← The Neuro Experience
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- [00:00]
A
Sheri, welcome finally to the Neuro Experience podcast.
- [00:04]
B
Thank you so much, Louisa. It's so great to be here with you today. And I'm really thrilled and excited to talk to you about the book and about all these other interesting things that are happening in the world of neuro.
- [00:15]
A
Yeah, I want to get into it. I'm so excited. Cutting the path. Cutting a path. The power of purpose, discipline and determination. I want to get into that tagline. But before we do, break it down for us, give us a brief background on who you are because you are magnificent. For everybody listening, I went and saw Sheri. When was this? When we. When did you do your talk?
- [00:37]
B
This was, I believe it was about last summer in Manhattan where we met.
- [00:41]
A
Yeah, that's where we met. And actually the reason you should know that I found out about you, I was attending neurology grand rounds that week, I think it was, or the week before. And somebody had mentioned you that they will be going to this event. And I was like, what is this event? Female neurosurgeon.
- [00:58]
B
What?
- [00:58]
A
I don't know about a book. Okay. And that's how I got there.
- [01:01]
B
Oh, it's so great. It was so nice to meet you. At the Lenox Hill Women in Neurosurgery event. So a little bit about myself. I'm a woman neurosurgeon. There's 219 board certified women neurosurgeons in the United States. So I feel very proud and very lucky to be a part of that. I've been in practice for over a decade. I went to Brown University for my residency, started in the world of neurosurgery. I've worked for private practices, I've worked for big health systems, hospital systems. And I really wanted to write about my experience in the field. And I had this idea about writing a book about my life as a woman in neurosurgery and talking about how I was a mother and how I was a wife and how I was a surgeon and how I gave to my patients and how you can be all of those things and you can be multifaceted. So, you know, I was about five years in practice and I had a lot of people coming up to me and asking, why neurosurgery? You know, why are you doing this and how do you have kids and how are you married? And tell us about that experience. And so I really thought this was the time to put it into a book format. And I had been writing stories all throughout my residency about just fascinating, amazing things that were happening to me. And I kind of collected everything together and really put it into manuscript and, you know, it took off from there. I mean, it was a lengthy process, but it's so well worth it to, you know, hold this in your hands and, you know, have it compiled over, you know, almost a ten year project.
- [02:46]
A
Yeah. Those notes during your residency were actually taken in the form of voice notes, if I'm not mistaken. And I distinctly remember reading that there was. You were in a craniotomy, which I know also well, what you were talking about offline. You're in a craniotomy and you experienced morning sickness. And I want to know, can you just take me through that? Because that's when you started to document. Hey, nobody else has really written about this, like experiencing nausea during a craniotomy or during surgery.
- [03:19]
B
Yeah. So, you know, I was a resident and, you know, like many residencies in the United States, they're very much apprenticeships. So, you know, the senior surgeon is there kind of hanging in the background a little bit and kind of training and teaching. And so I kind of had one of my first opportunities to do a craniotomy and resect a tumor, take out a tumor. And I was so thrilled and excited and, you know, I wanted to learn, I wanted to see and do as much as I could. At the same time. I was also pregnant with my first daughter, and the tumor was, you know, glioblastoma. So it was a very malignant tumor. We had to make sure we got all of the potential margins that we could. I wanted to do a great job for the patient, and the senior surgeon was allowing me to do that operation at that point. So I had kind of successfully come through the ranks. However, as I was doing the surgery and getting to kind of the critical moments, kind of these waves of nausea were washing over me. And it was a moment where I thought to myself, oh, no, I can't scrub out of this operation. I need to do this. I need to help this patient. I need to learn how to do this. And so it was this moment where I almost willed away the nausea. And it's kind of this mind body type of connection. It was, think about something else, think about the surgery, think about the moment, kind of divest in your mind, separate yourself. And I think after that was over and the moment was over, I thought I'd never read a book about a woman surgeon who's pregnant and who's doing an operation and kind of has to talk themselves down from something that's very human. Which is morning sickness, you know, and so I wrote about that and I, well, I voice memo'd it and I also wrote and I and I kind of categorized it as a moment to put in the book. And I was really glad to write about it and have it in there. I mean, there were a lot of stories that we had to cut because of the length of it. But that, that story was really kind of important about how do you navigate, you know, in your own mind when you're dealing with a patient's life, but then you have, you know, your own feelings and your own life and your own, you know, your own things you're going through.
