In 1997, long before he became director of neurosciences at UCHealth’s Memorial Hospital, Dr. John McVicker performed Colorado’s first deep brain stimulation.
A neurosurgical procedure used to treat conditions like Parkinson’s disease and essential tremors, DBS implants a device that sends electrical stimulation to targeted areas in the brain that control movement.
McVicker remembers it like it was yesterday.
“At the time, we were doing all of these awake … so intraoperatively we were testing the electrodes, turning them on, and essential tremor we control usually within a few seconds,” he said. “So to have a person break into tears because they hadn’t seen their own signature for a decade — they were hardly able to hold a pen, let alone write with it — to flip those electrodes on in the operating room and have the patient give us a handwriting sample was absolutely dramatic. It was one of the more memorable things in my life.”
Throughout his career, McVicker has been driven by a pioneering spirit and a determination to bring cutting-edge neurosurgical techniques and comprehensive neurological care to Colorado.
As director of neurosciences at Memorial, he has been instrumental in building the hospital’s neuroscience capabilities so that — starting in late September — Colorado Springs patients will no longer need to be sent to Denver or California for certain kinds of urgent care.
Dr. McVicker took a rare spare half-hour to talk to the Business Journal about the developments he’s seen in neurosciences and the major changes coming to patient care in the Springs.
A lot of different things. A close family friend who taught me to climb and to do a lot of mountaineering here in Colorado was a neurosurgeon. I spent a lot of time in alpine rescue, and Colorado Mountain Club was a big part of what I did growing up, and he was a huge influence. But my father was a surgeon, and I had no intention of following in his path because I saw how hard he worked. So it wasn’t until college — my major was molecular cellular developmental biology and I put myself through college doing electron microscopy in a neurophysiology and neuroanatomy lab — I realized that, for a lot of different reasons, I loved the nervous system.
What major changes have you seen since you started?
The changes have been unbelievable — absolutely unbelievable. [When I was an intern] we got a brand-new device, an EMI scanner, which was the very first CT scan available. We thought it was absolute magic.
During my training, microsurgery — the use of the operating microscope with a very bright light and a very stable platform with some depth of field — allowed much more precise neurosurgical intervention both in the brain and in the spine. Stereotactic radiosurgery developed during my training — things like a gamma knife or single-dose focused radiation for intracranial tumors. You can paint just a very small area, say just the size of a raisin, with very high-intensity radiation, sparing the tissue around it.
More recently, the ancillary management of the malignant brain tumors that used to be uniformly fatal within eight to 12 months has actually produced a number of people who are surviving. Our ability to manage some of these malignant tumors is by no means perfect — we don’t cure these still — but instead of living a year, people now live four or five years potentially, if we get a good resection. I’ve seen a tremendous amount of change. Nanotechnology, the use of fluorescence, the use of image guidance and the ability to go directly to a deep tumor knowing precisely where it is, based on the imaging and not just on a guess. For many years, the only way you could tell where a tumor was in the brain was by the symptoms it caused. And you could be falsely misled very, very readily.
When you went into neurosurgery, were you concerned about the mortality?
Yes. But not so much the surgically related mortality, because by the time I was in training people didn’t die on the operating table very often. But the disease processes themselves can be so aggressive or so debilitating that people would die because of the disease regardless of our intervention.
I think if you take that seriously and you take that interaction you have with people and with people’s families seriously, that is a very difficult part of neurosurgery to learn. How do you help people deal with their mortality? How do you help people’s families deal with their loved ones’ mortality?
It’s something I think takes experience.
What qualities do you think are the most important in a neurosurgeon?
Heart, soul, brains and hands. Probably in that order.
What is your main goal?
[As Director of Neuroscience] I have control over the direction and the strategy that we embark on, and that’s very important to me because the very reason I’m in Colorado Springs is … to bring high-quality, technically difficult surgical expertise to a community so that they don’t have to wade through the medical students, don’t have to wade through the academia that can make certain things very difficult for them. And so they don’t have to leave home.
If there’s anything that I want to do, it’s to bring southern Colorado the expertise and the infrastructure to do everything that they need done — or at least 99.9 percent of it — here at home, [done] well, and without having to travel. There’s no reason people in Colorado Springs should need to embark on medical tourism to Denver.
How close are we to reaching that goal?
About a month. Until now, almost the only cases that we have shipped are cases that required endovascular management or vascular neurosurgical management. Over the last six months, we’ve been very hard at work recruiting people. We’ve [recruited] an interventional neuroradiologist that I worked with at Swedish [Hospital, in Englewood] for a decade, who trained at Yale, and we’ve recruited an endovascular neurosurgeon from Florida who trained at Cleveland Clinic, and they’re both going to be in the saddle in another month.