Dr Rupy: Sherry, it's so lovely to have you back on the podcast and since we last chatted, a lot has happened since the pandemic and you've written this wonderful book. I wanted to get right into it. In recounting your journey of becoming a neurosurgeon, what are the main things, what are the main takeaways you want people to get from Cutting a Path?
Dr Sherry Dewan: Thanks Rupy for having me on again. It's really great to connect and see you after all these years. Yeah, you know, writing the book was really a journey for me that kind of began about ten years ago and I was kind of finishing up my residency in neurosurgery at the time and you know, one of few women in the program that had gone through and I just felt like I had to share the story with people. And you know, the main takeaways from it are really, you know, really I'll use the subtitle, you know, it's it's really purpose, discipline and determination, which is kind of the three hallmarks of the book. And you know, I'll go back to, you know, purpose first, which is the first word in the subtitle because I think it's important, we always talk about finding your passion, finding your passion. And I truly believe, yes, passion is is a key component, but really, I think as a physician, it's really about your purpose. You know, why are you here? Are you here to help people? Do you enjoy being around patients? Do you like people, you know? Do you want to help people? And I think, for me, that was my purpose and it's always kind of been throughout. And I think that was my main goal in putting the book out, was to tell people that we all have a purpose, whether you're a doctor, a lawyer, you know, a scientist, in business, we all have a purpose on this earth and I think identifying it and understanding our gifts and what we can give the world is is very important. And so that's really why I wanted to put the book out is to inspire people and to show them using my story that you know, really anything is possible if you truly put your mind to it.
Dr Rupy: I want to dive into this concept of purpose actually, because in a lot of ways, I feel very fortunate and lucky to know what my purpose is, what my passion is and how I've been able to construct a life from, you know, my teenage years of really understanding what I wanted to do, you know, diving into the altruistic side, diving into the science side and diving into that that patient connection side, like actually having those relationships with humans. For someone who's reading the book or or listening to this, how do they actually navigate exactly what that purpose is? Because I don't think this is just something for people of a younger age to to understand. I think it it's something that everyone at all stages of life should really be asking themselves and actually constructing a life where they can honestly answer to themselves, I am living a life with purpose.
Dr Sherry Dewan: Yeah, and that's a great question because I think purpose can change as you go through life, you know, I mean, I think you have, you know, a purpose when you're a student, right? And the the purpose is to get good grades and learn and then there's a purpose, you know, when you kind of move through life and you have a family and then there's a purpose to provide and you know, and I think, and then you know, when you have your children and you're watching them grow and then there's a purpose to, you know, provide guidance and advice and watch them live out their dreams. And then maybe there's a stage where they're no longer in the home and you know, and and you know, and then there's all sorts of alternatives, right? Like maybe there's no children in the picture or maybe there's, you know, or maybe you're caring for an elderly parent or I mean there's so many different scenarios and I mean, I think purpose can change, purpose is malleable, our lives are malleable, our lives are dynamic, they're constantly changing. I think really looking at what gets you up in the morning, what makes you, you know, want to get up? What makes you look at the sun and say, today is going to be a beautiful day? And what are the key components of, you know, that sort of living and that sort of lust for living that you have inside you, you know? And I think once you identify that in whatever way it is, I think that's really, you know, the the beauty of where life comes from and the beauty of where living comes from. And it may not be easy to get to that purpose, you know, for everybody because we can be so bogged down with the day-to-day and the grind and you know, and I think taking a step back and really examining and self-examining and saying, you know, what are the things that make me tick? What are the things that I love? What are the things I enjoy? You know, what am I, what is my passion? What is my purpose? What are the, what are all these things? And I think once you identify that one thing, you know, you go for it 110%.
Dr Rupy: Let's let's use your specific example as a way in which you you really dived into your purpose and and your passion because, you know, as a US-born Indian American, facing all the obstacles that you had to overcome throughout your journey of becoming a neurosurgeon in the States, you know, how how did you A, first find your purpose and how did you know it was neurosurgery considering all the hoops that you had to jump through, even more so, not only as a US-born Indian American, but as a as a female as well. You know, it's that there are so many challenges that you've articulated in your book. What, how did you know that that was your true purpose and that you weren't dissuaded from going down a different path?
