Before there were hospitals, prescriptions, or medicine as a science,
it was a calling, a promise to heal, to question, and to understand the human
body. Every discovery began with curiosity, and every breakthrough began
with someone asking, why? From ancient remedies
to artificial intelligence, this
is where science meets compassion. Welcome
to the Aesculapian Society. Today, I'm
honored to welcome Dr. Donald Whiting, a distinguished
neurosurgeon who serves as
System Chair of the AHN Neuroscience Institute and Department of Neurosurgery.
Dr. Whiting is nationally recognized for his
expertise in deep brain stimulation,
particularly in treating Parkinson's disease and other movement disorders.
We're excited to hear about his path into medicine,
his experiences in neurosurgery,
and his perspective on the future of patient
care. Welcome, Dr. Whiting. Thanks
for being on the show. Thank you, Dhruv. It's
a pleasure. So, let's move on to your
personal motivation and background. What inspired
you to become a doctor? My family
was in the appliance business. We had appliance
stores, and I was not very good
at selling appliances. But I was good at science, and then I started in school
getting more and more interested in it. And in college, my psychology major
involved a lot of rat and cat animal brain
surgery. So, I started liking doing that,
understanding the brain, and then that's
what drove me to go into neurosurgery.
Okay. So, I read an article about you online,
and it said that your mother was a
nurse. How important was parental guidance
in you becoming a doctor? My mother was a
nurse, and she really did have a strong influence
in me, particularly now that I
am a doctor, understanding the role of the
nurse in healthcare and how we're really
one big team. So, it really makes me much
more compassionate and understanding of
everybody else's role that makes my job successful.
Okay. So, how did your friends
and family react when you told them you wanted to be a doctor, especially your
mother? Well, as I told you, I was not good at selling appliances. My dad was
ecstatic that I was not going to be in the
family business. Yes. But they were also
very proud of me. Okay. So, what was your high school life like relating to
medicine? I was a little nerdy in sports,
but also studied a lot. I had, you know,
advanced classes and different things in high
school. And it was really, it was a
good well-rounded experience for me. Did you
do any volunteer extracurriculars to
help boost your application? Yes. I worked at
the Easter Seals Society in the summers
as an aide and as an assistant during high
school most of the time. Okay. So, on a
fun note, what would you be doing right now
if you hadn't chosen medicine? So, I
really, when I was growing up, I liked the
idea of a milkman because they get up
early, get done by noon, and then have the
rest of the day. So, thinking about that.
But seriously, I probably would have been in
the family business selling appliances.
Okay. So, thanks for your background. So, moving on to the path to becoming a
doctor. What was your process to becoming
a neurosurgeon starting all the way from
high school and starting to practice? So,
being from a family that was already in
medicine, I didn't really know what it took,
the steps to do it, besides working
hard in school. So, for me, it was learning a lot about the different things
you need to do to boost your application and to apply to the right places and
things like that. So, that in college was helpful. And then I actually went to
graduate school and got a master's so I could
learn more about the process before
going to medical school.
So, you went to Thomas Jefferson University, right? For medical school,
yes. For medical school. So, what do you do
after, like, medical school? Do you go
to residency? Yes. So, typically, after medical
school, you end up what's called
matching into a residency. So, the way that works is you apply to different
residency programs in the specialty that you're
interested in, whether it's primary
care, family medicine, emergency medicine,
or neurosurgery, or any of them. And then
you get interviews. And when you interview, then you make a list, and the
places you interview make a list, and it's
called the match. So, we'll rank 1 to 30,
the people we interviewed that we want to have
come here. And we pick 3 a year. The
student will rank all of the places they interviewed
in the order they want to go.
And then there's a big computer somewhere that
matches up their highest choice with
our highest choice. And that's what's called
the match. So, it's a big surprise,
usually, in March. On a Friday, it's called Match Day. We get an envelope that
says we're going to spend the next 3 to 7 years,
and that's where you go after that.
