Eben Alexander III, MD on Choosing the Medical Field

Eben Alexander III, MD

Tell us about your medical area of expertise and why you chose your area of expertise?

The short answer is that I followed in my father’s footsteps. He was the widely respected chairman of a neurosurgical training program, a consummate scientist, and yet also a spiritually advanced soul. In high school and early college, my main interest was in astrophysics and cosmology. After a summer job working as an orderly in the operating rooms at the hospital, I developed a passion and interest in medicine, although I also believe that I subconsciously compared my career prospects with my father’s enormous success and defaulted early on to a position of going into any medical field except neurosurgery. His career was so stellar, as a globally renowned thought leader, that I believed I could never really measure up to being as great as he was. Fortunately, when I finally did my basic clinical rotations, I fell in love with surgery.

Working with my hands had always been a pleasure, to build or fix things, and surgery seemed to be an ideal form of such a personal “craft.” In addition, I loved that in a given day’s work, as a surgeon, you could make a major difference in a patient’s life, far beyond what seemed to be available to physicians who were not surgeons. Of course, given the maxim “First, do no harm” that originated as an edict from Hippocrates over two millennia ago, one prays that such surgical efforts will only benefit the patient.

Early on in my neurosurgical residency training at Duke, I developed a fascination with the management of aneurysms and arteriovenous malformations, that is, an interest in cerebrovascular neurosurgery. Duke residents would often perform two years of research during residency if they were interested in an academic career, and my two years of research halfway through my residency were devoted to the vexing and deadly problem of what is called “cerebral vasospasm,” the pathological constriction of the brain’s blood vessels that often ensues 2-3 days after intracerebral hemorrhage from an aneurysm. Roughly a third of the survivors of the original hemorrhage succumb days or weeks later due to the ravages of vasospasm, and my research focused on trying to determine the mechanism and devise a form of treatment.

Following my neurosurgical training at Duke, I had secured a job as the main cerebrovascular surgeon at the Brigham & Women’s of Harvard Medical School in Boston. But first, I completed a cerebrovascular fellowship under an accomplished vascular neurosurgeon at Newcastle General Hospital in northern England. Through all of these rich experiences, I gained a confidence in my new career and knew I had made the right decision.

What are some of the greatest obstacles you face in your medical niche?

Although the modern scientific understanding of the nature of consciousness is shifting rapidly, medical training today continues to harbor the underlying assumptions of physicalism (or materialism) that are increasingly discordant with empirical data about all of human experience. These deep roots in the traditional materialist worldview are increasingly damaging – it is high time for medical education to catch up with the extraordinary implications of a more modern view of “free will” and the power of mind-over-matter. For the most part, a surgeon’s craft responds to cause and effect, bringing a physical remedy to physical symptoms. Yet, especially in neurosurgery, we often encounter that which cannot be explained through physicality alone. So, as I immerse myself in the study of new perspectives in science, following what I witnessed in my own life-altering near-death experience in 2008, I am constantly bumping up against and frequently discarding prior assumptions honed from that former training – expanding my understanding through a deeper connection with consciousness and the quantum field of this universe, which physicists are coming to realize is fundamentally “mental.” And such obstacles or assumptions are not limited to the medical niche of neurosurgeons, but rather spark the ultimate challenge for all of humanity over the eons: What is the fundamental nature of reality?

In order to attempt an answer to this question, one must begin with a far better elucidation of the relationship between the mind and the brain, and the ultimate nature of consciousness itself. This is the holy grail of convergence for all philosophical, scientific, psychological, and theological concerns about the nature of existence.

The currently popular worldview of physicalism, or materialism, is loaded with fatal flaws around the nature of consciousness itself, and is clearly not correct. Yet so many of our broad social and cultural assumptions about the nature of reality are hinged in this false belief system, especially damaging with its false sense of separation. I believe that what we see as the current awakening of humanity is a natural extension of our history, and we must embrace a refreshing and radical new worldview to become more aligned with the underlying nature of reality – this is the critical mission of our time. And, by the way, by better grasping the nature and meaning of such a new worldview, surgeons and all physicians can better serve their patients who are multi-dimensional by nature and often present to us with not only physical, but psychological and spiritual components of illness that require a broader understanding.

