- Email: [email protected]
Zhou dynasty and the art of neurosurgery
COLLEGIAL COMMENTARIES
Yong-Gu Chung, M.D., Ph.D. President-Elect of Korean Neurosurgical Society, Korea University Hospital, Seoul, Korea
I
met Professor Liangfu Zhou for the first time during an endoscopic symposium in Germany during February of 1998. At that time, it was very rare to meet Chinese neurosurgeons in an international meeting seemingly because of the political and economic situation in their country. At first glance, he seemed like a young neurosurgeon who was eager to learn new things in the field of neurosurgery. Afterward, we had so many conversations not only regarding the academic field of neurosurgery but also cultural understandings. I really appreciate the wonderful job he has done to start and continue communication with neurosurgeons in other Asian countries, including Korea. I respect him for his contribution to growing the field of the neurosurgery in China during the modernization period in 1990s. His hard work and achievements earned him academic scholarships during the 2000s. We must applaud his accomplishments not only in the development of neurosurgery in China but also in bridging relationships between neurosurgeons in China and other countries. He is the sort of man who really likes to ride his bicycle to the hospital and enjoys sipping Chinese tea every day. He respects the Chinese culture of ancestor worship and a strong family tradition. Everybody believes that the Department of Neurosurgery at Huashan hospital has played a vital role in the development of neurosurgery in China under Professor Zhou during the last two decades, and when I look at their clinical activities, person power, and investment, I firmly expect that they are going to be one of the hubs of neurosurgery in the world. Congratulations to Professor Zhou!
1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.11.029
Takanori Fukushima, M.D. Carolina Neuroscience Institute, RaleighDurham, North Carolina, USA
I
have known Professor Liangfu Zhou for the past 10 years.
Professor Zhou is one of the top experts in microneurosurgery in China. He is a well known pioneer of cranial base surgery. I have been collaborating with him on his annual skull base dissection courses in Shanghai. Professor Zhou became Professor and Chairman at the Department of Neurosurgery, Huashan Hospital, Shanghai, in 1984. Professor Zhou specializes in cerebrovascular surgery, skull base surgery and minimally invasive neurosurgery. He has taken many honorable positions in the Chinese medical societies and international neurosurgery societies. He is a member Academician of the Chinese Academy of Engineering. He has received a number of awards and much recognition. There are 102 faculty members in his department, and
WORLD NEUROSURGERY 77 [2]: 226-232, FEBRUARY 2012
they perform nearly 10,000 operations a year with 19 residents. At Huashan Hospital in 2010, there were 288 cases of aneurysm clipping, 1124 meningioma resections, and 271 acoustic neuroma operations. Professor Zhou is a strong leader of neurosurgery in Shanghai and works very hard both during the week and on weekends. He is a man of science and an excellent clinician. I admire his talent and enthusiasm in pursuing progress in microneurosurgery and clinical education.
1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2012.01.042
Juha Hernesniemi, M.D., Ph.D. Professor and Chairman, Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
A
fter the founding of the People’s Republic of China in 1949, the development of neurosurgery started in Shanghai and Beijing. A frontal lobe glioma was removed successfully for the first time in 1950 in the Chung-Shan Hospital in China. A few years later, in 1953, the neurosurgical department of the Chung-Shan Hospital moved to the First Red Cross Hospital, which was the predecessor of Huashan Hospital. Similarly, our own Töölö Hospital in Helsinki was originally the First Red Cross hospital in Finland. Since 1950s, the Department of Neurosurgery in the Shanghai Huashan Hospital has grown to become one of the continent’s leading and busiest neurosurgical units. In addition to high-level clinical competence, the Department of Neurosurgery at the Huashan Hospital has shown commitment to basic and clinical research, which is a prerequisite for constant progress and development. In 2010, the number of neurosurgeons in the Department of Neurosurgery at Huashan Hospital was 102, and there were 600 beds for neurosurgery. Surgeons in the department treat nearly 15,000 patients a year (14,717 patients in 2010; 9,932 of whom underwent surgery). These operations included approximately 1100 meningiomas, 1000 pituitary tumors, 300 aneurysm clippings, and 180 bypass