• Pediatric Neurosurgeons
• Famous Neurosurgeons
• Neurologists
• Advice about the Brain

Richard Nagle performed neurosurgery on my daughter several years ago. He was a kind and gentle man. The surgery was long & complex, and successful. I trusted him with my daughter's life, and he was deserving of my trust. Dr. Zovikian was in the same practice, and visited us at the hospital once or twice after the surgery, and he seemed like a good man and a fine physician too.

My son has been treated by Dr. Nagle as his primary neurosurgeon. (I say "primary" because he has seen all the other neurosurgeons in the group, except Zovickian, at one time or another since they back each other up.) I have nothing but positive things to say about Dr. Nagle, who is a soft spoken, caring person, who inspires confidence by straightforward talk. I have full confidence in his surgical skills (although I really have no basis to judge -- he just inspires my confidence). In my son's case (which involved a somewhat complicated case of hydrocephalus due to Dandy-Walker Syndrome), I would say Dr. Nagle is on the conservative side in recommending surgery. In contrast, Taekman has seemed to me to be somewhat more aggressive, e.g., quicker to insist that my son be admitted to intensive care.

Nagle was good in explaining options about the different kinds of surgery that could be done. He did have clear opinions about what he planned to do (which from my point of view was fine, since I was in no position to determine which kind of surgical procedure was better). But he did listen to the opinions of other doctors (in the beginning I took my son to a pediatric neurosurgeon at UCSF, who suggested a different procedure). In the end, Nagle consulted with a different colleague at UCSF about how to handle my son's case and changed his approach. He ended up doing the first surgery in the way that the UCSF pediatric neurosurgeon I had seen would have done it. The shunt failed within a few months and was redone as Nagle had first proposed. There were complications with the revision which scared me, but Dr. Nagle took it all in stride and assured me he would get him out of the hospital (which he did). The revision ultimately failed as well a year and a half later, but by then my son seemed to be o.k. without a shunt (much to all the doctors' great surprise). I periodically take my son in for follow-up, just to make sure he is doing o.k., and always enjoy the office visits.

My youngest daughter (now age 7) has acquired hydrocephalus (which was diagnosed at 13 days). She was "shunted" at age 6 mos and her neurosurgeon is Dr. Zovickian (of Taekman, Nagle & Zovickian). She was seen by Nagle & Taekman as well, both in the days before the diagnosis and post-op. They were both thoughtful and helpful. Dr. Zovickian is a very reserved person (those who know him will now be muttering "that's an understatement"). What I most appreciated about him was that when it was time to focus on my daughter, we had his full attention. I didn't at think he was anywhere else but with us. He is an excellent surgeon and I trust him completely.

i am a special educator locally and have heard nothing but praise for dr. taekamn. the families i work with are very pleased with his work. -K

Jenny 10/99

I am posting for a good friend of mine who needs cervical disk surgery and
is looking for recommendations for brilliant neuro-surgeons. He has had a
couple of consultations and wants to be sure he has chosen the right doctor
for him so he is looking for further names. If anybody has experience
either good or bad we would appreciate your posting.

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Kathleen

I'm a bit cynical about famous neurosurgeons, based on experience.  I had
cervical disk surgery twice.  The second surgeon was world-famous, the
head of a Northern California university teaching-hospital neurosurgery
unit.  The operation and post-surgical care were immediately followed by
long-term problems that may have been avoidable.  (My spinal cord swelled
up and was damaged).  When the symptoms showed up a few days after
surgery, someone on the surgeon's staff said I wasn't supposed to be
having the symptoms I was experiencing, but nobody followed up.  The
surgeon seemed to think it was my problem -- as if I was being an
uncooperative patient by not getting well.

Some problems with using a world-famous surgeon:

1) He or she is probably a professor, and residents have to practice on
someone.  Of course, your friend can ask about this, but how can you
really tell who did the actual surgery?

2) He or she may be more overconfident even than the average neurosurgeon
-- it takes a lot of arrogance to cut into somebody's brain based on a
fuzzy MRI.  The downside of arrogance is that if something goes wrong, the
doctor may be unable to admit it to him/herself, and respond early.  This
may have contributed to the problems I now have.  Plus it's damn
irritating!

3) Disk surgery is relatively routine neurosurgery.  World-famous
surgeons, sought out for the tricky, nonroutine surgeries, may get less
practice on disks.

4) World-famous surgeons maybe get less sleep than the less famous.
(Mine had been at work for 10-12 hours before he got to me.)  Plus they
may be past their prime -- they're famous for what they did 10-20 years
ago, not last week.

My advice:  Don't be in a hurry; do your homework on what the surgery and
post-surgery entail.  Ask several neurologists who they would recommend -
it may not be the famous guy.

How often does the doctor do this type of surgery?  (It should be weekly
or more often.)  Does the doctor prefer laminectomy only or does he/she
also do fusion?  What type of procedure makes more sense to your friend?
Does the doctor reschedule you if a prior operation keeps him/her working
late, or does the doctor keep going no matter how tired?  Does your friend
have any say about this, can your friend get schedules for early in the
day?  What does the doctor use to prevent swelling (prednisone, naloxone,
something else, nothing?)

Does the surgeon *listen* to your friend?  How does the surgeon follow up
on patients while ensuring objectivity?  (If you asked my surgeon, he'd
say my surgery was perfect.  But he didn't much listen.)

What about the hospital?  Nurses can catch (or make) life-and-death
mistakes.  So can observant friends and family.

Please don't use my experience as reason to worry overmuch.  My spine was
a mess from multiple injuries and hard to operate on.  To the extent I was
injured, I've gotten much better over time.  And while I'm still ticked
off about the whole thing, I also recognize that I did need the surgery,
and would be much worse off without it.