Dr Sherry Dewan: Yeah, I mean, I think I always knew even as a child that I wanted to do something with the brain. I was absolutely fascinated by neuroscience. And, you know, you know, going to the library, checking out books on medicine, checking out books on science and always really wanting to, at the core of it, understand this mysterious organ, you know, that holds all of our hopes, thoughts and dreams. And you know, just truly fascinated by it. And as I went through, you know, school, it was just, you know, working in neuroscience research labs, always involving myself in some sort of, you know, brain research or cognitive research and and then, you know, in the book, in the second chapter, I go into really the pivotal moment, which was my own mother suffering from a ruptured aneurysm when, you know, I was in my 20s. And, you know, my mother was this tigress, if you will, of a woman. I mean, she was on every board you can imagine. She was very active in the community. She was a professor of political science, a PhD and you know, one morning, she got, you know, developed a severe headache and was told essentially that she had a ruptured brain aneurysm. And that's when I met a neurosurgeon for the first time, who is Dr Johnson, who I talk about a lot in the book. And he saved her life. And that was kind of a pivotal moment for me because although I had been so interested in neuroscience, here was a living example in front of me of a save. He had just saved my mother and his skill and his talent was so inspirational to me that I thought, this is my path. I want to save other people's mothers. That was my goal. And so, you know, I went after that goal, knowing that whatever I did with this profession was so impactful to people that that I would have the skills and the knowledge just like he did, you know, and the talent to be able to do that. And so, it was a real-life example, you know, really for me. And I think even in the times where I struggled and the challenges that I had, whether it was, you know, gender discrimination or ethnicity, you know, and I did list some of those examples in the book. I always knew I had a path, you know, and there's one example in the book that was kind of early on was when I was a medical student and, you know, I had invested all this time and energy in applying for neurosurgery and I knew it was pie in the sky. You know, I knew it was going to be so incredibly difficult to match. It's a 50% match rate. I had done all these sub-internships and I was, you know, at this interview and you know, this very, you know, very well-known, respected neurosurgeon, you know, looked at my application and said to me, you know, neurosurgery is really only for white males. You know, and closed my application. And, you know, what do you do with that information? I was in my 20s, I had invested so much time and energy in this. I loved it and I had a real-life example of my mother sitting right in front of me who was alive. You know, and so, you know, at that moment, I think, and I think many people have that moment. You know, many people have naysayers or people that don't believe in them or maybe you don't even really truly believe in yourself, you know, at times. But, you know, and so I think the the the ideas of overcoming those obstacles and and powering forward despite the fact that you may have people that don't believe in you is really, really, you know, important and you know, and I and I think at any stage of your life, whether it's as a student or as a parent, a grandparent, you know, any stage of our lives.
Dr Rupy: I remember reading that moment in the book actually, and you use a French saying to describe something of having a sort of a quip, a comeback, but actually when the moment has passed. I can't remember for the life of me what that French saying is. I'm not too sure if you remember yourself either. But I've had those moments many a time, not obviously in that situation, but that that sort of expression that that needs to come to mind of of of having something to to say back to that. But you must have been gobsmacked at that point, you know, particularly as someone who's in their 20s, perhaps is still gaining a lot of confidence trying to muster a presence for themselves. I mean, what, how did you recover from from instances like that?
Dr Sherry Dewan: Yeah, I mean it was, it was one of these situations where, you know, before that I had a lot of people tell me, you know, don't go into neurosurgery or don't pursue this field because you're a woman, you you won't be able to get married, you'll end up divorced, you won't be able to have children. So I'd had all of these people who weren't in the profession telling me that. But what I guess what was really challenging was now to have somebody who was in the profession telling me that, you know, and so that was a moment where I thought, oh my gosh, you know, is he correct? You know, should I not be applying for this residency because I'm Indian, because I'm a woman, you know, is he is he correct? And you know, I had this moment where I second guessed myself. And it really was my support structure. It was my parents, it was my now husband, who were like, no, that's ridiculous. You know, and didn't even give it a second thought and just, that's ridiculous, stay on your path. You know, hold your course. And I think, you know, one of the things I talk about in the book too is finding your, you know, your collective, finding your people, finding that your board of directors, if you will, the people that you go to for, you know, your pieces of advice and bounce things off of that you trust and they have no ulterior motives other than wanting to see you excel. And so they've kind of been my board of directors throughout my life and throughout the book, I write about, you know, talking to them when I have these very low moments. You know, another very low moment was, you know, when I became pregnant for the second time and I was a resident and, you know, pregnancy wasn't popular in the residency program. It wasn't done. And how that, you know, affected me in terms of my colleagues and how they weren't supportive of that and me wanting to be a mom and, you know, trying to, trying to balance all of those hats and all of those roles and and so, you know, that's another I think key component in the book is not just the initial going into the residency program, but remaining in it and, you know, having moments where I felt I may quit, you know, which is what I what I had written about, you know, when I was a when I was a sixth year resident.
Dr Rupy: Talk a little bit more about the unpopularness of pregnancy during residency for our listeners because I don't think a lot of people would understand the psychology behind that and perhaps the environment that residents across all different specialities, not just within surgery, but in medicine and across the pond here in the UK as well, those sort of unspoken cultural norms that perhaps non-medics wouldn't really be privy to.
Dr Sherry Dewan: Yeah, I mean, I think pregnancy in medicine in general, has always been viewed and I hope this is changing and I think it's changing, but has always been viewed as a negative. It's always been, you know, especially for surgical subspecialties, you know, well, how much time are you going to take off? How are you going to make up the call? You know, you won't be able to stand in the operating room for lengthy periods of time and do the procedures. So it's always been viewed as a negative and I hope and I feel that it's changing. I think it's changing slowly, but I do feel like it is changing from my experiences that were, you know, a decade ago. You know, the physicality of pregnancy is very difficult. There's water retention, you know, your legs are swelling, you know, your blood volume is increasing, you have, you know, hormones raging through your body, you haven't slept, you've been fatigued and you know, there's a lot of experiences that I had during both my pregnancies as a resident that, you know, went beyond the, you know, psychological to the fit, you know, the physical aspects of the pregnancies are very demanding. And I I truly feel like the pregnancies were the hardest things I've ever done in my residency just because, you know, literally going into work every day and dealing with, you know, getting up at 5 o'clock in the morning and rounding and taking care of patients and operating all day and then, you know, leaving at the end of the day and my legs are like tree trunks, you know, as I'm walking out and so that that's one component and then I think the other component is the psychological stress of not being supported at your at your program. And how that affects you also, you know, and so, you know, in the book I did talk about people that did support me and I had a senior neurosurgeon who was very kind and, you know, was really a champion for me and and if I didn't have his support, I think it would have been all that more challenging, you know, and so again, I'll kind of go back to the, you know, the collective, the board of directors, the people who want you to excel because I think you need to kind of identify and find those people and draw from them and draw strength from them.