procedures per year. These numbers are more than impressive. After my return from the first and very memorable visit to Huashan in 2007, my colleagues and fellows in Helsinki were frightened for a week or two by the astonishment on my face. After I broke the silence, they had difficulties in believing what I had been witnessing in the modern operation rooms in Huashan Hospital. At this point, I finally realized that most of the western neurosurgeons are not aware of the eastern art of neurosurgery. This is the reason why many western high-level neurosurgeons are far behind the level of skillful neurosurgeons in Eastern Asia. Luckily, I have had the opportunity to become good friends with Professor Liangfu Zhou, and our established collaboration offers remarkable possibilities to me, to my “young and hungry” neurosurgeons, and hopefully to the professor himself. Much of the success of the Huashan Hospital can be attributed to Professor Liangfu Zhou, whose understanding of the impor-
www.WORLDNEUROSURGERY.org
227
COLLEGIAL COMMENTARIES
tance and demands of being an exemplary and dynamic leader far surpasses average standards all over the world. The wisdom of his work has surely the flavors of traditional Chinese principles of strong and successful leadership. It is written in the historical Chinese book Art of War by Sun Tzu that “[n]o leader should put troops into the field merely to gratify his own spleen; no leader should fight a battle simply out of pique. But a kingdom that has once been destroyed can never come again into being; nor can the dead ever be brought back to life. Hence the enlightened leader is heedful, and the good leader full of caution.” For sure, the Zhou dynasty will continue to grow in strength and stay the course. I personally hope that Professor Liangfu Zhou will carry on making amazing art, the art of neurosurgery, as long as possible. My heartfelt congratulations on your nomination! 1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.10.002
Takeshi Kawase, M.D. Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan
I
t may be a common feeling for all the people who ever met professor Zhou that his spirit is younger than 50 years. I became acquainted with him more than 12 years ago, but my impression of him has not changed in that time. Our first meeting was in New Orleans, at the reception of the American Association of Neurological Surgeons Congress in 1999. Speaking frankly, he was not a man of dignified appearance, which was common in a Chinese professor, but rather more relaxed. During my first meeting with him, therefore, I did not realize that he was one of the great founders of Chinese neurosurgery! He founded neurosurgery in Huashan Hospital in Shanghai in 1970 and became a professor in 1989 after having studied in the United States. In 2001, he became the Director of Neurosurgery Hospital and Institute, which is a leader in neurosurgery in Shanghai. He introduced microsurgery during its early stages to China, and the number of surgeries increased threefold in those 10 years in his hospital. His interest was always on scientific and technical points, in addition to revising microsurgical techniques. He was interested in the field of skull base surgery, and I heard his high-level presentations frequently, both abroad and in China. He was completely different from other senior neurosurgeons, who could not speak English well. He published more than 130 papers in English and trained postgraduate students with international motivations. Therefore, he has been respected and loved by younger generation not only in Shanghai but in China as a whole for his highly accomplished scientific career and generous mind. He received many awards and prizes in those 20 years for his long scientific and educational career, and he was selected as a Chinese Engineering Academician in 2009. When I met him this summer in Beijing, it was a miracle that his liberal and scientific orientation was further advanced even though he was older than 70 years of age. He might demonstrate a concept that the man who has been thinking academically survives longer than the man thinking politically. I sympathize with his way of life because a doctrine of my university has the similar concept, i.e.,
228
www.SCIENCEDIRECT.com
“the pen is mightier than the sword.” He is a man who leads not only in China but in the whole world as well, and I fully congratulate professor Liangfu Zhou for being selected as Neurosurgeon of the Year 2012 by WORLD NEUROSURGERY. 1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.11.028
Peter Nakaji, M.D. Neurosurgery Residency Program Director, Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA
A
