Neurosurgeons Discuss Their Craft

Jeffrey Dembner, M.D., and Mary Mancini, M.D., compare notes on the changes in neuroscience.

Neurosurgery is one of the most technically challenging disciplines in medicine. The nervous system—comprised of your brain, spinal cord and nerves—is made of billions of cells making trillions of connections. And when damaged, these cells generally do not grow back. Neurosurgeons operate on the brain, skull, neck, back, spinal cord and the blood vessels supplying these organs in order to preserve the delicate network driving thought, behavior and movement.

NorthBay Medical Center recently welcomed neurological surgeon Dr. Jeffrey Dembner to its medical staff. But Dr. Dembner isn’t NorthBay’s first neurosurgeon. That honor goes to Dr. Mary Mancini, who opened her practice at the hospital in 1986, fresh from her residency, and is now retired. She currently serves on the NorthBay Healthcare corporate board of directors.The two surgeons recently sat down together to discuss their profession.

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Dr. Mancini: Neurosurgery is dramatically different now. When I began practicing we didn’t have the impressive array of medical equipment that is available in NorthBay’s new operating room. This is a quantum leap in technology and a huge addition to medical care in this community.

Dr. Dembner: I’m truly impressed by NorthBay’s willingness to invest in the equipment necessary for a successful neuroscience department. I’ve never seen such a thorough exchange of learning or an execution of new ideas and practices occur so quickly and efficiently, and have it be so well-received.

Dr. Mancini: When I began my practice, the hospital’s goal was to have a neurosurgeon. But there were times I had to refer patients to UC San Francisco, because I didn’t have the sophisticated equipment now available.

Dr. Dembner: There is very little that I feel I will have to transfer to another hospital. The thought of brain surgery scares people. They think consulting a neurosurgeon means they will leave with an appointment for surgery. But much of my practice is the medical management of neurological diseases. That means I’ll see many spine patients, for example, who don’t need surgery but who will benefit from my consultation and care.

Dr. Mancini: Fortunately for this program, you have the same CEO now that I had in 1986. It is rare for a hospital to have a CEO this long, but Gary Passama has proved a visionary for meeting the healthcare needs of Solano County. He knows a successful program takes more than
a good doctor.

Dr. Dembner: I know NorthBay wanted to hire a neurosurgeon for some time and with the determination to apply for a Level II trauma designation, the time was right. But I’m bringing NorthBay so much more than they expected. I’ve been introduced as a trauma surgeon, but I want to be clear that I am not just a trauma surgeon. While I care for head and spine trauma, I came here with the desire to build a comprehensive neuroscience program.

Dr. Mancini: When I started at NorthBay, by default, everything came to me. A good deal of my first year was spent in dealing with traumatic injuries. In fact, my first case came before my official start date. The first day I was at the hospital a trauma case arrived—a 15-year-old girl with
a severe head bleed. I saved her life, and that began a lifelong friendship between me and her family.

Dr. Dembner: When you make a dramatic difference in a patient’s life, you want to keep in touch and know they’re doing well. Nine years ago, a woman with a brain tumor came to see me. She had been told her tumor was inoperable and fatal, and she wanted a

Dr. Mancini: One thing that hasn’t changed in our profession is the human element.

Dr. Dembner: You’re exactly right. All of this magnificent new equipment is really the standard of care everywhere. Any hospital can buy it. Patients do their research and they demand it. Neurosurgery is so complex and the majority of my patients won’t come from the emergency department, they will be referrals and patients looking for the best physician they can find. And now they need not travel beyond central Solano County.

It’s the people who make a neuroscience department successful. I’ve been described as an “old-school new doctor.” I’m very hands-on and positive outcomes are very important to me. I care for my patients for the entire length of their treatment.

Dr. Mancini: I did the same. There were times when every patient in the ICU was mine. Now intensivists work in the ICU and share in some of the responsibility for care of the patient.

Dr. Dembner: Having an intensivist, or hospital-based critical care specialist, in the hospital 24 hours a day is a tremendous benefit for patients. But that doesn’t mean I don’t manage the care of my patients before, during and following their hospitalization.

Dr. Mancini: I think patients
appreciate it when one physician has the ultimate oversight of their care.

Dr. Dembner: My ultimate goal
is excellent patient care and excellent outcomes. I have ownership of this program and I spend all of my time at NorthBay Medical Center. I live
in Fairfield and I have a long-term commitment to this community.

Dr. Mancini: Neuroscience is a
real game changer for our community. I’ll look forward to watching the service develop and supporting it as
a board member.