Dr Rupy: Yeah, yeah, yeah. I I wish I I could say that it's it's changing for the better. I agree, it's probably very slow, but the the isolated incidents that are closer to home for me don't really speak to that actually. Like one of my best friends is an ENT surgeon and when she got pregnant, intentionally and planned and stuff, she had very many of the same questions that were posed to you as well about time off and and how people are going to be restructured within the team, especially within the NHS where we're strapped for doctors across all different specialities. And she was subject to a lot of bullying and she's one of the best ENT surgeons in the country. And the same with one of my other good friends who does obstetrics and gynaecology, you know, the same things and some very frank conversations with other female surgeons about, you know, freezing one's eggs and and actually having to jump through all these other obstacles that we as as men who are not going to be bearing children don't have to do. So there's always going to be an inherent disparity in the escalation of one's career just based on our our life opportunities and and decisions. So it's it's it is slow, but I I unfortunately I I feel like it's we're still stuck in the in the dark ages when it comes to that facet in in medicine.
Dr Sherry Dewan: Yeah, I mean, you know, I I do agree with you. I mean, I I I do see some changes on on, you know, at least the surgical side. I feel like it is a little bit more accepted, but I think the thing that bothers me the most is that the minute a surgical resident gets pregnant, it it's perceived as if she's not committed to the field. And I think, because of, oh, well, you're going to be a part-time surgeon and, you know, and I I felt that when I became pregnant, especially with my second, I was kind of, it was kind of, oh, well, she's not committed or, you know, she's going to be a part-time neurosurgeon and and everyone just assumed that. And, you know, I have three kids now, you know, and I'm full-time. It's, you know, so I think the perception and the reality can be very different and I and so I would say, you know, never let anybody put you in a box, you know, never let anybody tell you what you are capable of or what you are not capable of because you only know that from you, right? And and so I think, you know, and I I hope, I really hope that in the next 10 years, we do see a change because motherhood and bringing life into the world is one of the most incredible things I've ever done. And for women who are doctors to not want to do that for fear of retaliation or a lack of support would be very, be a very sad commentary on medicine.
Dr Rupy: Yeah, yeah, yeah. And on the subject of motherhood, I do want to go back to your mum's role and everything here because beyond being the inspiration for neurosurgery and obviously her unfortunate experiences, she sounds like a a very powerful influence on you. You know, perhaps where the the tiger analogy sort of comes from. Can you talk a bit more about your your mother and perhaps how she instilled the the other elements of this book, the the discipline, the determination, perhaps?
Dr Sherry Dewan: Yeah, my mother was and still is today just a very powerful force. She really propelled my career. She told me I could do anything I wanted in life and, you know, never never allowed me to back down if there was ever something that was in my way. And I think having her and watching her even battle her own health conditions and still today be such an active, functional person, has been really inspirational, you know, and I think everybody in their life needs somebody like that where they're looking at them and saying, oh my god, if this person can do it, I can do it, you know. So, you know, I think the biggest thing was she, you know, obviously instilled education, the the love of academics in me, but she also, you know, taught me a lot about values and taught me a lot about, you know, never backing down and being determined and when people were telling you no, if you didn't believe them, well, you just keep doing what you're supposed to do, you know, and you know, there were so many examples that she had given me of like, you know, there's one in the book I I love that she had given me, you know, about track stars, the women that run track and, you know, they have long nails and long hair and, you know, manicures and all that stuff. And so you would never think, you know, why would a track star look like that? And same goes for, you know, how I looked in neurosurgery. I mean, you know, I was a girl. I, you know, didn't defeminise myself because I was in a male-dominated field and, you know, so her examples of like, look at the other women in the world who, you know, do what they do and and they don't look the type, you know. One of the things that I really loved about the book is that I've had so many people reach out to me throughout the world who, you know, I feel like it's becoming more normalised to be a woman, to be ethnic, an ethnic minority. And I hope my story can do that for women. I hope that there are women who who say, you know, I may not fit the mould, but I really want to go into this profession and or I want to go into surgery in general or or I want to do something that is unexpected of me, you know, and have the confidence to do that by looking at my story and seeing that, you know, I was able to get, you know, where I wanted to go ultimately, you know, despite all of these things.
Dr Rupy: Yeah. And that that discipline element that obviously is required in medicine. Like, how else do you instill that in the book? Because as a as a central pillar of what people should be expecting from from your work and and your experience in the biography of your of your journey thus far. Like, what other elements have you have you dived into to to really sort of instill the the discipline requirements for for your journey and and how might that be applicable to somebody else?
