His Life’s Work: Interview with a Neurologist

March 30, 2017

This article was inspired by the story of Kalae, which can be watched here .

Dr. Roekchai Tulyapronchote sits at the Neuro Center, reading from a file and taking grateful sips of his black coffee. When I get his attention, he smiles and asks me for just a few minutes while he finishes what he’s doing before we can start our chat. Dr. Roekchai is not a man with a lot of free time, and considering his line of work, I am not surprised.

Looking over a small sampling of his professional history – Mahidol Universtiy, the American Board of Vascular Neurology, the American Board of Psychiatry and Neurology, the Thai Board of Neurology, Cerebrovascular Disorders Fellowship at St. Louis University School of Medicine, Fellowship on Stroke at the American Stroke Association – it’s easy to see why Dr. Roekchai is one of the leading neurologists in the field.

Our interview begins with the doctor telling me that he doesn’t like to seek recognition for what he does, he just does the best he can for each of his patients because it is his duty. He also believes that no other profession would have been right for him because this has always been his passion. Nevertheless, I asked Dr. Roekchai just a few questions about what he does, why he does it, and what gets him through the tough cases. What I walked away with was a small glimpse into the strong mind of a doctor who works tirelessly on behalf of his patients.

Q : So, what exactly do you do here, Doctor?

Dr. Roekchai : I am a neurologist, with a focus on Neuro Critical Care and Stroke, and a particular interest in Hyper-acute Stroke Treatment, Neuro-critical Care, and Endovascular Treatment of Stroke. That’s a lot of words for saying that I work with the brain at its most critical time, usually during stroke or in cases of a sudden onset of a coma or other brain trauma. My work involves a lot of investigation, research and testing because that’s at the core of the scientific method; you posit a theory and test it until you can figure out exactly what is going on with your patient and what you can do to create a positive outcome for them.

Q : What led you to this line of work?

Dr. Roekchai: Without sounding like too much of a dreamer, I believe we are all born with gifts and talents that we should not ignore, but with those gifts also come our own inner voice that tells us where we should walk. It is important not to ignore that inner voice, because when you are working to be highly specialized in your field, whatever it may be, there will be a lot of hours and days and even months when the struggle to achieve higher will feel like a burden. But as long as you followed your voice to the right path for yourself, it will be worth the struggle.

I knew as soon as I started in Medical School that I wanted to specialize in Neurology, and that positive knowledge in what I wanted to do has never left me. Even today, I am excited by new developments and relish any opportunity to learn more. When I have a difficult or challenging case, I see it as an opportunity not only to do my best work, but also to learn everything I can from it. This work requires passion, and the ability to sustain a high level of dedication over a long period of time, because the people who put their lives in your hands need you to be more than 100% there with them every step of the way.

Q : What helps you to get through the difficult cases?

Dr. Roekchai : Without a doubt, it is hope. We show up every day to our jobs with the hope that our best efforts will be met with the best possible outcomes. When I say hope, I am not talking about a passive sense of sitting on the sidelines while waiting for something magical to happen. Rather, the hope I am describing is a state of mind that accompanies direct action. When I have a difficult case, I do everything I can to present my best work to the betterment of my patient. With that effort, I also hope that my work is met with the best conditions that may not be within my control. What I can control are things like my training, education, skill, drive, and even sometimes the environment and equipment around me. However, these things cannot guarantee a positive outcome. Everything else that we can’t control falls within the realm of hope – we hope that the things we can’t control will still work in our favor.

Another factor that I believe helps me get through the difficult times is a willingness to be flexible in my thoughts and actions. Although we wish it were the case, things do not always go according to plan every day. When this happens, what are your options? You can lament the fact that your plan failed and spend your time in frustration, or you can be flexible, roll with the punches, and come up with a better plan. Usually, the latter is going to be a better approach, especially if you have a patient whose life depends on your ability to adapt quickly to changes in plan. Medicine is a science, yes, but at the very core of the scientific method is trial and error. Whatever well-researched treatment plan you may have made for your patient might need to be changed unexpectedly because of the way their body responds, and in that time you don’t have time to be stubborn about your original plan, you have to adapt quickly and be flexible. This ability has helped me get through many tough situations. As long as you prepare yourself with the knowledge that nothing will go exactly as planned all the time, and you are prepared to face it as it comes, you can approach each difficult case with confidence.

That’s it. That’s what I try to do for each of my patients – give them my best efforts, be ready to change as necessary, and always be ready and willing to fight on their side for as long as they are willing to fight. Usually, these things have made a huge positive difference in the lives of my patients.

Dr. Roekchai is the Director of the Neurology Center at Bumrungrad International Hospital’s Neuroscience Center.



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