ALEXANDER KONOVALOV

"THANKS TO NEUROSURGERY, I HAVE LIVED AN INTERESTING AND EXCITING LIFE"

Director for several decades of one of the most emblematic neurosurgical institutions all over the world, Dr. Konovalov is a living legend. His tireless activity made Burdenko Institute (Moscow) one the centers with the largest experience in any kind of neurosurgical procedure. Our interview is stained by the terrible and recent loss of Dr. Alexander Potatov. They both organized dozens of fruitful teaching activities in cooperation with WFNS Foundation. 

Dr. Alexander Konovalov

What were the issues that were most addressed in the courses held in Russia in collaboration with the WFNS Foundation?

From 1977 to 2016 there have been arranged 6 WFNS Courses in the largest cities of Russia – Moscow, St-Petersburg, Novosibirsk, Irkutsk, Kazan, Sochi.

Besides, similar WFNS Courses were organized in the former USSR republics: in Astana, Kazakhstan (2011), in Odesa, Ukraine (2011).

WFNS courses were focused on the main problems of Neurosurgery: neurooncology, vascular pathology, neurotrauma, spinal pathology, pediatric neurosurgery. The leading Russian specialists took part in these courses together with the foreign faculty.

What characteristics should these courses have for WFNS Foundation to participate in?

The primary task of the courses is to get acquainted with the most meaningful achievements of the leading world experts.

The task of WFNS educational courses is to level up Neurosurgery in the country with a vast territory to that of the most developed countries.

Dr. Konovalov, you were born into a family of doctors, your father was a neuropathologist and your mother was a specialist in infectious diseases, does your vocation for medicine come from your family?

I was born in a family of doctors. My grandfather was a famous general surgeon in Moscow. My mother was also a surgeon at a young age and assisted her father (my grandfather) during operations. Later on, when she had to take care of the kids, she started working as an infectious. My father was a neurologist, for many years until the end of his life, he headed the Moscow institute of neurology. His colleagues often gathered at our house. They were outstanding people, enthusiastic, and truly devoted to their profession. They discussed problems caused by different diseases and treatment details, and I often was an unwilling participant in these discussions. My father worked much with the microscope at home and told me about mysterious diseases and changes they might cause, which for me were difficult to understand.       

Moreover, I spent my childhood and youth on the territory, which previously was built and headed for many years by my grandfather. All the above mentioned has prompted me to get interested in medicine, particularly in neurology, already at an early age, and there was no problem with choosing a profession.  

After World War II, there were many wounded people in the hospitals where your parents worked; do you have any accountable memories?

During the war, my mother, younger brother, and I were evacuated for 2 years to a small town in the Urals. The war miseries were complicated by the diphtheria epidemic. My mother was the only specialist in town who had experience in intubating choking children. There was a period when almost every night she was called to help sick children.

 During the war, my father continued working in Moscow treating the sick and wounded. Treatment of the wounded was the primary problem of the post-war time.

What made you choose the specialty of Neurosurgery?

As it may seem strange, I became a neurosurgeon quite by chance. My dream was neurology, and after graduating from the medical institute, I became an intern at Moscow institute of Neurosurgery, which in those years had a renowned group of neurologists. The education was aimed at studying the basic principles of Neurosurgery and assisting during operations. I became interested in Neurosurgery that became the meaning of my life.  I have devoted almost 65 years to this marvelous specialty.

You took neurosurgery from the former Soviet Union to the whole world. How have you been treated as a neurosurgeon?

Starting from 1975 (for 39 years), I have been Director of Moscow Burdenko institute of neurosurgery. At that period, I operated on the most difficult cases, mainly deep-seated brain tumors (tumors of the brain stem, III ventricle, tumors of the pineal region, and others. Surgical removal of craniopharyngiomas was especially interesting for me; my total number of operations exceeds 1500. However, my primary task as a Director was the modernization of the institute that was located in the building unadapted for the needs of neurosurgical patient treatment, had only five operating rooms and lacked equipment. In 1999, a new surgical building with all modern facilities was opened. Today, we have 21 operating rooms, including specialized ones fitted with CT and MRI.

