Here's how 6 spine surgeons prepare before a busy day


For many people, a morning and night routine can help with preparing for a busy day, and the same goes for spine surgeons. Here's how six spine surgeons say they like to prepare ahead for their workdays:

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: What areas of advocacy are you involved with for surgeon and patient concerns? Are there any issues you wish more spine surgeons would engage with?

Please send responses to Carly Behm at by 5 p.m. CST Wednesday, March 1.

Editor's note: Responses were lightly edited for clarity and length.

Question: What are your morning and night routines that help you prepare for busy surgery days?

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (Livonia, Mich.): Mens sana in corpore sano. This is Latin and translates to "a healthy mind in a healthy body" in English. I have always believed in having a sound mind in a sound body. Exercise is an important contributor to mental and psychological well-being. My night routine before a surgical day starts with a focused workout and a healthy meal. Then, I proceed to view the pre-operative evaluation notes and imaging for the surgical cases the next day. After reviewing the surgical plan and key steps in my mind, I have a well-rested sleep. In the morning, my routine consists of a fasted cardio workout to stimulate my mind and body with a burst of energy, and then I proceed to have a light snack. At this time, I proceed to the hospital early to make sure all the operating room necessities are in place and that the patients are arriving as planned and feeling well-cared-for. Then, I answer any of the remaining questions a patient may have.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: On nonsurgery days I like to drive my son to school. We listen to music on my playlist. A lot of times I play something for him that I just heard or he plays me something he's into. We chat about his day or about our plans for the weekend. Then I usually go for a long walk before the clinic starts and get ready for the day by getting physically active. I usually call my brother to check in on him, as he's in practice on the East Coast.

On admin days or days that I have off I like to go for a long bike ride somewhere between 10 to 15 miles; it really helps center me and wind down.

For the evening we always have dinner together as a family. Dinner is device-free unless I'm on call, and we usually chill watching a comedy or National Geographic until my son goes to sleep. Our dog likes to set up shop on someone's lap, just so everyone can get in on the relaxation. Work and life is stressful, and I try to sop up every bit of family time I can.

Edward Perry, MD. Swift Institute (Reno, Nev.): We aggressively plan with patients the clinic day where surgery discussions are finalized, including sharing spinopelvic parameter measurements and approach options with them and highlighting why the final plan is what it is.

As a result, I don't have to spend the night before big surgeries and big surgery days going through the plans again. Instead, my best routine is to spend time with my family, eat a wonderful home-cooked healthy meal that I am blessed to enjoy with my family, with a fire in the fireplace, a game of cards and get to bed by 10 p.m. so that I am fully rested and ready for the 10 to 12 hour day ahead.

Vladimir Sinkov, MD. Sinkov Spine (Las Vegas): Surgery can be quite stressful both physically and mentally. With years of experience, it becomes more routine though. I review the cases the day before and make sure all the arrangements for the surgery (implants, clearances, support staff, etc.) have been finalized. I make sure to get enough sleep and some good nutrition for dinner and breakfast. If time allows, I workout the night before as well.

Jeremy Smith, MD. Hoag Orthopedic Institute (Newport Beach, Calif.): Any good spine surgeon does their homework. The night before a case, I review the images for surgery and go over the plan I prepared to address the issue. I review my notes. In my mind's eye, I imagine each step of the procedure I'm going to do and any potential difficulties I might encounter during surgery. Most importantly, I get a good night's sleep!

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The more labored surgical days are managed like all others. Routines consistently involve individual case review with advanced providers/surgical assist, which follows a meticulous secondary and tertiary checklist met prior to room entry. Our health system provides these anesthesia-led supervisions for high acuity patients. Operational routines characterize efficiency, and these subsequently equate to safety and more desirable outcomes.

What an (auspicious) opportunity to acknowledge our surgical team/health system that has afforded our patients exemplary pre/intra/postoperative care reflective in three decades of noteworthy experiences and creditable outcomes. Being able to complete this kind of complex care on certain kinds of patients is an affirmation to all those professionals who render care within our health system. I am profoundly grateful for all their efforts, especially in the vigil of the pandemic and its ongoing impact to healthcare delivery here and elsewhere. 

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