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The Making of a Neurosurgeon; Dr. Sean Lavine

Picture a little boy, about ten years old, freckled, with blond hair and high Irish cheeks running toward the neighborhood park.  A crowd has gathered and this earnest boy makes his way through. In his left hand he carries a worn blue tackle box. In it is his usual stash of band-aids, ace wraps and neosporin.  Someone is hurt and he jumps in to help.

Forty years later, that boy has become Dr. Sean Lavine, a neurosurgeon and specialist in endovascular and cerebrovascular surgery.   The field of medicine he has chosen is a tough one too.

In this innovative and intense area of medicine, Lavine thrives.  One of his mentors, Dr. Martin Weiss from the University of Southern California’s Department of Neurosurgery (USC) says, “He has a rare combination of intellect, delightful personality and very high technical capacity – that is a perfect combination for being an outstanding neurosurgeon – which is what he is. That is just how I feel about him. I am very proud of him.  I’m proud to have been associated with him and look forward to following his distinguished career. He was the kind of person that you wanted to like. You had to like him because he was just someone who made you proud to be a neurosurgeon.”

When Lavine entered his undergraduate studies at the University of California Los Angeles (UCLA ) he says, “I had the idea that I would do medicine – That, I knew from the start. I had no idea at that time that I would be interested in the neurosciences.”

While a sophomore at UCLA, Lavine met Charles Olmstead,Ph.D, professor in the Department of Psychiatry and Biobehavioral Sciences.   Olmstead was recruiting students to intern in his Developmental Disabilities Immersion Program (DDIP).  According to Olmstead, “We took between thirty and thirty five undergraduates from UCLA and moved them into a communal living type situation.”

Lavine says, “When I met Olmstead, I was looking for something a little more intense. UCLA is a huge school with 450 people in a science class. I was intrigued by the small classrooms and the intense experience [that the program offered].” Lavine was accepted into the program and spent one whole quarter, living and studying at a state Hospital for the developmentally disabled.

Olmstead says, “They [the undergraduates] had to do community service, work a certain number of hours and then go into one of the laboratories and work up a research project.  There were eight full UCLA professors running labs there at that time. Sean completed his research and was able to present it at the Society for Neuroscience‘s meeting that year (1985) in Dallas. He was very young to present.  Sean was spontaneous – when he saw something he was interested in, he jumped on it.”

Lavine says, “I studied Krabbe’s Disease.  I did surgery on mice, isolating the sciatic nerve then taking electrical recordings.  That is when I got into the surgery side of things.”

Also, Lavine says, “At DDIP, I got to see the incredible consequences of neurological diseases in people.  There were kids there, for example, who never had their hydrocephalus treated. They were never shunted so their heads just grew and grew until they were basically the size of a table top. There were also people there who were self-mutilators and ultra violent because of neurological disease. This all had a huge impact on me.”

When the program ended and he graduated from UCLA, Lavine took a year off to work as DDIP’s coordinator.

By the end of that year, Lavine had been accepted into several medical schools. Lavine says, “I am always looking for a new challenge and a new experience. I could have stayed in California but when I got into Cornell, in New York City, I jumped at the chance.”

It was at Cornell that he solidified his interest in neurosurgery and after four years, Dr. Sean Lavine returned to his home state of California and began the first of a seven-year residency in Neurosurgery at USC.

Head of USC’s Department of Neurosurgery at the time was Dr. Martin Weiss who says, “We only accept two residents per year into the program- so, it’s competitive.  I was chairman of the department for 26 years. I trained roughly 50 residents during my career. He [Lavine] is certainly one of the top residents that have come through our program. He was someone who took his work seriously. Wonderful sense of humor but serious about what he does and Neurosurgery requires someone who is serious about his work.”

Lavine’s residency at USC coincided with an exciting time in neurosurgery, with the emergence of a new area of specialization called Interventional Neuroradiology, now renamed Endovascular Surgical Neuroradiology.  For the first time, neurosurgeons were officially being trained in the endovascular techniques formerly reserved for interventional cardiologists and neuroradiologists.  Applying these techniques in the arena of brain surgery was revolutionary and allowed for faster, less invasive treatment for a greater number of conditions.