There were opened the first in Russia radiological department equipped with Gamma-knife and Cyber-knife, an electronic accelerator and PET department.  The number of operations performed at the institute is over 10.000, besides the radiosurgery ones.  More than half of operations were carried out in patients with brain tumors. All the basic fields of surgery are presented at the center: oncology, vascular pathology of the brain (aneurysms, arteriovenous malformations, extracranial vascular pathology); pediatric neurosurgery, severe traumatic brain injury, spinal and functional surgery. The intensive care unit plays an important role in the institute structure.

For these long years, a team of brilliant researchers and unique surgeons has been formed.

For 40 years I have been President of the Association of neurosurgeons, first of the Soviet Union (until 1991), then of Russia. The basic task of the Association was to improve the level of Neurosurgery in the country that is why it was highly important to establish a close partnership with the European Association of Neurosurgical Societies (EANS) and the World Federation of Neurosurgical Societies (WFNS). One of the successful examples of this collaboration was EANS Congress in Moscow in 1991.

What do you feel about being the most important figure in the specialty in your country? What challenges did you have to go through to get there?

As for the “Challenges” I had to go through – I will simply say that it was not an easy way for me. To support the development of Neurosurgery in the USSR and in Russia I had to convince the officials by real achievements and, mostly, by successful surgical results.

With so much experience and knowledge, 32 years as director of the Burdenko Institute of Neurosurgery, is there anything that may scare you in this profession?

You ask what may scare me in my profession – it is hardly possible to scare me but to make me concerned – yes. The surgical risks and responsibility force us considering all possible complications that may occur in order to avoid any loss. A long-time experience is of great help here.

If you started over, would be engaged again in Neurosurgery?

Yes, by all means. Thanks to Neurosurgery, I have lived an interesting and exciting life and hope, not in vain.

What has been your greatest professional recognition? What has been your biggest personal achievement? What about your staff?

My greatest professional recognition – For more than a 60-year experience I have had both surgical success and failures.  One of my rare and unique surgeries was a successful separation of craniopagus girl twins 30 years ago. One of my greatest achievements is my followers. At present, I spend more time in the operating rooms admiring their virtuous work and learning much from them.

What is the current situation of Neurosurgery in Russia?

For the latest decades, the level of Neurosurgery in Russia has been notably improved: new centers have appeared in different regions, including the giant Siberian area. They have all modern facilities and equipment to perform complicated operations on a high level.

What would Dr. Potapov’s recently deceased highlight? How his friendship with him was born. Tell us some anecdotes about living with him.

Alexander Potapov came to work at the institute in 1973. He started his career as a neuro intensivist who later on became a brilliant expert specializing in treating patients with severe head injuries. Prof. Potapov’s recognition in this field of neurosurgery by the World Federation of Neurosurgical Societies resulted in his being elected Chairman of the Neurotraumatology Committee of the WFNS.  

For the past 10-15 years his special scientific interest was the treatment of glial tumors.

Alexander Potapov was highly self-motivated and intensely interested in brain sciences and advanced technologies in Neurosurgery. He was a born leader.

Thanks to these qualities he has been my close friend and assistant as deputy director for 25 years.  It was the principal time for the institute – the time when practically a new neurosurgical complex arose. All these changes occurred in a difficult time for the country – the period of “perestroika” (restructuring), the disintegration of the Soviet Union. Prof. Potapov’s professional qualities were of the utmost importance then. 

Since 2014 he has become Director of the institute.

And that will keep you attached to him forever?

Alexander Potapov was a unique person with a wide range of interests. I would like to mention two traits of his character. First, his striving to get actively engaged in rendering medical assistance in case of urgent emergencies (during catastrophes) – the earthquake in Armenia in 1988, gas pipeline explosion in Arzamas in 1988, military actions in former Yugoslavia. Second, attracting scientists of different specialties – physics, chemists, genetics – to solving neurosurgical problems. He was the first to start applying stereolithographic techniques in skull reconstructive surgery. The joint efforts of Prof. Alexander Potapov and one of the leading physicists in the country Academician Vladislav Panchenko have received the highest scientific award in our country – the State prize.