By Anja Opitz
Prof. Dr. Peter Vajkoczy (54), Director of the Clinic for Neurosurgery at the Charité, operates on nothing less than the human brain. BZ spoke to him about his work and the demands he places on himself and his team so that the patients receive the best possible care.
BZ: Mr. Vajkoczy, do you remember your first operation?
Prof. Dr. Peter Vajkoczy: At least the feeling beforehand: I was totally shocked when the boss in the X-ray conference said that this case was for the beginner. I was far too nervous for the sublime feeling of seeing the human brain for the first time.
What do you find so fascinating about the human brain?
For me it is the most aesthetic organ. It is so finely and detailed designed by nature with structures that are mostly less than a millimeter in size but are so thoughtfully arranged that they form the perfect result of evolution. If you then think about the variety and complexity of the functions behind it, the whole thing becomes even more great and great.
How is the brain still a mystery to you?
Although I am now quite experienced in the hand movements, I still have a long way to understand the brain. The areas that have to do with language and motor skills have now been developed quite well. But in structures that z. B. with emotions, memory and personality aspects, we ask ourselves daily how the functions are interconnected. We often see disorders of these functions in patients, but do not understand their cause.
So brain surgery is always risky?
Unfortunately, we are sometimes rudely reminded that we do not yet understand everything. Sometimes we just don’t know that certain structures e.g. B. have something to do with the language – and suddenly the patient has a deficit in language understanding after the operation. This means that brain surgery always carries a relevant risk and that we should always approach our work with respect.
How do you deal with the responsibility of being able to save a life, but also destroy it?
I consider it a privilege that patients let me perform such complex surgeries on their brains. That’s why I walk the path together with them. Even if there is a complication, it means: be honest and get through the dry spell together. It is crucial to make an effort not to disappoint the patient and to learn from the complications for future operations.
What do you tell your patients before the operation?
It is important to inform the patient well beforehand and to be aware of the risks. But I try to end the conversation with optimism and hope. Patients shouldn’t be allowed to go into the operating room in fear.
Can information also be too much for the patient?
Yes, because at some point it gets confusing and distracts from the essentials. Unfortunately, doctors are not prepared during their studies for how we communicate with patients and enlighten them. You learn that from experience.
What do you need to have to be a good doctor?
Above all, physicians must be decent people: honest, transparent, humble, courageous, with a certain humility and a willingness not to shirk difficult conversations or admitting mistakes.
What else is important?
A sense of responsibility in all situations towards the patient is important. And of course a good knowledge and training in making sensible decisions.
Brain surgery is considered the pinnacle of medical craftsmanship. Why is it important that doctors still don’t feel lofty?
Demystifying the profession is very important to me: Yes, brain surgery is a demanding job and our predecessors did pioneering work. But we have him well under control now and don’t have to take ourselves so seriously as people. This gives us space to educate new generations and discover new things, to further develop the field.
But many people have so much respect for the “demigods in white” that they remain silent. What do you recommend patients to do when they see a doctor?
My recommendation: Go into the treatment with a basic level of trust, trust the system. Especially when it comes to a serious illness.
Then you shouldn’t google your illness beforehand?
I really appreciate it when patients are well informed and have prepared questions. But you shouldn’t read the whole internet, because not all information is relevant and sometimes confusing.
What role do relatives play for you?
You should always include them: four ears hear more than two, younger and unaffected people may be able to process the information better and ask questions.
How do you react when a patient wants a second opinion?
I support my patients in this! A lot is shaped by the personality and experience of the doctor, the possibilities and the philosophy of the individual clinics, so there can be differences in the assessment.
And what do you do then?
Decide according to gut feeling, because the chemistry between doctor and patient is crucial for the course of therapy. A good doctor is not offended when a patient chooses a colleague.
Can you describe the feeling when you “fixed” a brain?
If it was a routine operation that went well, it’s a good feeling, then I tick it off. If it was a complicated or rare operation that you were looking forward to, then I’m incredibly happy and proud. And that’s what you should do: be proud of what you do. And pass this positive energy on to the patient.
How long does this feeling last?
You have to be aware that something can happen the next day that puts a damper on you. That’s why it’s important not to open up a big barrel and get arrogant.
How do you break bad news to patients?
It is important to have a calm conversation situation that is appropriate to the message. To take time. show compassion. To give hope. If you have to tell someone that their tumor might be malignant, you should try to emphasize the positive aspects. I believe there is always hope in any situation, no matter how bad.