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Dissecting the Journey of a Neurosurgeon – Dr Nirmala Shankar

According to the Asian Journal of Neurosurgery, there are only 2.5% of female neurosurgeons in India. Dr Nirmala is an inspiration, being one among them to conquer the field. Currently pursuing a fellowship in Functional neurosurgery, she specializes in pediatric neurosurgery, neurosurgical procedures for epilepsy and skull base surgeries. She is also working as a consultant neurosurgeon at Aster Group, one of the most reputed hospitals in Bangalore, India. As she opened up about her journey, it was definitely not a walk in the park. Along with her struggles, she shared with us all the accolades and glory she received in the profession. Keep reading to know more about her story.

Steering her way into medicine

Dr Nirmala says becoming a doctor has always been her dream. She recalls an incident from when she was in the 7th grade, which made her want to become a doctor— “ I started dreaming of becoming a doctor because of my uncle who had a Myocardial Infarction a.k.a heart attack. Back then getting him to a cardiologist was difficult as there weren’t any near our place. This made me consider becoming a cardiologist.” Thus began the pursuit of her journey in medicine.

During her undergraduate days at Sri Devaraj Urs Medical College and Teaching Hospital, she was introduced to the field of surgery and fell in love with it. She recalls, “I was lucky to get a lot of chances to assist during my general surgery rotation. While assisting, touching the tissues and holding the appendix and witnessing procedures like cholecystectomies felt surreal.” Her fascination for surgery only grew with time and she decided to take up general surgery for her residency.

It was during her residency when she was first introduced to her love and passion, Neurosurgery. The chief and her mentor, Dr. Ravi Gopal Verma, was the one who prodded her to pursue the field. Reminiscing, she says, “I would often question sir as to how I would be able to take up neurosurgery given that it is a very male-dominated field. But with each procedure I assisted him in, he would clarify all of my questions and doubts regarding joining the field”

One of her night shifts in the department of neurosurgery during her residency fully convinced her to super specialize in neurosurgery. She recalls, ”A patient with a head injury was brought to the casualty at night. He was able to talk as he was wheeled in and was shifted for an emergency CT scan. By the time he was shifted back, he had lost his consciousness. He was diagnosed with Subdural Hematoma i.e. a collection of blood between the brain and the skull. After a procedure called Burr Hole Surgery was performed by the concerned neurosurgeon, he nearly regained his consciousness. He was then taken to the operation theatre for further intervention. A few days later, he went home having completely recovered.” She says this incident where she saw a patient being saved in the nick of time inspired her to take up the field.

A typical day for a neurosurgeon

“Where my day starts and ends is quite a blur”, she says. Her day usually starts at 8 am. Scheduled surgeries await her regularly. She also consults patients on an outpatient basis on specific days of the week. After her hectic day as she heads back home, she is often called back to treat patients who arrive in the emergency and require immediate attention. Only by 2 am the next day is she able to go back home after completing the procedure and post-operative care instructions and documentation. She is back again in the hospital at 8 am for the scheduled procedures the following day.

She says,” Most of the days, I have to stay back in the hospital to ensure the required care for the patients is being given by our staff, as most often they wouldn’t be equipped enough to take care of patients who have undergone neurosurgical procedures. This often holds me up in the hospital. Hence, I would be in the hospital for at least 2 to 3 days at a stretch. I would not know what is going on at home during this time.”

Moments that touched her life

She adds she was happy to call herself a neurosurgeon and in her work in another instance as she continues to take us back to her experiences. “One of the days when I was on duty, at around 2 am after midnight, a young guy was brought to the emergency with a head injury following a road traffic accident and he was very unstable and not conscious; on the Glasgow coma scale, he was a 5. On CT, there was a Subdural Hematoma and required immediate surgical intervention. The patient party was very skeptical to see a female neurosurgeon and kept asking if anyone would come to help me out.

But I was confident I would be able to handle the case and went ahead. There was a lot of blood loss during the surgery but I was able to do the surgery well. He recovered well. Six months later, his parents came to visit me and said that they weren’t able to thank me for that day and that whatever their son can do today is because of me. Hearing those words of gratitude is a moment I hold dear to my heart.”

