Once upon a time, before delving into the mysteries of the brain, Madison Michael scaled mountains. A graduate of the University of the South at Sewanee and eager for challenge, Michael headed west after college to take up mountain climbing. He eventually supported himself as a mountaineering guide in Wyoming, where he led climbing groups up the rugged Tetons. As his expertise grew, more distant vistas called: Africa's Mt. Kenya and the highest peaks of the Ecuadoran Andes were soon added to his list of conquests. But despite his love for the outdoors, something about the practice of medicine as portrayed on the quirky TV show Northern Exposure spoke to him. Like climbing, it appealed to his competitive nature, and also to his desire to help people. Michael was accepted to the University of Tennessee College of Medicine and completed his neurosurgery residency in Memphis. There, he worked under Jon Robertson,MD, who soon became his mentor. It was Robertson who introduced Michael to skull base neurosurgery which became his specialty. 

 

As it turned out, mountain climbing was good preparation for the demands of brain surgery. Both pursuits require preparation, precision, and risk. “The involvement of the physical and mental world is what I like. The long hours, the ability to work on a millimeter of tissue for hours on end takes mental patience,” said Michael. “The way we allay our fear of risk-taking is by practice and intense dedication to the mission, by practicing moves you'd do in surgery, by learning anatomy and getting prepared. That preparation can be hours, days, months, or years. The key to success in life is finding what it is you love and doing it.”

 

Michael has always lived by that adage, whether climbing mountains or extracting tumors nestled deep in the brain. Now, in addition to being an assistant professor in the department of neurosurgery at the University of Tennessee Health Science Center and a neurosurgeon at Semmes-Murphey Neurologic and Spine Institute, Michael was recently named medical director for the Methodist University Hospital Neuroscience Institute.

 

Physicians at the Neuroscience Institute treat 2,700 tumor patients annually, “which puts us in the top five leading programs in the U.S.,” said Michael. Many of those brain tumors are rare conditions that appear in just one in 100,000 or sometimes, one in a million people. But thanks to sophisticated imaging technology and tools like Gamma Knife radiosurgery, which enables doctors to eradicate brain tumors and blood vessel malformations with one of the most advanced nuero-radiological treatment options available today, Michael said neurosurgeons at Methodist can offer more precise treatment of tumors.

 

Michael's workload is a mix of consulting with patients, performing surgeries, and teaching medical residents, “Teaching is a big part of my day. And one of the most gratifying,” he noted. Michael also presents a weekly case for the Virtual Brain Tumor Board. The online service, which Methodist launched several years ago, gives surgeons from around the world the opportunity to learn from a multi-disciplinary panel of experts who share their findings and discussions on rare neuro-oncology cases. In addition, the panel reviews active cases physicians submit for review and Michael answers questions doctors post on the Web site. “Some tumors are only treated with chemotherapy or radiation, so having all the disciplines weigh in [on a case] gives the best treatment for the patient.” Michael points to the tumor board as one way the hospital is helping to advance the field of neurosurgery. “There is a commitment on the physician level and the hospital level to make neurosurgery the best in the region. We're committed to pushing this field forward,” said Michael.

 

That commitment also extends to Michael utilizing new, less invasive types of operations, like the craniofacial approach to removing tumors that grow from the sinus cavity into the brain. This form of surgery, which shrinks tumors with targeted radiation and chemotherapy before extracting them through a hole in the skull, means taking advantage of innovations that have occurred in radiation therapy and computer-assisted navigation.

 

“In the old days, doctors did their exam and they had a hunch about what was going on. Much was learned by doing longer incisions for exploration. Now we use microscopes to operate on patients but with the refining of techniques and the advances of technology, we've been able to improve upon [the work of] our forefathers,” he said.

 

As these less invasive surgeries develop, it is leading to shorter hospital stays and better patient outcomes for those diagnosed with brain tumors. Michael knows his patients appreciate such advances, but what makes him good at what he does harkens back to the appeal of doctoring as portrayed on Northern Exposure, “You've got to have both the head and the heart there to be a good doctor. At the end of the day, despite the technology, you're still treating a person and you have to take that into account. We all gravitate toward that kind of person.” Dr. Joel Fleischman would agree.