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动态
本期仁医医疗特别邀请到国室是德国最大的神经外科诊所之一。Prof. Veit Rohde和他的团队凭借着高度专业化的技术，最先进的设备和最好的护理，专注于功能维持和微创治疗原则的持续应用，得以治疗整个神经外科领域相关疾病。
哥廷根大学医疗中心神经外科
下萨克森州最高水平的跨学科治疗中心
哥廷根大学医学中心的神经外科诊所是德国最大的神经外科诊所之一。每年有5000例门诊病人和2000例住院病人接受约3000例手术治疗。为了给每个患者提供最好的护理，尤其是肿瘤疾病（癌症）患者，哥廷根大学神经外科与其他学科共建了跨学科的大学综合癌症中心（G-CCC）。
由于拥有大量临床病例的高水平专业知识，多年的临床经验和最佳的医疗效果，Prof. Veit Rohde领导的哥廷根大学神经外科诊所是德国神经外科学会在血管疾病尤其是脑出血领域的认证中心。
Prof. Veit Rohde领导的科hde和他的团队与康复中心紧密合作，以确保即使在术后也可以进行最佳治疗。
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采访录
1. 您是何时决定从医的呢？又为什么专攻神经外科呢？
Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in neurosurgery?
这问题很难回答，我上高中的时候就对生物很感兴趣，但当时对于是否从医并没有特别明确的规划。在德国，高中成绩非常好的顶尖学生才会被医学院录取，我成绩特别好，于是顺其自然地选择了医学院，并不是出于自己的规划。我就这样开始学医了，很快我意识到这是一个十分正确的选择，我感觉学医很有趣。至于选择神经外科，也不是提前明确规划的。当时只有两个外科领域，不需要先在普外科培训后再进行专科培训，那就是心外科和神经外科。我就这样选择了神经外科，后来还当上了主任。
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. 您职业生涯中是否有对您来说很重要的导师，他们教会您什么，是如何启发您的呢？
Who have been your greatest influences? What have they taught you and how have they inspired you?
我认为对我职业生涯影响最大的人是两位神经外科医生，他们给我很大帮助。他们是Prof. Hassler 和 Prof. Gilsbach。第一位是我在图宾根大学工作时的导师，图宾根是我职业生涯开始的地方，他让我得到了快速的成长，他是我在神经外科领域的手术和科研工作的领路人。
第二位是Prof. Gilsbach，我跟他在亚琛工业大学工作了十一年，他教会了我如何在神经外科取得成功。我从他们身上学到最重要的一点是，要想成为一名好的神经外科医生，你必须有非常强的纪律性。在做手术时，你必须对自己做的所有操作有清晰的认知。他们对神经外科的深刻见解和超前思维对我影响非常大。
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. 您领导哥廷根大学医疗中心神经外科已经快二十年了，这期间您遇到最大的挑战是什么？接下来几年的计划是什么？
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?
其实没有特别具体的某件事，但是有一个挑战在过去的二十年中如影随形，那就是预算上的限制。作为神外医生，我们总想在手术中投入最新的技术，但医院的行政部门却希望把成本控制得越低越好。这使得双方形成了对立关系， 有时候很难处理，对我们来说的确是个挑战。尤其是现在科技发展得很快，我们想要投入新的设备等等，我们会跟行政部门详细说明，我们所做的一切都是以病人为中心，但有时他们并不是这样考虑的。
至于接下来几年的计划，首先是处理好刚才提到的这个问题。其次，现在距离我退休大概还有8年，我们是全德国最大的神经外科之一，设备精良、医护团队训练有素，我希望把科室很好地交接给下一任主任，这就是我接下来几年的计划。
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. 作为大学教授、医生、管理人员，您如何平衡行政、临床、科研、教学工作及个人生活？以及尽管有这么多其他工作，如何将重心始终保持在病人身上？
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?
我日常工作重心是临床工作，凡事以病人为出发点，其次是激励年轻的神外医生投身科研。我已经过了要亲自到实验室做科研的年纪，我现在主要是给年轻医生提供想法，提出研究假设，让他们付诸实践。至于行政工作，我已经尽可能把它们分担给其他团队成员。这样一来，我的工作始终能以病人为中心，追求病人福祉。
至于个人生活，也是我需要努力平衡的，我很幸运，我的妻子也是神外医生，所以我们在家的时候也能讨论一些专业上的问题，这样就有更多休闲的时间。
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. 德国脊柱学会在全德范围内认证了30家一级脊柱中心，哥廷根大学医疗中心是下萨克森州唯一的一家认证中心。这一认证对病人来说意味着什么？请问您领导的神经外科与Prof. Lehmann领导的骨科与创伤外科在脊柱领域是如何进行多学科合作的？
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，我们能成为全国仅有的三十家认证中心之一，同时是下萨克森州唯一一家。一级脊柱中心的认证，要求该中心神经外科和骨科与创伤外科进行紧密合作。这样的合作使得病人能接受更好更全面的照护，因为我们对处理复杂的脊柱疾病非常有经验，这些在二级或三级脊柱中心是比较少见的。
在我们脊柱中心，我们和骨科与创伤外科医生之间的合作非常紧密。对于患有复杂脊柱疾病患者，我们会一起讨论，甚至一起手术。对于常见的脊柱疾病患者，比如腰椎间盘突出症或简单骨折，通常由神经外科或骨科与创伤外科进行手术，这取决于哪个科收治病人入院，但对于复杂的病例，我们都会合作，以求给病人提供最好的照护。
Prof. Lehmann（左）与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. 在神经外科领域至今还存在较大的性别差异。德国36所大学医院中，只有两所神经外科由女性主任领导，但其实医学院中大概70%的医学生都是女性。您认为德国大学医院在鼓励更多女性从事神经外科方面做得如何？该如何改进？
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?