So, you spent 7 years in residency, right? So,
when I did, it was 6. Oh. It moved to seven
about 10 years ago. So, long-term, does going
to a prestigious medical school like
Harvard or Yale matter to a non-elite university?
So, I went to a college called
Grinnell, which is 1,200 people in Iowa, which
then got me into medical school with
Thomas Jefferson. I think, in the end, where
you go depends on what you learn and
how you do. The name matters a little bit,
but it's mostly how you individually
perform. So, it doesn't matter as much as
people make it out to be. Right. Because
there's different skill sets along the way. In medical school, in high school,
college, and medical school, it's really about
doing the best you individually can.
But when you pick people to be in our residency programs, it's more about
teamwork. So, some people are really good
individual workers, but not necessarily
good team workers. So, really, where people go for school through those years
matters this much because it shows that they're
smart, but it doesn't really tell
us the whole story. So, on one of the parts of the application, you have to do
the MCAT, right? How did you prepare for
it? So, I did all the things everybody
does. I got the exam books to practice from. I took the courses. I did all the
things to get the best score I could get.
So, for you, what was harder, passing
medical school itself or getting accepted? Into
medical school, getting accepted. So,
what made getting accepted harder? I didn't come from a medical family. My
family was in sales. So, there's a lot of
nuances you learn from a medical family
about how to be prepared with your application and everything else. All the
check marks that they look for in medical
school. So, that's what made it hard for
me. I didn't have the background going into
it. Looking back, is there anything
you wish you had done differently in your pre-med
years? No. I had a great time and
I learned a lot and made a lot of good friends.
And in the end, life's a journey.
So, you might as well enjoy that. It's not
about the end result so much as the ride.
So, you said you had friends before. How did you manage stress and maintain a
social life during medical school? Well, the
one thing that I've learned over the
years is that if you're so focused on one thing, you lose balance in life. So,
keeping balance between social and family
and work and exercise is what makes you
very successful. So, where I went to medical school, it was very much built
around having balance in life. So, they fostered
that to help make you a better
student. So, this time when you went to medical
school, you were healthy? Oh, yes.
Okay. Yeah, we had flag football teams. We
had basketball leagues. We did all the
physical, you know, things as a group for
team building. We had, you know, study
groups. We had all the things to keep it balanced. Okay. So, when you were
studying, was AI ever incorporated into medicine?
Those two letters weren't part
of my training when I was in school because that was in the mid-80s. Oh, okay.
You say that like I'm 400 years old. But...
Oh, I'm sorry. But no, I mean, that just
wasn't part of what we had back then. No, I'm
sorry. No, I'm joking. Thank you. And
so, move on to the day-to-day life of your
neurosurgeon. So, what do you actually do
normally for every day? You know, my wife
asks me that every day, but I'm kidding.
So, usually get up early, come in, make rounds
on the patients that we've taken
care of, either operated on or whatever, early in the morning to get ready for
surgery, which usually starts around 645.
Or clinic, which usually starts around
730, where we see patients. And then do that
through the day. And at the end of
the day, round on the patients we've taken care of, check on everybody. And
throughout the day, during the day, teach
the residents and the medical students
that are with us along the way. So, there's teaching. There's taking care of
the patients. There's doing the business of filling out the paperwork and
everything. Okay. So, can you walk me through, like, a common case you take on
during or about surgery? Sure. I do a couple
of things specifically. One is deep
brain stimulator surgery. So, what deep brain
stimulator surgery is, is minimally
invasive brain surgery. Where we make a small
little opening in the skull and put
an electrode that's about two millimeters in
diameter deep into the brain to a relay
center that helps control symptoms that are
out of control. So, specifically, for
example, Parkinson's disease is a disruption of different circuits in the
brain that control the smoothness of movements. It makes tremor and it makes
rigidity. That's because the circuits are out
of sync. There's a relay center where
those circuits interplay to keep that synchrony.
