Name: Nancy Epstein
Education: Residency, Bellevue Hospital Center
When and why did you join the Congress of Neurological Surgeons?
I joined the CNS as soon as I was eligible. I finished my neurosurgery residency with Dr. Joseph Ransohoff in December of 1981. I was the first female neurosurgeon he trained, and the first that NYU trained. I was the 12th board certified woman in neurosurgery in the US. I joined the CNS as I knew at that time that it fostered the development and academic progress for young neurosurgeons. Over the years, not only has this been true, but as one had become more senior, the CNS still demonstrates integrity and support for those not only in academic institutions, but for all practicing neurosurgeons irrespective of gender or other factors. I was the President of the Cervical Spine Research Society in 2001, after holding many of the prior administrative positions. I am now Editor in Chief of Surgical Neurology International, the first fully on-line neurosurgical journal publishing since 2009; the prior EIC was James I. Ausman, M.D., who was also the prior editor of Surgical Neurology for many years. What is unique about SNI is that we publish in the forefront what is most important to us all; the facts about risks/complications of procedures, and benefits and alternatives for our patients without undue influence from manufacturers.
What advice do you have for new CNS members on how they can best reap the benefits of CNS membership?
I would recommend coming to the meetings where you can talk and interact with neurosurgeons of all ages. I would also attend panels such as the one on October 22, 2019 to learn about how to be an effective reviewer for a neurosurgical journal. You should stay involved in not only reading but writing to maintain your intellectual interest in neurosurgery over time.
How did you get into the field of neurosurgery?
My father was a neurosurgeon, Joseph A Epstein MD. My uncle was one of the first neuroradiologists, Bernard S. Epstein MD who wrote the book SPINE, and many others including those on; cerebral angiography (used before MR and CT to localize brain tumors and establish different diagnoses) and pneumencephalogrphy (to use air and displacement of the ventricles again to locate cranial tumors before MR and CT). My uncle’s books included my father’s patients. Additionally, Joe was one of the first members of the Cervical Spine Research Society, and was President in 1981, the first years I attended that meeting. I grew up rounding with my father on the week-ends and visiting recovery rooms, floors and even getting into the operating room (age 11, I was 5’11” and taking intraoperative photos). I became a neurosurgeon as a congenital defect-wanted to be one since the age of 4. This profession was my dream and the surgery is still the best part of any day.
Describe your job in a tweet (i.e. 280 characters)
I am the Chief of Neurosurgical Spine/Education at Winthrop Hospital, now called for the last year NYU Winthrop. Here, I have continued my academic endeavors including editing and writing for Surgical Neurology International, and reviewing for other journals as noted above. I also give regular lectures/seminars and grand rounds for staff, PA’s, and this past year for the newly in-coming orthopedic residents.
What is the biggest challenge you face on the job, and how are you managing it?
Time spent and efforts made to make sure patients not only get the best care, but necessary care has become the biggest challenge. Furthermore, they should not be subjected to unnecessary epidural injections; these procedures line the pockets of the radiologists/pain management specialist but have no documented long-term efficacy and marked risks and complications.
What research, science, and/or technology do you see having the biggest impact on the future of neurosurgery?
As there are many devices available for treating different neurosurgical/orthopedic spine problems, they should only be applied where and when needed. I find that increasingly we fail to actually and adequately examine the patient, understand their attendant comorbidities, and adjudicate treatment based on that individuals’ needs.
What are you proudest of in your life or career?
I am proudest of the following; (1) patient care: I have tried to provide the best patient care that I could; I always got up in the middle of the night, went in to see the patient, and make the best decision/offer the best surgery that I could.
(2) I am also most proud of having written in 1993 about introducing intraoperative somatosensory evoked potential monitoring to cervical spine surgery:
Epstein NE, Danto J, Nardi D: Evaluation of intraoperative somatosensory evoked potential (SSEP) monitoring during 100 cervical operations. Spine, 18(6): 737-47, 1993.
This was later followed by articles advocating using motor evoked potentials as well. I think such monitoring has added to the safety of spine surgery, and continue to use it on a daily basis.
(3); Very early on, as I traveled to Japan when I was Program Chair for the Cervical Spine Society and the Spine Sections of the AANS/CNS, I recognized and wrote about Ossification of the posterior longitudinal ligament, and have published numerous articles about it.
If you could interview anyone, who would it be and why?
I would love to have interviewed Harvey Cushing. I had read that he diagnosed a frontal lobe low grade glioma in his own sister based on behavioral changes. They operated in silence, and the scrub nurses had to know what he needed without talking to reduce the risk of infection. I would like to find out how he motivated his staff to get such an incredible amount done with so little in terms of diagnostic studies, antibiotics, adjunctive treatment modalities.
I would like to have interviewed Leo Davidoff, a neurosurgeon, from the Albert Einstein College of Medicine. I knew him only as a young child, sat on his lap and his wife’s lap. But to have an adult conversation with him neurosurgeon to neurosurgeon would offer great perspective on where neurosurgery was and how far it has now come.