本期仁醫(yī)醫(yī)療特別邀請到國室是德國最大的神經(jīng)外科診所之一。Prof. Veit Rohde和他的團隊憑借著高度專業(yè)化的技術(shù)，最先進的設(shè)備和最好的護理，專注于功能維持和微創(chuàng)治療原則的持續(xù)應(yīng)用，得以治療整個神經(jīng)外科領(lǐng)域相關(guān)疾病。

哥廷根大學(xué)醫(yī)療中心神經(jīng)外科

下薩克森州最高水平的跨學(xué)科治療中心

哥廷根大學(xué)醫(yī)學(xué)中心的神經(jīng)外科診所是德國最大的神經(jīng)外科診所之一。每年有5000例門診病人和2000例住院病人接受約3000例手術(shù)治療。為了給每個患者提供最好的護理，尤其是腫瘤疾?。ò┌Y）患者，哥廷根大學(xué)神經(jīng)外科與其他學(xué)科共建了跨學(xué)科的大學(xué)綜合癌癥中心（G-CCC）。

由于擁有大量臨床病例的高水平專業(yè)知識，多年的臨床經(jīng)驗和最佳的醫(yī)療效果，Prof. Veit Rohde領(lǐng)導(dǎo)的哥廷根大學(xué)神經(jīng)外科診所是德國神經(jīng)外科學(xué)會在血管疾病尤其是腦出血領(lǐng)域的認證中心。

Prof. Veit Rohde領(lǐng)導(dǎo)的科hde和他的團隊與康復(fù)中心緊密合作，以確保即使在術(shù)后也可以進行最佳治療。

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 采訪錄 

1. 您是何時決定從醫(yī)的呢？又為什么專攻神經(jīng)外科呢？

Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in neurosurgery?

這問題很難回答，我上高中的時候就對生物很感興趣，但當時對于是否從醫(yī)并沒有特別明確的規(guī)劃。在德國，高中成績非常好的頂尖學(xué)生才會被醫(yī)學(xué)院錄取，我成績特別好，于是順其自然地選擇了醫(yī)學(xué)院，并不是出于自己的規(guī)劃。我就這樣開始學(xué)醫(yī)了，很快我意識到這是一個十分正確的選擇，我感覺學(xué)醫(yī)很有趣。至于選擇神經(jīng)外科，也不是提前明確規(guī)劃的。當時只有兩個外科領(lǐng)域，不需要先在普外科培訓(xùn)后再進行?？婆嘤?xùn)，那就是心外科和神經(jīng)外科。我就這樣選擇了神經(jīng)外科，后來還當上了主任。

That's a very difficult question. During my school time, I was highly interested in biology, but there was no clear plan to study medicine. As you know, if you have very good grades in Germany during school, you are allowed to study medicine and I had very good grades. Therefore, it was sort of preformed but it was not a very clear decision by myself. So I studied medicine and I soon recognized that this was a very good decision - It was very good and very interesting for me. But, again, the step to neurosurgery was also not so well structured or well planned before. During that time, there had been only two surgical disciplines in which it was not necessary to make general surgery in addition, and this had been cardiac surgery and neurosurgery. That's the reason why I ended up as a Chairman in neurosurgery.

2. 您職業(yè)生涯中是否有對您來說很重要的導(dǎo)師，他們教會您什么，是如何啟發(fā)您的呢？

Who have been your greatest influences? What have they taught you and how have they inspired you?

我認為對我職業(yè)生涯影響最大的人是兩位神經(jīng)外科醫(yī)生，他們給我很大幫助。他們是Prof. Hassler 和 Prof. Gilsbach。第一位是我在圖賓根大學(xué)工作時的導(dǎo)師，圖賓根是我職業(yè)生涯開始的地方，他讓我得到了快速的成長，他是我在神經(jīng)外科領(lǐng)域的手術(shù)和科研工作的領(lǐng)路人。

第二位是Prof. Gilsbach，我跟他在亞琛工業(yè)大學(xué)工作了十一年，他教會了我如何在神經(jīng)外科取得成功。我從他們身上學(xué)到最重要的一點是，要想成為一名好的神經(jīng)外科醫(yī)生，你必須有非常強的紀律性。在做手術(shù)時，你必須對自己做的所有操作有清晰的認知。他們對神經(jīng)外科的深刻見解和超前思維對我影響非常大。

I would say my greatest influence had been made by two neurosurgeons which had helped me during my career.

