Dr Sherry Dewan: The first one really is to move. And we don't move enough. We literally, when we're at home with our computers or laptops, we're at a desk or maybe you're sitting on the couch. Um, and you are not moving your body in the way that you should. So every, think about every 45 minutes to 60 minutes you should be getting up and changing your position.
Dr Rupy: I'm Dr Rupy and this is The Doctor's Kitchen podcast. The show about medicine, food, lifestyle and how to improve your health today. And I'm chatting with the amazing Dr Sherry Dewan, who is a board-certified neurosurgeon who was inspired to become a doctor actually after her mother was rushed to the hospital with a ruptured brain aneurysm, a story that we get into a little bit later. She is one of just 219 female neurosurgeons in the United States. There are just under 4,000 neurosurgeons there that represents around 6% of the entire workforce. She works at the Northwestern Medicine Central DuPage Hospital in Chicago. She graduated from Northwestern University and completed her neurosurgical residency at Brown University, which is an incredible one if you haven't heard of it. She actually specialises in pituitary tumours, Gamma Knife radiosurgery, minimally invasive degenerative spine disorders, but she's also a passionate advocate for diet and lifestyle, how we eat and how that affects the brain. And she's also in the process of publishing her first book, which is Cutting My Own Path. A great, great title. In today's episode, we talk about the evolving situation with COVID-19 in Chicago and how she's actually gearing up to look after intensive care patients. Everyone is really becoming so flexible in the response to this virus. It's quite amazing to hear some stories from the front line and I think you'd benefit from listening to how the Americans are dealing with the situation. And if you like this kind of stuff, then we can try and get some more inspirational stories from those who are on the front line to give you a perspective of of how we're all in this together, literally on a global level. We talk a bit about posture actually, to to speak to the current issues with people working from home. You're not going to be commuting, you're not going to be able to walk as much as you would do naturally, so your steps are naturally going to be down. What can you do with your posture to make sure that you are sitting well for hours at a time? We talk about moving every hour or so, the flexion of your neck and how that can impact lower back pain, as well as other methods and other exercise modalities that can improve or prevent against back pain. As someone who has suffered with back pain for over 20 years, I don't think I've actually talked about it before. Yoga and other modes of physical exercise are absolutely invaluable to me, so I have to move every single day and it speaks to Sherry Dewan's experience as well. We talk a little bit about diet in this episode, but it's more geared towards Sherry Dewan's incredible career, how she got into it, and with a particular focus on how females in the medical industry can cut their own path to take the title of my my guest's book to soon be released. Or actually she's soon writing it. We we also end on what positives can come out of this terrible situation. Not to make light of of COVID-19 or trivialise the impact of this virus on a global level, but I think there are certainly optimistic takeaways and I hope you find some solace in that at the end of the pod. Please give this a five-star review, check out the newsletter on the doctorskitchen.com, the links to my guest will be on the podcast website, the doctorskitchen.com/podcasts. For now, on to the chat.
Dr Rupy: How are you, Sherry?
Dr Sherry Dewan: I'm well. I'm well. I'm hanging in there, just like many other doctors in the US and all over the world. We're trying to kind of jerry-rig it together and make it work and try to keep as many patients safe as we can while also keeping ourselves and our own families safe.
Dr Rupy: Absolutely. Um, just for those of you who just want to recap of what you do and everything, you currently work in Chicago and you're a neurosurgeon?
Dr Sherry Dewan: That's correct. I work in the metro Chicago area. So I work for one of the largest health systems in Illinois and we have multiple hospitals. Um, they're kind of spread out all throughout the Chicago area with our biggest hospital being downtown. Um, so I work in one of the satellite facilities, um, that's about 45 minutes outside of the city. And, you know, um, it's a busy place and we take a lot of, you know, we're a level two trauma centre, so we take trauma. Um, and my practice encompasses not only the trauma but also, um, spine and brain. So essentially brain tumours, uh, aneurysms, that sort of thing and then degenerative spine. So that would include, you know, your disc herniations, spinal stenosis and things like that.
Dr Rupy: What we're witnessing over here in the NHS is, um, the incredible flexibility of our healthcare system that we thought was quite rigid prior to this. Um, I currently work in emergency medicine. I've just been sent over the rota actually for the next couple of weeks and we've actually realised that we actually have a lot of capacity, um, with staffing and we're strategically trying to, um, map out where we might need extra staffing resources as healthcare workers on the front line inevitably get sick. Um, I'd love to know a bit about how your role has currently changed both electively and in response to, uh, urgent work like trauma, like you said. Um, and what the morale is like currently as well where you're at.
