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It was a humbling surprise to be greeted with applause when he entered Toronto Western Hospital's (TWH) operating rooms (OR) one day last month.
This OR day was a special one for neurosurgeon Dr. Mark Bernstein, and his colleagues from the OR and the Division of Neurosurgery showed up bright and early to commemorate it with him. After 36 years of spending one or two full days every week leading surgical procedures in the OR, the case on Oct. 26 would be Dr. Bernstein's last.
"Stopping surgery is a radical cut down, this is where I've done my most important work, and where I've had the most fun," says Dr. Bernstein. "Though it is the right time for me to take this step, ending the surgical part of my career is really like leaving a family – the operative environment is a really special community."
The decision of a surgeon to stop operating is an individual one, and one made between the surgeon, an institution's surgeon-in-chief, and the surgeon's division. The choice is often resource-based: with only so much OR time that can be shared among surgeons in a division, there comes a point in every veteran surgeon's career where it makes sense to cede time to newer recruits.
"I started considering when to retire from neurosurgery about two years ago; choosing to do it puts me in charge of my own destiny," Dr. Bernstein says. "There's nothing 'good' that can be said about the pandemic, but the slowdown that it brought did help make this transition easier."
Though he leaves neurosurgery, he doesn't do so without having made a profound mark in the field.
"Dr. Bernstein has been a trail blazer who led the Neurosurgery Division through transformative years, and contributed to putting TWH on the international map through his pioneering work in managing brain tumour patients, research and care," says Dr. Gelareh Zadeh, Head, Division of Neurosurgery at TWH. "He made history by converting complex brain surgery for tumour resection to a day procedure – truly revolutionizing the field – and this is but one among many accomplishments.
"He will be missed but well remembered among his neurosurgery colleagues."
Dr. Bernstein has much to keep himself busy. He will continue seeing neurosurgery patients in consultation, doing gamma knife procedures, conducting research and seeing patients in the community as a home palliative doctor, a practice he started several years ago.
He'll also have more time to "walk the dogs and talk to them."
Still, he concedes that successfully completing his last surgery case as a neurosurgeon has given him much to reflect on.
"When you're in the moment of a big event, the significance doesn't hit you till later," he says. "Having such an intimate and intense job, one that you're really into, it leaves a bit of hole when it comes to an end.
"I won't miss the physical act of surgery so much, but the nurses and anesthetists, mentoring residents, my surgical patients, that's what I'll miss."