Brains of the operation
Dr Basant Kumar He performed India’s first awake craniotomy, has spent years pushing the envelope in neurosurgery. He’s now the first Indian to receive a prestigious American lifetime achievement award. Meet the doctor who would do more
After decades spent pushing the envelope in neurosurgery, Dr Basant Kumar Misra has won a global honour. Meet the doc who would do more
Dr Basant Kumar Misra, 68, is the kind of neurosurgeon whose life belongs on a TV show. For someone whose work involves trauma and morbidity, he is gentle, almost always calm and measured. Yet, when there are risks to take – convincing a hospital to adopt expensive tech, trying out a radical technique, staying on in India despite plum jobs abroad – he isn’t one to hesitate.
It’s easy to see why Misra was awarded India’s highest medical honour, the Dr BC Roy National Award in 2018. And why in August, he became the first Indian to receive the International Lifetime Achievement Award in Neurosurgery conferred by the American Association of Neurological Surgeons.
Odisha-born Misra – his father is the renowned economist Baidyanath Misra – has spent his career making medical procedures short, safe and painless. And making brain surgery minimally invasive using cutting-edge technology.
It’s an unusual path, even in a country filled with stellar doctors. But Misra has always loved a good challenge. As a school student, it was his excitement for the unknown that helped draw him to the medical profession. When he started off as a young neurosurgeon in the 1980s, the MRI had just been invented , and wasn’t even used widely. Misra, however, knew that technology would be the key to future breakthroughs. In the 1990s, he convinced the top bosses at Mumbai’s PD Hinduja Hospital and Medical Research Centre to invest in gamma knife radiosurgery equipment to treat tumours. It was an era when clunky home computers were just entering middle-class homes. No one could fathom how pencil-thin beams of radiation could be targeted, without anaesthesia, at a diseased spot without damaging the surrounding parts of the brain, and allow the patient to go about life normally the next day.
His risk paid off. By 1997, Misra had performed South Asia’s first gamma knife radiosurgery. In the years that followed, he became the world’s first surgeon to perform Computer-guided Aneurysm surgery. He’s also the country’s first doctor to perform an awake craniotomy, a procedure performed on the brain while the patient is awake and alert.
Dr Basant Kumar Misra won the Dr BC Roy National Award, India’s highest medical honour, in 2018. Last month, he became the first Indian to receive the International Lifetime Achievement Award in Neurosurgery conferred by the American Association of Neurological Surgeons.
If Misra has been front and centre in India’s medical tech revolution, it’s also because there have been parallel changes in the healthcare economy. “The problem about 20-25 years ago was finance,” says Misra. “Government institutes were not getting adequate funding, so corporates stepped in. There came the golden period of private enterprise getting into the medical facilities. And suddenly everything changed.”
For Misra, India became the place to be, to study and to work. He’d completed his degrees from institutes in India, and been to the UK’S University of Edinburgh on a Commonwealth Medical Scholarship, but returned to practice here. “For a doctor it’s a win-win situation,” Misra says. “The number of patients one sees here is much higher than in any other country. An Indian neurosurgeon will operate 10 times more often here than in the West.” And as with anything else, the more surgeries doctors perform, the better they become.
The work is also much more traumatic – fellow humans trusting him with their brains. “It’s a privilege that has to be handled with a lot of care, a lot of patience and deliberation,” Misra says, “Every millimetre counts. The person can go back to his or her family, a mother can be saved, a child can go back to her mother. There is nothing more rewarding than that.”
Dr Sanjay Agarwala, director of professional services and head of orthopaedics and traumatology at the hospital, has worked with Misra for 25 years. “Misra’s calm demeanour makes for a great personality for all kinds of patients who come with worries,” Agarwala says. “He’s meticulous in the way he talks to patients and expounds on the reasons they have a particular problem. And in the way he makes checklists for his team during surgery. These are enduring factors which make a good surgeon great.”
India, it seems is finally catching up to Misra. When he finished his training, one of his chiefs strongly discouraged him from pursuing neurosurgery. “In those days, only cardiac surgeries were glamorous,” he recalls. “Nobody talked openly about who their neurologist was because the perception was that if it has something to do with the brain, you’re not normal. Thank goodness I stuck with my instinct.”
The awards, then, are merely secondary. “When everyone tells me a case is not salvageable, but the patient walks out of it in three months, comes to my cabin and asks me, ‘Hi doc, how are you doing?’ That’s the greatest reward I can receive,” says Misra.
Misra has helped Indian healthcare go high-tech, performing South Asia’s first gamma knife radiosurgery in 1997 at Mumbai’s PD Hinduja Hospital and Medical Research Centre. Over the years, he’s pioneered Computer-guided Aneurysm surgery and the awake craniotomy in India.
Misra is president of the Asian Australasian Society of Neurological Surgeons and the World Federation of Skull Base Societies. He is also the first vice-president of the World Federation of Neurosurgical Societies, and visiting professor at 14 medical schools and hospitals, including Harvard Medical School.