- [05:40]
A
Hello, everybody. Welcome back to the show. It's Louisa Nicola. I'm a neurophysiologist and human performance coach. I'm the founder of neuro athletics where our mission is to democratize brain health education so you can perform better, think faster and live longer. And joining Me today is Dr. Sherry D1. She is a full time board certified neurosurgeon practicing in Chicago. She is one of roughly 200 board certified women neurosurgeons in the United States. And today we're talking about her journey into neurosurgery, her incredible book, Cutting a Path. We talk about pituitary tumors, vascular disorders of the brain, and the various memories that Sherry has from her residency years who have shaped who she is today. For example, Sheri shared a story of what she learned from an accident victim who was rushed to the ER with glass in her brain. This episode meant so much to me and I'm pretty sure that it will mean just as much to you. Sheri and I met at a women in neurosurgery conference around eight months ago where she actually spoke about her book. And the tagline of her book is the power of purpose, discipline and determination. I was so incredibly inspired by historic, which is why she's joining me today. So if you haven't, before we move into the episode, if you haven't smashed the like button on Apple itunes or on Spotify, for the love of your brain, go through and do so. Also, if you want to get to know me a bit better, head on over to YouTube. I release all of these episodes in video form along with other educational videos that can help you have a healthy performing brain, go through, do that. Have an awesome day. Let's get into the episode real quick. Today's sponsor is InsideTracker. You know, I've been using InsideTracker for almost two years now. I do this for all of my clients at Neuro Athletics and it's probably the best and most simplest way for you to understand your blood work in real time. Not only do you get all of your biomarkers tested, you don't even have to think about it, you just go through. I highly recommend you getting their ultimate plan. They will give you all of the biomarkers that you need tested to see how well you are performing. Meaning how healthy are you? So many people take this philosophical view of health thinking that they are healthy just in the absence of disease, and I have to tell you that that is no longer true if you don't do your bloods at least once per year. I recommend twice per year, but some are reporting that they don't even do this once a year. Go through check out InsideTracker. You can get 20% off. Like I said, I recommend their ultimate plan. InsideTracker.com Louisa you'll get 20% off if you use code Louisa20. Also, just to let you know that when you do your blood work with InsideTracker, it comes with an app and the app automatically syncs with your data. So when you get the results it gives you an automatic a plan to work through. It tells you how to exercise, how to sleep better. It also it also links with some of your trackers. Mine links with my Oura ring so it can tell me Louisa, your CRP is going to be high today. It's probably high because you don't sleep well or you don't exercise enough. It doesn't say that because I do sleep well, I do exercise enough, but I'm just giving you an indication. So go through. Check it out. InsideTracker.com Louisa for 20% off off a huge thank you to Keto Brains for supporting today's episode. Keto Brains is a highly effective nootropic stack. I've been having Keto Brains for quite a number of months now. I have this at around 2pm and I'm doing this for two purposes. One because it helps with my mental clarity and two for the neuroprotective benefits that the ingredients have in it. So for those of you who don't know, the ketogenic diet is a very popular diet amongst the brain energy space people because it helps the body's primary energy source shift from using glucose to ketones which are derived from fats. And this specific supplement here, the Keto Brains supplement, helps with many, many purposes. First and foremost it contains C8MCT which has been shown to almost double the ketone energy in a healthy Brain. It contains alpha gpc. This is a single supplement that I give a lot of my clients. This crosses the blood brain barrier to production of acetylcholine. It has L Theanine. This also crosses the blood brain barrier and this increases GABA and has been shown to trigger the release of alpha brain waves to enhance relaxation and creativity. Last but not least, it has lion's mane. And this is a medicinal mushroom that supports healthy brain aging and stimulates the production of two important compounds, nerve growth factor and brain derived neurotropic factor. So if you want a delicious coffee that is good for your brain, that is going to help you supercharge you throughout the day depending on when the, when you get your peak mental clarity. If you need to work throughout the day, go no further than keto brains. If you want to try this, you can go to ketobrains.com you can enter code neuro and get 20% off. I will put the links below. So that's 20% off when you use code neuro at checkout. I mean that's, that's apparent in a lot of people who really, you know, love their career and they're very career oriented. However, however for a neurosurgeon it's just like the margins are very, very slim. You know, you have to be all in. Which actually brings me to your tagline, discipline is the second. So purpose we're going to get into. Discipline is something I love touching on. I was, you know, as many of the listeners know, I was a triathlete, I raced for Australia and I was extremely disciplined in that time, you know, training anywhere from 40 hours a week. It was a ruthless battle. And all I can remember when people ask me, you know, how did you keep that up? I think, well, I was, every moment was accounted for. I was also studying and it was just, I was so disciplined. And then I read this on your book and it really inspires me as a woman now, obviously not doing that but now in my career. So can we just touch on that for a moment and talk about how you maintain discipline even today as a neurosurgeon?
