I’m fascinated with the workings of the human brain By Gerardo D Legaspi, MD Associate Professor, University of the Philippines, College of Medicine, Philippine General Hospital, and President of the Association of South East Asian Nations (ASEAN) Neurosurgical Society (2011-2013) and the Academy of Filipino Neurosurgeons (2011-2012)
I
was born and raised in Manila, the capital city of the Philippines. I grew up in a neighborhood which was a relocation site for squatters in the city and which eventually evolved to be a subdivision. I was educated in a Catholic school (La Salle) and later on at the University of the Philippines. So my growing-up years exposed me to toughies in the neighborhood as well as men of God. My parents raised us with disciplinarian principles, all five boys and one sister. I had no medical exposure at all in the family. No one was involved in the health industry. I was the first one in my family to enter the profession of medicine. It may sound like a cliché, but the idea of being helpful to others - maybe in a dramatic, St-Elsewhere-TV-series-kindof-way - got me interested in medicine. I knew I wanted to be a neurosurgeon even in my second year of high school, especially after watching a pituitary case treated with Gamma Knife in the 1970s on a Scientific American TV special. Neurosurgery...a natural career choice My fascination with the workings of the human brain, combined with my awe for the dramatic results that a surgical intervention can produce, naturally led me to neurosurgery as a career choice. Initially I concentrated mainly on cerebrovascular surgery, doing my research and Master’s degree in Thailand under the auspices of Paris Sud University (under Professor Pierre Lasjaunais). The sheer volume of patients needing good care for their brain tumors eventually made me gravitate to this field. I can see
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Brain Tumour
Above: Gerardo Legaspi participated in last year’s Ironman race in the Philippines where the Academy of Filipino Neurosurgeons fielded a relay team. Dr Legaspi competed in the cycling leg of this gruelling competition.
now the potential to optimize comfort and function preservation, as well as the importance of a minimally invasive way of taking out these lesions effectively. I am always motivated by the fact that no two tumors are alike and that each patient requires a unique understanding and planning. There are two sources of strength for me on a day to day basis: my family and my patients. I believe that if everything is in order with your family, a lot of the emotional stresses become so easy to handle. When we say “family” here in the Philippines this means not only my wife and children but parents, siblings, cousins and even distant relatives! The psychological stress from dealing with dreaded diseases and potentially complicated procedures is eased by the
feeling of trust that you get from patients after discussing their conditions with them. My confidence is enhanced by the knowledge that they have understood things, and that after weighing-up the options and seeking other opinions, they decide to have the treatment with me. People are always curious to know what a neurosurgeon does to relax. “Work hard play hard” is my motto. Always in search of that perfect work/life balance, I play the sax, flute and guitar, occasionally with a band. Jazz is my genre. I actively do road and mountain biking three days a week, and compete in weekend races. I also run. Fixing up my garden is also one way of unwinding. On weekends, I drive an hour away from the city to a farm where we plant mangoes and rice. Often though, just chilling out with my family at home, especially around dinner time, is enough to “unsnag” me for the day. Challenges of the healthcare system in the Philippines The healthcare system in our country is generally still based on the “fee for service” model. A small number of our patients have private medical insurance which is usually inadequate to cover the whole treatment for most brain tumor cases. Seventy per cent of our people rely on government services for their health needs and at most the government can only support 30% of their treatment. So it is the inability to provide ideal treatment, as per current standards, that is the biggest challenge in the treatment of brain tumors in our country. Often