这个问题很难回答，你说得对，确实至今还有较大的性别差异，但是住院医师，或低年资医生群体中，性别比已经大概达到了1:1的平衡，所以这是有所改善的。但确实，女性很难得到神经外科主任的职位。
德国大学自几年前就一直在努力促成女性顶级神经外科医生的申请，但是我们仍然面临这样一个事实，即女性进入最后三名候选人名单的情况很少见。因为有时大学担心，如果女性神经外科医生最后没有得到这个职位，她可能会起诉大学以争取这个职位。某种程度上来说这是一种恐惧。如果我们能努力减少或消除这种恐惧，德国的女性神经外科主任就会越来越多。
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. 您对如何培养年轻医生有好的建议吗？您对年轻的神经外科医生有什么建议？
Do you have suggestions on how to train the young generation (to the Chinese chiefs)? What advice would you give to the young neurosurgeons?
又是一个难题，尤其是中国和德国或欧洲的体系其实有点不一样，但是还是有共通点的。首先我认为，医院或科主任在挑选年轻医生时，必须挑选那些已有扎实科研基础的学生。因为在住院医师阶段不可能完全将这些科研知识传授给他们。我的理念是，医院应该实施结构化的教育项目，这个跟下一个问题的答案有所关联。
作为德国神经外科学会的主席，我正在制定一个适合大多数德国医院的结构化教育计划，给全德国的年轻医生提供同质化标准化的培训。同时我一直鼓励住院医生参加培训课程。有欧洲的培训课程，也有德国国内的培训课程。这些培训课程通常是长达四年的结构化项目，这四年间的培训覆盖神经外科领域所有的知识。我们应该鼓励年轻医生参加这些课程。
接下来我想讲下中国和欧洲的不同之处。在欧洲，很多手术不能让年轻医生上台操作，因此年轻医生实操的机会是不够多的。我强烈推荐年轻医生参加这些培训课程，这些培训课程，以及一些解剖学课程提供了在模型上实操的机会。这些是我能想到的能给年轻医生提供更好的教育的方法。但最重要的还是要在各医院推行六年制结构化住院医师培训计划。
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年起您任德国神经外科学会主席，这对您来说意味着什么？您任期内的计划是什么？您认为此类学会对学科和医生有何重要意义？
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?
对我个人的意义，一方面是对我多年来在外科领域做出的成就的认可，另一方面是对我多年来对德国神经外科学会的支持的认可。我认为，当选学会主席的两年，某种程度来说是对我的奖励。刚才已经提到，我任期内的主要工作，是推动神经外科住院医生的标准化教育培训制度，以及高年资医生的标准化继续教育培训制度，这是我任期内工作的重点。
至于学会的意义，我认为学会是很重要的。德国神经外科学会非常重视科研工作，因此我认为学会可以推动本领域内科研的进展。除此之外，学会还可以代表神外医生应对不断变化的政策，代表神外医生向政府表达我们的想法。其实德国神经外科学会不算大的学会。我相信我们与德国外科学会的紧密合作对提高外科医生和神外医生政治地位大有帮助。
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. 您在国际上知名度很高，至今您最自豪的职业成就是什么，为什么？
You enjoy a great international reputation. What is your proudest career achievement to date and why?
好像没有特别明确的哪件事。但每次我参加学术会议，参加培训课程时，年轻医生告诉我，他们被我所做的临床工作或科研工作所影响，这令我感到非常自豪和开心。这证明多年来我对年轻外科医生的职业发展是有帮助的，哪怕只有一点点，我对此感到自豪。
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. 作为一名医生，您最享受您工作中的哪一部分？假如您不从医的话，您会从事什么行业？
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?
我想把这个问题改一下，改为“作为神外医生，你最享受工作中哪一部分？”因为我不想成为内科医生，我想做神外医生。
工作中我觉得最享受的有两点，第一，如果我们把本职工作做好，我们真的可以治愈病人，这是我们与神内医生的差别。除了个别恶性脑部肿瘤之外，我们可以给病人的未来生活提供良好的期望。对我来说这是非常令人着迷的，我们可以为了病人争取巨大的胜利。虽然有时候我们无法取得胜利，但这就是硬币的另一面了。
另一方面，神经外科医生总能接触到最新的技术，许多计算机科学技术早就已经进入神经外科领域。我们总是面临着最新的技术，这也是非常令人着迷的。我们正在接触人工智能，我相信这也会被神经外科领域应用。一直接触新想法和新技术能让我们一直把握时代的脉搏，我非常享受这一点。
我还真的不知道如果我不做医生的话会选择什么职业。下决心从医已经是三十多年前的事了，当时也有考虑是否要学地质学，但我也不确定（如果不做医生的话）我是否真的会从事地质学。
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. 您有什么兴趣爱好？
What are your hobbies during your leisure time?
上学的时候我是一个半职业中长跑运动员。我现在还保持着这个习惯，我每周跑步两到三次，试图从日常工作中抽离出来，享受新鲜空气和自然景观。
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.
