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EDITORIAL
Year : 2019  |  Volume : 67  |  Issue : 4  |  Page : 964--965

We Stand on the Shoulders of Our Teachers … So that We Can See Further …

P Sarat Chandra 
 Department of Neurosurgery, AIIMS, Delhi, India

Correspondence Address:
Prof. P Sarat Chandra
Department of Neurosurgery, AIIMS, Delhi
India




How to cite this article:
Chandra P S. We Stand on the Shoulders of Our Teachers … So that We Can See Further ….Neurol India 2019;67:964-965


How to cite this URL:
Chandra P S. We Stand on the Shoulders of Our Teachers … So that We Can See Further …. Neurol India [serial online] 2019 [cited 2019 Nov 12 ];67:964-965
Available from: http://www.neurologyindia.com/text.asp?2019/67/4/964/266286


Full Text



It is but with a sense of trepidation and a feeling of great honor that I write my first introductory Editorial, which I would like to keep very short.

One must have oft heard of this term “We stand on the shoulders of Giants ….”

This term was first used by Sir Isaac Newton who used this quote and repeated it often: The actual phrase is “If I have seen further, it is by standing on ye shoulders of Giants.”

The phrase is most famous as an expression of Newton as a metaphor and is actually attributed to Bernard of Chartres.

Bernard of Chartres used to say that “we [the Moderns] are like dwarves perched on the shoulders of giants [the Ancients], and thus we are able to see more and farther than the latter. And this is not at all because of the acuteness of our sight or the stature of our body, but because we are carried aloft and elevated by the magnitude of the giants.”

This phrase cannot be more truer for training in Neurosurgery and Neurosciences in general. Training in medicine particularly has always been based on the model of apprenticeship. This has been because the nonlinear knowledge stream acquired from clinical and hands-on research paradigms could never fit into the linear methodologies and hypothesis provided in textbooks.

Taking this concept to neurosurgery, a lot depended on the work of our forefathers. There is this interesting article published on a review of Dr. Cushing's surgical cases at Johns Hopkins Hospital which revealed new information about his early operative experience with acromegaly. Although in 1912 Cushing published selective case studies regarding this work, a review of all his operations for acromegaly during his early years has never been reported. The authors retrieved 37 patients who were operated by Cushing for pituitary pathologies. Of these, nine patients who presented with symptoms of acromegaly and one with symptoms of gigantism were selected for further review. Two patients underwent transfrontal “omega incision” approaches, and the remaining eight underwent trans-sphenoidal approaches. At the time of last follow-up, two patients reported resolution of headache, four patients reported continued visual deficits, and two patients reported ongoing changes in mental status. The article has an interesting title to provide a metaphor to purpose of this article.[1]

Closer to home, Prof. B Ramamurthi laid down very strong foundations for stereotaxy, epilepsy surgery, and subarachnoid hemorrhage.[2],[3],[4],[5],[6],[7],[8],[9] Prof. Tandon's [10],[11],[12],[13],[14],[15],[16] work on gliomas, epilepsy, eloquent area surgery, and neuro-oncology again contributed significantly to allow us to “stand on their shoulders.” The purpose of this editorial is not to provide a treatise to all the forefathers of neurosurgery but to demonstrate a humble insight that “we are able to see further only because we are standing on the shoulders on these giants, many known and several other unknown.”

Neurology India particularly played a very important role in education for neurosurgery, neurology, and neurosciences not only from India but also from various parts of globe as it is a unique platform which is completely open access. It was started in the year 1952 by Prof. Ramamurthi and now completes 67 years of its existence. The founders have no doubt worked a lot to bring it to this stage and I of course would here like to express my personal acknowledgement to my immediate past editor Dr. Sanjay Behari who has introduced many unique features make it a truly global journal.

Today, Neurology India has a greater responsibility to provide pragmatic knowledge to students and teachers likewise. To that effect, I would truly like to thank all the contributing authors and the blinded reviewers who have contributed tirelessly to make the journal what it is today. The year 2019 saw Neurology India gain an impact factor of 2.71 making it one of the top journals for neurosurgery, neurology, and allied neurosciences.

