By Quan Xiaoshu, Qu Ting & Li Bin
BEIJING, Aug. 28 (Xinhua) -- Chinese neurosurgeon Li Yongjie can still recall the details of the first brain operation he did to treat Parkinson's disease after he returned from the United States 20 years ago.
"It was the first microelectrode-guided stereotactic surgery ever conducted in China. Although there was an assisting team, no one actually knew how to do it except me," says Li, director of the Beijing Institute of Functional Neurosurgery at Xuanwu Hospital, and a pioneer in his field.
Stereotactic surgery was developed from the stereotactic method in the 1940s. The patient's head is fixed in a frame so that a thin electrode can be precisely directed to the target area in the brain through a small hole on top of the skull.
Hoping the advanced technique would take root in China, Li was clear about the significance of the first operation. He didn't sleep well for several nights before the operation, and went over the procedures again and again in his head.
On July 12, 1998, he completed the operation in eight hours, mostly by himself. "I blended and injected the anesthetics, installed the fixing frame on the patient's head, scanned the brain with magnetic resonance, calculated the position of the target spot, and kept on comforting the patient during the operation," he recalls.
It was a success. More patients came to him. By the end of that year, Li and his team had worked out a set of standard procedures and performed dozens of operations each month, each taking only two hours.
"I brought back the operation skills as a seed, and it has grown into a thriving tree," Li says.
The institute now treats more than 30 neurological dysfunctions, including epilepsy, dystonia and chronic pain, making it one of the world's most comprehensive medical institutions in the sector.
CHOOSING ADVENTURE
Li attributes his achievements to China's reform and opening-up, which allowed him to be adventurous and have a say on his own destiny.
Born in 1961 in Datong, north China's Shanxi Province, Li grew up during the Cultural Revolution (1966-1976). His father, labeled a "rich peasant" who had to be "remolded", urged him to study hard in those chaotic days.
"I was timid and reticent; I had to grow up early and it was lonely," Li said.
China resumed the gaokao, the annual college entrance exam, in 1977. Li was happy to see the nation starting to embrace "the spring of science," which valued education and knowledge.
Good grades gave him confidence. He came top in a provincial physics competition in high school. In 1979, he enrolled at the prestigious Beijing Medical University, now the Health Science Center of Peking University, to study medical science.
"It wasn't really my choice. It was my mother who wanted me to be a doctor," says Li, who took more than five years to agree that it was a worthwhile career. From then on, he was more aware of his inner voice at each decisive moment.
In 1994, Li, with a doctor's degree from Shanxi Medical University, gave up a steady job as a surgeon in Taiyuan, and sold his allocated apartment -- a much coveted goal under the housing distribution system -- to pursue advanced studies at Johns Hopkins Hospital.
"When I was a graduate student, two teachers from the United States had aroused my curiosity of the outside world. They were eloquent and open-minded, and the knowledge and techniques they brought to us were new and advanced," Li recalls.
After China emerged from its long closure and began its reform and opening-up in 1978, many talented young Chinese went to study abroad to expand their horizons and better themselves. At its peak in the 1980s and 1990s, the TOEFL (Test of English as a Foreign Language) exam drew more than 100,000 students every year, as a pass was required for admission to universities and colleges in the United States.
NEW IDEAS
At Johns Hopkins Hospital, Li first witnessed the marvel of the stereotactic surgery, when it was used to treat a woman suffering from Parkinson's disease.
Just seconds after the surgery, her right hand stopped trembling for the first time in 10 years. She turned her hand over and over, and tears welled in her eyes.
"I determined then to master the technique," Li says.
In 1996, he joined the medical center at Loma Linda University, a leader in the stereotactic field. After more than two years, he finished his apprenticeship, reaping gratitude and happy tears from patients. He also got his green card.
But rather than continue his successful life in the United States, he made an unusual decision -- to return to China.
Work and living conditions in China lagged far behind developed countries in the 1990s. More than 70 percent of Li's classmates from university had gone abroad, but only two came back.
"I had no hesitation as I preferred challenges. In the United States, I could foresee my life beyond retirement," Li says. "I would have regretted not seeing all the changes in China, which was developing at such a great speed."
PASSING ON EXPERIENCE
Under Li's direction, Xuanwu Hospital opened the Beijing Institute of Functional Neurosurgery in 1998. The institute has now treated more than 100,000 patients and performed more than 20,000 operations.
Li is always considering new technologies. Stereotactic surgery has been mostly replaced by deep brain stimulation, a new method to treat movement and neuropsychiatric disorders by sending electrical pulses to specific targets in the brain through implanted electrodes.
His institute has ranked first in the world in the number of implanted neurostimulators for 10 years running.
Li also keeps exploring new treatments. "Whenever we treat a new disease, I do all the research work and carry out the operations at the initial stage. But after the surgery program is established and proves effective, I pass it over to my colleagues and students," he says.
He shares his knowledge and experience. The institute has held 16 training sessions, attended by thousands of doctors from all over the country. "Every time, Li takes the lessons and many of the trainees have gone on to become the pillars of their provincial- or city-level hospitals," says Lu Xiaoli, one of Li's colleagues.
"When I first returned from abroad, we were fighting alone. Even the name of functional neurosurgery was unheard of," Li says. "A lot has changed over the years, and hospitals and medical schools around the country are eager to develop or expand their functional neurosurgery departments."
Li wants to accelerate this progress. In the preface to his Functional Neurosurgery treatise published this year, he estimates that more than 5 million neurological patients in China can benefit from proper and timely surgery.
"Such huge potential demand for medical services cannot be ignored, nor can the historic opportunity to propel the discipline be missed," he writes.
Li is now researching non-invasive surgery, and even considering the utilization of artificial intelligence.
"A human brain has 60 billion to 70 billion cells. If each cell were a star, the brain would be as infinite as the universe," he says. "I would like to take more adventures in it."
(Xia Ke also contributed to this story.)