Dr Sherry Dewan: Well, you know, the jobs are very fluid now and I think we've all been asked to float, if you will, for a lack of a better term. Um, we're being asked to potentially run the ICUs if COVID patients, um, overwhelm, uh, the floors. We've been asked to travel to different hospitals within the system. Um, we recently got an alert from the mayor and, um, the state asking for doctors to come to McCormick Place, which is a convention centre. They've actually converted to a 3,000 bed COVID hospital. Um, so all of a sudden, you know, you're no longer a neurosurgeon. You're an ICU doctor, you're a physician, you're triage, you're, and so I, I think that that's important for everyone in the healthcare field to really, um, have this moment where they say, I have these skills and I can contribute societally. Um, one of the big challenges for me has been, you know, when this happened, all of the patients that we had on the schedules for surgeries and for elective visits, it all stopped. So there's, there's, you know, and we did the emergencies that we could. Um, the challenge is those patients are still in pain. They still need surgery. And we can't give them a definitive answer as to when we're going to be able to get these things accomplished. So, originally we had said April 15th and now we're pushing it back now that the state has kept our shelter in place till April 30th. So, I think that's the challenge too. It's, it's not just the COVID patients, but it's the patients that are at home with maybe a huge herniated disc and they can't get their surgery done and they're living on pain medication. So, um, we're trying to be as cognisant of all of this as possible. And I also think, um, very innovative too in many ways. I've been so impressed by my colleagues who have had, uh, the foresight to say, okay, we see this coming and we're going to change our schedules and we're going to go and learn about telemedicine and telehealth, which has always been this thing in the background. You know, we've always heard about doing e-visits, but everyone's been afraid to do them. I don't know about you, but all of us, you know, we have, we don't want to do e-visits. It's kind of terrifying. You can't examine the patients. Um, but I think it's really changed the way that we view innovation and new technology. And, and so I've done a number of e-visits now with patients. If they're in their 70s or 80s, we do a phone call. Um, if they're younger and they understand the technology better, we do FaceTime, we've Skyped, I've Zoomed with patients. So I, I think to answer your question, we all need to be aware of this global pandemic that we have found ourselves in and really think about the ways that we can help, um, societally and it's, and it's not going to be easy.
Dr Rupy: Yeah, no, absolutely. It's funny you say that about telemedicine because, um, so I, I work in general practice as well as in emergency medicine. So I see the breadth of patients from the primary to secondary care sphere. And it's incredible just how quickly GP practices that have been traditionally quite, uh, reluctant to engage in telemedicine services will shift to actually appreciate the value of telemedicine. I think whenever we're out of this, whether it's three months or six months, and there's some even scarier predictions than that, I think it will change healthcare hopefully for the better. To echo what you were referring to earlier is, I'm worried actually about the number of missed diagnoses and the number of seemingly less urgent cases that will become more urgent over the next three months. Um, I, I work as an ambassador for, uh, a gynaecological, uh, cancer charity and they're particularly worried about the number of misdiagnoses of female cancers that are particularly worrying already because health professionals don't ask the relevant questions in primary care. So these are things and challenges I think we're going to have to come up to in the next couple of months and those are sort of worrying things. But right now it's quite reactionary and it's, it's actually amazing to see the capacity to increase hospital care spaces as well. Like you mentioned the conference centre, we're doing the same thing. We've got a 4,000 bed capacity unit in, um, uh, the Excel Centre in London, um, that's just being created in the space of a week, which I just think is absolutely nuts.
Dr Sherry Dewan: Yeah, and that's, that speaks to how, um, fragile but yet interconnected we are as a society and, um, how innovative we are. You know, um, we've not only spanned this, this breadth of telemedicine and telehealth, but children are going on to remote learning and they're doing Zoom meetings. You know, six-year-olds, seven-year-olds and, you know, so I, I think that as a society, we, you know, we're going to, we're going to prevail and we're going to conquer it. But unfortunately, we're going to lose a lot of people along the way. And, you know, the challenge is, um, for us is to prevent that loss. Um, I, I don't know about you, but I already know friends and colleagues that have contracted, um, and some have, have passed away. Um, you know, friends that are on ventilators, um, who are young in their 30s, 40s. So I think it's going to affect all of us. Um, you know, we had a prominent neurosurgeon die in our community last week in New York and, and so that affected many people that knew him. Um, you know, and one of the other challenges for surgeons is that we're seeing that the, that the virus can aerosolise. And when you do surgery, obviously there's an intubation. Um, and so now we're trying to understand even when we move past this crisis period and we're heading into, let's say we're in mid-May, we're in June, how do we navigate our practices, you know, do we all wear N95s across the board? When we intubate a patient with a surgical mask on top, do we test the patient for COVID? What if you can't? What if it's an emergency, you know, subdural haematoma evacuation? Um, so how do we navigate those waters now because we're learning and understanding more about the virus? Um, so that's, that's another challenge that I foresee coming down the road.
