Think Neuro

20. On COVID-19, Brain Surgery, and Never Wasting a Crisis | Dr. Daniel Kelly


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When Dr. Daniel Kelly and his three colleagues founded the Pacific Neuroscience Institute in 2015, they knew it would be much more than a medical practice. It would be an institute in the true sense of the word, with a mission to heal patients, do research, and educate new doctors. Dr. Kelly and his team didn’t let up on that three-pronged mission during the pandemic. To the contrary, they doubled down, publishing 8 big papers in top-flight medical journals, all of them centered on the minimally-invasive brain surgery that PNI specializes in. One paper focused on complication avoidance analyzed the ten-year track record of PNI doctors using endoscopes to go through the nasal cavity and remove non-cancerous tumors called adenomas from the pituitary gland. It’s a tricky operation because the pituitary sits among very delicate structures, including the carotid artery and the optic nerve. The results: Out of 514 patients, only four had permanent complications, and three of those occurred before 2016. In another paper, PNI doctors described what they’d learned about how to get brain surgery patients out of the hospital more quickly to make room for COVID-19 patients. The PNI team used anesthesia with fewer side effects, cut down on narcotics, and did immediate postoperative CT scans. The result: ICU use fell to 29% from 54%, and 41.4 percent of patients went home on day one, up from 12.2 percent before the pandemic. Best of all, there was no change in complications or readmissions. Dr. Kelly quoted Winston Churchill in the paper: “Never let a good crisis go to waste.” PNI made the most of the pandemic, for its patients, and for science. Learn more by listening to this episode.
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