- [12:20]
B
Yeah, I mean I think that is one of the keys really in life in so many ways. And you know, it's, it's waking up at 5am and saying I really don't want to get up at 5am but kind of forcing your body to, you know, do the workouts and do the meditation and be present in your life as a wife, as a mother, as a surgeon, as a caregiver. So a lot of my life, I mean, I think, you know, it was very goal oriented behavior that I think is what drove me. It was setting parameters for myself and setting tasks for myself and saying, okay, I have to achieve this by this time. I need to achieve this by this time. And I think that really has helped me in so many aspects of my life, just being disciplined and being organized and having an organized thought process. We used to do this in residency. Every year we would write a goal sheet and they would make us write, you know, what are your tasks that you want to achieve this year? And you know, and how are you going to use discipline to do that? And it could be anything. It was, I want to learn how to do this type of surgery or I want to attend this course or. And so I carried that with me after I graduated from residency and I started creating a goal sheet for my family too, in my personal life. And it could be anything. It was, I want to learn how to ski this year, or I want to. And I think by the end of the year, you look at those goals and you say, have I achieved this? Have I not? And how can I get to that point where everything is achieved? And so I've used discipline to really guide my goal. Directed behavior, I think, is really what it is. And, and to that point, I'll also say it's also really helpful of not falling into like a rut with something in your life, you know, because I think a lot of times we can fall into a rut or we can fall into depression or however, you know, we describe it. Right. And I think if you have goals that are concrete, you really kind of avoid some of that. Those pitfalls.
- [14:34]
A
Yeah, yeah, 100%. What about discipline within the. Or when you're actually during. What's that like?
- [14:42]
B
Yeah, I mean, discipline to me is the goal directed behaviors. Again, over and over, it's in your mind making, you know, the task at hand about the patient. You know, like, it's not about you the minute you get into the operating room. And it's all about the skills and the time and the energy that you're going to put in to providing this procedure to your patient. And, you know, and the discipline comes from, I think, the motor memory of doing it over and over and over. So, you know, there are operations that I've done, you know, over a thousand times, and it's the same operation over and over and do it the same way and have the nuances. And it's kind of like being a pilot, like Flying a plane and, you know, having the same team of people and training your team. And so, I mean, I think discipline in the OR is key to a successful operation. I think if there's a lack of focus and a lack of coordination by the team, I think that's where things can kind of go awry.
- [15:46]
A
Yeah. And for you, that can mean the difference between life or death? Literally. Sheri, you know that I am obsessed with neurology, evidently, neurophysiology. And I know that you have a subspecialty within the neurosurgery field, which you've just published an amazing paper, but that field is neuroendocrinology. Is that correct?
- [16:06]
B
That's correct. So I do a lot of pituitary tumor surgery. We did publish a paper about our experience using a technique and piece of equipment called an intraoperative mri. So it's very cutting edge. You know, patient has the tumor taken out, they go into an MRI machine, and we can actually identify how much of the tumor has been resected and if we need to take out more. So we utilize this technology and published our findings about it to really show that, you know, technology can help patients in so many different ways if it's utilized and learned about properly. So it was very exciting for me to put that out there into the medical literature. Like many projects, it took several years for us to gather the data and publish, but, you know, very happy and excited for it to be out.
- [17:00]
A
Oh, my God, I can't wait to tear that paper apart when we get offline. Why don't you just give us a brief overview of the pituitary gland and what it is? I know a lot of us hear from it from more of a neuroscience textbook perspective. We hear about this. We hear about people speaking about it. I know I do often, and I would much rather have your take on someone who is actually dealing with, you know, the tumors of the pituitary gland, what it is, what it's responsible for, location, et cetera.
- [17:31]
B
Yeah. So pituitary gland is an extremely important gland in our body. It's located within what's called a sella, which is like a bony structure that it sits in, and it secretes hormones. So those hormones are responsible for our maturation, our puberty, our lactation, our growth, and also our ability to regulate our thyroid. So it's very important structure. And, you know, one of the most fascinating things to me is I've seen quite a few patients that have had growth hormone deficiency. So basically, they're overproducing growth hormone because of the pituitary gland.
- [18:14]
A
Does that mean that would be really big? Isn't that what Tony Robbins has?
- [18:17]
B
Yeah. So basically, it's called acromegaly is the medical terminology for it, and. Or we call them acromegalics. And it's fascinating to me how much under diagnosis there is of this condition. So I've seen patients who have come with, you know, very prognathic jaw, large forehead, and they've never really known that they had a growth hormone issue. And eventually somebody says, let's check your pituitary gland function. And lo and behold, they find out that they're overproducing growth hormone. So, you know, some of those patients will end up having MRI scans of the brain and will find actually a large tumor that's secreting growth hormone. So in some of those instances, you know, I've actually gone into surgery, taken out that tumor, and then kind of trended their hormone levels for the next six months to one year. And in some instances, their features have softened over time. You know, so it's. It's fascinating to me that, you know, especially with the pituitary gland and what it can do if it's dysregulated.
- [19:28]
A
And now in those cases, are they. Are they ever benign? Are they always benign? What's the percentage?