Dr Rupy: Yeah, I mean, that's horrible to hear actually about the number of healthcare workers affected in your community. Um, in the UK, we are luckier in that, um, it hasn't seemed to affect healthcare workers as much, but that will be coming. There have been a few, luckily none that I know personally that have succumbed to the disease. Um, and certainly the lack of PPE, personal protective equipment, um, has come to the forefront in terms of the political discussions. I was only just fit tested for, um, a mask this week. Um, and that again owes to the, the number of, the lack of masks that we have. And this is a global issue as well across all healthcare systems just crying out for the simplest of things, a mask that will fit them and protect them from this aerosol disease. And it's important what you said about the aerosolisation of the virus that a lot of people don't realise. I know that we've had a few intubations in our emergency department where people weren't wearing the appropriate PPE. And this was two weeks ago prior to, you know, the degree of severity of the lockdown, um, the, the number of people that we were actually aware of like how, uh, contagious this disease is. Um, there's a lot of issues I think that are coming to the forefront and every week it seems to get more and more, um, we seem to have more and more information amongst us staff. Putting aside the acute, um, response that you guys are, are stepping up to, how are you managing this on a personal level? Uh, you have family, you know, you have friends, you're dealing with the psychological trauma as well of losing colleagues. Um, how, what are your coping mechanisms?
Dr Sherry Dewan: Well, you know, I, I've been a neurosurgeon for a long time now and I think the job itself is high stress and if I didn't have my strategies that I've always employed, um, you know, I think it would be, it would be tough, but I, I believe in yoga, I believe in meditation. Those are things that I've always, um, lived by, practiced. Um, I've done yoga for over 20 years and you know, when you have these moments where you're watching the news, you're watching CNN or you're watching, um, you know, more bad news and more bad news and, and you're getting news from family or friends and, um, I think those are the moments when you need to kind of reach within and whether it's take a walk, you know, with social distancing, whether it's yoga, I meditate every day for 20 minutes. I've done that for years. Um, it's to kind of, remove yourself for a minute from what's happening globally and say, wait a second, I'm okay right now. People that I know are okay. You know, we're going to get through this. And that's what I've always done. I mean, I'm sure you as a physician too have your strategies that you've employed, you know, through the years. But of course, none of us have ever lived through anything like this.
Dr Rupy: Yeah, I mean, it's completely unprecedented and the number of people that have actually reached out, um, and said to me, look, I'm trying to get into meditation now, um, which is great that people are actually respecting that it can be a tool, but in reality, it, it, it's more of a preventative tool in the way that you're using it right now. The reason why I practice gratitude, the reason why I meditate as often as I can, um, the reason why I've been involved in this sort of community of, of thinking about health from a, a holistic point of view, um, is in a preventative capacity so you can deal or better deal with situations that are completely outside of your control like a pandemic or even other less severe, uh, scenarios as well that will obviously, uh, occur to you as you go through life. Um, there are a number of different, uh, healthcare practitioners now that have set up groups where they do, uh, group meditation over Zoom as well. So at the end of your shift in emergency, you know, everyone's doing meditation together. Um, I've started doing something with a friend of mine who's a neurogastroenterologist. It's quite amazing and I think self-care is going to be a huge thing after this is said and done as well.
Dr Sherry Dewan: Yeah, I would definitely agree with that. And it should have, I mean, it should have been important to begin with. But again, you know, as, as, as physicians and as people in general, we neglect our own needs and, um, I think that's, you know, you have to take care of yourself first if you want to be able to take care of your patients and your family.
Dr Rupy: Yeah, absolutely. And to that point actually, I did want to ask you about, about, um, posture in particular. Uh, there's a lot of people, um, who are going to be not commuting anymore, not being able to walk outside as much as they'd like to. They're going to be cooped up indoors, um, and they're going to be working from home, sat on a chair, perhaps from hours on end, um, without that break of commuting to work. So, I was wondering whether you had any advice and tips for people, uh, working at home now, uh, and, and relying on communication tools without being able to go outside for a walking meeting, which I was a big fan of prior to this.