Her life outside of the hospital

Without a second thought, she says, “My biggest stress buster has been my daughter; she would make me listen to her favourite new songs and suggest we go to the movie she thought we would enjoy together.” Despite all her hectic schedule she always finds time for her daughter. She says that pre-pandemic, she used to disconnect and go travelling with her family outside the country, away from the responsibilities of a doctor.

Challenges as a woman in a male-dominated field

One of the major hurdles in the field that Dr Nirmala mentions is the misogynistic stereotypes, from her peers more than from her patients. women in the field are often perceived with prejudice, despite the sex ratio in medicos in favour of females. Though these days some have accepted this fact, it’s still a struggle.
She also says working with an all-male department was a hurdle, especially with family responsibilities. She says, “It was quite difficult at the hospital front with an all-male coworker situation. I never used to take a break during periods, but other female coworkers could, sometimes. Breastfeeding my daughter required me to request my boss for permission.”
She further adds, “ Dr. T. S. Kanaka, the first female neurosurgeon in Asia, followed by Dr. Prathika Chary, pioneering female neurosurgeons in India, chose not to get married and dedicated their lives fully to the field. However, their counterparts got married, had kids, and yet had successful careers. Yet, the former was perceived as the norm—if a female doctor wants to pursue neurosurgery, she should be dedicated to the field and have no family life, unlike today “
In her case, she says, “ My parents were adamant that I had to get married after my post-graduation and I could study whatever I wanted to, but only if my partner would let me. According to them, they had given me enough education. Thankfully, My husband, Dr. Shankar, has been very supportive of my decisions and here I am, a neurosurgeon. He fully understands what my job entails and has built the trust that exists between the both of us. He is fully aware of the odd timings I have to cater to. He fully takes care of our daughter.”
Being an active member of Women in Neurosurgery India, a chapter under the Neurological Society of India, she says, they have enabled several female surgeons to take up neurosurgery and also network, ask for advice regarding career prospects and fellowships they could go for and much more. “Through this group, we are able to encourage female surgeons to step into this field”, she says.

Juggling between home and being the badass surgeon

She says she would not be able to do all she does without the support of her husband, her parents, her in-laws and her siblings. She says, “Thanks to my family, I can ensure my daughter is well taken care of and don’t have to worry about her in between my surgeries or my busy hours in the hospital”.

She further adds the pressure that is brought on by the profession, she often overcomes it by crying, as she needs to calm herself, before she heads back home, as she won’t be able to show it home, to her family.

She sometimes vents it out by talking to her chief’s wife. She says talking to his wife has been an outlet for her, especially woman related problems such as having to go back home in between an emergency to being there for her daughter to struggle with menstruation, that men are generally unable to truly understand.

Her inspiration to keep going

She says, “ If I were to name one person who was my biggest cheerleader throughout my career in neurosurgery, I would say it is Dr. Ravi Gopal Verma. I would approach him with every problem I encounter in my life. He even played a major role when it came to choosing my husband. Thanks to him, I was able to find my next best cheerleader and supporter, my husband.” She says her passion for the field is high and that she dedicates time to learning more techniques and about the subject to better her skills as a neurosurgeon. She mentions that she is quite satisfied working in this field. She says, “ When I see a patient go home fully recovered, the joy it gives me is unexplainable”.

Something she enjoys and dislikes in her job

As she went on about what she likes about the job, she fondly recalls one of her patients who has followed up with her for the past 12 years. She recalls, “ Before I joined Neurosurgery, there was a patient, a young girl who had just appeared for her first-year B.Sc. exam, met with a road traffic accident after a call with her parents. She was brought to the emergency in very bad condition. She was operated on by my chief. She was in a coma for some time and she recovered after which she completed her B.Sc. and M.Sc. to this day she follows up with us. We were all invited for her wedding and she is one patient that had an impact on me and I remember to this day.”
However, for her, the cons of the field have always been the peer pressure and the stereotypes a woman has to face. She says as the field is becoming more technology-dependent; anyone can take it up if they are willing to spend the time and effort, irrespective of gender. She adds that she feels women tend to have more precision in their techniques during their procedures than male neurosurgeons.

