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<\/p>\nContributed by Lynda Huey<\/p>\n
<\/p>\n
What do you<\/em> remember about your life when you were five years old?\u00a0 I remember running around outdoors, squealing with delight as I rolled down grassy hills, and catching dozens of frogs when it rained.\u00a0 What spine surgeon Dr. Alex Rasouli remembers is very different.<\/p>\n He recalls, \u201cI wrote my first computer program when I was five years old.\u00a0 It was about basic language.\u00a0 I was learning vocabulary at that age and my program allowed me to write a multiple choice test of vocabulary words.\u00a0\u00a0 We had a Texas Instrument computer and I programmed it to generate a test of words and a collection of randomly-generated definitions, all of which were wrong except one.\u00a0 I would have to pick out the correct definition.\u00a0 It also printed out flash cards for me.\u00a0 I loved technology; I loved computers.\u00a0 I was a computer geek.\u201d<\/p>\n Being precocious continued throughout his life.\u00a0 At age ten, without any computer training, he wrote an algorithm that would prevent a computer from generating the same number twice in a row.\u00a0 \u201cOn the surface, that looks like a pretty boring and useless thing,\u201d he said, \u201cbut when it comes down to randomly generating a test or randomly selecting people out of a queue, you don\u2019t want the same thing to come up twice.\u00a0 It takes a lot of computer know-how to do that, but if you have a passion for something or it comes to you naturally, you just intuitively figure out what to do.<\/p>\n \u201cWhen I got my first car, I turned it into nearly an autonomous self-driving car, years before Mercedes made theirs. \u00a0I had another car that I interfaced with a full-fledged Macintosh computer at the center screen,\u201d he said.<\/p>\n Alex Rasouli was born in London.\u00a0 His family moved to San Diego when he was six months old. \u00a0The family moved to Salt Lake City for three years, then to Fullerton and Newport in Orange County. \u00a0After graduating from Stanford, he went to med school at U.C. Irvine, did his residency at UCI, then a fellowship at the University of Miami-Jackson Memorial Medical Center. \u00a0\u201cThey take only one orthopedic resident each year. \u00a0Those are the best fellowships,\u201d he says. \u00a0\u201cYou get to see everything. \u00a0All of the attention is on you and all of the scrutiny is on you.<\/p>\n \u201cThen when I became a professional in this medical career, I was the one who brought computer-guided surgery in the spine to Cedars-Sinai with the help of my colleagues who are in leadership positions.<\/p>\n \u201cThe same things that are required for you to be good at with computers make you good at surgery, which is a very logical, focus-driven algorithmic process where one task can\u2019t be completed unless another task before it is completed.\u00a0 At the same time,\u00a0there\u2019s this art in surgery that\u2019s not scientific or focus driven, but is just art \u2013 an expression of something that you can\u2019t quite describe.<\/p>\n The same is true with computers.\u00a0 Yes, it\u2019s all numbers, binaries, codes, routines, sub-routines, but there\u2019s an art in being able to put it together and apply it to an everyday task.\u201d<\/p>\n The surgeons at Cedars soon learned they had an incredible computer whiz in their midst.\u00a0 Much more on that later.\u00a0 Let\u2019s go back to Dr. Rasouli\u2019s younger years.<\/p>\n \u201cI chose not to move through school more quickly than others of my age.\u00a0 We had that option, but I just went through school like anyone else and did well.\u00a0 I finished most of my high school course work about a year ahead of time, but I chose not to graduate early.\u00a0 Instead, during my last year of high school, I did computer modeling of HIV mutation rates at UC Irvine.\u00a0 That required computer programming.\u00a0 HIV is a virus that is like the flu virus.\u00a0 Every year the flu virus mutates and changes and HIV does that except maybe thousands of times faster, which is why finding a vaccine or a cure has been challenging, because you\u2019re working to find a cure for what you thought was HIV, but the next day HIV is a completely different virus, with limits of course.<\/p>\n \u201cSince HIV was a significant epidemic at the time I was going through high school, I decided to apply some of my knowledge to that, and we came up with a model of how to follow the way HIV mutates within a person, within a people, and also across patients.