Philosophy In Motion
Personable Neurosurgeon Puts Patients At Ease
By George Fuller
If you had a smooth voice warm enough to melt butter, you might become a DJ on an underground FM radio station.
If you had a countenance so calming that heart rates lowered when you simply walked into a room, you might become a yoga teacher.
If you could explain brain-twisting technology so that a person of average intellect and education could easily understand it, you might become a technical writer.
But Arnold Etame, M.D., Ph.D., didn’t follow any of those career paths. He became a brain surgeon and continues to astonish those who typically don’t expect hyper-brilliant people like our good doctor to be warm and down-to-earth.
A recent patient observes: “Dr. Etame was so personable, so informative, which is exactly what you want.”
Yes, but personality can’t vanquish a tumor. Nor can information put cancer into remission. Although both can put a patient in the right frame of mind for helping to deal with the disease, the doctor’s talent and ability certainly are essential.
Speaking of talent, Dr. Etame (pronounced: ā tah’ māy) has gotten a bit of attention lately for his. Specifically for his skill in using lasers to destroy tumors found in the soft tissue of the brain. The technology he uses is called Visualase, an MRI-guided laser ablation technology used to perform minimally invasive neurosurgery. The description that follows may sound a bit like science fiction.
Light energy is directed to soft troublesome lesions by what is likened to a sophisticated GPS guidance system. Energy delivered through a laser probe “cooks” the tissue that needs to be removed. The first step in the operation involves the use of MRI “mapping” that effectively puts the guidance system in place and makes precise targeting possible. Then, Dr. Etame and his laser probe take over. After the procedure, the laser application is removed and the scalp is closed — usually with only one stitch. The procedure, which is often performed on otherwise inoperable tumors, is pain-free, can be performed while the patient is awake, usually requires only a one-day hospital stay, and subsequently has a shorter recovery time than other brain surgeries.
Heady stuff, no?
Dr. Etame’s path to laser brain surgery began in a decidedly un-heady fashion, inspired by watching episodes of “Trauma: Life in the ER” and reading the Time magazine’s “Heroes of Medicine” series.
“Watching those shows and reading those articles, I gained an enhanced appreciation for the critical role of surgery in medicine. Hence I came to the conclusion that surgery was pretty cool.”
Further inspiration came from his neurosurgeon mentors during medical school and residency training.
It turns out, for this self-described ordinary soccer-loving kid, school was also pretty cool. He did well. An understatement that just might rank up there with “Rembrandt was a pretty good painter.”
He thrived in the tougher-than-tough British education system adopted by Cameroon, where he grew up. He went on to college at the State University of New York at New Paltz, medical school at University of Iowa (“The neurosurgeons let me hang out with them in the OR”) and snagged a Ph.D. from the University of Toronto — where his dissertation focused on the therapeutic use of nanoparticles in treating brain tumors. Next came a research fellowship in neurosurgical oncology at the Labatt Brain Tumour Research Centre-The Hospital For Sick Children in Toronto, a neurosurgery residency with the University of Michigan Health System, an assistant professorship in oncology at the University of South Florida, and finally to Moffitt Cancer Center where he is now an attending neurosurgeon and staff scientist.
Why Moffitt when he could have gone anywhere? He gets suddenly quiet. A steady hand finds his chin and rubs it slightly.
“You know, what I love about this place is the same thing I loved about Toronto. And it’s the reason I’m here — the philosophy at both places is that you work on patients to ease their immediate suffering, but you also work in labs to find long-term solutions. Moffitt has a strong focus on research, especially research that will translate into better patient care.”
Here he has most certainly positioned himself to put that philosophy into practice.
In one of his research initiatives, Dr. Etame is the principal investigator on a phase III vaccine trial for patients with glioblastoma multiforme, an aggressive and invasive brain tumor.
Dr. Etame’s clinical practice focuses on management of primary and metastatic tumors of the brain, spine and peripheral nerves. He performs a substantial number of surgeries in eloquent and non-eloquent regions of the brain with image-guided stereotactic techniques entailing functional MRI and diffusion tractography neuro-navigation. He also directs an awake-brain tumor resection program for patients with tumors close to critical areas for speech and movement. He has performed more than 200 image-guided brain surgeries within the past two years. And in collaboration with the Radiation Oncology Department, he co-directs the stereotactic radiosurgery program for brain and spine metastatic tumors.
But when you talk to Dr. Etame, he makes it sound clear-cut and uncomplicated. His words are simple and gentle. Like a spring breeze gently tossing the leaves of a dogwood tree back and forth in slow motion. Seriously.
You know, one might say Dr. Etame’s information delivery system is his strongest suit. But, of course, that wouldn’t be exactly right. Performing brain surgery with a laser beam is pretty cool, too.
IF THERE WAS A CURE FOR ACUTE TREPIDATION, I WOULD HAVE SOUGHT IT IMMEDIATELY.
THEY WANTED ME TO TALK TO ONE OF DR. ETAME'S PATIENTS ABOUT HER EXPERIENCE. AND I DIDN'T WANT TO.
There are some people (let's call them, uhhhh, angels) who can visit hospitals and chat up patients like they were sitting next to them at the airport. I'm not one of them. I did not believe my intrusion would be welcomed.
The patient was Mrs. Darlene Westbrock, a woman whose brain tumor had been removed but had begun growing back and was leaking fluid, causing swelling that was leading to seizures. Dr. Etame had been called in to perform laser surgery, noteworthy for its remarkable success at destroying tumors in sensitive, inoperable situations.
I needn't have worried at all. From her lounge chair in a cozy corner of Moffitt’s infusion center where she was getting chemotherapy, Mrs. Westbrock welcomed me with open arms, even the one attached to the IV, and — with a smile that seemed to stretch from here to forever — put me at ease immediately. I pulled up a chair close to hers, turned my recorder on, and for the next 30 minutes listened to someone who now has a place on my list of "people who have every reason not to be upbeat but are anyway." Her husband, Jerry, had a few words as well. Here are some quotes from our conversation.
DARLENE WESTBROCK: "Three and a half years ago I was diagnosed with ovarian cancer. My oncologist was at another hospital in town. About a year ago, when he moved out of town, he didn't hesitate in recommending Moffitt. 'Moffitt really is where you need to be,’ he said. They work as a team here. Dr. Khoury (Moffitt neuro-oncologist Michael Khoury, M.D.) was also on the team. He gave us options. He laid them out very clearly. One of the options was laser surgery with Dr. Etame."
JERRY WESTBROCK: "Dr. Etame is definitely not what we expected. Very personable. He has this low-key approach. Very calming voice. He makes you feel relaxed and confident. He asked a lot of questions. I think we talked for about an hour. I knew we were in the right place with the right doctor. After surgery, he showed us slides of what he'd done. He even drew pictures for us with his pen. You expect a brain surgeon to get in there and get it done and that's it. You just don't expect bedside manner with brain surgery. Or we didn't anyway."
DARLENE WESTBROCK: "I know now Moffitt is the place I was supposed to be."