Dr Sherry Dewan: Yeah, definitely. Um, you know, there's a lot of great work from home strategies you can employ. Um, and I, you know, I can give you kind of three quick tips. Um, the first one really is to move. And we don't move enough. We literally, when we're at home with our computers or laptops, we're at a desk or maybe you're sitting on the couch. Um, and you are not moving your body in the way that you should. So every, think about every 45 minutes to 60 minutes, you should be getting up and changing your position. Um, it was actually interesting, I saw a study where they tracked, uh, fitness trackers throughout the quarantine. And what it, what it showed is that people are actually sleeping more. So they're moving less and they're sleeping more. You know, so, um, I think it speaks to the point where we really need to get out and be and be doing more, you know, we need to be moving. We need to be whether it's taking a a walk around the block with a six-foot distance or moving within your own home. So that's the, the first tip. You know, if you're, if you're going to be an eight-hour day at your computer, set a timer or look at the time and say, okay, in an hour, I need to get up and move. Um, so that's the first. At the second is, you know, we actually had a quite a bit of an uptick of patients calling into the office because of neck pain. Um, they're looking at their computers and the neck is flexed for the majority of the time, or they're doing Zoom or Skype calls and their neck is flexed. And so a lot of patients were calling in the first week and saying my neck is in horrible spasm, um, it's locked, it's very rigid, I can't turn my neck. Um, and so, you know, typical things to employ would be obviously, you know, you could ice or take a mild anti-inflammatory, but, um, really it's to think about your neck in a more neutral position, think about holding it in a more neutral position. I might say be more ergonomic. Uh, so, you know, if you're going to be using a laptop, stack books underneath it so that you're more eye level. If you're using your phone, also try to have it on more of an eye level so that you're not craning the neck. Um, and then again, I think taking those breaks is really important too throughout the day. Um, the other thing that's happening is a lot of low back pain. You know, societally, we have a lot of low back pain as it is, but especially with work from home, um, patients are calling in and also saying, you know, my back is hurting, I'm sitting in one spot. So, um, what I would recommend for that would be to really engage the core muscles, your abdominal core muscles. And even when you're sitting at the computer working to kind of have a strategy to clench those muscles, um, you know, pull your belly button in towards your spine, the back of your spine. And if you maintain repetitions of that throughout the day, it's really going to help your lower spine, um, especially because we don't have a lot of stability in that region. All we have is our abdominal muscles and for most people, they're not that strong.
Dr Rupy: Yeah, I mean, some of those, uh, exercises that you're describing there seem like they come, they stem from yoga, uh, or different sort of movement, uh, mechanisms. Is that something that you're a big fan of as well?
Dr Sherry Dewan: Definitely, definitely. And just, you know, learning yoga and being a practitioner throughout the years, I've kind of designed even, you know, some programs and things that I do for myself, but, you know, maybe at some point I could even put into some type of, uh, formalised program for patients. Um, and that would be a, you know, a hope down the road.
Dr Rupy: Yeah, yeah. And the scientific basis of yoga, what, do you, do you, um, sort of speak to that side of things or is this something that has come from your cultural background and, and how you've, you know, engaged in different ways in which to people can move their body to prevent, uh, low back pain and other issues?
Dr Sherry Dewan: I think it's probably a little bit of both. You know, um, I have, I've personally, you know, my family is from India, although I was born in the US, and, you know, I remember very vividly going to visit my grandmother in India and having a yoga teacher come to the house and, you know, um, you know, when I'd visit India, we do yoga there and it's, it's actually very different than the, the American style of yoga. Um, but I think it's a little bit of both. It's, it's the spirituality of yoga that I've always loved. It's not necessarily that you're burning a lot of calories or doing a lot of cardio, but you are in many ways, um, you know, moving your body with, with the intent to, it's basically intentional purpose. And that's what I really love about it. Um, and I also think we could learn a lot from Eastern medicine in so many different ways. Um, you know, with patients that I have that I follow that are long-term back pain patients, if they would even employ some of the yoga strategies into their daily life, they could avoid a lot of unnecessary medication, a lot of unnecessary pain. Um, you know, I'm a huge fan of dieting, exercising, eating right, and, you know, really going back to the, the origins of how we take care of our bodies and, um, instead of thinking about, you know, taking medications for inflammation, for blood, blood pressure, although that's needed at times. Um, also in terms of surgery, I mean, I've had patients who are young and they may have a disc herniation or spinal stenosis or, um, some, some issue with the spine that can be really managed with a, a holistic approach. And, you know, we have to kind of think carefully about those patients, but, you know, if I see them, I'll say to them, listen, you know, I really don't think we need to do surgery at this point. I think, you know, we can think about a yoga program or we can think about aquatherapy or we could think about a number of different strategies before we go under the knife, you know. So I think that's, that's different than many surgeons who, you know, as surgeons, we love to operate. That's why we got into the business, you know. But I think we need to really take a step back and, and look at the patients and say, what's the, what's the best thing for this patient? Like, how are they going to truly benefit, um, from, from my skills and my knowledge about this disease process?
