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An Interview with J.J. “Buddy” Connors III, M.D.

You’ve been described as one of the pioneers of Neurointerventional Surgery. Describe the process that led you pioneer a new field, and what made you so suited for a career filled with innovations?
I did not set out to do what I do now. Indeed, I didn’t even start out in Radiology. But the pseudo “concrete” nature of radiology lent itself to my interest. Then, due to the fact I had some eye-hand coordination (apparently) interventional radiology seemed simple to me. Neurointerventional surgery grew out of Interventional Radiology.

When you say Interventional Radiology, what exactly does that mean?
It’s the ultimate minimally invasive surgery. You make a small nick in the skin, pass tools through that, and use a fluoroscope [essentially, an X-ray videocamera] to guide you while you work. This field was founded by radiologists, largely because we were the only ones who could figure out what we were looking at on the screen, but this sort of work is now done by cardiologists, neurosurgeons, neurologists, and others.

From there, how did you get to working in the blood vessels of the brain?
Due to my proficiency, I kept getting assignments to do more progressive things. The field on catheter work in the brain was new, and we’d started treating aneurysms by filling them in like potholes. We’d block the blood flow to tumors, in hopes of starving them, or at least slowing their growth. If a patient had a vascular malformation that looked to be at risk for bleeding, we’d shut the flow down. The whole field was growing like crazy, but had huge and obvious deficiencies for revascularization of occluded vessels. In the 1980’s and early 1990’s, this whole concept was new, but revascularization seemed like a no-brainer to me [laughs]. If you don’t re-establish the flow of blood to the brain, the chance of halting or reversing the devastation of the brain is exactly zero. You’d be surprised at how may people disputed that. There are still a few, but even the government is starting to recognize the benefit of preventing brain damage in people with big hunks of clot sitting up in their brain.

So, you were in at the ground level?
Pretty much. I wasn’t the first, but I was in on the action when things really took off. We were still making our own tools, or bringing in something with some other use and hoping it would work. Most folks today have no idea how much things have changed. That’s one of the few advantages to getting old…you have a better perspective on things.

Was there an “a-HA” moment for you?
Not for my career; it was a slow ooze…..into it. There have been numerous “it is obvious this is how this is supposed to work” moments, like “it is easier to zigzag up a steep slope than to walk straight up it”. I’ve smacked myself in the forehead a million times, and those moments still happen. I hope they keep happening, because that’s where the learning happens. We’ll keep getting better, but we’ll never figure everything out. There’s always something new to learn.

Do you believe that “going against the grain” is mandatory for innovation?
No…..sometimes the obvious solution works, and sometimes the obvious “dumb idea” turns out to be successful. There are always obstacles in the way of progress, regardless of the undertaking. A lot of rebels only look like rebels at first, because the ignorance that they are fighting is stamped with the seal of majority acceptance. Sometimes, when you’re right, the rebel looks like a visionary, and the former status quo looks stupid. Other times…..

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1 Redstone Science Fiction #2, July 2010 | Redstone Science Fiction { 07.01.10 at 12:55 am }

[…] An Interview with J.J. “Buddy” Connors III, M.D. , Director of Interventional Neuroradiology at Vanderbilt University Medical Center with Paul Clemmons […]

2 J.Watel { 07.10.10 at 7:29 pm }

Great Interview. I met Buddy at ISC a few years ago. What a fireball he is! He must be mellowing, or you hired a censor.