Q&A: Dr. Juan Uribe, Chief of Division of Spinal Disorders
Like his father, a neurologist, Dr. Uribe was fascinated by the central nervous system. However, he wanted a more hands-on role.
“Neurosurgery was a field where I could use neuroscience knowledge and apply it to some hands-on work,” he said. “As a neurosurgeon, you can see the results right away.”
Dr. Uribe has practiced neurosurgery for 21 years and specializes in minimally invasive spine techniques. He joined Barrow Neurological Institute in 2017 as the chief of the division of spinal disorders, chair of spine research, and vice chairman of neurosurgery.
We talked to Dr. Uribe about what it’s like to work as a neurosurgeon and how he expects the field to change in the future.
Why did you choose to specialize in the spine and, specifically, minimally invasive spine surgery?
The spine is a very complex mechanical apparatus with many moving parts. What happens in one vertebra can affect the entire body, so I was really interested in how I could manipulate the spine to try to improve people’s lives. Back pain is a very common problem. Then I got into spine and found that the surgical solutions were, to me, very aggressive. They involved big exposures and lots of trauma to the soft tissues, so that’s why I started really getting attracted to minimally invasive techniques—how to get to the spine through smaller portals. Trying to deliver the same surgery with minimally invasive techniques that you do in the standard open techniques, it becomes a passion. I always like to challenge what’s conventional. I’m always trying to find out, how can we make things better without compromising what works?
What spinal conditions do you treat?
Anything from trauma all the way to tumors. In the middle, you have all the degenerative cases and deformities. I like to treat a lot of scoliosis because scoliosis is very challenging, and it’s when you put all your skills to a maximum. I pretty much treat the whole spectrum of spinal diseases that we can do with surgery.
How long can some of your cases take?
It depends. It can go as little as 15 minutes if it’s a vertebroplasty for a compression fracture in the spine. If it’s a complicated deformity case, we may actually have to split the surgery into two stages—two days, six to eight hours each day.
How are you able to stay on your feet and focused for so long?
You forget because you’re so absorbed in the case. It’s interesting because sometimes when you are waiting for your wife in a store and you have to be standing, after 20 minutes you feel like you have to sit down. In here, I go five to six hours and forget that I’m standing because I’m so focused on my work.
What is the most difficult part of being a neurosurgeon?
The most difficult part of being a neurosurgeon is dealing with complications—when you try your best and the results are not what you’re expecting. Another difficult part is when the knowledge and techniques that we have are not enough to help a patient. It’s very hard to have to say surgery is not a good option for them, but it’s also what drives us to keep trying to get better and find more solutions.
What do you love most about being a neurosurgeon?
The fact that we can help people and that we have the permission to try. The most rewarding thing is when a patient says, ‘You changed my life. Now I can enjoy what I do, enjoy my kids, go on a trip.’ That’s probably the best part of what we do.
What do you think makes a good neurosurgeon?
You have to have the stamina, the energy, to be able to handle various stressful situations for many years. Neurosurgery is a marathon. A combination of good training, good common sense, and good hands makes a good neurosurgeon in terms of technique, but at the same time you have to be compassionate. We are physicians, and our mission is to help people. You also have to be an honest person and be able to recognize your limitations. Sometimes there’s a situation where we cannot help at all, and we have to be able to recognize that.
What advice do you have for people considering or pursuing a career in neurosurgery?
It’s a beautiful field of medicine, but you have to be 100 percent sure that it’s what you want, because the job itself will consume most of your daily activities. You have to be prepared to work long hours and spend a lot of time in the hospital. Your personal activities become secondary. If you’re questioning whether neurosurgery is for you, then you better do something else because this is more than a full-time job.
What would you say is one of the biggest public misconceptions about neurosurgeons?
That we are very awkward people. People think a neurosurgeon is someone very unique, but we’re like everybody else. We just take a lot of risks; that’s what makes us different. Normally, a neurosurgeon is, by nature, a risk taker. It’s not unusual to see neurosurgeons who are sky divers, and many of us have motorcycles. We’re very competitive.
How do you envision the future of neurosurgery?
The future neurosurgeon will be in a vigilant mode of coordinating multiple systems. For example, a surgery will be totally guided by robotics, virtual reality, and augmented reality. We’ll be coordinating from a remote area, making sure that all the systems work. It’s going to be very standardized, so a lot of patients will have access to really good neurosurgeries. It’s going to be similar to a pilot flying an airplane. You get into the plane and make sure all the systems are working correctly, and you have to intervene when something goes off of the standards. Otherwise, the systems and computers will basically do the surgeries for you.
This interview has been edited for brevity and clarity.