Dr Sherry Dewan: Yeah, I mean, I think the discipline aspect, you know, when you're in medicine especially, we know all about discipline, delayed gratification and I think above all consistency. And, you know, when we're consistent in our work, it's, you know, we know we have to be somewhere at a certain amount of time, we're there, you know, the work has to be done with excellence. You know, whether you're taking care of patients or whatever you're doing, there needs to be a consistency and a discipline in the way that you conduct yourself, you know, professionally in your in your workplace. You know, because in many instances, you know, there's something that happens at 2 o'clock in the morning and all of a sudden, you're in the operating room, you know, taking care of somebody and everything has been thrown out the window in terms of the logistics of the day and you know, so I think for me, the discipline has really come from, you know, a daily practice that's involved, you know, meditation and yoga that is very consistent. I typically like to meditate and have a quiet moment for myself at least twice a day. It's interesting because when I was a teenager, I had gone to visit my grandmother in India and I met a yoga master. She used to, she used to have these yoga masters come to her home and he taught me this visualisation technique that I kept with me throughout my whole life. And he was really teaching me transcendental meditation, although he didn't call it that at the time, but he was really teaching me this concept of manifestation and visualisation of a path and kind of looking at a goal as a far and then, you know, going through your the steps of reaching the goal. And so I I really held on to that, throughout my life. And so I, you know, twice a day will sit down and have quiet time with this daily practice and, you know, visualise what I want, manifest it. You know, I was once told the universe is benevolent and is on your side, you know, and I and I really believe that. I believe, you know, you're going to have ups and downs in life, you know, you're going to have times of extreme stress, you're going to have times things aren't going your way. But I think if you truly believe the universe is supportive and benevolent, you know, I think you'll get to where you need to go. And, you know, the yoga has really centered me. I do a daily yoga practice, even if it's five or 10 minutes. Somebody recently taught me about chair yoga. They said, you know, Dr Dewan, you can actually do yoga in your chair while you're at the office. So I thought that was kind of cute, you know. So, I don't know if you've tried it, Rupy, but
Dr Rupy: I haven't tried chair yoga, no. Tell me about it.
Dr Sherry Dewan: Yeah, so it's like, you know, more about toning your core while you're sitting in a chair and it's for people that are more office-based and so I think the daily practice of meditation, yoga, healthy eating, healthy living, I mean, you know all the more about healthy cooking and and, you know, how important our diet is to how we function at our best. So I think incorporating all of those things has really led to the discipline that I have in my daily job, which is, you know, at its core, really, you know, opening the most sacred organ in the body and operating in it with confidence. And, you know, I think that comes from centering yourself in your own life and also your personal life. You know, I like to be very centered with in my own personal life. And someone had once told me that surgeons in general like to have equilibrium, you know, and and I think that really rings true. I think if things aren't good at home, it's very hard for things to be good at work. And especially in neurosurgery because we're dealing with, you know, the the most sacred organ in the body and because our work is so important, I think it's even it's even it's even, you know, the the most important component of what we do.
Dr Rupy: I want listeners to get a real understanding of just how disciplined you are to maintain a daily practice like that, mindful moments, because your job as a neurosurgeon is manic. It is just like, you know, hugely intense procedures, but lengthy procedures as well and call outs at all times of day, in the middle of the night and stuff. So, why don't you walk us through for for listeners who who wouldn't know about neurosurgery, like what a day could entail and at what points do you have the discipline and that sort of, that the rigor to be able to put in to to slot in those those daily practices? Because that for me, just hearing that is phenomenal, but I don't think many people will understand why.
Dr Sherry Dewan: Yeah. Yeah, so, you know, I cover a hospital, we cover trauma. So what can happen sometimes is patients can come in and it's a very tenuous situation and someone has to go to the operating room immediately. It's life, it's truly life and death. You know, there's been instances where I've taken care of children that have been hit by cars and they have bleeding in the brain and need emergency surgery. I've also taken care of the elderly that have had strokes. But a lot of these things happen in emergency situations. So, you know, one minute you could be enjoying a coffee and the next minute you're rushing off to the operating room. So it's it's almost like your mind and your body go into panic mode, you know, and and and so I've kind of trained myself through the years of not getting into panic mode, you know, it's a very controlled situation where, you know, you know, yes, there's somebody dying and yes, I'm the one to save them, but at the same time, it's, you know, become so rote with muscle memory and, you know, that, you know, going into the operating room and performing that type of operation is, it's second nature at this point. But I think mentally centering myself allows me to be able to take care of the emergencies and remain calm and focused while I'm doing it.
Dr Rupy: And I think part of that process of of remaining calm is not even practice in the moment, it was it's after the moment. And I remember reading in your book actually about how you have this sort of traumatic imagination of you with the scar on your scalp when you were thinking about your mother in the hospital. And I don't know whether that was a recurring dream, but the sort of trauma of of that sort of seems to have imprinted on you as you're you're going through your your your training and your your speciality. And that sort of conjured a question for me as to how you would deal with something so traumatic as, you know, dealing with child fatalities and and obviously the the injuries that you see on a on a week-by-week basis. Like, how do you compartmentalise that and how do you deal with the the relaxation afterwards as well when when these things are happening so frequently for you?
