In surgery, there is no window for error. A slight mistake or even the smallest of errors can be the difference between life and death.

No doctor wants a complication, and this is something that sees specialists such as Dr. Valdes Rios Jose Enrique, and the entire team that he works with carefully calculating each and every step of any procedure that they undertake.

Dr. Rios is a Neuro Surgeon, and his clinic, Valdes Dreams is based at Lenmed Bokamoso Private Hospital.

“Neuro surgery is a complex field, and one error can cause the death of a patient,” he explains.

A Neuro Surgeon is a specialist doctor who diagnoses and treats conditions related to the brain, spine and other parts of the nervous system.

Their work revolves around neuro oncology - brain and spine tumors, neuro- trauma - brain and spine injuries, which can be caused by a sudden injury, and includes concussions, and traumatic brain injuries, neuro vascular surgery, paediatric neuro surgery, spinal surgery, pain management, epilepsy, as well as stroke and skull base surgery.

His field of medicine is very complex. But it is this complexity, that he loves dearly about his job.

“Neuro surgery is a complex field of medicine. We deal with people who have conditions such as brain tumour, abscess, or traumatic spine injuries. We also see patients who have genetic conditions,” he explains.

He says that the most important thing as a doctor is to see a patient smiling after a procedure. He admits that not all procedures go well at 100 percent and that sometimes, complications might arise, but the attention that the doctor provides to the patient goes a long way.

When he sees happy patients, it gives him great joy. His wife is a doctor and sharing his exciting days with her after a busy day is the highlight of his day. Most of us have routines and rituals that we undertake before embarking on duties.

During theatre days he plays classical music in theatre. Classical music, he says puts patients at ease, and makes them forget and stop worrying about the procedure at hand.

For the doctor, classical music makes him relax and focus. Surgery or any procedure that involves delicate organs such as brains can be stressful not only on the patient, but on the doctor as well.

In theatre, it is better to have four hands than two hence he pairs with his colleague, Dr. Rodriguez on his theatre day which is Thursday. In his clinic, he sees about 20 patients a day.

As a General Neuro Surgeon, he is able to work on both children and adults on the central nervous system. This involves brain tumors, congenital malformations especially on children, and spine problems.

Epilepsy is another condition he attends to. In some cases, patients might not respond to medication for Epilepsy, and this is where surgery might be needed but there is a criterion for that procedure.

At the moment, he is not operating on Epilepsy patients as this requires certain technologies. He points out that they are bringing more technology to Bokamoso to advance the care and treatment that they give patients.

“This year, we are expecting more equipment to improve the quality of treatment that we give patients,” he says.

Brain tumors, for example is undetermined. But some tumors, can occur during pregnancy. The most important thing is to treat them. Some of these tumors might be benign, but the majority are malignant. In their field, they interwork with other doctors such as oncologists.

For a population of Botswana, he says that the country has more accidents. He recently operated on two patients aged between 25 and 46 years who suffered cervical spine injuries following a car accident.

“A patient can come with a spine injury from a car accident, or they come with spinal stenosis and disc herniations, which is a condition between vertebrate affecting the roots”. He says such patients present severe pain on the leg.

The disc might be removed to fix the problems. The spine might have a tumors and degenerative diseases. Explaining further on spine injuries caused by car accidents, he notes that this mostly affects young people.

The patients had spinal compressions, and are quadriplegic. After procedure, they need rehabilitation for a long time.

“The aim of the surgery was to align and decompress the spinal cord . The patients already had motor deficit and will need neuro rehabilitation,” the Doctor says.

It is difficult for young people or anyone to be walking one day, and the next they are not. As a doctor, he says that miracles can happen and what is important for their healing process is for them to have faith.

Some patients might have an injury at one level or multiple level stenosis especially in elderly patients. The aim of the surgery would be to eliminate the cause of the compression. After surgery, pain will disappear immediately after.

Normally, a patient will come with neurosurgical diseases, for example brain tumors , and this would be an elective procedure. His job would be to sit down with them and explain the treatment and procedure that will be done, and the complications that can happen.

No doctor wants a complication. Sometimes, bleeding might happen, especially when intra complications happen.

“Complication can happen even with the more experienced hands,” he points out. For patients’ safety, and surgeons, he says that they want to create a top level neuro surgeon facility at Bokamoso hence the new technology.

He will undergo training on endoscopic procedures, which is a minimalist procedure this year. This procedure will be offered soon at the hospital.

He says the brain is sensitive and is one of the most important organs of the body. They manage trauma patients with head injuries, and skull fractures, and tumors in different locations of the brain, as well as accumulation of fluids on the brain.

Congenital malformations will spina bifida, which happens during pregnancy. Some of these conditions might result in disability. Botswana currently has three neurosurgeons in private and four in public hospitals.

His late father who was a Neurologist inspired him to venture into this field. He wanted to learn more and study the brain and spine, but wanted to go beyond what his father was doing as a Neurologist.

Born in Cuba, on his arrival in Botswana, he worked for Princess Marina Referral Hospital where he started Spine Surgery. He recently ventured into private practice.

“I wanted to help people not only with my knowledge but with my hand,” he says.

Presently, he says that not lot of people go into this specialty. In his country, he says that only one person in a district town could train as a Neuro surgeon.

To enter the specialty in Cuba, he also says that one had to do an exam, where they are tested on their knowledge of the central nervous system and also had to have a certain level of IQ.

In total, a doctor takes four years to qualify, but to acquire experience and be able to perform complex procedures, they will have about four or five years of experiential learning.