We put that electrode into that
relay center and adjust the electricity to
re-synchronize the circuitry, almost like
you adjust the thermostat in your house to get the right temperature from your
furnace. We can do that with the electrodes. To get that electrode into the
right area, we have to be within one millimeter of accuracy where we put it.
It's a very narrow area we're going for.
So, we have MRIs and CAT scans that we
take the data and put it into a computer. The
computer then gives us the information
we need and it's almost like GPS for the brain.
That gives us a 3D reconstruction
of the brain and we can get in there right
where we want to be. Then we do it awake.
The surgery is awake so we can test it and
see the improvement of the motor function
right away and we know we're in the right
spot. Then we just put a little plastic
cap that locks that down. Close up the incisions
and they go to the recovery room
and then get CAT scan, go home the next day
and we bring them back a week later to
hook that electrode up to a little battery
pack like a pacemaker on the collarbone.
Then that has about 70,000 different settings we can set to adjust the
electrical activity around that to give us
the different adjustments we need to
realign that circuitry. So, it's very precise
minimally invasive surgery to get
back the control of somebody's motor function when they lost it with the
disease. Okay. So, I'm sure like there sometimes are complications. So, how do
you deal with complications or worst case losing a patient? That's a very good
question. I think, you know, with anything
we do to try to help function, there's
always some risk. We talk to the patients
ahead of time when we're planning the
surgery about what the risks are versus the
benefits. And generally, we like to
have a significant difference between benefit being the highest number, risk
being as low as possible. Given that, when
we do have some situations occasionally
where there are complications, you know,
we work to improve that, help them get
through that, help them work with them and
their family to get them back to the best
function we can afterwards. Okay. So, by the
contrast from above, what's the most
rewarding moment you've had in your career? The most rewarding moments are
giving people the control of their life back.
So, for example, there's a story not
too long ago about a 17- or 18-year-old girl
who had Tourette's syndrome. So, since the
age of 2, she was not able to be out in public school systems or in activities
because the tics, the abnormal reactions that
happen spontaneously like tremors and
twitches and things kept her from being able to be in a classroom. We did the
surgery and she got essentially rid of all
of those symptoms and ended up getting
engaged, getting married, taking classes in
a classroom, sitting in the front row
and doing presentations, which her whole
life she hadn't been able to do and now
she could. Okay. So, during these surgeries, is AI and robotics currently
integrated into them? So, AI robotics is part of spine surgery, part of brain
surgery in some situations. So, yes, it is
getting integrated into it. And, in fact,
what we do with brain surgery, as I mentioned, with realigning some of the
circuits with the electrodes, big data analysis,
AI and miniaturization of computers
is allowing us to start developing closed
-loop systems, which means we don't have
to do any adjustments. It senses it in the
brain, the computer analyzes it, and then
it sends a signal to avert or fix that behavior, all from a device that's
implanted on the skull and into the brain.
So, that's just the beginning of the
advancement. The future is very bright for
this kind of thing. Okay. And, again,
another fun question. What's something about being a neurosurgeon that would
surprise most people in their daily life?
I think, you know, being a brain surgeon
isn't rocket science, as they say. Anyway,
it's really a very – it's a great job.
It's a fun job. And when you're well -trained, you know, it's a job that, like
I said, is very rewarding. But I think people have the idea that the brain is
very complex and how would you be able to figure all that out? It's very much
understandable and very much controllable
with the right training and experience.
Okay. So, that actually leads right into the
next topic, qualities and skills. So,
just like you said, it isn't rocket science. The quote, this isn't brain
surgery. It's also sometimes said. With you
actively practicing brain surgery, how
much of it is academics and how much is communication
skills? Wow. That's a very
deep and smart question. You have to be very well-versed in the anatomy and
physiology because, you
know, as they say, it's very expensive real
estate in the brain. There's no room
for error with not knowing your anatomy. So, academics is very important,
understanding all of that. But also, you know,
your physical dexterity, your skill
set is very important. But communication is so important because it's not you
alone. It's your team. So, there's anesthesia. There's the circulating nurse.