Dr Sherry Dewan: Yeah, that's a great question. I think that's actually, as a doctor, not dealing with those things is what contributes to I think a lot of our burnout, you know, as a profession. And, you know, there's a chapter I have in the book which is put a pin in it. And the chapter is basically about how when you're dealing with the trauma and you're in the moment, you know, and there's a scene in the book where I have a accident victim come in and she, um, had part of her scalp had been taken off by by basically a barrier. And there was glass and everything in her brain and how I was tasked as the neurosurgery resident with removing the pieces of glass from her brain in the in the emergency room. And as I'm doing it, she wakes up and starts having a conversation with me. And so in the moment, here I am as a young neurosurgery resident, and the moment I'm like in a twilight zone moment, you know, where I'm like, is this a bad horror movie, you know, like what is happening? But I also know that in order for me to help her, I have to step outside of it, take the glass out of her brain, get her upstairs to the operating room and do what I'm supposed to do. So it's this, and she, you know, and she did great, the patient did well, you know, and so it's, it's this put a pin in it. It's, okay, focus on the task. This may seem completely out of sorts, crazy, twilight zone, you know, Hannibal Lecter type of situation, but, you know, take care of the patient, deal with it, and then process later. And so, after these really kind of horrific accidents or just wild situations that I've had, I would go back to it, you know, whether it was six hours later, 12 hours later, the next day, and kind of internalise it and say, what did I experience here? And how did that make me feel? And, and I think just doing that is was my way of coping with some of the things that I saw. And I think we should all do that, you know, and not just in medicine, just in general, because I think the tendency is just to push it down, push it down and, you know, not acknowledge it. And I think that, that chapter is really speaks to that.
Dr Rupy: Yeah, I love that expression, putting a pin in it. But I I I and I I agree with you. I think a lot of times we just put pins in things and we actually don't unpin them a little bit later on and actually process exactly what we've pinned there, what we've experienced, etc, etc. And I wonder if you can give us a bit of a an insight into what it's like when you do unpin it, when you do reflect on your day or your week and and how you deal with with those quite challenging memories and and experiences.
Dr Sherry Dewan: Yeah, and it took me, it took me a long time, especially as a neurosurgeon, you know, we do see a lot of death. And when I started my residency, it was very hard for me because, you know, I had never experienced, you know, dealing with a patient who came into the emergency room who was essentially, there wasn't much you could do to save, you know, and so that was really hard for me as a young resident dealing with the death, dealing with the sadness, having to tell families, you know, their loved one was brain dead or having patients that, you know, I knew weren't going to make it in the ICU and but I think through the years, it's become, you know, knowing that they got the best of me, that I gave them the best that I could. And, you know, also allowing patients in many ways to pass away with dignity because, you know, one of the things, at least, you know, and I know in some countries, probably the UK, like in the United States, it's everybody always wants to pull out all the stops. You know, even if the patient is like 95 years old, you know, and sometimes it's sitting down with the family and just saying, let's be real, you know, it's a situation that there's no quality of life here. You know, yes, we could go to surgery and we could perform brain surgery, but this may not save your loved one in the way that you remember them. And I think having that conversation and allowing patients to pass with dignity, I think is really important too. And that's one thing I've learned a lot throughout my career and the way that, you know, I advise families and is really is really that is, you know, sometimes pulling out all the stops when we get to our advanced age may not be the best option. So.
Dr Rupy: Yeah, yeah, yeah. We we used to have something called the Liverpool Care Pathway. Um, it's been superseded by another series of protocols that can be locally agreed as well. I'm I'm really, uh, privileged to have experienced such good palliative care teams in the hospitals that I've worked in. And actually during my time in Australia, it was sort of the opposite actually, probably similar to what you're describing in the US actually, where it is a case of we will operate on anyone, we will throw all the drugs, all the interventions and sort of leave the quality of life or the the absolute extension of life to to one side because really you just want to be giving 100% or 110% in many cases all the time. And I think frank conversations with with patients' families is is certainly the way to go, but it it is very difficult as I'm sure you can attest to to have those conversations because you don't want to ever be seen as giving up or or, you know, not putting enough effort in, but actually you've got to be, it's beyond realism, it's it's actually what what is in the best interests of of the patient. And you know, it's funny you were talking about having your your your board of directors because I remember reading in the book, there's a character called Dr Peter, I think, who is a experienced neurosurgeon who who said something like, your life can be surgery, but your patients' lives aren't your life. And as long as you can do that eight times out of 10, you'll be all right. And I thought that was so touching because it's it's real because, you know, as much as we try, our patients' lives always do seep into ours. And I'm I'm wondering if that eight out of 10 rule did apply to you or perhaps it's been a bit more or less, I'm not too sure. What what why don't you tell us a bit more about that?