Her advice to the aspiring female neurosurgeons

As long as they have a passion for the field, there should not be a problem. She also adds, “In my opinion, women are good at both precision and multitasking, so take this field up, if it interests you

-Dr Nirmala Shankar

She says she would recommend it to her juniors as she is highly satisfied with her profession and she says "Having job satisfaction with this profession is guaranteed".

As she moves forward, she hopes to treat more kids affected by epilepsy. She says “Currently, I am doing a fellowship in functional neurosurgery, which deals with movement disorders and epilepsy. It focuses more on epilepsy in the pediatric age group as it is very common; they often lead a normal life ahead if treated well. Treating kids with epilepsy is mostly curable, and I look forward to working with more of them.” And so can you.

Content Editor: Dr Rizana Riyaz
Reviewer: Giripriya Pai, Maanasa Sachidanand, Sraddha S Bharadwaj, Jasmine Rimani
Interviewer: Maanasa Sachidanand

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Harshitha Pai
Harshitha Pai
1 year ago

Being an aspiring medical student myself I felt really inspiring reading this story.. Thank you for capturing such impactful photographs.. Surgery is so tedious but still this blog made me curious than before, now I’m actually waiting for surgery to start in my curriculum.. Hats off Doctor, you managed and are still maintaining the balance so beautifully.. You are a true idol❤

Richita
Richita
1 year ago

This blog is just Wow! It has really inspired me to work hard towards my goal and balance the other half of my life as well. Dr. Nirmala is truly an inspiration for all💗

Akhila
Akhila
1 year ago

@Nimmi, You are a great inspiration for many people inside and outside of family. I have seen from close proximity your struggles throughout your journey so far, to achieve your dreams. From childhood days, making bold steps to enter medical profession without any background, keeping solid determination throughout your studies, navigating career & personal journey together is tremendus effort. Despite many things of ups & downs, your ever smiling, helpful and positive attitude has bought all success and achieve your dreams. You are true role model for current & next generations!!!

Thx to this great article & author!!

Deeksha
Deeksha
1 year ago

Wohh.. This story was just awww, it reminded my childhood which was the way similar. As a medical student i can just add doctor’s life is harder but it is a heart filled profession in which we can save a million’s of life .And even this vlog showed hw 2 hangon on a goal we do hv… #Doctor u r the best

Mamatha
Mamatha
1 year ago

Superb nimmi. Very proud of you. You are really a wonderful asset to the society. Soft spoken person whom I know since childhood. You are an inspiration to the whole womanhood. Keep going and may you succeed in all your endeavours and reach new heights💐💐💐💐💐

Jahnavi
Jahnavi
1 year ago

As a medical student, I find myself enjoying these type of articles.. I loved your story. The photos made it more interesting.. I’m curious about my future now and would love to experience these things ahead.. this was so good.. thanks for this article..

Manjula
Manjula
1 year ago

Very very proud of you Nimmi. You will be role model to all upcoming medical student. Your sacrifices paid good result. All the best for your future dreams.

RAJU M S
RAJU M S
1 year ago

Proud of you Nirmala ( Nimmi) a true inspiration to the Womankind, i can very well recollect that you would score 1 st Rank in all the tests / exams right from primary to 10 th Grade May you continue to treat umpteen numbers of patients and gift life to all of them, but please do take care of your health as well, that is more important GOD BLESS i would end with a famous quote of Alexandra Fuller which reads ” THOSE WHO CHOOSE TO BECOME DOCTORS DO IT BECAUSE THEY HAVE TO HEAL”

Roe Joy
Roe Joy
1 year ago

Amazing article. Truly goes to show that all societal boundaries are made to be broken. Please upload more articles like this. Thanks <3

Ajay Singh
Ajay Singh
1 year ago

Inspirational story of how doctor Nirmala has battled stereotypes to become an accomplished neurosurgeon. Impacting lives in a positive way of so many patients, truly worth emulating.

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