There's the scrub nurse. There's people from the device company. There's the
residents and the students. And everybody
has to really work in a very coordinated
dance type way. And you can't really be out
of sync. And then, as you mentioned,
when something goes awry, you can't panic
about it. Everybody has to come together
in an organized way. And that's all about communication.
Okay. So, what qualities do
you think are useful for being a neurosurgeon? Certainly, honesty and
integrity are number one. Being intelligent. But also, as you mentioned,
being able to communicate. Being able to be, being able to take charge of a
situation calmly and authoritatively. But get the team to work with you. So,
collaboration is very important, I think.
So, when talking about surgery, you're
like the boss, essentially? We would call the captain of the ship. Okay. And
finally, do you think future doctors will have
AI into their curriculum? I think AI
is going to be a very integral part of all
of medical education and treatment. And,
in fact, now, just using AI to source information
that would have taken hours or
days to do not too long ago. And actually, you
know, put together a meaningful action
plan. AI is really revolutionizing that and making people that were average at
finding information very, very good at it.
So, I think it's really helping to bring
things together to help people work on solutions
rather than spending all their
time working on getting the information. Okay.
Well, thank you. And let's move on
to your career and lifestyle. So, what percent
of being a doctor is about money
versus helping people, would you personally say? That's a really good
question. It depends. I mean, it really should be about helping people because
there's better ways to make lots of money.
And I think if you go into it to make
money, you're picking the wrong route and
you're not going to be happy with your
career. You know, working on Wall Street,
being in banking, being in investing,
things like that, definitely build around making
money. Not about really a whole lot
of other things, but making money. In medicine, the hours, the commitment, the
personal investment really isn't worth any
amount of money if you're not doing it to
help people. Plus, the reward, in the end,
isn't the money. It really is the feeling
you get for helping people get their lives back
or saving their lives or doing things
that integrally help their lives. So, I don't
think people that are in medicine
for the right reason are in it for the money. Okay. So, what would you say are
the biggest benefits of this career? Would
you say it's like watching people get
their motor skills back? So, the biggest benefit
of being in medicine is you go to
work and feel good about the fact that just going to work is going to make a
difference in the world. And, too, it's a respected career. People, you know,
respect you. It does give you a reliable income
no matter what specialty you're in.
And it helps you really then, in other ways, help the community because you're
respected as a volunteer or a board member or things like that because of your
knowledge. So, I think it's a good career
for stability, for happiness and reward
and for helping the world. So, if someone has
a passion for medicine but they go to
school and they get into debt, would you still
say it's a good idea for them to go
into it? So, you mean they get into school and
then get in debt going to school? Yes.
I think that's the nature of the business at
this point is it does – it's expensive
to go to medical school. But in the end, the government had some plans to help
forgive debt over the years for certain specialties,
which is really good. But in
the end, the career will give you enough
income to pay that debt off. I think if
you quit with the debt without getting the career, you're kind of committed to
finding that career that's going to pay that
debt off, which may or may not be as
lucrative to do that. So, I think getting
a debt is part of the nature of it and
sort of part of the end game. I was – frankly, I was about 50 when I paid off
all my debts from school. So, where do you
see yourself in 10 years? Still working,
retiring? Hopefully alive. But I've been doing
this now – I've been in neurosurgery
since 1991 with six years before that in
residency. So, probably another four or
five years, I will retire. I have seven grandkids
right now that I love spending
time with and, you know, hopefully spend more
time with them. Probably always be a
little bit connected to this. I work with
two of my sons in our department, and I
have a really great group of young neurosurgeons that I hope to follow their
careers and be helpful with them too. So,
moving on to family and personal life,
how's the work-life balance in neurosurgery? It's a career known for
being especially demanding. So, work-life
balance is variable over the years. When
you're in your residency, the first couple
of years of residency are pretty intense
because you're getting all the basic knowledge there, patient care management,
the ICU management, things like that. So, it's a time commitment. And with all
residencies, there's an 80-hour work week. So, you can't work more than 80
hours in a week, but also then there's study
time and things like that. So, the
first couple of years, it's a little bit
harder to have a great balance. But the
last five years, it's very balanced as far
as work time and free time and other
things that you do. And, in fact, a lot of
our residents have a regular physical
fitness regime that they do to stay physically fit. They do a lot of outside
activities together and apart, and a lot of them have families. Once out of
residency, again, the first couple of years, while you're building your name,
building your practice, you're working pretty
hard. You have debt that you want
to pay off, so you're working pretty hard.