Dr Sherry Dewan: Yeah, I mean, he was, I he's still in practice today, he's a great guy. You know, and and I think what he was trying to tell me is you can't take it home with you. You know, I mean, because at the end of the day, we do what we do, we try to help, we do the best that we can to our ability. But, you know, we go home to our families and we go home to the people that we love and although I love my patients, and many of my patients have become friends and have become close to me, at the end of the day, you know, I go home to my family and and so we can't take it home with us. I mean, we have to, you know, with my with my family, the minute I walk into my home, I put on my mom hat, you know, the neurosurgeon hat is left behind and the mom hat goes on and, you know, I'm their mother and I'm making their lunches and I'm, you know, driving them to sports and so I think, you know, in so many ways, if we brought home everything from the hospital into our personal lives, into our home, I don't know if we'd be able to function as healthy individuals. You know, because because we all need a balance, we all need, we all need a yin and a yang to our day and to our lives and we all need, you know, to learn how to deal with all the facets that we have in front of us. So that's something I try not to internalise a lot of the things that I've seen, a lot of the things that have happened. Some things stay with me a little longer than other things. You know, I'll have situations where maybe I felt a kinship with the patient a little bit over something and that lingered with me. You know, I've attended funerals of patients that I've taken care of. Unfortunately, I've had to attend, you know, funerals of children that I've taken care of, accidents and things like that, but I try to just, I guess I try to say, you know, I did what I could for them in that moment and you know, be at peace with that.
Dr Rupy: Yeah. You you've mentioned a few concepts here that I think are really important for people if they want to develop their own toolkit of mental well-being. One of the things you mentioned earlier was delayed gratification, a concept that I'm obsessed with because I think it's so important, particularly in today's environment of instant gratification, uh, via social media or via your shopping or, you know, there's no, there's never a need to wait for anything these days. And I think it expands to our careers. And if you think about medicine, the the arc of your career will span decades, you know, still in training. And the other thing is, you know, this ability to compartmentalise, this ability to put a pin in it and reflect on it later and ensure that you do reflect on it later and being disciplined about that. I wonder, you know, because you're operating obviously at the extreme end of these concepts, how would we essentially help listeners to this conversation develop their own mental health toolkit such that they can dive into these concepts of delayed gratification, putting a pin in it, being able to compartmentalise in their own lives, regardless of what situations, how extreme or or non-extreme that they're operating at. Like what what sort of tips would you give people perhaps from that chapter to to start practicing today?
Dr Sherry Dewan: Yeah, I mean, I think, um, a lot of times, societally, especially now more than ever, um, you know, we're an instant society. We want everything right away, right now. You know, we want, you know, our food on time, our plane on time, you know, everything needs to be on time and and I think, you know, in medicine, as you know, it's such a journey and, um, you know, I do worry that people are going to say this is too lengthy of a career path for me, you know, and I and I do worry that we're going to have less people interested in the field because of it. But what I would say is, you know, when you get to the place where you're where you wanted to go and it took you such a long time to get there, it feels just really incredible and it's like no other feeling in the world. And I don't think, you know, you don't need to be a brain surgeon to feel that. You could do, it could be anything. You know, whether it's you want to challenge yourself athletically or you want to climb Kilimanjaro or even something, you know, like a goal of getting your child potty trained, you know, like my sister is currently doing, you know, I mean, there there's so many, there's so many goals that you can have that that just feel so amazing on the other end. And, um, and you know, there's also a chapter about, um, what's temporary in the book. And, you know, there's one story where I was studying for the MCATs and all of my friends were going out and just having the time of their lives and they were like, Sherry, why can't you come hang out with us, you know, and how come you can't go to this party and that party? And it was like this because I'm studying for medical school, you know, and that is our lives a lot of times in medicine, but in law, you know, I mean, if you're a lawyer and you're dealing with legal cases and I mean, in business, I mean, I have many friends in business who work harder than I do because, you know, they have to take meetings all over the world and, you know, delayed gratification of of their companies and things like that. And so, I think it's applicable to any stage in your life and applicable to any field, really, this concept of, um, thinking about when you get to that that place where you've reached the pinnacle, how great it's going to feel and how proud you are going to be of yourself for having stuck with it, you know, and there is no price that you can put on that. It's it's a it's a completely different feeling. Um, like a life moment.
Dr Rupy: You you've mentioned goals and visualising. I I I want to dive into that a bit actually because I think, you know, I goal set, I'm a big fan of visualisation or vision boarding or actually as Dr Tara Swart who's a friend of mine, a psychiatrist and someone who speaks quite a lot on the subject, she she refers to as action boarding because a vision board is sort of like, you know, something that you do and you don't really identify whether you can actually achieve it. An action board is actually, no, I'm going to action these things. These are going to happen at some point in my trajectory along life. How how do you set goals and what is currently on your action board?
Dr Sherry Dewan: Uh, so I am a huge planner and goal setter, obviously. It's it's a part of me, it's who I am. Um, every year, I actually write them down. So I make a list list for myself and it's divided up into personal and professional as kind of broad categories. Um, in professional, it can be anything. It can be, you know, I want to learn a new technique. I want to go to, um, you know, a course in X city to learn something. The personal side is also anything. I wanted to learn how to ski last year. So, you know, that was on my personal list. And then the third category that kind of developed over time was the, so it's personal, professional and then family is my third category. And then the family goals are, you know, what do I want for my family for the year? And I usually do three goals under each category. And at the end of the year, I refer back to it, usually around October, just to make sure that we're kind of on track with where I want to be. So I'm a huge goal setter. Um, in terms of what's next, I mean, you know, I feel like in so many ways, I've always wanted to be a neurosurgeon, I've always wanted to be an author, I've always wanted to be a mother and so, um, and a good wife. I've been married 18 years and so I feel like I've checked a lot of the boxes of things that really, um, you know, really I wanted. And, um, you know, what comes next? I mean, I have another book that's going to be hopefully coming out in the next two years. Um, but really it's time for me to kind of help my kids realise their dreams and, um, really be a light post for them to go out into the world and do wonderful things. And so, you know, I think my next goal is really getting my family and my kids where where they need to be, which is kind of independent, um, functioning, wonderful human beings that get put out into the world to do great things.