\u00a0 It turned out that when HIV goes from person to person, only particular strains of those hyper-mutating strains are transmitted.\u00a0 So while it can change rapidly within a person, when it is transmitted to another person, it resets, the clock resets close to what it was when the first person got it before transmitting it to another person.\u00a0 There are only particular strains that are not significantly changed that are chosen to go on.\u00a0 A lot of people capitalized upon that concept to work toward a vaccine.\u201d<\/p>\n As of today, researchers think they are on the verge of a breakthrough toward that vaccine.\u00a0 It\u2019s interesting that a teenage boy in Southern California helped them reach that stage.<\/p>\n In junior high school, Alex\u00a0 had decided to become a doctor, because he was really interested in science.\u00a0 But science for what purpose?\u00a0 \u201cEveryone has a purpose in life,\u201d he says.\u00a0 \u201cIn my opinion, my purpose is to mix my passion for technology and passion for people, and I think medicine is a natural hybridization of the two.\u201d<\/p>\n \u201cMy first exposure to surgery was at Stanford in a cardio-thoracic lab where we would operate on living sheep\u2019s hearts, transplanting heart valves or placing in prosthetic heart valves.\u00a0 It was intense; there was no room for mistakes. I was always drawn toward the most challenging aspect of any field.\u00a0 Maybe I was seeking an adrenaline rush; maybe I was bored by anything else.\u00a0 That\u2019s when I decided to do surgery.\u00a0 The stakes were high.<\/p>\n \u201cI gravitated toward orthopedics.\u00a0 Of all the rotations in orthopedics, spine surgery appealed to me the most, because it was by far the hardest.\u00a0 They were the longest surgeries, the most physically demanding for both the patient and the physician, with no room for error.\u00a0 If there is maybe 1% room for error in all the other fields of orthopedics, there is zero room for error in the spine.\u00a0 That\u2019s a significant amount of responsibility to take on.\u00a0 It\u2019s so hard that technological innovations such as augmented reality, digital surgery, and robotic surgery are a perfect match for me.\u00a0 What the human eye can\u2019t see, we can get help with from technology.\u201d<\/p>\n This is where Dr. Rasouli grows animated, talking about future possibilities.\u00a0 \u201cAugmented reality lets you see the physical world as it appears to you unaided or unenhanced, but then on top of what you see are projected other pieces of information.\u00a0 We could see where the underlying neurological structures are.<\/p>\n When you\u2019re looking at the spine, you only see the one dimension of bone.\u00a0 You don\u2019t see what\u2019s under it, and you don\u2019t see what\u2019s under that and under that.\u00a0 It would be nice for you to see whatever you want in three dimensions.\u00a0\u00a0<\/em><\/strong><\/p><\/blockquote>\n \u201cAny augmented reality that works knows where your head is looking in space and if I\u2019m looking at, say that door, the computer would know I\u2019m looking at that door and would project information about that door.\u00a0 Google glass is merely an elegant iteration of augmented reality.\u00a0 We were using bigger goggles before Google glass was available, but it will get to a point where either a doctor will wear a contact lens during a surgery or goggles that are small and lightweight.\u00a0 My dream for surgery is to be able to go into the OR wearing something like that so there\u2019s absolutely no guess work. \u00a0It would work on the concept of a patient having X-rays or MRIs before the surgery and then those studies being fed into a computer and synced up in three dimensions with the way the patient is positioned in the operating room.\u201d<\/p>\n \u201cFor a lot of the more complex surgeries we do these days, and that my very talented colleagues do these days, we get CT Scans of the patients that go into the computer three-dimensionalized, and the computer tells us where to put our screws and rods to minimalize risk of injury to the patient.\u00a0 It guides our hands figuratively now but I\u2019ll bet in about five years, it will guide our hands literally through robots that use that information to tell us where to put various instruments.<\/p>\n \u201cThe logical extension of all this is that one day maybe a surgeon won\u2019t need to be there the whole time.\u00a0 Robots will do the surgery and they\u2019ll do it better than we could.\u00a0 That has significant cultural and legal hurdles to go across.