- [19:36]
B
Yeah, so typically they're benign. So pituitary tumors are benign. And sometimes we do recommend radiation treatments afterwards in order to kind of kill off any of the little cells that may still be present. But utilizing the intraoperative MRI is really key because, you know, sometimes in the surgery itself, you're unsure whether you've taken out enough tumor, and sometimes tumor that's behind the pituitary gland that's not visible. So utilizing the MRI technology while the patient's still asleep and can go into the scanner and come out is very useful because, you know, now you can see. Okay, there's another piece that's back there. Let me go back in with the team, take that out. And again, this is without having to wake up the patient. So, you know, really groundbreaking type of work, I think, in this field, and, you know, really excited to see how, you know, things evolve in the next five or 10 years and if hospitals will start kind of employing more of this technology.
- [20:39]
A
You know, I. I'm dreaming of the day that I get to actually be in the OR and. And visibly see. I've seen these. I don't know who. I don't know if, you know, like the. I was reading about the first ever Intraoperative mri. I don't know where it was, but obviously it was displayed somewhere. I saw it and I thought, this is monumental and groundbreaking and would this assist? Okay, so a lot of people may be wondering as well. I still wonder this. When it comes to cancer diagnosis, you know, sometimes you think, you know, I know this to be apparent in ovarian cancer, for example, and, you know, you don't know you have it until the late last stages, and then that's it. You can't do anything about it. Have you been in an instance where you've seen the progression of maybe a stage one, stage two glioblastoma where you've saved a life because you've actually seen it ahead of time and the patient has never even known or even experienced a symptom that could possibly indicate that they've got a tumor to begin with?
- [21:43]
B
Yeah, I mean, I've definitely seen gliomas that have not transformed into GBM in younger patients. You know, utilizing MRI technology as a screening tool is a really fascinating avenue. And it's actually very, you know, very controversial because, you know, many people believe that using it as a screening tool will actually cause more false positives. And so, you know, that's the big.
- [22:14]
A
Debate around the whole pronovo full body mri. Actually, I was the one who I, I put out there. I don't know if you agree with this. This was probably about a year ago. Please correct me if I'm wrong. I said that it could be a possible scam because if you're going to go in and have a full body mri, which it's not indicated, then it will come up with many false positives, which is going to. You're going to end up paying so much more just to figure out that that was just, you know, you're healthy.
- [22:42]
B
Yeah, yeah. And actually, many health systems have come down and said they don't recommend it for those factors. Now, I will say I was at a conference the other day and was speaking to a neurosurgeon who was telling me that, you know, their lab was coming out with a lot of different blood biomarkers for a lot of these diseases. And so it may be the trend that instead of a full body mri, we're just looking at a tube of blood and we're able to see, okay, well, this biomarker is showing, and that gives you a proclivity to XYZ. And even for vascular disorders like AVMs and aneurysms, I think there's a lot of opportunity in the next Few years of data biology, if you will, and learning a lot about what our own chemistry says. And so it's. I think it's a really exciting time to be in neuro. You know, in so many have you been affected?
- [23:44]
A
And I want to get back to the book in a moment, but have you been affected positively by AI?
- [23:50]
B
So AI, we're just starting to integrate into the clinic. And so there is a company that, called Playback Health that uses AI technology to enhance the patient doctor communication. So we're just starting to integrate Playback Health into the clinic. So I'm very excited about that. There is an ambient listening feature that allows us to take the conversation and condense it so that even the writing a medical note is faster.
- [24:21]
A
Wow.
- [24:22]
B
It also has the ability to share a scan with maybe a family member in Florida or maybe a family member in Texas or. Or, you know, the ability to share information. So definitely using AI for. For telehealth and for patient communication. We also use robotics. So I just integrated the spine robotic system into our clinics, into the surgery centers. That's been fascinating technology. I've switched over to, you know, minimally invasive spine fusions through robot robotics about four or five years ago. So I think the world of neurosurgery is really expanding and growing at kind of a lightning pace. And I would say there are, yes, some drawbacks to utilizing technology. Most of it, I think, is a learning curve and allowing everyone on the team to feel comfortable utilizing the technology. But once you are at a place where people are comfortable and you've seen the results, I think the sky's the limit with it.
- [25:26]
A
Yeah. And I cannot wait to see how the healthcare industry just, you know, completely revolutionizes, I hope, in some aspect, due to AI and robotic surgeries, especially those intraoperative MRIs. On that note, you're in a trauma. You've got a trauma center at the hospital, correct?
- [25:46]
B
It is a trauma center.
- [25:47]
A
It is a trauma center. You described a moment in your book in the operating room where you had an accident. You had a. A victim who underwent an accident and her scalp was ripped off, and you were the one that was called in to take the glass out of her brain. Can you describe that moment from literally getting the page to getting into the or? I cannot imagine. Like, you know, you're just sleeping peacefully, and then you get this, you know, during surgery, you get this page and it's like, what? I've got to remove glass from a brain?