Dr Rupy: Yeah. I mean, you're so you're such an inspiring character and a role model for people across the world. I mean, just reflecting on some of the things that we've talked about today, you know, goal setting, uh, a form of transcendental meditation, you know, setting time every single day to ensure you have mindful moments. Are you quite different to your colleagues? Because most of my friends in surgical specialities don't really talk to me about this kind of stuff, if I'm honest. They don't really seem to have these kind of practices, at least daily anyway. I mean, do you do you see yourself as quite, um, uh, out of the ordinary compared to your your neurosurgical colleagues or or in medicine in general?
Dr Sherry Dewan: You know, I think I'm probably somewhat different. Um, but I do feel like there are quite a few people that I'm starting to meet now that espouse to, you know, I mean, talking about mindful moments and meditation is actually more common now in the operating room than it ever used to be. I mean, I mean, 10 years ago, if you were to tell the OR, we're going to do a mindful moment before starting surgery, you'd probably be laughed out of the operating theatre. But now actually, you know, there's a lot of neurosurgeons that espouse to it. There are people that have like a a huddle or, you know, and I think it's actually a lot more common now than it used to be. And I think the old breed of surgeon is slowly kind of moving on and, you know, new breeds of surgeons are coming up that are, you know, more about, you know, multi-faceted life and, you know, really a balance that probably wasn't ever dreamt of, you know, 10 years ago. So, I think there is a new crop of and a new generation of surgeons, at least that I see. Um, you know, and some of my colleagues, my older colleagues, I feel that they also, you know, I was listening to one of my senior colleagues talk about doing yoga the other day and I thought, wow, I never would have pictured that individual doing yoga, but you know, it's there and I think it's a lot more accepted now, you know, and um, and I hope that, you know, me being around them has kind of allowed them to think about the career and the the profession in a different way too. So.
Dr Rupy: It's it's interesting because like, uh, you know, I've been sort of talking about this for a little while and I never would have imagined some of my, um, friends doing this as well in different industries, uh, and different backgrounds, but it seems to be a thing that's creeping up. What what do you think is on the horizon that perhaps people aren't talking or doing right now, uh, within medicine that might become commonplace in the next like 5, 10 years?
Dr Sherry Dewan: Well, I think at least in my profession, um, I feel like, you know, just robotics and AI are even more important now. Um, I think AI is going to just be a huge explosion for us in the next 10 to 15 years and how we use that. The other day I was talking to somebody and they were telling me how, um, they had developed this AI technique to, um, identify depression in patients. And, um, when they were calling the suicide hotline and how they were using AI to kind of help screen through these through these patients. And I thought that was just incredible, a change in how we view, um, mental health and medicine in general. And I and I think, um, I think we're going to see more of that, you know, and I think we're going to become more well-rounded as doctors. And, um, and I think our patients are also going to take more initiative on their health too, which I already see.
Dr Rupy: In what way do you think they're taking more agency over their health that you're seeing today?
Dr Sherry Dewan: I think, um, at least what I see a lot of is I see a lot of spinal disease and in many patients, at least in the US, you know, obesity is is a major issue. Um, and, you know, telling somebody that weight loss is going to be actually the key to their spine health can be a very difficult conversation in many ways, you know, and so now I think, you know, one of the things we instilled was actually a bariatric program and we have, you know, a situation where we're now referring patients to nutritionists and aquatherapy in the pool and bariatric surgery if needed, instead of just telling them, okay, let's go do a spinal operation and a fusion surgery on you that may or may not benefit. So, and people are receptive to that, you know, more so now than I think 10 years ago. So, I do wonder if some of the the COVID effect of people not wanting to be in the hospital per se, you know, as much, plays into that where they're saying, wait a minute, let me look at my physique and let me see, you know, if my BMI is so high, maybe if I brought my BMI down, that would be beneficial to me, you know, so I think they are taking more agency over over their own health.
Dr Rupy: Yeah, yeah. And I think it's spilling over beyond, uh, just nutritional medicine for the likes of cardiovascular health. Um, you know, people are looking at their plates as a way to mitigate against mental health, uh, inflammatory disorders, um, spinal diseases as you've just said there. You know, are you seeing more sort of medically tailored meals or, um, the the sort of studies looking at food as medicine? Because I I feel that America is probably a little bit further ahead of the curve than the the UK on this. Um, probably out of, uh, the the the severity of the need based on the the metabolic illnesses that, you know, you guys have got a high prevalence of over there.
Dr Sherry Dewan: Yeah, I'm seeing a lot of patients who are very in tune with anti-inflammation diets. Um, I have a lot of patients that have spinal arthritis, so they're developing, you know, total body, total neck pain all the way down to the tailbone. They're taking turmeric, they're, you know, really focusing on, uh, inflammatory, you know, markers in their blood and and how they can bring those down. And so, it's it's, you know, a lot more accepted now than it used to be and it's a lot more common for us to say, okay, let's let's go a holistic approach. And I think that's really the way to go. I mean, surgery is obviously there for people who need it and, you know, but I I've always espoused to, um, conservative management first, you know, and conservative management includes the healthy lifestyle and the dieting and proper weight, you know, before the operating room.