Dr Rupy: Yeah, I mean, I, I love this concept of rewilding. It's where you put your body in the correct environment, whether it be physically, whether it be nutritionally, emotionally, and you allow the body or almost to look after itself. And that sounds like, you know, a bit of an out there concept, but in reality, when you look at the different mechanisms by which nutrition can impact your brain, your mood, uh, your gut, uh, function, it can do incredible things. And I think, um, perhaps patients, uh, particularly of a Western descent, need to understand just how much control that they have over their lifestyles. And perhaps, and not to trivialise the current situation that we're in at the moment, um, but perhaps this could provide a moment of stillness where people actually look at their own bodies and actually engage in self-care in a more meaningful way with the, uh, overall outcome of being, uh, something that could be quite positive going forward.
Dr Sherry Dewan: Absolutely. Absolutely. I mean, even looking at foods that could help you increase your immunity right now to protect yourself from virus, you know, I mean, you think about, you know, what can you, what vitamin A foods can you get? What vitamin C, what vitamin E, you know, what type of foods that have zinc in them? You know, so even if you were to take a step back and look at what vitamins and food groups do I need in my daily diet right now to help me fight as hard as I can, um, so that I'm not, you know, my immune system isn't compromised. Um, you know, and everyone's at home, so it's the perfect time, right? I mean, it's the perfect time to really delve into this topic and to learn more about food and nutrition and, and, um, and immunity and health for your body.
Dr Rupy: Yeah, I, it's the perfect time. I'm like inundated with messages at the moment of like, you know, people trying to support their immune health using food, using dietary tactics as well as other things. And I wrote an entire chapter on this in my last book, um, uh, eating for immunity. And it talks about all those different things that you talked about. And I think where there's a temptation to try and supplement your way out of it, actually food can create this incredible orchestra of different nutrients that can support your body in multiple ways. So it's not just about say the individual zinc component, it's the polyphenols, it's the fibre, it's the, it's how everything's structured together in a, in a perfectly absorbable form as well. Um, on that note actually, I was going to ask you, what, what does a daily like meal look like for you at, and perhaps not at the moment, but generally, like, how do you, how do you tend to eat?
Dr Sherry Dewan: You know, I'm, um, I'm a light eater. I eat a very light, I, I do eat three meals a day. Um, but I eat a very light breakfast, a light lunch, and then usually I'll eat a heavier dinner. Um, I'm a huge fan of Greek yoghurts. I, you know, I'm a huge fan. That's usually my go-to meal first thing in the morning. Um, I'll start out with a Greek, with a Greek yoghurt, um, and usually a fruit. And lunchtime, it'll be something like a soup, something very light. Um, the job is very physical and so I feel like if I eat heavy during the day, I can't move properly. Um, and if we're operating for four to six hours, I want to make sure I have enough sustenance but also don't want to be tired during the process. Um, and then usually in the evening, I'll do something like a, you know, a lean meat or a fish and vegetables. Um, but I, I have to get vegetables every day or I, I can't function, you know.
Dr Rupy: Yeah. Totally speaks to me as well.
Dr Sherry Dewan: Yeah, and I'm very fortunate. Um, I tell, I tell any woman that wants to go into surgery, you need to meet a man that can cook. And, um, I, I'm very fortunate to have, um, an amazing husband who's not only a scientist, a biologist, but he's also a fantastic cook. So, um, he really has this amazing meal every day when I get home from work. So I have to give him credit for that.
Dr Rupy: I just wanted to ask a bit about the types of surgery that you generally perform, uh, obviously prior to your redeployment into ICU and intensive care. Um, what are the surgeries that you tend to do on an elective basis?
