Mm-hmm.

Um, they, they just, um, have this, um, what you call plasticity or this sort of, um, melding with the technology so that they're not a- actually thinking about, "Oh, I, um, I've gotta imagine my hand holding that mouse and moving it to the left." They, they...

It becomes more instinctual.

And I think there's, um, you know, um, this ability of the technology to sort of differentiate the signal and to be able to, to know the intent without having the person actually, uh, go through that process of thinking about that image.

So that's, um, I think a version of plasticity that is happening with these devices where, you know, you, you kind of, um, you settle in with it.

And, um, you, you kind of, um, learn, uh, what it takes to drive the device or the algorithm, and it, it becomes more seamless and more, uh, intuitive.

Uh, and I think that's happening.

When you look back in your time, do you think that there is one patient story that stands out to you?

Mm-hmm.

Um, they, they just, um, have this, um, what you call plasticity or this sort of, um, melding with the technology so that they're not a- actually thinking about, "Oh, I, um, I've gotta imagine my hand holding that mouse and moving it to the left." They, they...

It becomes more instinctual, and I think there's, um, you know, um, this ability of the technology to sort of differentiate the signal and to be able to, to know the intent without having the person actually, uh, go through that process of thinking about that image.

So that's, um, I think a version of plasticity that is happening with these devices where, you know, you, you kind of, um, you settle in with it and, um, you, you kind of, um, learn, uh, what it takes to drive the device or the algorithm and it, it becomes more seamless and more, uh, intuitive.

Uh, and I think that's happening.

At a, at a neuron level, you know, plasticity is a lot of different things.

It's, um, you know, the frequently firing neurons, they learn to...

Mm-hmm.

Tell us a little about your journey and then how to advise young people who are trying to develop mastery, not competence, mastery.

Yeah.

Well, it's hard to unravel where I am today and where I began.

But I just trained with Dr. Spetzler, and I saw a master surgeon doing his craft.

And when you see something that's inspiring, you just want to imitate.

And so for me, a lot of it was just wanting to get to his level and then finding that I really enjoyed the process of learning.

satisfying thing to use your hands to build something something like bypass surgery which you're asking about you're creating something from nothing and when you can develop the skill level to make that happen in front of your eyes and bring that to life.

it takes decades right and i'll tell you how pedestrians we spine surgeons are neanderthals when i have a new resident coming in and i'm like oh that that you know you've done better I'll be like listen here's what you're gonna do you're gonna go to Home Depot you're gonna get a box of a thousand nails and a two by four and a hammer and you're gonna hammer a thousand nails into the wood and then you can come back to my OR okay now I'm sure that's not how you train or at least at the early stages microvascular surgery or microsurgery tell us about some practical steps what can people do do they have to go to the lab