Q I specialise in neurology because...
A It is the last frontier in clinical medicine, with so much more to be discovered. With a greater understanding of how the nervous system functions, new therapies have emerged for illnesses previously thought to be untreatable.
For example, deep brain stimulation is now used to treat severe tremors in Parkinson's disease.
Even safer and more effective interventions are now available.
Q The brain is fascinating because...
A It is a complicated organ, with a complex circuitry and wiring, which controls much of the rest of the body. The brain helps us sense, appreciate and interact with the wonderful world in which we live, through what we see, hear, smell, taste and feel. We are only just beginning to uncover its many secrets.
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BioBox
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DR N. VENKETASUBRAMANIAN RAMANI
Age: 56
Occupation: Specialist in neurology and consultant at Raffles Neuroscience Centre in Raffles Hospital
Dr Ramani had the jitters on his first day as a house officer in the paediatric department at Tan Tock Seng Hospital in 1983. He had written a prescription to douse the fever of a four-year-old child, but kept checking it for fear that he might have written an incorrect dose. An overdose could potentially cause nausea, vomiting and even damage to the liver. He recalled how the nursing officer gently prised the paper from his hands "in front of very amused nurses".
Now, with 23 years of experience as a neurologist, he is confident about treating patients. He sees those with conditions affecting the brain, nerves or muscles, and reassures others that they have no major illnesses.
He relies on ultrasound tests to check for narrowing of major blood vessels leading to the brain, performs nerve conduction tests to diagnose nerve problems and uses scans like computed tomography and magnetic resonance imaging to detect structural abnormalities such as tumours and strokes.
Dr Ramani is a member of numerous local and international committees as well as an editorial board member and reviewer for journals related to medicine, neurology and stroke.
Q One little-known fact about the brain is...
A It has an innate ability to recover from brain damage, for example, after a stroke or a head injury, by reorganising itself, in what is known as neuroplasticity.
Studies have shown that these changes occur even at the level of brain cells to form new connections and pathways.
Neuroplasticity also occurs in healthy people during the formation of memory and learning.
It is driving research in areas including visual problems, learning disabilities and rehabilitation after stroke and brain injury.
Q What I do is like being...
A A detective trying to uncover a problem; a chef putting together the best medical recipe; and a bug buzzing annoyingly around the patient, asking why is he or she still smoking or not doing the recommended exercises.
Q A typical day for me starts...
A At 5am with a 30-minute morning run - unless the haze prevents me from doing so.
After that, I take my son to school, catch up on paperwork in the office and then do my ward rounds. I then run my clinic in Raffles Hospital till 6pm.
On Monday afternoons, I run a clinic at the Raffles Medical Centre in Shaw Centre.
On Wednesdays, I go to the National University of Singapore to teach medical students and attend meetings with research colleagues- roles which I find as stimulating as seeing patients.
Q I come across all types of cases...
A With the bulk being patients with tension or migraine headaches. I also treat those who have had a stroke and, hence, are unable to walk or talk well; those who have numbness in the feet and legs from their nerves being affected by longstanding diabetes; and those with dementia such as Alzheimer's disease.
Others come with minor and non-specific symptoms that usually fade away as mysteriously as they appear .
Q I love patients who are...
A Positive about themselves and their future, who are willing to make the extra effort to help themselves recover, who tell their families not to worry and allow them to be as independent as possible.
Q Patients who get my goat are...
A None, really. But I am concerned when patients fail to report a symptom until they are about to leave my consultation room.
At times, this symptom may be more serious than the one the patient came to me for.
For instance, someone with a headache may mention in passing, as he is leaving, that he has had significant changes in stool habits with occasional blood in the stool, which can indicate bowel cancer. I will have to arrange to speak with the patient at a later time to explore the new symptom.
Q Things that put a smile on my face are...
A Patients trying their best to show me how much they have improved in their mobility by bravely pulling themselves out of their wheelchairs, refusing any help from their families, and triumphantly entering the consultation room on their own steam.
Q It breaks my heart when...
A A patient tells me that he has given up, or that there is no point in taking medication.
Q I wouldn't trade places for the world because...
A I wouldn't know what else to do!
Q My best tip...
A Take charge of your health. When it comes to your body, you are your own boss. Take care - you have only the rest of your life to enjoy this lovely world .