- [26:20]
B
Yeah. Yeah. So that was a really incredible story. Again, you know, a story I Had to put in the book just to show people this is the dual life, you know, as a neurosurgeon. And you can be asked to do these just, you know, these unimaginative things. So I was a resident and, you know, got the page from the emergency room. You know, we worked at a trauma center, very trauma heavy. It was level one at the time. Lots of car accidents, you know, gunshot wounds, things like that. And, you know, when I had gone down to see the patient, the scalp was gone, you know, because the head. The patient's head had hit a barrier, basically called a jersey barrier. So that portion of the scalp was gone. And so. And part of the chapter was Put a pin in it. And it was essentially correct.
- [27:10]
A
Yes.
- [27:11]
B
Yeah. Because as I was prepping the patient and removing the glass and the patient actually woke up because.
- [27:21]
A
And started speaking to you as you do.
- [27:25]
B
Right. And so it was one of those kind of twilight zone moments where as a neurosurgeon, where you can have a patient that's actually very sick, but they still are conscious. And I entitled that chapter, put a pin in it, because at the time I had to, again, we talk about distancing ourselves. I had to kind of go to this place in my own mind where I distanced myself from actually what was happening because I had to take care of the patient. And, you know, at that moment with them talking to me and I'm trying to remove the glass and there's brain tissue and there's so many people all around, and everyone's trying to get the patient to the operating room, and it's chaotic. You kind of have to, in your mind, become like a Zen like creature, you know.
- [28:14]
A
Yeah.
- [28:15]
B
And just say, this is the situation. We're going to handle it. We're going to figure out a strategy to make this work and we're going to take care of this patient. And that's what happened. You know, I do also say in that chapter about going back afterwards and processing that moment, because I think that's where there are a lot of, like, the burnout and a lot of the, you know, a lot of the issues in healthcare that come up for physicians where we never really deal with what. What we're seeing and what we're doing. You know, and particularly when you work at a trauma center, I think you can see some really horrible things, and you have to kind of be able to, you know, intern, not necessarily internalize it, talk about it with people or with yourself, and put it in a place, you know, in your mind. That doesn't go to a negative place, but it's a positive place. It's, how did I help that patient? What happened to that patient? How was I instrumental in changing that person's life or doing something to help that person's life? And so that's how I always think about things, because I think if you dwell on those particular aspects of the job, I don't think you'd be able to function properly. There were, of course, some things I left out of the book, things that I've been involved with. There have been child abuse scenarios and really horrific things as a neurosurgeon that I've seen and dealt with. But again, I think it's important to, at the moment, put a pin in it and then kind of go back and process all of it so that you don't internalize every single event that happens.
- [29:56]
A
Yeah. I mean, needless to say, I think having a therapist and talking through all, all of this would definitely be beneficial. And all of this, I guess, aligns with your purpose, which you got into neurosurgery to begin with because of inspiration from your mother's neurosurgeon. And talk to me about that, what happened then and then that moment. Because neurosurgery is not something where you just like, I'll just go into it. It's not like accounting. Right. You've really. It's a. It's definitely a major decision. And I think it might even, I don't know, correct me if I'm wrong. A lot of women probably shy away from this discipline because of the hardships that come with it. It's long. It's, you know, people think that they can't have children during residency. So talk to me about what happened during your mother's diagnosis to the neurosurgeon, to finding your purpose.
- [30:51]
B
Yeah. So, you know, I was always interested in the brain ever since I can remember. I was a kid that went to the library. I checked out books on biology, neuro, anything brain related. I was fascinated by. And so this kind of took me through this path where, you know, I was interested in medicine, interested in science, interested in neurology, neurosurgery, all of these things. And then, you know, as fate would have it, my own mother in, you know, kind of at the prime of. Of her life. She was 49 years old, developed a sudden severe headache one day and went to the emergency room and was diagnosed with a ruptured brain aneurysm. And so I was in my 20s. I vividly remember going to the ER and meeting a neurosurgeon for the first time. And his name was Dr. Johnson, Dr. Doug Johnson. And he basically said to us, she has a 30% chance. She had a 30% chance of making it to the hospital. I can airlift her to the closest, you know, level one trauma facility, but she may die in transport. And we need to do an angiogram of the brain, which is a dye study, and that's essentially it. And she's likely gonna need an operation. And, you know, this is a moment where my mother had been extremely healthy, extremely active. She was on multiple boards of multiple organizations. She was a full professor, teaching political science. She had written books. I mean, she was at the prime of her life, you know, when we were looking to celebrate her 50th birthday. And all of a sudden, all of that changed. And this is, you know, 20 years ago, where, you know, the aneurysm management has changed more that now that there's a lot more coiling of aneurysms and more minimally invasive. But she had open brain surgery. She had what was called a craniotomy. He did go in and clip the aneurysm, and she suffered a stroke. So she had that to deal with. And so that really was a pivotal moment for me because it was meeting him, just being so inspired by his talent and. And his, you know, ability to help a complete stranger. You know, he was on call for the hospital that night, and that's where he had come in. And really how he altered not only her life, but the life of myself and, you know, my family and the effect that he had. And so, you know, that really cemented my desire and my purpose to go into the field. And, you know, whether it be a woman or not, you know, it, you know, and I was advised many times to avoid neurosurgery. I was told, you know, can't be done. It shouldn't be done. You'll never get married. You'll never have kids. I've been married 18 years. I have three kids. You know, so a lot of, like, programming against these things goes into this. But I think, you know, I always had a strong family. I always had people behind me who said, you can do this. And it was my sister, my father, my mother, as she started to get better, my husband. Later on, you know, we got married, was this support network around me that allowed me to really pursue the career. And, you know, I'm so grateful that I didn't listen to all of the kind of naysayers and all the negative talk that, you know, that had been kind of programmed into me because I wouldn't have, you know, the life that I have and the enjoyment that I have. And so that's also why I wanted to write the book, was to put that story out there for people because, you know, it still happens today in medicine quite commonly that, you know, women are told, you can't be surgeons, you can't be mothers. And I really feel, and I hope that by the stories of myself and all the other women that have gone through the process and successfully been married and successfully have kids, that'll change the dialogue, you know, for future generations.
