Dr. Mark Bernstein, a world-renowned neurosurgeon, will be able to expand his teaching activities in developing countries and in Toronto, thanks to a $5.5 million gift to the Toronto General and Western Hospital Foundation made in honor of Barrick’s late CEO Greg Wilkins. “We are very excited to be able to make such a positive impact in communities that are struggling to care for patients with neurosurgical conditions,” said Dr. Bernstein. “Most people in the world never get access to the people and equipment Greg Wilkins did. They get sick, they suffer and die without medical help. The incredibly generous gift of Vera Wilkins and Barrick Gold will help us decrease some of these global inequities in health care, and enrich the lives of those less fortunate than us.”
Dr. Bernstein is the inaugural holder of a chair named in honor of Greg Wilkins, and will be spearheading a larger program focused on treatment of diseases of the brain.
Vera Wilkins, Greg’s wife, explains, “Greg and Mark had many conversations about the need to increase resources and knowledge in this highly specialized medical field – especially in poorer countries where the need is enormous. Greg wanted to give back for the excellent care he received at the Toronto Western Hospital and wanted patients less fortunate than him to have a real, fighting chance. Ultimately, it was Peter Munk, Mark and Barrick physician Dr. Bernie Gosevitz who came together to find a way to achieve this vision that was so important to Greg. He would be honored and proud of what is being done here today and what will come out of this in the years to come.”
Dr. Bernstein is passionate about using his surgical skills to help others abroad. About 10 years ago, he began traveling to developing nations to work with local surgical teams. He describes what he does on these visits as “sustainable teaching,” but others may see it as something much larger than that: a literal matter of life or death for patients and the medical staff he trains in new surgical techniques. He and his teams are acutely aware that often, if it weren’t for their visits, patients would go untreated. “I recall one girl in China who would have died if it were not for the surgery we taught her medical team to do while we were there.” Being able to pass on those skills to doctors and nurses abroad is a driving factor for him, and his enthusiasm has attracted other Canadian colleagues to go on these overseas surgical missions.
Dr. Bernstein has spent time during the past decade working with medical teams in Africa, Indonesia, China and Southeast Asia. In particular, he has taught them how to do awake brain surgery, which he pioneered. In fact, he also performed the first such surgeries in Indonesia, China and Africa.
“It’s relatively low tech – you don’t need a general anesthesia or a ventilator,” he explains. In fact, it’s critical that the patient remain conscious to guide surgeons and help them extract a tumor without causing undue damage to nerves or surrounding brain tissue. The patient participates in the surgery by responding to doctors’ commands about sensation, hearing, speech and taste, so that the team knows where not to operate. “It’s like a road map. If there’s a pile up on the highway route you usually take to go home, you will detour and find another way. It’s the same with awake brain surgery,” Dr. Bernstein says. “We want to cause minimal or no permanent damage to the patient.”
Dr. Bernstein is on the board of the Foundation for International Education in Neurological Surgery (FIENS), headquartered in Chicago. Its mandate is to address the critical lack of trained neurosurgeons in developing countries. It has sent teams to Africa, the Americas and Asia. Health care volunteers pay their own way on these trips. As a result of the Barrick gift, Bernstein notes that he will be able to bring expanded teams on future missions, including more nurses and anesthesiologists.
Aside from the fact that technology is often lacking, language could be a barrier, but Dr. Bernstein insists that communication is not an issue. “We have found ways to communicate without words, interestingly enough.” He admits that in a field that relies extensively on expensive machinery like magnetic resonance imaging, having to do without can be challenging. FIENS also helps facilitate the transfer of equipment to areas that need it, oft en through donations from manufacturers or Western hospitals.
“Our objective is to connect with colleagues thousands of miles, cultures and socioeconomic status away,” he says. Dr. Bernstein prefers to take a hands off approach in the operating room when he is teaching residents, surgeons and nursing staff. “If they simply watch what I’m doing, they won’t learn it. I let them do the surgery while I walk them through it. It’s very much what I do here in Toronto as well.”
Dr. Bernstein follows up with emails after his departure, and keeps tabs on his foreign colleagues to see if they eventually need refresher training. Now, with the gift to the Toronto Western Hospital, it will be possible for some of these surgeons to receive additional training at Dr. Bernstein’s side in Canada.
In addition to one surgical fellow who will train for a year in Toronto with Dr. Bernstein, the Barrick gift will also allow three to four 10-day visits annually for doctors from developing nations.
“We’re heading back to Africa in the fall, with a group going to Nigeria,” he notes. “This time, we will be able to bring a bigger group, thanks to the Barrick gift.”
Dr. Bernstein concludes, “We often learn as much as our foreign colleagues do. The connections between people are very powerful. My hope would be to change the world and I know my colleagues at the hospital share my gratitude for this gift, which will make so much more outreach possible. I don’t want to touch the life of one or two people,” he explains. “I want to give them what we have and take for granted. I would like to see thousands of people – doctors, nurses and patients – benefit. If I teach a few doctors and then they are able to teach many more and care for perhaps thousands of patients as a result, that’s the ripple effect I’m looking for.”