Interview with a Neurosurgeon - Dr Adam Wells

When did you first become interested in medicine?

From a very young age in primary school. There was no-one medical in my family, but I found physiology and the brain really fascinating. Plus I like the idea of helping people in such a meaningful way, and it really is the most rewarding thing there's nothing else like it.

What made you decide to become a Neurosurgeon?

Professor Nigel Jones was a big influence on my decision to become a Neurosurgeon. I always knew I wanted to be a hands-on doctor like a surgeon. In my 3rd year of medical school we started neuroanatomy and I thought this is really cool. My friend had heard about Nigel and his lab. They did neurosurgical research and took on medical students so they could gain research experience. I approached him and did a 6 week summer research program in the lab. That was it for me, I ended up taking a year off my medical studies to work with him as part of an honours research year. Dr Amal-Abou Hamden was a registrar at the time doing a PhD on syringomyelia with Nigel as her supervisor, so I latched onto her project. After that it was Neurosurgery for me and nothing else. My focus then became getting onto the neurosurgical training program.

How long did it take to become a Neurosurgeon?

I did 6 years in medical school, plus the honours research year. Then a year of internship at the RAH, a year of general residency, and two years of basic surgical training. I finished med school in 2003 and I got accepted onto the neurosurgical training program in 2008. Once on the program that is another 6 or 7 years training. Once I completed the training program I did two additional Fellowship years. My final year on the program I was in Perth, so I came back to Adelaide for a Fellowship year. Then I did a second Neurotrauma Fellowship at Cambridge in the UK.

How was that overseas experience?

It was really good, I was particularly interested in Traumatic Brain Injury and they have one of the leading neurotrauma centres in the world with one of the world’s leading neurotrauma specialists, Professor Peter Hutchinson, so that was the big drawcard.

Where do you operate at the moment?

The Royal Adelaide Hospital and St Andrew’s Hospital

What is your area of interest?

My special interests are Traumatic Brain Injury and Brain Tumours but I do a bit of everything.

What do you enjoy most?

I enjoy operating of course, particularly when it is a complex procedure that is very satisfying, but the most enjoyable part is the patient satisfaction when you are able to change their lives for the better.

What are some of the more challenging aspects?

Some operations can be technically hard, but the most challenging thing is when you feel helpless. A patient with a terminal tumour, or who undergoes surgery and treatment but their tumour comes back and you have to tell them there is nothing more you can do. I take my hat off to those that work in paediatrics. I have done a few stints at the Women’s and Children’s Hospital throughout my training, but I can’t do it anymore. When you experience those bad outcomes it is so heartbreaking, particularly now that I have children of my own.

Tell me about a typical day

Everyday is a bit different, I could be operating, consulting in my rooms, doing research and academic work or in meetings.

My alarm goes off at 5:20am, I get up before everyone else to get ready for the day. This morning I was on the computer typing up letters and responding to emails this morning until about 6am. Usually I am out the door by 7, if I have operated the day before I will be in the hospital by 7:15 for ward rounds to check on my patients. If it’s an operating day I will be in the theatre from 8am, or on a Consulting day I will start seeing patients from 8:30am. Then I can be operating until about 6:30pm, after which I will go home and help my wife put our youngest to bed and have dinner and spend time with my family. We have three kids, two older girls and my boy our youngest is two. It is still very difficult to strike a work-life balance.

Why did you choose to be an academic surgeon and also conduct research?

Again it’s Nigel’s fault, he was an excellent teacher. I think it’s a noble thing to do, it’s very rewarding to find solutions to problems. The nature of research though is normally you answer one question and 10 more questions pop up. It also complements the clinical aspects and helps the specialty evolve as you find ways you can improve the service.

Do you have any advice for students that are considering pursuing Neurosurgery?

It’s incredibly rewarding but you have to be committed. Be as sure as possible that it’s what you really want to do because you do have to sacrifice a lot.

What do you enjoy doing in your spare time?

Spending time with my family of course. I don’t have much time for hobbies, but I do love watching and playing basketball. I actually collect Air Jordan shoes.

How do you build rapport with your patients?

I insist that people call me Adam, not Dr Wells. I like to get to know people and find out what is most important to them, what are their goals so that we are on the same page. At the end of the day it is about what they want, I like to be personable and I find if you are genuine and treat people kindly it is not difficult to build a rapport.

Are there any aspects of Neurosurgery that you wish there was more awareness around?

There is a particular condition called Neurogenic Claudication that is quite common but not widely known. People get terrible hamstring and back pain with walking, but unlike sciatica if you stop and rest it goes away. It can be caused by peripheral vascular disease, but also by degeneration of the spine leading to nerve root compression. It’s relatively easily treated, usually with surgery and it can be life changing in terms of quality of life. To get treatment though relies on the person telling their GP and their GP doing the right investigations to get the correct diagnosis. By the time people are referred to me they often can barely walk. After surgery they’re out walking around the block and can’t believe the difference, it would be great if there was more awareness around that.

What do you see as the value of the NRF?

We are so lucky to have the NRF here in Adelaide. There’s really nothing else like it that I know in the rest of Australia. We have extremely strong local support for clinical and basic neurosurgical research which is so important in order to advance the research. What it effectively means for South Australia is we’re batting above our weight in terms of conducting world-class neurosurgical research locally. More than half of the research that I’m currently doing at the RAH wouldn't be possible without the support of the NRF.

https://www.dradamwells.com.au/