- [34:52]
A
You just reminded me of a quote and it was, I remember the person who said the quote, but I've written it down actually, and it is ambitious people have two options. Marry a supportive partner who knows and understands exactly what they're signing up for, or number two, don't get married at all. And I think it's just incredibly important for anybody, but especially somebody who is really, you know, going into a life changing field and, you know, they want to do this. They've decided that this is the path for them to find somebody who is going to come on board with that. And that is a very hard thing to do.
- [35:34]
B
Yeah, yeah, I wholeheartedly agree with that, Louisa. And I think we touched on this at the Women in Neurosurgery event. And I remember, you know, us talking about this too as a group and there were a lot of questions about it, you know, and I'll say it again, like finding your person, that person that's going to support you, is really challenging, you know, and it may not happen the first time around. I mean, there, you know, and I feel so incredibly lucky to have met my husband at a time where, you know, he was 110% supportive of this life and he still is, you know, and even now we could be doing anything or be anywhere, but if I get a call from the hospital that I need to go, we go. And it's not even a question, you know, and I think that's, that's a very hard thing for a female or a woman to find because it's always, or more likely the other way around, you know.
- [36:25]
A
Is your husband in medicine?
- [36:28]
B
So he's a research scientist, so he professor. You know, because we have three kids, he's always been more on the part time side. So we really do have a good balance, you know, of a family life where he can be more home and I can be more at work. And I think through the years, my career has evolved too, you know, where now I take less call than I used to. And, you know, so, and for people who are listening, call as, you know, the 247 at the hospital. And so I think, you know, the career evolves too, and interests evolve and, you know, but I think that supportive spouse piece is so key. And you're right, it's so challenging to find. And, you know, for many people, they, they never find it, you know, and they kind of have to decide on their own what's more important to them.
- [37:20]
A
Yeah, 100%. I, I, I really, I really would love to go into purpose. And the reason why I want to go into it is because I think that it's a word that is just thrown around not many people really understand. In fact, it was just this morning, I actually have a very close girlfriend of mine who is going through a separation. And I, I said to her this morning, because she just cannot get her head out of it. I asked her, I said, what's your. She said, well, what does that mean? I was like, interesting. And I said, that's what I'm going to put on the agenda today to talk to Sheri about.
- [37:55]
B
Yeah. So I thought a lot about the tagline, the subtitle for the book, you know, and at one point I had grit in there. And I think grit is another very overused word, you know. And what does grit really mean? Purpose to me really rung a bell because, you know, when I have a moment of weakness or a moment where I'm not clear, I think about my mother and I think about her life and how it was so changed by this person, you know, and so, you know, I really go back to that. And every time I've struggled or I've had, you know, terrible call night, or I'm just exhausted or I've been working too much, I go back to her, you know, and I say, God, if Dr. Johnson had thrown in the towel, if he had given up, that would have directly affected me. That would affected my father, my sister, my husband. And look at the tentacles, the butterfly effect of that decision. So, you know, there's so many times even will, I'll call my mom today and I'll be like, oh, I'm exhausted. I just want to retire. And I'm saying it kind of off the cuff, you know, as a joke, and she'll say, nope, you're not ready. The world still needs you. You know, and because there's so few of us and we train so many years to get the skills that we have. And so I think, you know, my purpose has always been to really provide that service for other people and their families and their mothers and their grandmothers and their daughters. And, you know, and now at this stage of my career, I really feel like my purpose is becoming more global, too. And I look at doing charity projects abroad and I look at going into South India, which I've done before, and taking those skills and training people. And so I think, like, my purpose has really broadened now over the years, too. But the. But the goal is the same, and the goal is helping people through disease, you know, and helping them to live better lives and healthier lives, you know, by skills that, you know, I've acquired. And I. And I would hope that other neurosurgeons feel the same, you know, and about their skills and their gifts.