Dr Sherry Dewan: Um, electively, you know, in, in the US population, there's a lot of degenerative spine. So I, a, a, an elective surgery that's quite common would be a microdiscectomy, which is, uh, basically taking out a disc herniation, you know, it's pressing on a nerve, causing radiculopathy or nerve pain. Um, sometimes even weakness of the foot. Um, spinal stenosis, laminectomies, very common to basically decompress the spinal nerves, um, allow for relief of pain. Um, another big surgery that we do quite commonly is fusions. You know, I try, I try to limit the number of spinal fusions I do. Obviously, it's rods and screws and instrumentation in the lower spine. But, um, you know, those are candidates that basically are vetted through multiple different, different procedures till they get to the point where fusion's necessary. But then also necks, I do a lot of surgery in the neck. Um, also neck fusions, essentially the same issue with degeneration of the spine. Um, which really comes from inflammation too over a long period of time. So that kind of speaks to the whole food issue, you know, that we were talking about. But there's the spine practice and then there's the cranial practice. And so then the cranial practice is, you know, brain tumours, uh, shunts for things like hydrocephalus, um, brain aneurysms, and then there's the trauma component, which is, you know, subdural haematomas, epidural haematomas, um, evacuation of haematoma for things like stroke. So it's a pretty, um, wide practice. Um, I mostly focus on adults, although I have operated on children in trauma situations if it's needed. Um, so it, it definitely keeps me busy.
Dr Rupy: Yeah, absolutely, yeah. And to, to speak to the whole inflammation component as well, I think that's a very important part of the situation, particularly with degenerative back disease that, um, people perhaps don't know that much about. And it's not just about, you know, physically moving, obviously that's a very important part, but there is evidence to suggest that, um, inflammatory diets may be particularly troublesome for those who are looking to improve, um, their conditions or at least prevent them in the first place. What made you go into neurosurgery in the first place? I feel like there's a backstory here, um, that perhaps, you know, led you down this path because it's, it's a, it's less common, uh, out of all the different surgical specialities there are, it's less common for females to go into this particular, um, field, right?
Dr Sherry Dewan: Yeah, it's true. Um, so women actually in neurosurgery only comprise 6% of the field. So we are actually in the minority, um, we are only 6%. So there is only 219, uh, board certified women neurosurgeons in the United States. And, um, I feel very lucky to be one of them. Um, I'm actually joined the women's board of neurosurgery. I'm one of the executives. Um, and so our whole goal and mission is to increase women in our field, um, because there are so few of us. Um, I really, I think, you know, if you're looking at why I chose neurosurgery, you know, I didn't come from a family of doctors. We had a lot of, uh, professors, a lot of academicians. Um, I came from a family that was very intellectual, they loved books, but there were no doctors in my family. You know, everybody was a PhD, economics, that sort of thing. Um, and so, you know, I was around the age of eight or nine, maybe even 10, where I really started to, um, become fascinated with the brain. And I would go to the library and check out books about the brain and, you know, bring them home and read them and, and, um, I just became fascinated with, you know, the whole idea, the whole concept. It's, it's who you are, it's what you believe, it's how you're raised, it's language, it's everything. Um, and then, you know, through the years started to involve myself in anything I could brain related, whether it was a neuroscience research lab, um, whether it was a rotation in the operating room, whatever it was. Um, and then actually, you know, fate kind of played its own hand because, um, my mother who at the time was 49, um, actually suffered a ruptured brain aneurysm. So it was just an average day and, you know, she had a headache, she was having coffee with a friend. Next thing you know, she's unconscious, we take her to the hospital and it turns out that she ruptured an ACOM aneurysm. So, um, the first time I ever met a neurosurgeon, it was her surgeon. And, um, we met and he basically said to our family, we need to operate on your mother or she's going to die. And I was in my early 20s at the time and had no concept of what that even meant, you know, like my parents' mortality had never really come into my mind. So he operated on her the very next day after an angiogram and clipped the aneurysm and she survived and she did great. She just turned 70 years old. And, you know, he really, um, inspired me. You know, I, I really started thinking a lot about, um, what it means to, um, change a person's life. You know, and, and how you can do that and how you can be valuable and, and, um, and so that's when my path veered and I said, you know what, I've always been interested in the brain, but now I've seen the real life application of what you can do if you have knowledge and skills and, um, determination. And so I decided to go into it. So, um, you know, it was the time in med school where you're deciding between neurology, neurosurgery, and I went back and forth so many times, you know, knowing full well that the life of a neurosurgeon may not be the easiest. Um, but in the end, you know, I didn't want to look back in 10 years and not do what I wanted to for, for basically a fear of failing. Um, so I went forward with it and then, you know, obviously there were a lot of hurdles because there were very few women in