As a neurosurgeon, Dr. Laligam Sekhar is one of the trapeze artists of the medical trade. He walks the wire almost daily, performing as many as 250 high-risk operations a year at Fairfax, Va., and George Washington University hospitals.
A world-renowned specialist in the fields of skull-base and cerebrovascular surgery, he deals in brain tumors and other cranial defects. It was a life-or-death operation he conducted to keep a brain aneurysm from killing Michelle Petersen, then a 15-year-old Burke high school student, that convinced producers of the medical soap “Chicago Hope” to make the operation the centerpiece, in fictional form, of last week’s show.
The procedure he attempted never had been done before, not in this way for this kind of problem considered so difficult that Duke University Medical Center refused to try. After his first effort failed, Dr. Sekhar (pronounced Shaker) proposed cooling the young woman’s body temperature to the point of stopping her heart and cutting off the supply of blood to the brain while he did a more complicated bypass.
An aneurysm is an abnormal widening of a blood vessel, causing a weak spot that in some cases may rupture. In Miss Petersen’s case, a ballooning invader the size of a lemon already had caused nearly complete paralysis of her motor functions. The difficulty lay in finishing the operation to remove or circumvent the aneurysm with only a limited amount of time; the risk was the possibility of a heart attack while she lay on the operating table.
Working with a team of two other doctors under emergency conditions over a two-day period in November 1997, Dr. Sekhar opened up the brain by digging through the skull area behind her right ear and removing the temporal bone to gain access. (It was replaced later.) That took up the first day. In a 10-hour session the second day, the team and its support staff secured the graft and, today, after extensive time in rehabilitation, Miss Peterson is an 18-year-old freshman at Virginia Tech in Blacksburg.
Except for a few seconds of footage from the actual operation borrowed for show, very little on the screen was “real,” and no credits were given. In the television version, the patient was 11 and the 48-year-old Dr. Sekhar, played by actor Adam Arkin, was romantically involved with the female neurosurgeon on his team.
Until last Thursday, Miss Petersen, now fully recovered except for the loss of hearing in her right ear, never before had watched “Chicago Hope,” and Dr. Sekhar, whose TV fare runs to news and comedies, had seen it only “once or twice.”
If the medical procedure was unusual, so was the real surgeon being portrayed, a divorced father of a 16-year-old Thomas Jefferson High School student who lives with him in McLean, Va. A native of Madras, India, where he graduated first in his class from Madras Medical College, Dr. Sekhar is a relaxed, almost jolly, man who plays tennis and cricket weekly and works out regularly in a nearby gym with his son, Raja. “It’s important to keep stimulated,” he says. He says he also meditates and prays daily. Given the egos famous in his profession, he seems unnaturally modest as well.
“What takes the average surgeon six hours, I take three hours,” he states matter-of-factly. (A medical colleague confirms this.) He attributes his ability to “not just manual dexterity but from learning from mistakes” (not too many we hope) and the ability to “imagine an operation that has not been done spinal cord reconstruction, for instance.” He says he sees the possibilities of cures using DNA material “within 20 years.”
Both his father and a younger brother are doctors in India. He came to this country in 1974 to perfect his skills at Chicago’s Cook County Hospital and the University of Pittsburgh, where he worked for 16 years. He has had fellowships in Germany, Switzerland, France and Great Britain.
He moved in 1993 to Washington, where his academic title currently is Hugo Rizzoli professor of neurological surgery at George Washington University, but he says he plans to give up teaching in favor of establishing a pioneer organization to be known as the Mid-Atlantic Brain and Spine Institutes, a $20 million project to bring together research, education and treatment of neurological disorders.
“I think the brain is the most unexplored organ in the body the most difficult to get at. The brain is you. Brain and mind are connected, and I believe we have a soul separate from all that,” he reflected one day recently while explaining an upcoming operation that would be similar to the one he did on Miss Petersen. It would require finding a path between the critical facial nerve and the carotid artery.
“This one is a nine on a one-to-10 scale. Most are seven, or eight or nine. Michelle Petersen’s was a 12 or more.” He has a 98 percent success rate, he says.
In a crowded operating room, opposite the one where Miss Petersen once had been, Dr. Sekhar stood with fellow neurosurgeon Dr. Donald Wright ready to make the first incision on a patient nearly obliterated by wraps, taping and tubing. Only the upper right side of the head was exposed. Cut, clamp, cut, clamp: the first steps to clearing a pathway to get at a large benign tumor at the base of the brain.
Fifteen minutes later, Dr. Sekhar was done. The hard work would come several days later, working alongside two residents and using the giant plastic-sheathed microscope that hung menacingly overhead.
Dr. Sekhar gave a party in his home Thursday night to watch the “Chicago Hope” episode with Miss Peterson who flew in from college and her parents, Don and Nancy Peterson. The scene was like a celebration at the end of a successful sports season, full of cheers, laughter and applause, “Unfortunately my heart is much bigger than my house,” said the host, inviting everyone to a catered buffet of Indian food before the show aired at 9 p.m.
Friends and colleagues were amused at the melodramatic portrayal. “Shakes on the make,” someone whooped when the obligatory romancing began. “He took off his glasses with his surgical gloves on,” laughed a Fairfax Hospital nurse at the TV doctor’s anti-antiseptic blooper.
Diplomatic as ever, Dr. Sekhar pointed out how brave Miss Petersen had been and how understanding were her parents in contrast to the hysterical folks on the screen, while conceding that the show “gave a lot of the flavor of what happened.” It’s beneficial to focus attention on such matters, he says, and give hope for future advances in the field.
A smiling Miss Petersen didn’t comment about what it must be like to see the inside of your brain on television. A psychology major, she was thinking about the paper she had to write that was due the next day.