An Ode to my Mentor

25 May 2017

From the moment that we roll out into this big bad world, we receive instruction. First it is by our mothers or primary care givers. Then follows formal teaching through the schooling years. Some of us continue into tertiary education, receiving tuition in support of a degree.

One form of teaching however, stands out apart from all other modes of instruction. This is mentoring. Mentoring is a form of instruction which incorporates teaching and coaching with the aim of enhancing ability, self-awareness, awareness of the environment and value contribution. Additionally, resilience and fortitude evolve. Mentoring is unique in that the mentor takes a personal interest in the development of the mentored individual such that the gratification of achievement experienced by the recipient is shared by the mentor.

I regard myself as privileged, in fact blessed, in having had a mentor that nurtured me through my higher degree. Born in Holland, Dirk emigrated to South Africa as a child. Since the Dutch language has so much in common with Afrikaans, one of the two original official languages, Dirk was raised in a rural Afrikaans community and consequently Afrikaans became his mother tongue.

Dirk managed to attend university and subsequently graduated as a medical doctor. For several years, Dirk served his community as the beloved family doctor. At some stage Dirk tired of the life as a family practitioner and sought more ambitious pastures. Since he was bestowed with gifted hands together with a keen interest in the evolving field of neurosurgery, Dirk soon found himself specializing in this area of medicine.

After completing his studies in the UK and graduating as a neurosurgeon in the proud English tradition, Dirk returned to South Africa and set up a private practice in neurosurgery. After several years in private practice, Dirk yearned to begin teaching new and up and coming candidates in the field. Consequently he gave up private practice and took up a full-time academic teaching post.

When I commenced my neurosurgical training as a junior resident, Dirk was the Principal Consultant (one level below the Professor and Chief of the department). From the outset, Dirk whom I respectfully referred to as 'Meneer' ('Sir' in Afrikaans), took me under his wing.

He taught me the history of surgery and neurosurgery, about which he was passionate. Like most neurosurgeons I developed great pride in our pioneers (starting with Harvey Cushing, the first definitive neurosurgeon) and our history. I learned the names of all our surgical instruments, many bearing the names of their original developers to this day.

From his early days as a family/community doctor, Dirk maintained a special connection with his patients - a genuine non-judgmental sensitivity which he incorporated into my learning experience. This was further supplemented with Dirk's admiration for the comprehensive hands-on clinical approach of the British tradition of medicine. As a result, my clinical training was very much at the bedside. Special investigations such as blood tests, scans and the rest, supplemented what was gleaned from the clinical evaluation. Dirk always emphasized that the history and examination should already have provided most of the contribution towards the diagnosis, with special investigations merely fine-tuning the nature of the pathology.

This was so poignantly illustrated when Dirk was a visiting consultant at one of the big neurosurgical units in the US. While trailing at the back of a large entourage of surgeons on a ward round led by a 'big name' neurosurgical Professor, Dirk noted that the elderly lady whose bed they had just passed, appeared decidedly ill. Dirk called out to one of the residents, indicating concern for the woman's condition. The resident responded, "Her parameters are within normal limits", implying that since her blood tests indicated normal indices, the patient was fine. As it happens, the patient died before they completed the ward round! Dirk related this to me on his return, ending the account with " .... and so there was nothing to worry about since the patient died with normal parameters!"

My surgical training was comprehensive in every way. Dirk had masterful hands with technique and experience to match. And so I was mentored in the classical methods as well as in the newly innovated approaches. First Dirk performed the procedures with me assisting and then he assisted me in turn, before letting me go 'solo'. Often while assisting me, he would whistle or hum some classical music piece and asked me to identify it. Since I was ignorant of most of the classics, I invariably couldn't identify the pieces, to which Dirk responded 'you bloody barbarian !'

During my training, micro-vascular surgery was evolving as a new and essential component of neurosurgery. We didn't have our own training lab so Dirk and I set up our own. We were both averse to sacrificing animals in this regard. So I came up with the bright idea of using human placentas as a source of blood vessels upon which to hone our skills. Since we had an obstetric department with labor ward in our hospital, we had a ready supply of placentas. Therefore on regular occasions I'd make my way over to the labor ward to pick up a placenta or two. This was always met with the chorus from the sisters, 'Here's the nutty neuro resident again scrounging for placentas!' Dirk and I would then spend hours together working under the microscope, perfecting our techniques.

We had many wonderful chats together in his office. Our Friday afternoon ritual was to pick up our cups of coffee in the ward tea-room (cups only two thirds filled) and then proceed to Dirk's office. After closing the door we would top up the cups with a ready supply of whisky! Thereafter followed discussions ranging from neurosurgical issues, politics, philosophy and of course to the 'hot' new red-head nurse that had just started in the ward!

Indeed I was privileged and blessed to be mentored and nurtured in the art and science of neurosurgery as well as in many aspects of life itself. I remember Dirk's visible pride in my evolution as a neurosurgeon and how he celebrated my graduation.

This post is thus dedicated to the sacred memory of Dirk - my teacher and mentor. With much respect and appreciation. Dankie Meneer. Rus in vrede. Thank you Sir. Rest in peace.

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