the field. I didn't know any women in the field. Um, I was a med student, everyone told me, don't do this, this is a bad idea, you know, you'll, you're not going to succeed at it. Um, and so when I was a fourth year med student, I ended up going to Harvard to Brigham and Women's and I did a one-month rotation with, they had three women neurosurgeons there. And I met them and I was with them in the operating room and I loved the surgeries and I loved being with them and I thought, you know what, I can do this. You know, I'm going to do it. Um, and so, you know, I, I went through the match and, um, I matched to Brown University in, in Rhode Island. Um, I was the first woman they had taken in almost 13 years. They took one resident a year. Um, so, you know, and, and that was the path and, you know, I've started to write a book about it, um, because not only did I do that, but then I had my kids and that was also a big no-no, you know, don't have kids. You know, you can't be a mother and a good neurosurgeon, those two don't coexist. Um, now I have three kids, so, you know, go figure. But, um, so I started to kind of write a book about this as I came out into practice and I met all these young women and they said, God, we really want to go into neurosurgery, but is it even possible? And is it something that we can do? You know, can we have a family? Can we have a life? Can we have outside interests? Um, so I think, I think after, you know, going through the whole experience, um, I really would encourage any young woman or young man interested in the field to reach out to a mentor or somebody they admire and, and learn from them. You know, and I think that's what it's all about because we need more neurosurgeons, period. You know, we need more period, but we also need to encourage women and minorities to be going into the field. I mean, it's just so important. I mean, to have 6%, and there's only 219 women in the US. Um, we, we definitely need to increase those numbers.
Dr Rupy: And how do you, how do you inspire, obviously with your book that I'd love to, uh, get into a bit more, but how would you inspire, um, particularly females to get into the field when you know how many hurdles there are and how difficult it is, particularly when you want to juggle a family life and stuff and just the, the nature of the job itself. Like, have those changed over the last few years along your career or is it just as hard as it was 10, 15, 20 years ago?
Dr Sherry Dewan: I think it's changed a lot. I mean, I think residency, you know, my fifth year in residency was when they instituted the 80-hour work week restriction. But prior to, I mean, I was working 100 hours a week routinely. Um, I think it's become more humane for a lack of a better term. I, I think that, and maybe you've seen that in the UK system also, but we've definitely instituted work hour restrictions. I do think it's easier for people to have, for residents to have a family life. It's not easy, but it's easier than it used to be. Um, I do think also that, um, then we were 10 years ago. So, I, I would encourage anybody to get involved with neuroscience research, go into the operating room with a neurosurgeon, see if you like it, see if you enjoy it, you know, do you enjoy being in the operating room? Do you enjoy being procedural? Um, those are the sorts of things I would say to, you know, to get involved early and to see if this is your path. And, you know, the one thing in neurosurgery we always say is, if you can choose another field, do it. If you can't choose, if you can't choose another field, there's nothing else you want to do, then you go into neurosurgery.
Dr Rupy: Okay. That's, that's some pretty good advice, I guess, isn't it? Considering like, you know, how, how crazy difficult it is and stuff. What, do you have a name for the, um, the book that you're writing?
Dr Sherry Dewan: Uh, the book is called Cutting My Own Path, which is the tentative title.
Dr Rupy: I like it. I like it a lot. Yeah. That's great. And, and for, for residents or we call them foundation doctors at the moment, um, working in this current scenario, do you have any advice for people like that? Because they're, they're literally being thrown into the deep end. I've got a friend of mine that's just starting his ICU placement, um, where they're looking after five patients and one, one nurse per five patients, which is completely unheard of in the intensive care units. They're increasing their capacity in hospitals from 40 beds to 140 by taking over theatres because of, you know, the, the elective surgeries being cancelled and stuff. Um, what, what would you say to those people in the deep end right now?
Dr Sherry Dewan: I would say just keep going. You know, keep going. I mean, keep doing the work. This is a really difficult time for everybody in the medical field. You know, doctors are scared, they're terrified of contracting the virus, they're terrified of bringing it home to people they love. Um, you know, I would say keep going, you know, do, do the, do the work, try to be as safe as you possibly can. Um, you know, nobody has enough PPE right now. You know, we're reusing masks, we're using the same N95, we're doubling masks, you know, we're doing the N95 plus the surgical mask. Um, I think, you know, collectively everyone is nervous, everyone's afraid. Um, I really feel for younger doctors though because I feel like at least when you're more seasoned, you have an idea about sterile technique and how to avoid getting, you know, different pathogens on yourself. Um, I do feel for the younger doctors, I do feel like them being thrown in is really, it's, you know, a little unfair quite honestly. But, um, you know, I would say that we're all in the same boat in many ways right now and we're all trying to deal with it the best that we can.