It had been Prof. Hassler and Prof. Gilsbach. The first one was my senior in Tübingen. When I've started my career there, he pushed me a lot, he showed me the first operations and he also gave me the first insights into scientific work.

The other, as I said, was Prof. Gilsbach. I was with him eleven years in Aachen and I would say that he taught me everything which was necessary for a successful career in neurosurgery.

What they especially showed me is that you must have a very strong discipline if you like to be a good neurosurgeon and you must have a very clear mind about what to do when you're operating. They gave me insight and their thinking and thereby influenced me a lot.

3. 您領(lǐng)導(dǎo)哥廷根大學(xué)醫(yī)療中心神經(jīng)外科已經(jīng)快二十年了，這期間您遇到最大的挑戰(zhàn)是什么？接下來幾年的計劃是什么？

You have been leading the Clinic for Neurosurgery at UMG for around twenty years. What was the biggest challenge during the last two decades? And as the Chief, what’s you plan for the following years?

其實沒有特別具體的某件事，但是有一個挑戰(zhàn)在過去的二十年中如影隨形，那就是預(yù)算上的限制。作為神外醫(yī)生，我們總想在手術(shù)中投入最新的技術(shù)，但醫(yī)院的行政部門卻希望把成本控制得越低越好。這使得雙方形成了對立關(guān)系， 有時候很難處理，對我們來說的確是個挑戰(zhàn)。尤其是現(xiàn)在科技發(fā)展得很快，我們想要投入新的設(shè)備等等，我們會跟行政部門詳細說明，我們所做的一切都是以病人為中心，但有時他們并不是這樣考慮的。

至于接下來幾年的計劃，首先是處理好剛才提到的這個問題。其次，現(xiàn)在距離我退休大概還有8年，我們是全德國最大的神經(jīng)外科之一，設(shè)備精良、醫(yī)護團隊訓(xùn)練有素，我希望把科室很好地交接給下一任主任，這就是我接下來幾年的計劃。

I think there was no specific challenge, but it was an ongoing challenge during the whole time. This is that we have restrictions by the economy. We are, always dealing, as a neurosurgeon, with the aim of improving everything to have the latest technology to offer the newest operations, and on the other hand, you have the administration, who tries to to keep the budget low. This is, I would say, a tension, between those two points, which sometimes are quite hard to handle and which sometimes presented to challenge. Especially if the technology is moving very fast and you need to have a new machine or something else, and then you're discussing with the administration what's for and just to make clear that you're doing everything for the patient, which is not always seen in the same way by the administration.

(When it comes to my plan for the following years), I think it’s to be successful in this challenge, I just have mentioned. Second, I have to work, I think, eight years more, and I would have to hand over this department as one of the biggest in Germany with very good equipment and with highly trained neurosurgeons. This is my vision for the next upcoming years.

4. 作為大學(xué)教授、醫(yī)生、管理人員，您如何平衡行政、臨床、科研、教學(xué)工作及個人生活？以及盡管有這么多其他工作，如何將重心始終保持在病人身上？

As a professor, a surgeon, a clinic director, how do you balance your personal life, administration, clinical practice, research activities and lecturing? How does the focus remain on the patients despite every other roles?