Are there any procedures or ideals that you use that set you apart from other professionals in the same area of medicine?

One of my early mentors in neurosurgery stressed “you can always do an operation, but you can never take it back!” Clearly, the implication is that you should exhaust non-surgical treatments before resorting to an operation that always entails some possibility for ill effects or failure. Much of my academic career was devoted to developing neurosurgical techniques that minimized the operative or procedural trauma to the patient, while enhancing the probability for success. This theme of “minimal invasiveness” keyed much of our neurosurgical progress around the turn of the 20th century. For example, much of my neurosurgical career in the early 1990s was devoted to helping develop the field of linear accelerator-based stereotactic radiosurgery, in which precisely directed beams of radiation are used to treat tumors or vascular malformations, and to make functional lesions in the brain as a way to treat movement disorders, chronic pain, and behavioral disorders. Probably the most influential paper I authored during my career was a report in the Journal of the National Cancer Institute in 1995 describing our pioneering use of stereotactic radiosurgery in the treatment of brain metastases, which has become by far the most common use of this technology in the radiosurgical treatment of patients worldwide*. That early work refining linac-based radiosurgery, which has become the dominant platform globally, also resulted in a textbook on Stereotactic Radiosurgery (McGraw-Hill, 1993) that I co-authored with some of the leaders in the field – Dr. Jay Loeffler (currently chairman of Radiation Oncology and head of the Proton Beam Project at Massachusetts General Hospital and Harvard Medical School in Boston), and L. Dade Lunsford, who played a major role in bringing gamma knife radiosurgery into mainstream use worldwide.

Parallel to my work in radiosurgery, I was simultaneously involved as the main neurosurgical clinical liaison with GE engineers in a complete redesign of MRI scanners to develop interventional systems in which we could image and operate at the same time. This was a project at the Brigham & Women’s Hospital led by neuroradiologist Dr. Ferenc Jolesz, in close collaboration with engineers from General Electric, to develop the first such MRI unit in the world. I served as the main neurosurgical representative for the project, which became a decade-long adventure to completely redesign, not only the MRI scanner (into one that would enable two surgeons and the patient to be in the MRI during active imaging), but also every single instrument, drill, scalpel, monitor, microscope, etc. Everything had to be redesigned from the ground up, to be compatible with the intense magnetic field of the scanner. This extraordinary technology has opened the door to far safer and more efficacious procedures, guided by having active imaging during the procedure. And, ultimately the technology will enable the successful management of some of the most challenging cases in neurosurgery. This effort is more broadly chronicled in the textbook I co-authored with Dr. Robert Maciunas, entitled Advanced Neurosurgical Navigation (Thieme Medical, 1999).

My third major field of innovative endeavor involved my role as the Director of Brain Research at the Focused Ultrasound Surgery Foundation in Charlottesville, Virginia. I was familiar with the potential for the therapeutic effects of ultrasound (as opposed to the more commonly known role of ultrasound in imaging) from my work on the intraoperative MRI project at Harvard in the 1990s, but there was no way to deliver such energy through the skull at that time, so it remained a dream for the future of neurosurgery. However, in the early 2000s, Insightec (in Haifa, Israel), and Supersonic Imagine (in Aix-en-Provence, France) were companies that developed the advanced technology necessary to deliver ultrasound energy efficiently through the skull. Because of my experience developing advanced technologies at Harvard, I was invited to serve as the clinical research director overseeing research of focused ultrasound in neurosurgical applications (2008-2010).