Dr Rupy: Totally, yeah. And I think it's definitely going to be character building for a lot of doctors, but to that point, you know, psychological help, um, there's going to be a huge number of cases of PTSD, I think at the end of this and we're already making preparations for that over here in the UK by trying to minimise it with, you know, mindfulness and, um, counselling sessions during the process as well as after. Um, but I'd love to end on a more positive note. Is there anything that you're optimistic about going forward? I know that this is going to be a prolonged, uh, exercise. This pandemic is perhaps going to be longer than most people are preparing for, um, looking at the modelling and everything that's out there at the moment. What are you, what are you most optimistic about going forward?
Dr Sherry Dewan: Um, you know, I think I've seen a side of human nature that's really heartwarming throughout this whole thing. Um, I've seen such compassion from the nurses, from doctors, um, even neighbours, you know, I've seen people bringing neighbours' groceries. Um, I've seen people really going outside, above and beyond to help one another. And I think that's where we're going to end. You know, I think once all of this is cleared and unfortunately, we're going to lose people we love, um, we're going to come to a time and a place in our society where we're actually going to care more for each other. Um, because we have seen the worst. Um, I also think as a society, we are, you know, they say with kids these days, there's not enough grit, you know, with kids. They haven't seen enough, they haven't, um, experienced enough, everyone's so soft and I think this is really a learning experience for a lot of people. Um, you know, our essentials are not there, you know, essentials like toilet paper, paper towel, cleaning products. I mean, the essential things for your home are not available. Um, you may not get the quantity of things that you want, you may not get the products that you want. And it really teaches you about what do you really need to survive? You know, what do you really need? Um, and you know, you just need to kind of go back to the basics, I think, you know, in a society. And I think this is a very cautionary tale of, um, of the past maybe. And, and I would say looking forward, we're going to become a more self-sufficient society and we're going to become more technologically driven and we're going to care more about one another.
Dr Rupy: Yeah. I, I echo that. I, I really do hope for that as well. I've certainly seen outpouring of positivity, kindness, compassion from neighbours and, and people just, uh, trying to look after key workers and a new found appreciation for not just the NHS heroes or the, the healthcare heroes, but also the people that maintain the functioning of our society, the garbage collectors, the, you know, the people that run the trains and public transport and, and people, uh, who are cleaning the hospitals. All these different, um, professions that were, were just largely overlooked, but actually are so needed in society. So I think hopefully that will conjure this new, um, advocate of compassion for, for everyone. So, that's great. Um, where are you off to now, uh, Sherry?
Dr Sherry Dewan: Well, you know, duty always calls. Yeah. So, you know, um, between myself and my partners, we've split up shifts at the hospital. So, you know, just got to go in and, and take care of these patients and make sure that everyone's, you know, keeping safe and healthy at this time.
Dr Rupy: That's great. Well, good luck to everything. Um, stay safe and it was a pleasure chatting to you today, uh, Sherry, and hopefully we'll get to meet you in person one day.
Dr Sherry Dewan: Absolutely. It was so nice to be on.
Dr Rupy: I really hope you enjoyed that, uh, podcast episode today with Dr Sherry. Um, she's a total breath of fresh air considering she is a neurosurgeon and a huge advocate of diet and lifestyle as medicine. It's, it's a, a brilliant, uh, advocate. She is a brilliant advocate for what we chat about here at The Doctor's Kitchen. To summarise our conversation, regular movement, making sure that you're aware of neck flexion and actually putting some aids in to improve the neutrality of your gaze. So making sure that you're looking forward rather than down, as well as, uh, perhaps engaging in yoga or Pilates, um, to strengthen up your core muscles and make sure, uh, that you're working your abdominals as well as, uh, everything else, um, uh, that you can do with exercises. It's not just about hit training, it's not just about weight training, it's about getting a good mixture of different, uh, modalities to, to improve your flexibility and to improve your abdominal core strength as well. Uh, check out my guest at the doctorskitchen.com podcast, uh, episode, uh, page. And, um, make sure that, uh, you engage in some positive media as well. We touched on the positive aspects of what's happening out of a, an incredible, uh, situation that no one expected, but there are certainly, uh, benefits to, to be had from this. And I think it will lead to a more resilient and stronger, more compassionate nation, uh, at the end of this. So, um, please do try and, and fill your social media profiles with people that are spreading positivity. I'm trying to do that with mine at the moment, um, and any others that you, you come across, let me know and I'll try and shout out them as well. For now, have a fantastic day and I will see you next week.