我日常工作重心是臨床工作，凡事以病人為出發(fā)點，其次是激勵年輕的神外醫(yī)生投身科研。我已經(jīng)過了要親自到實驗室做科研的年紀，我現(xiàn)在主要是給年輕醫(yī)生提供想法，提出研究假設(shè)，讓他們付諸實踐。至于行政工作，我已經(jīng)盡可能把它們分擔給其他團隊成員。這樣一來，我的工作始終能以病人為中心，追求病人福祉。

至于個人生活，也是我需要努力平衡的，我很幸運，我的妻子也是神外醫(yī)生，所以我們在家的時候也能討論一些專業(yè)上的問題，這樣就有更多休閑的時間。

My daily activity is strongly focused on the clinical work, to make almost everything possible for the patients. The other focus is to stimulate research activity of young neurosurgeons. In my position, I do not intend to go to the lab personally, but to create new ideas, to create scientific questions, and gave these questions and ideas to your neurosurgeons which will do the research now.  I try to cut down the administrative work by putting on many shoulders in my team. By doing so I have a very strong focus on the patients and the well-being of the patients.

Concerning the personal life, well, it's also obviously a part of what I'm doing. I'm in a good position that my wife is also a neurosurgeon, so we are in a situation where we can discuss some professional issues while sitting at that table at home, which makes it easier sometimes to have more leisure time.

5. 德國脊柱學(xué)會在全德范圍內(nèi)認證了30家一級脊柱中心，哥廷根大學(xué)醫(yī)療中心是下薩克森州唯一的一家認證中心。這一認證對病人來說意味著什么？請問您領(lǐng)導(dǎo)的神經(jīng)外科與Prof. Lehmann領(lǐng)導(dǎo)的骨科與創(chuàng)傷外科在脊柱領(lǐng)域是如何進行多學(xué)科合作的？

There are 30 certified Spine Center of Maximum Care by German Spine Society and UMG is the first and only certified center in Lower Saxony. What does this mean to the patients? How is multidisciplinary collaboration organized for spinal diseases between the neurosurgery clinic led by you and the orthopedics and trauma clinic led by Prof. Lehmann?

首先我非常自豪，我們能成為全國僅有的三十家認證中心之一，同時是下薩克森州唯一一家。一級脊柱中心的認證，要求該中心神經(jīng)外科和骨科與創(chuàng)傷外科進行緊密合作。這樣的合作使得病人能接受更好更全面的照護，因為我們對處理復(fù)雜的脊柱疾病非常有經(jīng)驗，這些在二級或三級脊柱中心是比較少見的。

在我們脊柱中心，我們和骨科與創(chuàng)傷外科醫(yī)生之間的合作非常緊密。對于患有復(fù)雜脊柱疾病患者，我們會一起討論，甚至一起手術(shù)。對于常見的脊柱疾病患者，比如腰椎間盤突出癥或簡單骨折，通常由神經(jīng)外科或骨科與創(chuàng)傷外科進行手術(shù)，這取決于哪個科收治病人入院，但對于復(fù)雜的病例，我們都會合作，以求給病人提供最好的照護。

Prof. Lehmann（左）與Prof. Veit Rohde

First of all, I'm very proud that we are one of the thirty centers and that we are the only one in Lower Saxony. To be acknowledged as one of the Spine Centers of Maximum Care, needs that you have a defined collaboration with the trauma surgeons and the orthopedic surgeons. By structuring this collaboration, I think, you offer a better care for the patients because we are able to deal also with the complex spine cases which are not so often seen in other spine centers which are not Spine Centers of Maximum Care.

The collaboration with the trauma and orthopedic surgeons in our hospital is very good. For the patients, as I said, it means that all the complex cases are discussed together and sometimes are operated together. If we're talking about easy spine cases, let's say, a lumbar disc herniation or a non complex fracture, the patient is treated either in neurosurgery or in orthopedic and trauma surgery, depending on through which door the patient enters our hospital, but for the complex cases and that's very important for the complex cases that we are working together, we are discussing together, and we are trying to provide the best care for the patient.

