Proactive [Neurosurgery Wiki]

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====== Proactive ======

Serving to prepare for, intervene in, or control an expected occurrence or situation, especially a negative or difficult one; anticipatory.
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The decisive role Dr. [[Harvey Cushing]] (1869-1939) played in medicine goes far beyond the development of [[neurosurgery]]. His scientific devotion and commitment to patient care made him an ethical model of strict professionalism. This paper seeks to analyze the decisions Cushing made with the challenging case of HW, an adolescent boy with a craniopharyngioma (CP) involving the third ventricle. Cushing's earlier failure to successfully remove two similar lesions alerted him to the proximity of HW's tumor and the hypothalamus. Consequently, he decided to use the chiasm-splitting technique for the first time, with the aim of dissecting the CP-hypothalamus boundaries under direct view. Unexpectedly, HW suffered [[cardiac arrest]] during the surgery, but Cushing did not give up. He continued with the operation while his assistants performed [[resuscitation]] maneuvers. Such determined and courageous action allowed Cushing to succeed in an apparently hopeless case. Cushing's unwavering willingness to save patients' lives, even under extreme circumstances, was a fundamental trait defining his identity as a [[neurosurgeon]]. Analyzing the way Cushing dealt with HW's case provides valuable lessons for neurosurgeons today, particularly the importance of assuming proactive attitudes and, in certain cases, making painstaking efforts to overcome daunting situations to save a life
((Prieto R, Pascual JM. Cushing's dogged struggle against death: the astonishing
case of a patient under cardiac arrest surviving craniopharyngioma surgery. J
Neurosurg. 2020 Jan 17:1-10. doi: 10.3171/2019.11.JNS192487. [Epub ahead of
print] PubMed PMID: 31952045.
)).