mong a host of worthy candidates, the recognition of Professor Liangfu Zhou as the WORLD NEUROSURGERY Neurosurgeon of the Year can be received with warm enthusiasm. It might be too easy for an outsider to dismiss the remarkable achievements of Professor Zhou and his department, based at Huashan Hospital, in Shanghai as a mere epiphenomenon of the stunning rise of China as a whole. Yet, to do so would be disingenuous: Not all other centers have grown so quickly or so well, nor have they kept pace so admirably with the broader field of neurosurgery, which itself has undergone many transformations during the same period. From a unit of 60 beds in 1984, Huashan has become the largest center in China and one of the largest anywhere: More than 15,000 surgical cases are now treated there each year. This remarkable growth, however, reflects scope and quality as well as volume. Huashan now can hold itself with pride as an equal among the great centers of the world. Professor Zhou can be credited with excellent navigation through the opportune but also turbulent times that span his career. Shanghai has been a great city for thousands of years. However, in the early years of Professor Zhou’s tenure at Huashan, it was not the ideal setting for an ambitious neurosurgical enterprise and especially not for exploring the new and innovative in neurosurgery. Nonetheless, Professor Zhou applied his considerable energy and creativity to doing just that. When China was still isolated from contact with much of the outside world in the 1970s, he worked on microscope design and was the first in China to advocate the adoption of microsurgery and microsurgical approaches. He performed some of the earliest bypasses for aneurysm treatment in China. As both practitioner and promoter, he embraced skull base surgery, radiosurgery, neuronavigation, and minimally invasive techniques. More recently, he has embraced technology as a way to make operations safer, for example, by pairing neuronavigation with functional magnetic resonance imaging and magnetic resonance spectroscopy. The significance of Professor Zhou’s efforts on behalf of Chinese neurosurgery, especially in earlier decades when China was not as open as today, resources were more limited, and the exchange of ideas was more challenging, cannot be overstated. For these efforts he is credited appropriately by his peers for his key role in developing their specialty in China. His personal qualities, which reflect the Confucian virtues of honesty, diligence, and prudence, have served him well and earned the admiration of his countrymen. He now plays the role of the elder statesman with aplomb, still praised by his young colleagues for his interest in the development of their careers and in promoting neurosurgical excellence throughout China.
77 [2]: 226-232, FEBRUARY 2012 WORLD NEUROSURGERY
Yong-Gu Chung, M.D., Ph.D. President-Elect of Korean Neurosurgical Society, Korea University Hospital, Seoul, Korea
I
met Professor Liangfu Zhou for the first time during an endoscopic symposium in Germany during February of 1998. At that time, it was very rare to meet Chinese neurosurgeons in an international meeting seemingly because of the political and economic situation in their country. At first glance, he seemed like a young neurosurgeon who was eager to learn new things in the field of neurosurgery. Afterward, we had so many conversations not only regarding the academic field of neurosurgery but also cultural understandings. I really appreciate the wonderful job he has done to start and continue communication with neurosurgeons in other Asian countries, including Korea. I respect him for his contribution to growing the field of the neurosurgery in China during the modernization period in 1990s. His hard work and achievements earned him academic scholarships during the 2000s. We must applaud his accomplishments not only in the development of neurosurgery in China but also in bridging relationships between neurosurgeons in China and other countries. He is the sort of man who really likes to ride his bicycle to the hospital and enjoys sipping Chinese tea every day. He respects the Chinese culture of ancestor worship and a strong family tradition. Everybody believes that the Department of Neurosurgery at Huashan hospital has played a vital role in the development of neurosurgery in China under Professor Zhou during the last two decades, and when I look at their clinical activities, person power, and investment, I firmly expect that they are going to be one of the hubs of neurosurgery in the world. Congratulations to Professor Zhou!
1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.11.029
Takanori Fukushima, M.D. Carolina Neuroscience Institute, RaleighDurham, North Carolina, USA
I
have known Professor Liangfu Zhou for the past 10 years.