\u00a0 I\u2019m not necessarily advocating that.\u00a0 I\u2019m just saying you can\u2019t stop technology.\u00a0 If it lets you do something better, more safely, it\u2019s going to happen, if not in ten years, maybe in fifty years.\u201d<\/p>\n When asked what surgery Dr. Rasouli thinks he perform best, he doesn\u2019t hesitate, saying \u201canterior cervical surgeries.\u201d\u00a0 Those could be fusions or they could be artificial disk replacements in which the native disk is taken out and instead of fusing the patient, a prosthetic device is inserted that still allows some motion.\u00a0 The theoretical benefit, not yet irrefutably proven but basically proven, is that if you preserve motion, you may spare excessive motion at the other levels that could in turn degenerate.\u00a0 Dr. Rasouli has been doing artificial disk replacements for seven years.<\/p>\n \u201cThere was one big breakthrough with the devices and significant inertia afterward, because we\u2019re living in an insurance environment that decided it wasn\u2019t going to pay for innovation anymore.\u00a0 Companies stopped studying and making new disk replacements, because insurance companies don\u2019t pay to have those new disks used.\u00a0 It\u2019ll get better later \u2013 everything has cycles and phases.\u00a0 Until then, what made American medicine great, which is innovation and controlled risk-taking, which led to even greater innovation, those things that made our medicine great are simply not in play right now.\u00a0 We\u2019re working off what we came up with years ago and pretty soon another country or another culture may come up with new ways of doing things.\u00a0 If you read the scientific journals right now, you won\u2019t believe the preponderance of papers that come from Japan or China and a decreasing number of original manuscripts, papers, research articles, or discoveries that come from the western world, mainly the United States.\u00a0 We\u2019ve taken the concept of control by agencies and regulations and regulatory bodies to an extreme where it\u2019s suffocating innovation.\u00a0 For instance, the augmented reality:\u00a0 I can\u2019t begin to describe the hurdles that I would have to overcome to be able to use that in a case in the hospital.\u00a0 It exists in a rudimentary form that we need to perfect, but even when we perfected it, the companies with which I would work to get to that level would think twice because they\u2019d think, \u2018what\u2019s the bottom line?\u00a0 Will insurance companies say it\u2019s experimental?\u2019\u00a0 Experimental used to be a great word.\u00a0 Now it\u2019s a curse word.\u00a0 That\u2019s the unfortunate aspect of our field is now we\u2019re dealing with a number of decision-makers in key positions who would rather sit comfortably than push the envelope a little bit:\u00a0 CEOs of insurance companies, government officials, people who have lost the conviction to do great things because they\u2019re afraid of either getting sued, or because they answer to special interests, or because they\u2019re watching out for their pocket books.\u00a0\u00a0 Every society has an ebb and flow; every society has a peak and a trough.\u00a0 I hope we\u2019re not heading for a trough, because if we don\u2019t do these great innovative things that I described, other societies will.\u00a0 Technology will not stand still.\u201d<\/p>\n With all that talent and all that understanding of how medical decisions are wrapped up in business and politics, there clearly has to be down time in which to replenish his high enthusiasm.\u00a0 He lost a visible amount of weight recently from working non-stop. \u00a0So let\u2019s slow down and look behind the scenes at the man who is the surgeon.<\/p>\n \u201cMy wife Lily (dentist Lily Ghafouri, DDS) is the fun in my life. \u00a0She grounds me.\u201d \u00a0They walk with their dogs Joelie (left) and Charlie (right) around Holmby Hills for exercise and time together in the morning.\u00a0\u00a0 They spend their weekends in Newport where they have a house and week days in Westwood where they have a small apartment.\u00a0 \u201cOn weekends, we walk along Marguerite Ave. in Newport.\u00a0 We don\u2019t go in the ocean, but we walk right by it.\u201d\u00a0 They are avid readers of both fiction and non-fiction.\u00a0 Dr. Rasouli is currently reading\u00a0Anna Karenina<\/em>\u00a0for the second time while Dr. Ghafouri is reading\u00a0War and Peace<\/em>.\u00a0 Yes, they like Russian literature.<\/p>\n \u201cThe journal\u00a0Nature<\/em>\u00a0is my favorite periodical.