Dr Rupy: Yeah. And you you mentioned AI there and robotics. Do do on what side of the coin do you sit in terms of whether AI is going to eventually take over the role of the surgeon and the medical practitioner or do you feel like there's always going to be a requirement for a sort of human interface if you like or a humanoid?
Dr Sherry Dewan: You know, I think, um, so I use robotics in my practice. So I started, um, using spine robotics a couple of years ago to put in spinal screws. So I I did adopt it. I do remember being at a conference about 10 years ago and seeing the robot presented and I thought that will never happen. It's never going to happen. But you know, now I'm using it a couple of years later. Um, I do think though that you will always need a surgeon or a human or, you know, there is that, you know, that pendulum that swings, you know, where you become too technologically driven and then you lose the human capacity. And I think, you know, you do always need to have the human touch, no matter what it is. So, I don't think robots will ever fully take over. I think we're always going to be, um, we're always going to have a need for sure.
Dr Rupy: How old are your children, if you don't mind me asking?
Dr Sherry Dewan: So my kids are 13, 12 and 10.
Dr Rupy: 13, 12 and 10. Okay. Um, and in terms of their career trajectory, particularly your eldest, I guess they're thinking about, you know, what careers they might want to pursue. Is medicine something that you would advise, would want them to go into at this stage considering, you know, the the rise of of robotics and AI and all the other things. And and also the the stresses on on the medical forces as well or are you would you gently be nudging in a slightly different direction?
Dr Sherry Dewan: Yeah, you know, it's a really interesting question. I've been asked that question so many times about my daughters especially. I have the two oldest are daughters. And people have asked me, you know, would you advise your daughters to go into medicine? What are your thoughts about it? It's a really tough question and I think it honestly depends on each child's personality. Um, you know, I think medicine, it really is a calling. It is such a long road and wrought with so many different obstacles that, you know, if one of my daughters really wants to do it, I would 110% support her path. Um, that being said, I want them to fully understand what they're getting into, you know, because there are a lot of things that your friends in business and your friends in law aren't are never going to deal with, you know, and they're never going to take somebody's life into their hands. And, um, so so I think that, um, I would fully support them. You know, one of my kids really doesn't want to do anything with medicine. She's more interested in business. But my middle child has really expressed an interest in neurosurgery and, you know, and in medicine. And so I want to foster that interest, but I also want to be cautious and show her. I mean, I think one of the things that, um, is the biggest accolade is if your child wants to follow in your footsteps. To me, that's that's really just, it says it all that you haven't destroyed the profession for them mentally, you know, and um, because I've so many friends whose parents are doctors and they want nothing to do with it, you know, and um, so I feel like hopefully I've shown her that you can have a balance and you can have a multi-faceted life and you can be good at several things. And I hope I've instilled that in her and, you know, with the way things are changing, I feel like I don't even know what job they're going to have because at their age, it may not even be created now, you know, they're going to have some probably specialisation even within medicine that's, you know, robotics driven fellowship or some sort of track in medical school that's AI driven or some, you know, something. So I think it's going to be really interesting to see where where the pendulum swings.
Dr Rupy: Yeah, yeah. No, it's it's fascinating. I'm I'm chatting to people of various age groups right now and they're asking me this question. So I'm trying to garner as many responses as possible from people in various fields just to get an idea of, you know, what the perspectives are, what what what the the thinking is in in various specialities because it is a hugely disruptive time, a very exciting time. I'm like an eternal optimist. I just think medicine's going to get better as a result of AI and machine learning. We're already seeing that in both clinical and non-clinical hospital environments. Um, so I I'm pretty excited about it, but you're right. I think the the job descriptions and the job opportunities are going to vastly change. Um, like even looking at myself, you know, who would have thought that there would be a role for a general practitioner who espouses the benefits of eating well in a public health arena using social media as a platform, you know, it's just, uh, you can't really predict these things.
Dr Sherry Dewan: No, and that's the beauty of life, I think. It's so malleable, you know, and it's so dynamic and, um, and we can do so many things. We can be so multi-faceted that, um, that's where that's the beauty in life. I mean, you know, who would have ever thought an Indian woman could be a neurosurgeon and be an author and be a mother of three and, you know, so you just, um, you kind of have to do the things that feel right to you and, you know, and whether people view it as the norm or not, I don't think it really matters anymore.
Dr Rupy: Yeah, yeah, absolutely. Well, look, thank you so much for writing what what what is a wonderful piece. I I love your writing style. I think people are going to absolutely enjoy it and come away inspired from it. And I think how you've packaged purpose, determination, discipline, um, is wonderful and and using your own story and and being vulnerable with all the things that you've shared, I think is, um, has been fantastic. So, yeah, I can't wait for, uh, other versions of it, let's say, uh, beyond the the written word. I'd love to see it in a different form, but um, but yeah, no, congrats. It's it's wonderful.
Dr Sherry Dewan: Thank you so much. It's been such a pleasure coming on with you and, um, talking about the book and, you know, obviously congrats to you too and all of your successes. So inspiring to watch you as well.
Dr Rupy: Appreciate that. Thanks, Sherry.
