Neurosurgeon John Golfinos Combines Healing, Teaching, and Caring
Sunday, December 18, 2011
By Constantine S. Sirigos TNH Staff Writer NEW YORK - Listening to Dr. John Golfinos, of one America’s leading neurosurgeons and the Chairman of the Department of Neurosurgery at NYU’s Langone Medical Center since 2009, that message on car mirrors comes to mind: “Objects in mirror are closer than they appear.” Neuroscience and fields like artificial intelligence are closer to Star Trek phenomena than we realize.
Golfinos made a name for himself as one of the first to practice the gamma knife radio-surgery that has turned certain brain tumors from death sentences to fighting chances for a full life. And he is pioneering the only FDA-approved machine/brain interface, an implant for deaf people. Golfinos plans to continue to focus on better treatments for cancer, with some amazing implants to help paralyzed and blind patients along the way. Golfinos created the multi-disciplinary Brain Tumor Center at Langone. He is in a full residency program, so he teaches 80-90 percent of the time, but most of his teaching is spent in the operating room, working with the residents taking care of patients.
His devotion to his patients and his fascination with his field is obvious during a conversation in his office overlooking the East River. Golfinos’ father’s, Argyrios’ diploma from the University of Athens is prominently displayed there - he immigrated to the U.S. and became a revered cardiologist. His mother’s, Andromche’s “greatness genes” go back even further. She has descended from along line of lawyers, but born in Ioannina, she claims direct descent from Alexander - who was an Epirote on his mother’s Olympia’s side. Golfinos not only inherited brains, but also compassion. He says his work is very rewarding because patients “need not just a neurosurgeon but a friend, a priest, and a psychologist all rolled into one… those patients really need somebody.” Asked where that came from he said without hesitation: “Mom. She’s the last of the living saints…the sweetest person on the planet. ”Bedside manner may cure almost as many people as good hands and brains.
“We were raised mostly by our mother. Not that our father didn’t try. He was always busy,” Golfinos explained. But his father’s dedication and humaneness were a powerful inspiration, too.
Although there was no direct pressure on him to become a physician, Golfinos acknowledged that “in that strange Greek family sort of way, there was never a stated plan ‘you’re going to be a doctor,’” but realized deep down his father would be happy if he did, and so the foundation was established.
According to his oldest and dearest friend, Golfinos told people he was going to be a neurosurgeon from the time he was in the first grade. Nonetheless, Golfinos credits his sister, Anastasia - six years older and also became a physician - for the inspiration; she talked about science with him all the time. His eldest sister, Katerina, carried the Golfinos Siblings’ mathematical acumen into the banking industry.
Though Golfinos was interested in the brain’s and the nervous system’s physiological components, there was an additional dimension. “My father was a big proponent of the classics and he would talk philosophy with me, ”Golfinos explained. “He told me the brain held the secret of everything - even though he was a cardiologist.”
Until he went to medical school, Golfinos often wondered whether neuroscience would be intellectually stimulating enough for him. He said cardiology fit the bill because there were problems to figure out, “what’s really going on with this patient,” etc. Now, however, Golfinos knows that neurosurgery will always keep him interested and on the frontier of great changes. “Up until now, all of neurosurgery was about taking things out. Now we are trying to put things in,” beginning with electrodes that stimulate parts of the brain.
Dr. Golfinos grew up on East 72nd St. in Manhattan, but he was not a “Cathedral boy.” His relatives lived in Washington Heights and attended the St. Spyridon Church, where he was baptized and went for services every weekend.
Deeply proud of his parents’ life stories and dedication to education, Golfinos relayed: “My father is a southerner from Akrata near Patras, the son of a poor olive farmer. He was afraid to tell his father he had lost one of his shoes. For two years he walked to school in the rain and snow barefoot.” His parents met during the Greek Civil War, he was a doctor and she was helping out in the blood bank. They were married young and immigrated to the U.S. in the mid-1950s, happy for the opportunities that beckoned despite being poor students - he was a research student in Cornell and she was at Teachers College at Columbia University.
His parents nurtured Golfinos’ love of Hellenism, but in high school he took Latin, and he now greatly regrets not having studied Ancient Greek. He is very proud, however, that his 16-year-old son, Jason, knows Attic Greek well. Golfinos’ wife is not Greek but was open to Greek names for their children; she thought the children should have names that “could fly in both English and Greek.” They settled on Chloe and Phoebe for their daughters.