6. 在神經(jīng)外科領(lǐng)域至今還存在較大的性別差異。德國36所大學(xué)醫(yī)院中，只有兩所神經(jīng)外科由女性主任領(lǐng)導(dǎo)，但其實醫(yī)學(xué)院中大概70%的醫(yī)學(xué)生都是女性。您認為德國大學(xué)醫(yī)院在鼓勵更多女性從事神經(jīng)外科方面做得如何？該如何改進？

There is still gender disparity in the field of neurosurgery. In Germany, nearly 70% of medical students are female but only two of 36 university neurosurgical departments are headed by female. How well do you think German university hospitals are doing to encourage more women to pursue a career in neurosurgery, and how could this be improved?

這個問題很難回答，你說得對，確實至今還有較大的性別差異，但是住院醫(yī)師，或低年資醫(yī)生群體中，性別比已經(jīng)大概達到了1:1的平衡，所以這是有所改善的。但確實，女性很難得到神經(jīng)外科主任的職位。

德國大學(xué)自幾年前就一直在努力促成女性頂級神經(jīng)外科醫(yī)生的申請，但是我們?nèi)匀幻媾R這樣一個事實，即女性進入最后三名候選人名單的情況很少見。因為有時大學(xué)擔心，如果女性神經(jīng)外科醫(yī)生最后沒有得到這個職位，她可能會起訴大學(xué)以爭取這個職位。某種程度上來說這是一種恐懼。如果我們能努力減少或消除這種恐懼，德國的女性神經(jīng)外科主任就會越來越多。

That's a difficult question. You're right that there is a gender disparity. But on the level of the residents and also the younger staff members, I would say it's a 50/50 percentage. In this part, it's getting better and better. But you're right, it's still difficult to get one of the top positions in neurosurgery. I think that the German universities, since a few years ago, are doing a lot to facilitate the application of top female neurosurgeons, but we are still facing the fact that it's rarer for a woman to be on a shortlist of the last three applicants because sometimes universities fear that the female neurosurgeon, if she's not in the top position, might sue for getting the position. That's some sort of fear. I think if we are able to reduce the fear or eliminate the fear, the number of female neurosurgeons in top positions in Germany will go up.

7. 您對如何培養(yǎng)年輕醫(yī)生有好的建議嗎？您對年輕的神經(jīng)外科醫(yī)生有什么建議？

Do you have suggestions on how to train the young generation (to the Chinese chiefs)? What advice would you give to the young neurosurgeons?

又是一個難題，尤其是中國和德國或歐洲的體系其實有點不一樣，但是還是有共通點的。首先我認為，醫(yī)院或科主任在挑選年輕醫(yī)生時，必須挑選那些已有扎實科研基礎(chǔ)的學(xué)生。因為在住院醫(yī)師階段不可能完全將這些科研知識傳授給他們。我的理念是，醫(yī)院應(yīng)該實施結(jié)構(gòu)化的教育項目，這個跟下一個問題的答案有所關(guān)聯(lián)。

作為德國神經(jīng)外科學(xué)會的主席，我正在制定一個適合大多數(shù)德國醫(yī)院的結(jié)構(gòu)化教育計劃，給全德國的年輕醫(yī)生提供同質(zhì)化標準化的培訓(xùn)。同時我一直鼓勵住院醫(yī)生參加培訓(xùn)課程。有歐洲的培訓(xùn)課程，也有德國國內(nèi)的培訓(xùn)課程。這些培訓(xùn)課程通常是長達四年的結(jié)構(gòu)化項目，這四年間的培訓(xùn)覆蓋神經(jīng)外科領(lǐng)域所有的知識。我們應(yīng)該鼓勵年輕醫(yī)生參加這些課程。

接下來我想講下中國和歐洲的不同之處。在歐洲，很多手術(shù)不能讓年輕醫(yī)生上臺操作，因此年輕醫(yī)生實操的機會是不夠多的。我強烈推薦年輕醫(yī)生參加這些培訓(xùn)課程，這些培訓(xùn)課程，以及一些解剖學(xué)課程提供了在模型上實操的機會。這些是我能想到的能給年輕醫(yī)生提供更好的教育的方法。但最重要的還是要在各醫(yī)院推行六年制結(jié)構(gòu)化住院醫(yī)師培訓(xùn)計劃。

