Dr. Duke, who operated on magician Roy Horn after the onstage tiger attack in 2003, has practiced in the Valley for 14 years. He earned his degree from the University of Missouri, Kansas City, in 1993. Duke serves on the St. Rose Dominican Hospital Community Board and on the honorary board of the Nevada Society for the Prevention of Cruelty to Animals. Here are the highlights from his recent interview with Paul Szydelko:
I had an excellent mentor in medical school—Dr. Setti Rengachary. He had written some of the major texts for neurosurgery. We wrote papers together and book chapters. After I participated in neurosurgery with him, I knew that’s the type of surgery that I wanted to do. He was very passionate about education and teaching.
It’s really fascinating to watch how technology has changed the way we do surgery, even in the time since I left the Mayo Clinic [in 1999]. We’re able to help people using less-invasive means than were available even 10 years ago.
One major advance has been the development of a type of plastic that can be used in the inter-body space that allows us to not use donated bone anymore. We don’t have to worry about issues related to foreign tissue. Also the development of certain types of products that help bones heal faster has been very helpful in achieving a higher success rate in terms of fusion.
Procedures don’t take as long as they used to. Patients can have an operation that used to take three to four hours in about an hour. It’s surprising to people that it’s not as long a process, and the hospital stay is much shorter.
Better artificial-disc technology is also foreseeable—devices that replicate normal motion better, so they do the job of replacing the disc better.
Most patients come to me with pain complaints that have become intolerable. They’ve tried some conservative measures that have not been effective. When they first see me, they have no idea what type of surgery they may need or if they need surgery at all. Everyone coming in to see a spine surgeon would have some initial fear of the unknown.
The psychological part of what I do is probably the biggest part that people don’t know about. Psychology plays into pain complaints, it plays into interpretation and expression of pain complaints. You have to be very tuned into the psychology of the patient; you can’t simply look at an MRI alone and know that somebody needs surgery.
I was there when Mr. Horn came to the emergency room at University Medical Center. I was operating on a 1-year-old baby who was in a car accident and who had a brain bleed, and I was just finishing up. What I remember most is the strength of Mr. Horn—both physically and psychologically—that got him through this. If you look at the science behind what all happened, he really shouldn’t have made it.
A more recent memorable patient was a 30-year-old woman who had back pain for a few months and also pain that radiated into her legs. An MRI showed a 2-and-a-half-inch-long-by-an-inch-around tumor that was compressing her spinal cord. Going into that surgery I didn’t know if it was going to be benign or malignant and whether or not the whole thing could be removed. I was very concerned about her future. Fortunately it was a benign tumor, I was able to remove the whole lesion, and because of that, she will be fine and not have to deal with this again and live a normal life.
The satisfaction is really incredible in changing people’s lives and relieving them of pain and helping them become functional again.