Today as the Chief Editor, I but feel humbled to realize that I am but perched on shoulders of several hundred giants to whom all of us owe this gratitude.

The following issue has several articles of interest to all; review articles which provide current standards of DBS for Parkinson's, eye signs for pituitary tumors, and benefits and risks of statin therapy. There is an interesting meta-analysis on the role of aspirin in tuberculous meningitis to several original articles. We have provided expert commentary by some experts in these areas to provide an overview of the article and the standard of treatment to provide the reader an overview of the article. To mention, some original articles are role of endothelial nitric oxide synthase with subarachnoid haemorrhage, a comparative study of endoscopic versus microscopic pituitary surgery, using visual gait measures for post stroke patients, role of immediate drug reduction following surgery for drug-resistant epilepsy, role of anticoagulants versus antiplatelet drugs for carotid and vertebral artery dissection, and significance of fractional anisotropy to measure for peritumoral edema as a survival biomarker for glioblastoma to mention a few.

Finally, last but not least, is an interesting book review on autobiography of Prof PN Tandon, “Closed doors and open windows” which I would encourage everyone to read.

We hope that we will continue to grow to create a standard for neurosciences education.

We wish our readers a very happy reading.

References

1Pendleton C, Adams H, Salvatori R, Wand G, Quinones-Hinojosa A. On the shoulders of giants: Harvey Cushing's experience with acromegaly and gigantism at the Johns Hopkins Hospital, 1896-1912, Pituitary 2011;14:53-60.
2Balasubramaniam V, Ramamurthi B. Stereotaxic amygdalotomy in behavior disorders. Confin Neurol 1970;32:367-73.
3Ramamurthi B, Balasubramaniam V, Kalyanaraman S, Arjundas G, Jagannathan K. Stereotaxic ablation of the irritable focus in temporal lobe epilepsy, Confin Neurol 1970;32:316-21.
4Balasubramaniam V, Kanaka TS, Ramanujam PV, Ramamurthi B. Sedative neurosurgery. A contribution to the behavioural sciences, J Indian Med Assoc 1969;53:377-81.
5Ramamurthi B. Incidence of intracranial aneurysms in India. J Neurosurg 1969;30:154-7.
6Balasubramaniam V, Ramamurthi B, Jagannathan K, Kalyanaraman S. Stereotaxic amygdalotomy. Neurol India 1967;15:119-22.
7Srinivasan K, Balasubramaniam V, Ramamurthi B. Craniovertebral anomalies – A study of 24 cases. Neurol India 1967;15:42-5.
8Kalyanaraman S, Ramamurthi B. Simultaneous bilateral stereotaxic lesions, Neurol India 1966;14:151-3.
9Ramamurthi B. Are subarachnoid haemorrhages uncommon in India? Neurol India 1965;13:42-3.
10Tandon PN, Prakash B, Banerji AK. Temporal lobe lesions in head injury. Acta Neurochir (Wien) 1978;41:205-21
11Prakash B, Tandon PN, Banerji AK, Bhatia R. Experience with microsurgery. Neurol India 1977;25:215-8.
12Mohanty S, Tandon PN, Banerji AK, Prakash B. Haemorrhage into pituitary adenomas. J Neurol Neurosurg Psychiatry 1977;40:987-91.
13Prakash B, Tandon PN, Banerji AK, Bhatia R. Craniopharyngioma in childhood. Indian Pediatr 1976;13:243-6.
14Tandon PN, Mahapatra AK, Khosla A. Epileptic seizures in supratentorial gliomas, Neurol India 2001;49:55-9.
15Tandon P, Mahapatra AK, Khosla A. Operations on gliomas involving speech centres. Acta Neurochir Suppl (Wien) 1993;56:67-71.
16Tandon PN. Resolution of fluent dysphasia following excision of metastatic carcinoma from the arcuate fasciculus. Br J Neurosurg 1992;6:389.