Again, a difficult question, especially because the situation between in China and in Germany or in Europe are a bit different, but there are some common points. One thing is that the hospitals or the chiefs should pick out the students with a very good theoretical basis, or let's say, the basic scientific background already must be available, because it's not possible to to give this knowledge completely to them during the residency. I'm a strong supporter of a very structured educational program, which should be implemented in a hospital. What I'm doing, this is a bit linked to the next question, as the President of German Society for Neurosurgery is to develop a structured educational program which might fit for most of the German hospitals so that the training is not so different between different hospitals.What I always push is that the residents take part in training courses. There are European training courses. There are also national training courses. It's a structured program always for four years. And during this four years, the whole field of neurosurgery is covered. I think we should support our residents to make this.

Now I'm coming to the difference between China and Europe. In Europe we have the problem that we have not enough operations for the young neurosurgeons and for training the neurosurgeons and therefore I also strongly support every attempt to take part in courses in which you're able to learn things, to get experience by working with models, or courses in anatomy. These are briefly the things how I think we can make the education better, but the most important thing is a very structured program for every hospital for six years of residency.

8. 自2022年起您任德國神經(jīng)外科學(xué)會主席，這對您來說意味著什么？您任期內(nèi)的計劃是什么？您認為此類學(xué)會對學(xué)科和醫(yī)生有何重要意義？

You have been the President of German Society for Neurosurgery since 2022. What does this mean to you? What’s the plan during your term of office? How important do you think the professional societies are to the field of neurosurgery and to the surgeons?

對我個人的意義，一方面是對我多年來在外科領(lǐng)域做出的成就的認可，另一方面是對我多年來對德國神經(jīng)外科學(xué)會的支持的認可。我認為，當選學(xué)會主席的兩年，某種程度來說是對我的獎勵。剛才已經(jīng)提到，我任期內(nèi)的主要工作，是推動神經(jīng)外科住院醫(yī)生的標準化教育培訓(xùn)制度，以及高年資醫(yī)生的標準化繼續(xù)教育培訓(xùn)制度，這是我任期內(nèi)工作的重點。

至于學(xué)會的意義，我認為學(xué)會是很重要的。德國神經(jīng)外科學(xué)會非常重視科研工作，因此我認為學(xué)會可以推動本領(lǐng)域內(nèi)科研的進展。除此之外，學(xué)會還可以代表神外醫(yī)生應(yīng)對不斷變化的政策，代表神外醫(yī)生向政府表達我們的想法。其實德國神經(jīng)外科學(xué)會不算大的學(xué)會。我相信我們與德國外科學(xué)會的緊密合作對提高外科醫(yī)生和神外醫(yī)生政治地位大有幫助。

What does it mean for me? On the one hand, it showed that I've worked successfully in the field of, let's say, human surgery for a longer time and that I supported for a longer time the German Society for Neurosurgery. I think, I was elected as the President for a term for two years as some sort of award for this.

I already mentioned that one of my key work as the President is the improvement of the education of neurosurgeons on the level of residency, but also later to bring it to a higher level. This is very important for me.

Concerning the role of societies, I personally believe that societies are important. The German Society for Neurosurgery is a society which has a very strong focus on support of science and scientific work. And therefore, I think that societies can push research. On the other hand, it also has a role in dealing with changing political situation and trying to make our neurosurgical thinking clear to the politicians. The neurosurgical society is a quite small society. Therefore, I believe that our collaboration with the German Society of Surgeons is especially helpful for our political aims for improving the visibility of surgery and neurosurgery in the political field.

9. 您在國際上知名度很高，至今您最自豪的職業(yè)成就是什么，為什么？

You enjoy a great international reputation. What is your proudest career achievement to date and why?