Lavine says, “There was this group of about five guys right before us that really were pioneers. They went up against a lot, they had to get into angio rooms in the middle of the night and on weekends. The radiologists were very resistant to letting us in their area and they owned all the equipment to do this work. Those guys really had some struggles. One of them was actually trained by a cardiologist because radiologist refused to train him in those techniques.”

At that time, USC in particular was a hot bed of activity with a number of faculty who were pioneering this new arena.  In addition to Dr. Martin Weiss there were two others in particular:  Dr. Steven Giannotta, a specialist in Vascular Neurosurgery and current Chair of Neurological Surgery and; Dr. Michael Apuzzo, Edwin Todd/Trent H. Wells, Jr. Professor, specialist in Neurosurgery and Radiation Oncology, and a man who has been called, “the Godfather of Neurosurgery.”

Dr. Apuzzo says, “I felt that it was an important specialty that would be part of the future of neurosurgery. I felt that- as early as in the 80’s when it first began.  I went to Europe to see how they were doing it.  I went to Moscow and the Ukraine.  I came back and began to publish things about it.  We were the earliest to encourage neurosurgeons to do it.   When Sean trained it was a high point in the whole field of neurosurgery. [At USC ] it was a peak in terms of the people, level of the residents, and procedures done- and Sean was a part of that.”

Weiss, Apuzzo, and Giannotta all took a special interest in Lavine and encouraged him to pursue this new training.  According to Apuzzo, “We all felt he was an exceptionally talented person from many sides- in many areas.  He was part of the cream of the crop- and these are very good people.  He is a very unusual person with strength, dignity and the kind of intelligence you like all neurosurgeons to have.”

Dr. Giannotta says, “We thought he would be a pioneer.”

According to Dr. Lavine, “Gionnotta was really one of the guys that talked me into it. He insisted that the ‘pure open vascular surgeon’ was a thing of the past.  I was fortunate enough to be around him.  He saw the future very early on, as did Weiss and Apuzzo.   They all pushed me to apply for this fellowship.  It was a bit painful at the time because our training is so long to begin with.”

He was finally convinced and in 1998, after completing seven years of neurosurgery residency he entered into USC’s two year fellowship in Neuroendovascular Surgery and Neuro-interventional Radiology.

Lavine says, “The timing was really good for me.  I think I was number seven, possibly, of all the endovascularly trained neurosurgeons in the United States.  Now there are over a hundred of us.”

His mentors had been right too;  He was very well suited to this new specialty and he thrived.   Dr. Apuzzo says, “He was one of the very first people to be trained in both microsurgery and endovascular.  He was not only trained but talented.”

According to Dr. Giannotta, “Sean was technically, in surgery, sort of precocious.  It came very easy to him.   In that way, he stood out.   He is a good role model as a double threat vascular neurosurgeon who can do both open and endo-vascular surgery.”

“He was very much in demand when he finished his training,” Says Dr. Weiss. “He had his pick of numerous places that wanted him because he was so talented.  He could have had a job here if he wanted it.   I think he knew that but, he was enchanted by the opportunities at Columbia- which has provided a wonderful fertile environment for him.  Being a good farmer, he found a fertile field and grew the crops appropriately.”

Dr. Lavine has been at the Department of Neurosurgery for nine years now and he says, “ I still find the field very exciting. We are ultra sub-specialized at Columbia, unlike any other group.  Most places, they do a lot of general neurosurgery.  Here, we just really focus on one area.   In doing that, I have realized, you become an expert in the area and much more comfortable doing that kind of work.”

His field is also driven by technology that is constantly improving, with new methods and tools coming out all the time. “That, to me, is very exciting.  I love working with the new products and learning how to do the new techniques,” says Lavine.

Dr. Lavine’s enthusiasm is contagious and has made him a prolific teacher.   In addition to his role as Assistant Professor of Neurological Surgery and Radiology he is regularly invited to train residents and fellows across the country.   He says, “That gives me a tremendous amount of enjoyment.   I go to these fellows’ courses and lecture and do the hands-on training with people and try to inspire them to come into this field. There is still such a void.”

The making of any Neurosurgeon is long and arduous. It takes intelligence, skill, tenacity and sometimes it is just a matter of being at the right place at the right time.  The making of a great neurosurgeon, however takes much more. It takes bravery, heart, and most of all passion.  It is that fire in the belly that drives success.  It is what turned that little boy with the blue tackle box into the Neurosurgeon he is today.

patient journey

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