This exciting technology has the potential to revolutionize much of medicine, given its powerful thermal effects – no tumor cell can survive in that target zone. Such energy delivery, however, is hampered by any adjacent gas (such as air in the lungs, or gas in the gastrointestinal tract) or bone, somewhat limiting exactly what can be treated with focused ultrasound. Further, we can place very toxic medications into nanoparticles that render the drugs inert until the nanoparticles are carried by the bloodstream into the ultrasound target region, where the MRI-guided ultrasound energy can be used to liberate the toxic drugs from the nanoparticles right to the location where they can do the most good and the least harm. In addition, ultrasound energy can dissolve blood clots (in treating acute stroke, for example) and even open the blood-brain-barrier to allow certain drugs or antibodies to be released in targeted regions of the brain.

Why have you left behind the practice of neurosurgery today, and do you use any of your medical knowledge or skill in your work now?

I absolutely loved being an academic neurosurgeon and researcher, and I highly recommend the field to medical students looking to make a difference in the lives of their patients. And while I had a full recovery of my knowledge and technical skills within eight weeks of awakening from coma, and continued to consult in the field, it became apparent to me that my way of practicing medicine, and especially surgery, had always required my constant devotion. My post-coma career investigating new areas of research into questions of consciousness and substantive writing and lecturing about these big picture subjects left too little time to do my patients justice. With my presentation schedule ramping up and impending publication of my book Proof of Heaven in 2012, I realized I had to choose between ongoing involvement in neurosurgical patient care and devoting myself full-time to my new mission. As much as I enjoyed immensely my work caring for patients, I knew my more important mission involved full-time work in expanding our knowledge about the nature of consciousness, and sharing this most important message with the world.

When I practiced as a neurosurgeon, I was very hands-on from the time of an initial patient consult, through monitoring the patient’s efforts to heal through nonsurgical means first, then ultimately performing surgery when necessary, and following on closely during inpatient and outpatient recovery. I did not feel it would be fair to leave a patient part-way through his or her road to healing because I needed to fly across the country on a lecture tour. And to practice medicine means just that – to hone one’s skills constantly and continue doing surgery and caring for patients every week, not part-time when it fit into my schedule.

Certainly, my ability to focus intently, my strategic thinking skills and a deep knowledge of research protocols have contributed greatly to the quality and productivity of my current work and study. More importantly, my work today has the potential to affect many thousands (if not millions) more lives, as my articles and books are translated into 40+ languages. Many scientists, including physicians, physicists and engineers, contact me, grateful for a vision of spirituality in their lives that is fully consistent with their scientific training and understanding. They appreciate that fundamentally my message is very much about synthesizing our grandest scientific and spiritual qualities.

Other feedback from readers suggests that the information in my books challenges them to think outside their normal comfort zone or provides a new ray of hope when they are grieving or in despair. These are all forms of healing in the macro sense. One new practice I have developed, which has been practiced for millennia in different forms by different cultures, is meditation. It is one of my daily activities now and one that I encourage everyone to adopt, if they haven’t already. By going within, we find our answers, directions and purpose in this life.

My fascination with the brain continues strong, as I now know that it is not an organ that produces consciousness, but rather is a miraculous filter for allowing in consciousness which is fundamental in the universe. Some of my current research uses meditation as a tool for discovering how the brain can be entrained to calm, to allow in more flow from primordial consciousness, and thereby provide both healing effects and, ultimately, growth of our soul.

My message to students trying to decide on a career path is to always be curious, always seek to learn more and grow, and always know that you are part of the whole of humanity, which will flourish best through your unique contributions. And, whether you take up the practice of medicine or another field of endeavor, a daily practice of meditation may be your best friend throughout life as you connect with your soul purpose from the widest perspective possible.

Website: www.ebenalexander.com
Facebook : https://www.facebook.com/EbenAlexanderMD/
LinkedIn: https://www.linkedin.com/in/eben-alexander-iii-md-202345a/
Twitter: https://twitter.com/LifeBeyondD

*Alexander E III, Moriarty TM, Davis RB, Wen PY, Fine HA, Black PM, Kooy HM, Loeffler JS: Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J National Cancer Institute 87 (1):34-40, 1995.

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