GAMMA KNIFE TO THE RESCUE
Golfinos can now attack tumors with the gamma knife, which uses highly-focused radiation, and he can either pick off the lesions or take them out and then irradiate the bed where they were. Although only 10 percent of patients are cured, the process is still considered a revolution. People have survived for ten years with good quality of life. His team has used the procedure to treat melanoma, lung cancer and some other cancers.
The tumors that begin in the brain, however, are the most deadly. Half the patients die within 15 months, even though the chemotherapy has gotten better. Asked about whether cellphones are a cause of brain tumors, Golfinos said “There is no credible evidence. The evidence is just not there.” To learn more about the topic, Golfinos recommends the bestselling book: The Emperor of All Maladies.
One of the exciting things about cancer research is that a scientist never knows if a break-through in one specific area might help unravel related mysteries in other ones. For example, Golfinos says NF2 “is the story of benign tumor growth. The cells are growing. They don’t grow like cancers [malignant tumors], they just keep growing. They don’t stop, but they grow very slowly.” That enables a researcher to “pull apart” the disease and he said “if we’re going to make a breakthrough it’s going to be there first.” He said in cancer, “every single cell pathway and process has gone haywire and the whole cell is misbehaving, but in NF2 it’s only a couple of things, one gene.” He thinks it will be shown that benign and malignant tumor growth is related and the former will illuminate the latter, adding “it seems like more of a tractable problem and we might actually make a difference for these patients.”
Asked if there were new areas he might want to explore down the line, Golfinos said brain tumors is a large field and working on NF2 is probably enough for his lifetime, but he does hope to get to mind/brain interface for movement for paralyzed patients. “That’s the really fascinating stuff, along with vision. That will come down the road.”
MAY I SPEAK WITH DR. I PHONE?
Golfinos took a bunch of philosophy courses in college, in addition to music and art, so he is not averse to flying in the stratosphere of the imagination. Discussing what is on the horizon for humanity, the topic of machine/brain interfaces came up. “We already have that. I already do that,” referring to the hearing implant. “It is an auditory-brain stem device for people who are deaf. It gives them some sensation of sound - we can’t really call it hearing [for everyone], but it is getting there. For some people it is hearing, and a few can talk on the phone.” Golfinos doesn’t do the research, but he does the surgery, in the context of a strict clinical trial which began ten years ago.
He is also very excited about the Human Connectome Project that his colleagues are building (inspired by the genome project), a massive map of how the brain is normally connected, “which we never had before. One hundred billion neurons each with 20 connections amounting to trillions of connections. They are mapping it brain system by system and trying to put together all that massive information.”
At the same time [other scientists] are finally building computers with same amount of connections,” and he muses “what does it look like, when something like that starts to learn?” TNH asked him to make a philosophical and imaginary leap: I fat some point every neuron and connection of the human brain can be modeled, is the model going to be conscious, or is consciousness something else? Golfinos brought up the famous Turing Test for artificial intelligence, where an observer tries to determine just through a series of questions whether they are interacting with an unseen machine or a human being.
Golfinos asked, “Will it matter? If you can’t tell with the lights off, I’m not sure what that means, if that is the spark of life or not. That’s a deeply philosophical question.” And a legal question: Must all centers of intelligence - traditionally labeled “subjects” - be treated as persons? “There will be laws for that. We are already bumping up against what is conscious and not conscious.”
He said we should look more closely at “the artificial intelligence that is already around us, even ‘siri’ [the personal assistant application] on I phones. It’s a little bit crazy once you see interpretation functions. It’s always been language that sets us apart.” He is fascinated by the genetic modifications in human evolution that led to language: “Once you get to a phone that can understand what you are saying, you are getting close to the line.”
Golfinos believes the technological breakthroughs will “come down to the same debates you have in religion, free will, etc. If something has free will and can act independently, then you have a problem.” Philosophers of ethics call those things agents.
The gifted neurosurgeon can be very down-to-earth as well. He does crossword puzzles, exercises (not enough he says), and plays tennis and the piano– there is one in his office at Langone - but he cherishes the time with his children most of all. “They are a fulltime occupation, ”he said, smiling. Golfinos’ wife is a runner and exerciser - “she encourages me,” and has also adopted his late father’s wisdom that one should spend as much time a possible on the beach. Argyrios swam in the ocean until he was 82. It was his answer to every ailment - like Windex in My Big Fat Greek Wedding– a movie that he says was like a documentary about growing up the child of Greek immigrants. And he would not have had it any other way.