好像沒有特別明確的哪件事。但每次我參加學(xué)術(shù)會議，參加培訓(xùn)課程時，年輕醫(yī)生告訴我，他們被我所做的臨床工作或科研工作所影響，這令我感到非常自豪和開心。這證明多年來我對年輕外科醫(yī)生的職業(yè)發(fā)展是有幫助的，哪怕只有一點點，我對此感到自豪。

I think there is no one thing (which I am most proud of). I'm always proud if I'm going to conferences, to train courses, and to meetings, and the young neurosurgeons approach me and are saying to me that they had been influenced by what I've done or what I do in research for. These are the things which I'm happy about. It shows me that over the years, I, let's say, influenced a little bit the careers of  the future neurosurgeons. This is the thing which makes me proud.

10. 作為一名醫(yī)生，您最享受您工作中的哪一部分？假如您不從醫(yī)的話，您會從事什么行業(yè)？

What’s the most fascinating part of your profession as a medical doctor? And what would you have been if you had not been a medical doctor?

我想把這個問題改一下，改為“作為神外醫(yī)生，你最享受工作中哪一部分？”因為我不想成為內(nèi)科醫(yī)生，我想做神外醫(yī)生。

工作中我覺得最享受的有兩點，第一，如果我們把本職工作做好，我們真的可以治愈病人，這是我們與神內(nèi)醫(yī)生的差別。除了個別惡性腦部腫瘤之外，我們可以給病人的未來生活提供良好的期望。對我來說這是非常令人著迷的，我們可以為了病人爭取巨大的勝利。雖然有時候我們無法取得勝利，但這就是硬幣的另一面了。

另一方面，神經(jīng)外科醫(yī)生總能接觸到最新的技術(shù)，許多計算機科學(xué)技術(shù)早就已經(jīng)進入神經(jīng)外科領(lǐng)域。我們總是面臨著最新的技術(shù)，這也是非常令人著迷的。我們正在接觸人工智能，我相信這也會被神經(jīng)外科領(lǐng)域應(yīng)用。一直接觸新想法和新技術(shù)能讓我們一直把握時代的脈搏，我非常享受這一點。

我還真的不知道如果我不做醫(yī)生的話會選擇什么職業(yè)。下決心從醫(yī)已經(jīng)是三十多年前的事了，當時也有考慮是否要學(xué)地質(zhì)學(xué)，但我也不確定（如果不做醫(yī)生的話）我是否真的會從事地質(zhì)學(xué)。

I would like to change a bit of the question to what’s the most fascinating part of your profession as a neurosurgeon, I would say. I don't want to be an internal doctor. I would like to be a neurosurgeon. There are two things which are fascinating. One thing is that if we are doing our job very well, we are really able to heal the patient. That’s the difference to the neurologist. We could really provide the patients with good expectation concerning their further life, with the few exceptions of the malignant brain tumors. This is fascinating for me that we could have big victories for sake of the patients, and sometimes we have no victories, but that's the other side of the medal.

The other thing which is fascinating as a neurosurgeon is that we are dealing with the newest technologies, many of the computer science early find the way into neurosurgery. We are always are confronted with the latest technology. That's also very fascinating. We are now exposed to artificial intelligence and I think it also will enter the field of neurosurgery. If you're always exposed to new ideas and new technologies. You're always on the pulse of time, and that's very fascinating for me.

And what I'd done if not having been a medical doctor, I really don't know. This decision of being a medical doctor was made more than thirty years ago. I know that I was thinking about Geology, but I'm not quite sure if I would have done it. I really don't know.

11. 您有什么興趣愛好？

What are your hobbies during your leisure time?

上學(xué)的時候我是一個半職業(yè)中長跑運動員。我現(xiàn)在還保持著這個習(xí)慣，我每周跑步兩到三次，試圖從日常工作中抽離出來，享受新鮮空氣和自然景觀。

Well, in former times during studies I've been a, let's say, semi-professional middle and long distance runner.I kept this hobby - I'm running two to three times a week, trying just to inhale good air and the impressions from the nature and to get rid of the daily work.