Professor Zhou is one of the top experts in microneurosurgery in China. He is a well known pioneer of cranial base surgery. I have been collaborating with him on his annual skull base dissection courses in Shanghai. Professor Zhou became Professor and Chairman at the Department of Neurosurgery, Huashan Hospital, Shanghai, in 1984. Professor Zhou specializes in cerebrovascular surgery, skull base surgery and minimally invasive neurosurgery. He has taken many honorable positions in the Chinese medical societies and international neurosurgery societies. He is a member Academician of the Chinese Academy of Engineering. He has received a number of awards and much recognition. There are 102 faculty members in his department, and
WORLD NEUROSURGERY 77 [2]: 226-232, FEBRUARY 2012
they perform nearly 10,000 operations a year with 19 residents. At Huashan Hospital in 2010, there were 288 cases of aneurysm clipping, 1124 meningioma resections, and 271 acoustic neuroma operations. Professor Zhou is a strong leader of neurosurgery in Shanghai and works very hard both during the week and on weekends. He is a man of science and an excellent clinician. I admire his talent and enthusiasm in pursuing progress in microneurosurgery and clinical education.
1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2012.01.042
Juha Hernesniemi, M.D., Ph.D. Professor and Chairman, Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
A
fter the founding of the People’s Republic of China in 1949, the development of neurosurgery started in Shanghai and Beijing. A frontal lobe glioma was removed successfully for the first time in 1950 in the Chung-Shan Hospital in China. A few years later, in 1953, the neurosurgical department of the Chung-Shan Hospital moved to the First Red Cross Hospital, which was the predecessor of Huashan Hospital. Similarly, our own Töölö Hospital in Helsinki was originally the First Red Cross hospital in Finland. Since 1950s, the Department of Neurosurgery in the Shanghai Huashan Hospital has grown to become one of the continent’s leading and busiest neurosurgical units. In addition to high-level clinical competence, the Department of Neurosurgery at the Huashan Hospital has shown commitment to basic and clinical research, which is a prerequisite for constant progress and development. In 2010, the number of neurosurgeons in the Department of Neurosurgery at Huashan Hospital was 102, and there were 600 beds for neurosurgery. Surgeons in the department treat nearly 15,000 patients a year (14,717 patients in 2010; 9,932 of whom underwent surgery). These operations included approximately 1100 meningiomas, 1000 pituitary tumors, 300 aneurysm clippings, and 180 bypass procedures per year. These numbers are more than impressive. After my return from the first and very memorable visit to Huashan in 2007, my colleagues and fellows in Helsinki were frightened for a week or two by the astonishment on my face. After I broke the silence, they had difficulties in believing what I had been witnessing in the modern operation rooms in Huashan Hospital. At this point, I finally realized that most of the western neurosurgeons are not aware of the eastern art of neurosurgery. This is the reason why many western high-level neurosurgeons are far behind the level of skillful neurosurgeons in Eastern Asia. Luckily, I have had the opportunity to become good friends with Professor Liangfu Zhou, and our established collaboration offers remarkable possibilities to me, to my “young and hungry” neurosurgeons, and hopefully to the professor himself. Much of the success of the Huashan Hospital can be attributed to Professor Liangfu Zhou, whose understanding of the impor-
www.WORLDNEUROSURGERY.org
227
COLLEGIAL COMMENTARIES
tance and demands of being an exemplary and dynamic leader far surpasses average standards all over the world. The wisdom of his work has surely the flavors of traditional Chinese principles of strong and successful leadership. It is written in the historical Chinese book Art of War by Sun Tzu that “[n]o leader should put troops into the field merely to gratify his own spleen; no leader should fight a battle simply out of pique. But a kingdom that has once been destroyed can never come again into being; nor can the dead ever be brought back to life. Hence the enlightened leader is heedful, and the good leader full of caution.” For sure, the Zhou dynasty will continue to grow in strength and stay the course. I personally hope that Professor Liangfu Zhou will carry on making amazing art, the art of neurosurgery, as long as possible. My heartfelt congratulations on your nomination! 1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.10.002
Takeshi Kawase, M.D. Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan
I
