Neurosurgery is a team sport.
The neurosurgeon is usually the arrowhead the team must rally behind and around.
The plan originates at the arrowhead and is implemented by the team.
The burden of responsibility, however, is always at the arrowhead.
When I am called by the team to see a client, it is because I am the one to decide what must happen.
Sometimes, the neurosurgical management is just a component of the care continuum, and one must stand aside for the other members of the team to implement.
However, because our interventions tend to be disruptive of multiple body systems, we cannot walk away until the work is done.
We neurosurgeons must carry a heavy load, and it is telling, after a while.
This load of responsibility is not that different from the one that all doctors must bear.
Sometimes in medical school interviews we ask prospective students about the leadership status of the doctor in the team, and answers tend to vary widely.
For most people, the multifunctional nature of the team must lend to a system of shared leadership, with responsibility shifting from one functional unit to the next.
However, the whole premise of the physician is that we must be in charge of the physical being of the person.
When a doctor takes charge, it is not partial.
It is this path that we must travel when we take the oath at the beginning of our practice.
We commit to wilfully carry this burden, without complaint, to the best of our ability, to the end.
And it is true that no one takes this oath with us on that graduation day.
We recite it with our hands on our hearts, and it's a pledge we carry nicely framed from the graduation grounds.
We do recite it in the presence of family, friends, representatives of government, and indeed the nation.
It is not a quiet ceremony somewhere in a hidden bunker.
It is in the open, so that the nation can hear these words and agree.
Because the commitment is two- way, and there is not much we can do without mutual agreement.
Recently, as I have watched the World Cup, I have been reminded of the team enablement that neurosurgery requires.
I have also been struck by the parallels between soccer and neurosurgery.
It is instructive that the teams which have won the most games arrange their functionality around specific leaders.
And when these players have a bad day, the whole team has a bad day.
I have felt it when players have had to get up, when the challenge has knocked them down.
I have felt it when against the run of play, one pass from the opposing team carves open the defence that team strategy had hitherto bulletproofed.
There are days when I have come home feeling like Erling Haaland, when he had just led Norway to eliminate Brazil with 2 spectacular goals.
There are also the days when I have felt like Semenyo, running up and down the field with his heart and soul, and not getting a single shot on target.
There are those days when I get home broken and yet fulfilled, because the 7 hours in the operating room paid off when the patient lifted both arms up on the table.
There is a quiet exultation that becomes the high that one must enjoy when it comes, because all neurosurgeons know that it never lasts.
The next day may be one where we push on with the surgery, but we know we are down 4 goals to nil, there are seconds left, and certain defeat must be accepted.
I am grateful for my family who lighten the load, and my Father who keeps empowering me to stand up after each crunching tackle.
And I continue to pray for a system that will keep the pitch grass green.
The writer is a Neurosurgeon