\u00a0 I love books about World War II, the last war in modern history where we had a rise of undivided conviction and we acted on it.\u201d<\/p>\n The two doctors take a break for two weeks at a time to have fun traveling.\u00a0 \u201cParis is my favorite city in the world,\u201d say Dr. Rasouli.\u00a0 \u201cWe\u2019ve been there three times and intend to go back again.\u201d<\/p>\n The hard part of travel for Dr. Rasouli is taking the two weeks away from his practice. \u00a0He has to ramp down by doing a lot of surgeries the week before, then significantly fewer surgeries the week of his departure so that by the time he leaves there aren\u2019t any loose ends regarding patient care.<\/p>\n They also enjoy visiting Italy, most recently to Positano on the Amalfi Coast.<\/p>\n When he returns, he remembers how blessed he is to be practicing in an institution where all of his colleagues are exceptionally talented. \u00a0\u201cI wouldn\u2019t hesitate letting any of them operate on me,\u201d he says. \u00a0\u201cI have high regard for my colleagues. \u00a0Ted Goldstein (Theodore Goldstein, M.D.) is our exceptional leader, not divisive in any way. \u00a0It\u2019s a pleasure to witness his leadership as he bring us all under the same umbrella, so to speak.\u201d<\/p>\n Something I learned about Dr. Rasouli is that he has a sweet tooth and he particularly likes dark chocolate. \u00a0And that his patients like to hug him. \u00a0He says, \u201cPatients need to feel that the doctor cares, is on their side, is part of their \u2018family.\u2019 \u00a0So I tell patients, \u2018I would never do or recommend for you anything that I wouldn\u2019t recommend for a family member.\u2019 \u00a0You need to have a level of conscience that lets you say that with full integrity. \u00a0Patients are happy with that and that develops trust, so they hug me.\u201d<\/p>\n The word honorable kept coming to mind as I listened to Dr. Rasouli. \u00a0Now, writing this, I wonder if the words \u201caugmented,\u201d \u201cpreponderance,\u201d and \u201citeration\u201d were part of his vocabulary test that he created when he was five. \u00a0The words \u201cbrilliant\u201d and \u201chonorable\u201d most certainly should have been.<\/p>\n Lynda Huey, M.S., founder of\u00a0CompletePT Pool & Land Physical Therapy<\/a><\/span>\u00a0and\u00a0Huey\u2019s Athletic Network<\/a><\/span><\/span>, is a former athlete and coach whose own injuries led her into the water to find fitness and healing. She was educated at San Jose State University where she starred on the track and field team during its golden years. \u00a0Lynda is the author of four books on water exercise and water rehabilitation. \u00a0Lynda is happy to answer the questions of any of her followers on\u00a0Twitter.com\/lyndahuey<\/a><\/span>.<\/span><\/p>\n This Article First Appeared in\u00a0CompletePT Pool & Land Physical Therapy<\/a>.<\/p>\n <\/p>\n![\"\"](\"https:\/\/www.rasoulispine.com\/blog\/wp-content\/uploads\/2017\/10\/rasouliblog-1.2-700x1273.jpg\")
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View Site<\/a> | Twitter<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Contributed by Lynda Huey What do you remember about your life when you were five years old?\u00a0 I remember running around outdoors, squealing with delight as I rolled down grassy hills, and catching dozens of frogs when it rained.\u00a0 What spine surgeon Dr. Alex Rasouli remembers is very different. He recalls, \u201cI wrote my firstRead More<\/a>","protected":false},"author":1,"featured_media":26,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,6],"tags":[],"class_list":["post-16","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle","category-medical-news","category-technology"],"jetpack_featured_media_url":"https:\/\/www.rasoulispine.com\/blog\/wp-content\/uploads\/2017\/10\/rasouliblog-1.2.jpg","_links":{"self":[{"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/posts\/16","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/comments?post=16"}],"version-history":[{"count":29,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/posts\/16\/revisions"}],"predecessor-version":[{"id":323,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/posts\/16\/revisions\/323"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/media\/26"}],"wp:attachment":[{"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/media?parent=16"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/categories?post=16"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.rasoulispine.com\/blog\/wp-json\/wp\/v2\/tags?post=16"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}