- [40:14]
A
I love that. I think, you know, I get asked often, louisa, why do you focus solely on Alzheimer's disease and cognitive impairment? And it hasn't come from a personal. I've actually not had anyone other than my grandmother who actually lived a very good life until age 96. So that was great. But it was. I haven't had anyone close to me affected by this disease. However, my father did in late 2019. He did suffer a riot parietal lobe, in fact, and that I've seen, you know, a slight decline in his cognitive performance since then, which is a given post stroke in some instances. So I've done. But my purpose is very much aligned. You know, when you really look at the disease and the progression of it and the amount of people right now, I don't know if you probably do know the statistic statistics, around 55 million people worldwide have Alzheimer's disease. Unfortunately, that number is going to triple by the year 2050. And when you actually look at the progression of this disease, and it can definitely start out in your 30s, depending on how well you treat your brain, which I'd love to get into that with you as well, but I don't know what it is, but I feel like it's a. It's a calling. You know, I've. You know what it's like to publish papers. And the amount that goes into the amount of track changes that I have done on this paper that is about to be published is just unbelievable. The amount, I think there's like 1500 references in there. It's just ridiculous. And you just keep going. It's like it's skill. And then you acquire so much knowledge. It's like Well, I can't give up now. And so mine is definitely around democratizing brain health education just so we can. I mean, you can't end cognitive decline to an extent, we all decline cognitively. But you can definitely help people understand that even if you don't possess the genes responsible for these neurodegenerative diseases, you can still get them. So how can we work towards, through education, understanding how to have better brain health outcomes so we don't succumb to a disease where you literally forget who you are. You forget your name, you forget your soul. That is, you know, one of the only diseases that I know where you can actually, actually forget who you are and what your name is. And to me, that is tragic. And you're a mother. I'm not yet a mother, but I can. Does that scare you? Because you might think, imagine if I just forget my kids one day.
- [42:46]
B
Yeah. I mean, Alzheimer's is just devastating. And, you know, and I think diseases of the brain in general are so devastating because they go to the core of who you are as a person. It's your personality, your, you know. You know, you look at somebody with a brain aneurysm that's ruptured, and they don't remember things, details. You know, you look at somebody with a brain tumor, you know, because of all the steroids and all the chemo, they're not who they were. And I think, like, that's why, to me, neurologic diseases are so, so distressing, not only to the person, but to the families. Right. Because they're watching their loved one literally change in front of them.
- [43:29]
A
Correct.
- [43:29]
B
And, you know, so. So that's why I think, you know, what your work is in Alzheimer's is groundbreaking. And I cannot wait to read your research and your paper and see where it goes, because I agree. I mean, I think cognitive decline and losing oneself is, you know, is really one of the hardest things I think, with. With organic brain disease.
- [43:53]
A
Organic brain disease. That is amazing. I'm going to be using that a lot. I've never used that before. What's your stance? You know, I speak about the vasculature of the brain. The brain being the most vascular, rich organ in the body. What do you see when you're in surgery? I know what I see. I don't see as what, you know. You know, I'm not, you know, I'm not using a scalpel. But what do you see when it comes to that? You know, we talk a lot about the. The rise or the decline in cognitive abilities Due to, you know, the breaking down of these tiny little blood vessels, these capillaries or capillaries, if you're in the US and they, you know, this, they're like one cell thick. They start to die off even during hypertension. What are you seeing in, like, late stages, if you're seeing a brain of a. An 80 year old, what are you seeing when you're seeing the vasculature of this brain?
- [44:42]
B
I do think, you know, in surgery, you can tell if the brain tissue is healthy or not. I mean, you can see with somebody that is young, or if you're taking out, you know, blood clot from a trauma, you can see what a healthy brain looks like and what healthy brain tissue looks like, even not using a microscope. You know, on the flip side, there are times where maybe there's a patient who's on dialysis or a patient that has a blood vessel disease, and you can see that the tissue is not as robust. So it's very visible from a surgical standpoint to really be able to look at the tissue and kind of identify is it healthy or not. Now, obviously, microscopic would tell you more. You know, you'd be able to, you know, do a section and see. But I mean, there are, I would say looking at the brain of a 25 year old versus a 90 year old, there. I mean, there are differences from a surgical standpoint.
- [45:37]
A
Yeah. I mean, the space between the brain and the skull would be a lot more prominent. Correct. Because your brain atrophies as you get older.
- [45:49]
B
The brain atrophies. And so there's a series of veins that are on top of the brain called bridging veins. And those can typically tear sometimes and cause what are called subdural hematomas that can affect more of the aging population, can affect younger people, too, but typically the aging population. So those are kind of more diseases of, you know, of the elderly, if you will. And then we add blood thinners onto our regimen. Right. And then you really have kind of a recipe for disaster, which is why my entire.
