The pioneer of the use of 3D Technology in Neurosurgery is Italian.
Originally from Maddaloni, a small town in the province of Caserta, Italy in the region of Campania, Dr. Antonio Bernardo is an award-winning, highly distinguished neurosurgeon, currently making a difference at Weill Cornell Medicine in Manhattan.
Recruited as skull base expert, vascular surgery and virtual reality to neurosurgery in 2004 directly by the chairman of the Neurosurgery Department at Weill Cornell, Dr. Bernardo is Associate Professor, as well as Director of the Microneurosurgery Skull Base and Surgical Innovation Laboratory at the University.
“Sharing my knowledge with young neurosurgeons is what continues to inspire me most,” writes the luminary during our email interview. “Passing on our knowledge is the best way to contribute to the improvement of health care.”
Dr. Bernardo likes to give back. This comes from the experience he had in 1999 volunteering, for 14 months, in Peru for the Foundation for International Education in Neurosurgery (FIENS). “I was so enriched by the whole experience that I decided to spend most of my future career in providing surgical care, hands-on training and education to neurosurgeons from around the world,” he writes.
After having trained over 5,000 students and 55 dedicated fellows in his skull base and minimally invasive surgery courses, Dr. Bernardo remained faithful to his intentions. This without even mentioning the numerous international courses and meetings he is invited to attend as a guest, or honor speaker.
His story is impressive and I was curious to know what inspired him to start. As a young boy trying to better understand his science classes, Dr. Bernardo devoured his father’s extensive collection of neurological books. The anatomy professors during medical school also played an important rule.
This all led Dr. Bernardo to become a master in skull base and vascular surgery. The technical challenges in accessing lesions in the areas at the base of the skull are no barrier for “Dr. Skull,” who not only does the best to cure his patients, but also takes great care of what they become.
“[…] Well-executed skull base surgical approach allows for resecting a benign skull base lesion without causing any further neurological damage and without affecting the cognitive function of the patient,” writes Dr. Bernardo.
“Dr. Skull” received an MD from University of Naples “Federico II” with Summa cum Laude. He completed Neurosurgery residency at the Western General Hospital/ University of Edinburgh, Scotland. Then followed serving as scholar at the University of California, Irvine. Before joining Weill Cornell in New York, he was doing his fellowship under Dr. Robert Spetzler at the Barrow’s Neurological Institute in Phoenix, Arizona.
Lavinia Pisani: What do you miss the most about Napoli?
Antonio Bernardo: The ideal society is a harmonic balance of many different components. Some of these traits abound in Naples and I miss them the most. Neapolitan people are spontaneous, simple, friendly, funny, talkative, adventurous, and feisty. They are rebellions with a subtle irony and always wear a smile on their faces. Drama is not necessarily a defeat but the main ingredient to spice up their life. Naples is permeated by a boiling joy, which I identify with greatly but the Neapolitan epicurean approach to life unfortunately does not provide a proper ground for constructive planning.
L.P: What was the main challenge for you to face as an Italian in America?
A.B: As have many others, I had to face the many cultural differences, which pose a constant challenge for new Italians who come to America. Adjusting to and embracing the Anglo-Saxon mentality is the key to succeeding in this country. I soon realized that the ultimate reward of succeeding in such a prosperous and functional country was very worth the effort. I have to admit that my ability to prosper in the US was facilitated by spending my entire surgical training in UK before I landed here. Besides the obvious and well-known diversities in social habits, the main adjustment I had to face, particularly in my work environment, was to understand and embrace the Anglo-Saxon pragmatism, which is essential to the functionality of this country. “Facts speak louder than words” is the constant message you receive from American society and I was surprised on how fast and happy I was to learn it. I also learnt that constructive criticism, as opposed to arrogance, can only enrich one’s personality.
L.P: What does it mean for you to be in New York?
A.B: Being in New York and at the Weill Medical College of Cornell University means to be able to work in a very stimulating and challenging environment, which attracts the brightest individuals from all over the world. The Department of Neurological Surgery at Weill Cornell Medical Center is a world-class provider of minimally invasive surgical techniques for the treatment of neurological diseases. In the last 10 years the department has achieved remarkable breakthroughs in research. In such a stimulating environment I was able to personally design the Skull Base and Surgical Innovations Laboratory, which is a state of the art facility where neurosurgical fellows from all over the world are trained. The laboratory integrates exquisite cadaveric dissections, 3-D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills, and investigates new surgical routes to intracranial targets.
L.P: What are the biggest differences, you have encountered, between working in Italy and the United States?
A.B: There are many differences between these two profoundly different societies, but I can synthesize them in 3 main aspects, which highly influence the working environment: pragmatism, constructive competitiveness, and meritocracy. A pragmatic society where the best and brightest can fully express their potentials and where healthy competition inspires creativity and productivity is the perfect ground for progress and function.
L.P: What is the #1 lesson you teach to your students?
A.B: Work hard and don’t waste innate talent. Talent alone doesn’t shape excellent surgeons. Passion, empathy, competence, and hard work combined with talent can produce outstanding neurosurgeons. Apply the biggest effort to achieve the best possible training. A profound understanding of the intricacy of intracranial anatomy is crucial in the formation of excellent neurosurgeons and can only be acquired with meticulous and painstaking work in a surgical training laboratory. To attend courses and major meetings, keep abreast with technological advancements, visit other institutions to learn how others do things, and, most importantly, to seek constant inspiration to continuously ignite their passion and enthusiasm for neurosurgery. Never fall into the deleterious flatness of a sterile routine.
L.P: I have read Italy is leading in cancer research. As an acclaimed Neurosurgeon, specializing in brain and vascular tumors, what can you tell us about the developments that both Italy and the U.S. are working on? And where do you see the cancer treatment going 5 years from now?
A.B: Italy is at the forefront of medical research. There are many promising fields in which Italian and American scientists are working on and that are transforming the way we think about cancer and delivering treatment. “Precision medicine” is based on “custom tailored” therapeutic procedures based on specific genomic pattern. “Immunotherapy” relies on a century-old idea but with new techniques where a person’s own immune system can be stimulated to fight cancer. “Epigenetic therapy” is an intricate system where cancer could be treated in a different way, by transforming cancer cells back to normal cells rather than destroying them. Also surgical procedures are changing dramatically with the recent development and refinement of new minimally invasive techniques. There are many reasons to be hopeful about the future of cancer care and research.
L.P: After having had so many international experiences, what country/ies do you think Italy could look up to improve its medical system? And why?
A.B: I strongly believe that the American model is the gold standard for the quality of the medical care and assistance. Socialized medicine is an ideal and noble concept as long as it is able to guarantee an optimal standard of care. Regrettably in many national healthcare models where medical assistance is publicly available to everybody at no cost, the quality of care is often inadequate.
Unfortunately, incentive still represents the driving force for many individuals whereas pure passion and altruistic attitudes should suffice to inspire to provide the best effort in medical assistance. After having been exposed to the surgical training programs in many countries, I find the training model in US to be the most effective and meritocratic. The American medical training system produces overall excellent doctors which ultimately translates into an excellent quality of medical care.
L.P: What is your next goal?
A.B: I often find myself reflecting on what contributions I made and what I can still do for the care of those in need. My future goals are equally divided into clinical care, research development, and surgical education. I am fully committed to contributing to the advancement of the art and science of neurological surgery through research, education, and the maintenance of scientific and clinical scholarship.
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