Once you start having a family, usually
you can work it out where you do have the
opportunity to have work-life balance.
That's where it becomes a personal choice.
You have to decide you want to keep the
balance between work and family, physical
health and mental health and spiritual
health. So, that's something that we train our
residents to keep an eye on because if
you don't pay attention to that, you can
get down the rabbit hole of working too
much. But there is the opportunity to have
good balance. So, what are your hours?
Like, what time do you come in and then leave?
So, now I work probably about 10
hours to 11 hours a day. I don't work so much
on the weekends because I'm head of
the department. Most of my people that are,
my doctors that are earlier in their
career, they probably work about, maybe about
60 hours a week and then weekends.
And then they're on call. So, sometimes when you're on call, you're not
necessarily working, but you have to take phone
calls at night and things like that.
So, yeah, referencing the same article I cited before, both of your sons are
neurosurgeons. And now all three of you guys
work together at AHN's Neuroscience
Institute. What was it like the moment you
found out they followed you? So, before
that, when they went to college, I said,
you guys have, and my daughter as well,
who isn't a neurosurgeon, said, you have to
pick the career that makes you happiest.
Because no matter what you do, you can't go to work and hate it because you're
going to take that home after work and it's
not going to be a good life. So, pick
whatever you want to do. And for a while, I
wasn't sure what, they weren't sure what
they wanted to do. And then it turned out they
ended up going to medical school and
then it turned out they ended up going to neurosurgery.
So, it was, I was very proud
because that's a good career. Happy because during their childhood, I didn't
make it seem like a horrible life or they wouldn't
have done it. And then also it's
a responsibility because when you work with
them, when you're working with your
family, it's, it's, everybody has to elevate the ships. So, you can't have, I
can't be bad at my job, they can't be bad at
their job because we're all connected.
But it's similar with all the other doctors in my department. They're all,
we're all one big family. So, what's it like working alongside your own kids
versus unrelated colleagues?
So, at work, I really try to keep it the same
with everybody. And I think I have a
really good relationship with all of our doctors. At home, when we have family
events, my wife made a rule that we can only
talk about work for five minutes at
any family event. Because if not, it becomes overwhelming to the rest of the
family and it's not fair. So, we keep family, family, work, work. And it's, I
try, I have a good relationship with all our doctors. Okay. So, your son,
Alexander, said that you never missed a soccer practice. How did you actually
manage that kind of balance with having this career? Volitional effort to be
present during their childhood. So, I was very
busy at the time operating and doing
things like that. But I made my schedule such
that I was there when they had events
and I was there when they were growing up.
And the final question. What piece of
advice do you wish you had heard when you
were an early kid or teen? I think the
best, I had a lot of good mentors throughout. So, I got a lot of different
advice along the way that was all good. I think everything
worked out. And everything, every right turn
and wrong turn happened for a reason
that I learned from it. So, I think all the
advice I got was good. Sometimes not
necessarily timely. But I don't know that
I would have done anything differently.
Okay. Well, thank you so much for agreeing
to be interviewed. I'm currently thinking
of becoming either a neurosurgeon or a cardiothoracic surgeon. Leaning more
toward the neurosurgeon side. And I really
appreciate all of the information you've
provided me. Thank you, Dhruv. And I can tell
you neurosurgery is way more fun than
cardiothoracic surgery. So, pick us. Okay.
So, thank you very much. Yep. It's been a
pleasure. Thank you.