- [46:20]
A
The focus of my paper was literally on resistance training and cognitive decline. And we're looking at mild cognitive impairment patients and their outcomes from two years of maximal aerobic activity and also resistance training. And let me tell you, it. It is. It pays dividends to exercise, especially as it relates to blood, stroke, volume, and brain health.
- [46:46]
B
Yeah, absolutely. Absolutely. I tell people, tell patients, usually things go south when you stop moving, you know.
- [46:53]
A
Yes.
- [46:54]
B
Literally when you stop moving your body and you become more sedentary, that's when a lot of these diseases will creep in, you know, like your hypertension and your diabetes and, you know, all the other hypercholesterolemia and even the things that if we take the brain disease out of it, you know, the preventative health, I think, starts to decline, and that then kind of snowballs into all the other organ and body systems. So, I mean, I definitely think moving is key. Moving is like the secret of life, you know?
- [47:22]
A
Yeah, 100%. I. Okay, we're nearing the end, but I do want to Talk about how COVID 19 shaped who you are today and how you practice, because I know you did mention some of that as well, and that would have been a crazy time for you.
- [47:39]
B
Yeah, yeah. So, you know, I think my perspective changed a lot during COVID The hospital turned into a little bit of a war zone, really. I mean, we had turned the recovery room into an icu. Our elective surgeries were completely canceled, and we kind of went into this crisis mode phenomenon. I had never seen people dying at that rate before in my career. That was something to me that was, you know, delegated to war zones. And it really felt like every day was a battle. You know, I vividly remember going to the hospital and coming home at the end of the day and literally taking off every article of clothing in the garage and putting it into a basket, down to, like, the rubber band in my hair and, you know, running up the stairs to take a hot, you know, 20 minute shower and, you know, being fearful for my family and, you know, what I was bringing home and not really understanding or knowing yet what we were doing with this disease process. And so, I mean, I think it really tested me in so many ways. And, I mean, we had people get sick, we had doctors get sick, we had staff that we had to rotate the staff because we had to make sure that there were people available to do the surgeries and take care of the patients. You know, I saw a lot of patients, you know, die of the disease that I was consulted on for brain hemorrhages and strokes, and they were young, and that was really hard, you know, and I'll go back to put a pin in it, you know, because it's. You're dealing with it in the moment, and then you have to process it afterwards. And so it's hopefully a time that we've learned from and a time that if it ever happens again, we'll be more prepared.
- [49:34]
A
Yeah.
- [49:36]
B
You know, I think. I think one of the things that was the hardest to deal with was the how all of the elective surgeries were just stopped because I think that was very challenging for patients who needed operations, you know, and all of a sudden it was, hey, you can't have your surgery for six months. And then there was the swabbing of the nasal in nares with a COVID positive result that lingered for months and months and months because we were picking up dead virus. And then we weren't allowed to operate on those patients because they may have Covid. So a lot of. A lot of barriers there. I think it tested me as a doctor tested me in many ways. And like I said, I really hope that we've learned from it. I know I've learned from it personally in my practice, and I know that, you know, if it ever happens again, I'll. I'll hopefully be prepared with some of the skills that I. That I utilized for this.
- [50:32]
A
Gosh, Sherry, I think I could talk to you. I feel like I need to do a part two with you and just talk about different areas of the brain. Actually, that's going to bring me to my last question. I've got two. Two last questions. What is your favorite area of the brain and why?
- [50:46]
B
Oh, gosh. You know, I think the pituitary region, the gland, is. Is really my favorite area of the brain. It's because I'm so fascinated by the secretion of hormones and how that can affect your entire body. So I have to say the pituitary gland would be my most, you know, my most curious region.
- [51:07]
A
Mine is the cerebellum. Okay. And last but not least, what's happening with you? What's got, like, your. Your. Your book tour, like, it's changing lives. I know that we're going to see an influx of female neurosurgeons because you really are, as your book says, cutting a path. You really are, you know, inspiring so many. You've inspired me. That night was really inspirational. I want to know, are you going to be doing any more? Are you going to do another conference somewhere? I'd love to come and see you. And what does the next six months look like?
- [51:38]
B
So I have a lot of really great projects that I'm kind of in the works on. I have a very exciting global health project that I'm hoping to get off of the ground in the next six months. So we'll kind of see about that. I'm going to be coming back to New York to do a GBM panel for the glioblastoma organization. So I'll be back in May and would love to see you, Louisa, as a guest in the audience. And I'm actually going to be going to Miami to tape a podcast next month about the book. So a lot of book promos and a lot of speaking engagements and talking a lot about the things that I love and really hope to keep on inspiring people to do their best and to go out in the world and make bold moves and and create change and be the ripple effect that you want to see.
- [52:31]
A
Oh, my gosh, I cannot wait. And I'm going to see you in May. I will link everything below. And your book is available everywhere, so we'll link all of that below. Sheri, thank you so much for being part of the Experience podcast.
- [52:42]
B
Thank you so much. Louisa, it's been so wonderful to talk to you today.