State-of-the-art neurosurgery comes to Rhode Island.
A native of Istanbul, Ziya L. Gokaslan, MD, FACS P’18 always wanted to live by the ocean. So it’s no surprise then that he fell in love with the Ocean State. “It is as pretty as the Bosphorus in many places,” the neurosurgeon says.
Gokaslan moved to Rhode Island last July, when he became the chief of neurosurgery at Rhode Island Hospital and The Miriam Hospital and chair of the Department of Neurosurgery at Alpert Medical School. He is also the clinical director of the Norman Prince Neurosciences Institute at Lifespan and the Brown Institute for Brain Science. He came to Brown from the Johns Hopkins University School of Medicine.
Brown Medicine talked to Gokaslan about his new role.
You are a neurosurgeon and researcher who focuses on the treatment of primary and metastatic spinal tumors, sacral neoplasms, and spinal cord tumors. What do you hope to accomplish at Brown?
The environment here is great and very unique. Brown University is a world leader in neurosciences with 130 scientists from across the campus focusing on advancing knowledge in this area. On top of that, we have wonderful hospitals and an excellent department with expertise in all areas of neurosurgery including cerebrovascular surgery, pediatric neurosurgery, pain, peripheral nerve surgery, and spinal surgery, as well as central nervous system tumors and stereotactic radiosurgery. Working with the Norman Prince Neurosciences Institute, we have a tremendous opportunity.
Is there anything from your 13 years at Johns Hopkins that you would like to recreate?
Hopkins has been exceptionally successful in creating a culture where the physician-scientist model is celebrated, and clinical and basic science research are fully integrated into the care of the patients. I would like to create a similar culture here.
How will you coordinate efforts between clinicians and basic scientists?
I need to be an effective facilitator, which is my main role, with one foot on the Brown University side and the other at the hospitals to create a bridge for all neurosurgical faculty and the scientists at the main campus. If I can create opportunities for people to share their interests and research in areas such as neuroprosthetics, neuroengineering, and basic neuroscience, and combine that with our clinical experience, then we can make a great difference in the lives of our patients.
There is a picture of a man on your wall running a marathon who was told he might never walk again. Can you tell us about him?
This is a patient of mine on whom I operated for a spinal cord tumor. One year later he was able to run a marathon in 4 hours and 15 minutes. He won that medal and framed it and sent it to me. It was a very gracious gift. There have been a number of patients who have come to me with conditions deemed to be incurable and tumors considered unresectable because the risks of surgery were so high. I have enormous respect for the patients who are able to make the decision to go through these very risky surgical procedures.
If you could research and solve one aspect of the molecular biology or the surgical resection of CN S tumors, what would it be?
I believe real advances in improving survival will derive from our ability to better understand the genetic alterations driving the tumors. An exciting area of research is brain tumor immunology and it is already showing great promise. We now know that tumor cells express a certain set of specific antigens on the cell surface. One can genetically engineer T-cells that can express receptors that recognize these specific antigens and selectively kill the tumor cells. This is a very exciting field, which is likely to have an immediate impact on the outcome of these patients.
What specific kind of technology, either now or in the future, would you like to have in the operating room?
The optimum is a fully integrated operating room where all the images, MRI, CT, angiogram, and functional studies can be made immediately available and fully merged, so that the surgeon can navigate precisely and seamlessly in the brain using computer guidance with full integration of the microscope and instruments, as well as real-time neurophysiological recordings to get immediate functional feedback. We will be building such an operating room at Rhode Island Hospital starting next year.
What is the most important role of a leader? How will you know if you have been a successful chairman?
To effectively articulate a clear vision and direction for our department while providing an environment for our faculty, staff, residents, fellows, and students to realize their maximal potential that would ultimately translate into improving the lives of our patients.
The patients whom we have the privilege of serving are and will always be at the center of what we do. I want our department to be the best in the country, where you would want your child, husband or wife, mother or father to be treated, where we push the envelope every day to advance our field through research, education, and clinical care. When you get sick, if this is the first place you want to come for your care, then I know I have been successful.
Did you have a mentor? How important are mentors?
I had multiple mentors over the years, and I think that is one of the most important responsibilities of a senior faculty member or the chair of a department. Without a mentor, a person can get lost. The system is very large. A mentor, however, should be completely unselfish and driven by only the best interest of the individual sitting across from him or her. If you have a mentor like that you should consider yourself very fortunate, because it opens doors for you, your career moves forward very rapidly, and you do not waste any time.
What kind of medical student goes into neurosurgery?
It is a specialty that requires a very significant time commitment. The people we attract are incredibly dedicated and compassionate. They love neurosciences, the brain, and the spine. We are fortunate to attract the cream of the crop. They are very curious people and a lot of them have been involved in research. We joke among ourselves that we would never be able to get into the residency if we were competing with these students now. They are incredible.
Why should someone choose academic medicine as a profession?
It is an incredibly stimulating environment. For people who are curious, who want to have a real impact on the lives of people, it is the best profession ever. You are using your mind, your manual dexterity (if you are a surgeon), and you are taking advantage of new technology, knowledge, and information every day. It is very exciting. There is never a dull moment. You never get bored.