t may be a common feeling for all the people who ever met professor Zhou that his spirit is younger than 50 years. I became acquainted with him more than 12 years ago, but my impression of him has not changed in that time. Our first meeting was in New Orleans, at the reception of the American Association of Neurological Surgeons Congress in 1999. Speaking frankly, he was not a man of dignified appearance, which was common in a Chinese professor, but rather more relaxed. During my first meeting with him, therefore, I did not realize that he was one of the great founders of Chinese neurosurgery! He founded neurosurgery in Huashan Hospital in Shanghai in 1970 and became a professor in 1989 after having studied in the United States. In 2001, he became the Director of Neurosurgery Hospital and Institute, which is a leader in neurosurgery in Shanghai. He introduced microsurgery during its early stages to China, and the number of surgeries increased threefold in those 10 years in his hospital. His interest was always on scientific and technical points, in addition to revising microsurgical techniques. He was interested in the field of skull base surgery, and I heard his high-level presentations frequently, both abroad and in China. He was completely different from other senior neurosurgeons, who could not speak English well. He published more than 130 papers in English and trained postgraduate students with international motivations. Therefore, he has been respected and loved by younger generation not only in Shanghai but in China as a whole for his highly accomplished scientific career and generous mind. He received many awards and prizes in those 20 years for his long scientific and educational career, and he was selected as a Chinese Engineering Academician in 2009. When I met him this summer in Beijing, it was a miracle that his liberal and scientific orientation was further advanced even though he was older than 70 years of age. He might demonstrate a concept that the man who has been thinking academically survives longer than the man thinking politically. I sympathize with his way of life because a doctrine of my university has the similar concept, i.e.,
228
www.SCIENCEDIRECT.com
“the pen is mightier than the sword.” He is a man who leads not only in China but in the whole world as well, and I fully congratulate professor Liangfu Zhou for being selected as Neurosurgeon of the Year 2012 by WORLD NEUROSURGERY. 1878-8750/$ - see front matter © 2012 Elsevier Inc. All rights reserved. DOI: 10.1016/j.wneu.2011.11.028
Peter Nakaji, M.D. Neurosurgery Residency Program Director, Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA
A
mong a host of worthy candidates, the recognition of Professor Liangfu Zhou as the WORLD NEUROSURGERY Neurosurgeon of the Year can be received with warm enthusiasm. It might be too easy for an outsider to dismiss the remarkable achievements of Professor Zhou and his department, based at Huashan Hospital, in Shanghai as a mere epiphenomenon of the stunning rise of China as a whole. Yet, to do so would be disingenuous: Not all other centers have grown so quickly or so well, nor have they kept pace so admirably with the broader field of neurosurgery, which itself has undergone many transformations during the same period. From a unit of 60 beds in 1984, Huashan has become the largest center in China and one of the largest anywhere: More than 15,000 surgical cases are now treated there each year. This remarkable growth, however, reflects scope and quality as well as volume. Huashan now can hold itself with pride as an equal among the great centers of the world. Professor Zhou can be credited with excellent navigation through the opportune but also turbulent times that span his career. Shanghai has been a great city for thousands of years. However, in the early years of Professor Zhou’s tenure at Huashan, it was not the ideal setting for an ambitious neurosurgical enterprise and especially not for exploring the new and innovative in neurosurgery. Nonetheless, Professor Zhou applied his considerable energy and creativity to doing just that. When China was still isolated from contact with much of the outside world in the 1970s, he worked on microscope design and was the first in China to advocate the adoption of microsurgery and microsurgical approaches. He performed some of the earliest bypasses for aneurysm treatment in China. As both practitioner and promoter, he embraced skull base surgery, radiosurgery, neuronavigation, and minimally invasive techniques. More recently, he has embraced technology as a way to make operations safer, for example, by pairing neuronavigation with functional magnetic resonance imaging and magnetic resonance spectroscopy. The significance of Professor Zhou’s efforts on behalf of Chinese neurosurgery, especially in earlier decades when China was not as open as today, resources were more limited, and the exchange of ideas was more challenging, cannot be overstated. For these efforts he is credited appropriately by his peers for his key role in developing their specialty in China. His personal qualities, which reflect the Confucian virtues of honesty, diligence, and prudence, have served him well and earned the admiration of his countrymen. He now plays the role of the elder statesman with aplomb, still praised by his young colleagues for his interest in the development of their careers and in promoting neurosurgical excellence throughout China.
77 [2]: 226-232, FEBRUARY 2012 WORLD NEUROSURGERY