deliver without sympathy: “I’m sorry to have this conversation with you, but your daughter is really sick and we need to take her to the operating room right now.” So to some extent, it’s important to make sure they understand the situation, to make sure they understand what the plan is … to make sure they understand what’s happening, to make sure [they know] Tell them what the risk is and then what we’re going to do. And then staying with them, not moving away later, going after the surgery and talking to them and then, [making rounds] As much as you need in the ICU, and I think it’s critically important as well.
Assault weapons as a public health problem
I’ve seen some really horrible injuries from gunshot wounds, and it’s not specific to a weapon attack, but I’ve seen some injuries to the brain and spine that left a girl paralyzed, in a quadruped position on a ventilator. And it has been part and parcel of a society where there are guns in them. … What we see today with these assault weapons is a lot of damage. I have a friend, John Martin, who is the head of pediatric neurosurgery at Connecticut Children’s Hospital. And after Newtown [Sandy Hook] Shots, he describes, are all dressed and waiting for the kids to get to the hospital until they realize that so many people have died because no one is really coming. And I’m having a hard time understanding why we need this weapon in society.
Sam Brigger and Seth Kelly created and edited this interview for the broadcast. Bridget Bentz, Molly CV-Nesper and Laurel Dalrymple have adapted it for the web.