Zibby interviews internationally renowned pediatric neurosurgeon Dr. David I. Sandberg about BRAIN AND HEART, a warm, brilliant, and unforgettable memoir that captures the medical and emotional intensity of pediatric neurosurgery. David touches on navigating difficult conversations with families, his experiences performing surgery in low-resource countries like Haiti, and the toll—and joy—of a life spent caring for children in crisis. He also opens up about his recent Parkinson’s diagnosis, his difficult decision to step away from surgery, and his plans to pursue a new path in social work.

Transcript:

Zibby: Welcome, David. Thank you so much for coming on Totally Booked with Zibby. We are interviewing you. I have a special guest host today, my mother-in-law, Miriam Padberg Owens. Welcome to you. 

Miriam: Thank you. Thank you. 

Zibby: And welcome to David Sandberg.

David: Thank you so much for having me on your podcast. I'm so honored. 

Zibby: Oh my gosh. I'm honored to even talk to you. You're such a hero. Seriously. 

Miriam: Hero. 

Zibby: And as we were just saying. So my husband, Kyle's father Bernard, is married to Miriam and she was in Haiti when you were there and met you in person as a huge fan, and that's why we are doing this together. She happened to be reading your book when I was prepping for the podcast, so it's perfect. 

David: The crazy coincidence. Crazy coincidence. 

Miriam: The crazy coincidence. Absolutely. 

Zibby: So brain and heart, the triumphs and struggles of a pediatric neurosurgeon. This book was absolutely gorgeous, instructive, emotional, inspiring. Why don't you tell listeners why did you decide to write this book and what is it really about? 

David: Thank you so much. So I've been a pediatric neurosurgeon for over 20 years, and I never thought I was gonna be an author. I started. Writing down stories, little tidbits of stories, because the stories we see are crazy and memorable, and I'm like, I wanna remember this.

Maybe I'll write something about it one day. That's the first thing. And the other is I have a lot of difficult conversations with families, a lot of amazing conversations with families too. And during those conversations, I choose my words. Very carefully, but often there are other thoughts that go through my mind and I've often thought to myself, it would be very interesting for families to know what I'm actually thinking as I have this conversation.

And I thought that those conversations and what I'm thinking would be helpful not only to families of patients I've treated, or patients I haven't treated, but who've had children or other relatives with serious medical problems, but also, or. Young people who are considering a career in medicine or a career in neurosurgery or a career in any surgical specialty to see if this is a good fit for them, if this is right for them.

Zibby: You know, you wrote something so interesting in the book, which is after you described the many conversations you have with parents, your approach, the honesty, the, you know, trying to just distill everything, not shroud it like some doctors, you said, despite your many, many years of training, no one ever taught you how to have that kind of conversation.

David: Yeah. It's kind of crazy. I think. These days in some medical schools, but not all. There is a little more training on interaction with patients. I received absolutely none, and actually when I have these difficult conversations with families, when appropriate, I always try to bring along the most junior person on our team, whether it be a junior resident, a medical student, to just sit there with me and I introduce them and I say, is it okay if they're here and I have them listen to what I say.

When a child has died or when a child is, is parents are being given a terrible diagnosis. And what I tell them afterwards, first of all, I check to make sure they're okay, but what I tell them afterwards is, listen, I. You may have some of these conversations in your career, and what you should do is watch other people have them as much as possible, and pick out the pieces you like from what I said, eliminate the stuff that I said that doesn't resonate and form your own style. And then I tell them my opinions on what should be included in those conversations. 

Zibby: You also wrote about even the training of, uh, and then we'll get away from the, the medical training pieces of it, but I found them so interesting. You talked about how in your day, so to speak, you were a hundred hours a week and nonstop, and you would stop anything and always would, and that now there are all these guardrails set up for residents, you know, to protect their sanity and mental health and obviously years.

Navy SEAL training type like was, was hard to bear, but that, is there something lost in regulation of, of the time and the work life? Can you talk about that a little bit? 

David: There's definitely something lost. I mean, I think the purpose of restricting work hours was the idea that you've got tired residents who are gonna make mistakes because they're tired.

What they didn't account for is that one of the major causes of mistakes in medicine and there are so many, is poor communic. And the more handouts there are, the more times you're signing out to somebody else instead of staying on yourself. The more opportunities there are for miscommunication, which can lead to disaster.

Not to mention the fact that there's a certain ownership that we should take. Of our patients as doctors, if I have a sick patient in the hospital and that family is depending on me, that's my patient. And it actually doesn't matter what else I have going on or what time I got to the hospital that morning or the day before.

And that's an attitude that I think is really important to instill because these are tough. Fields that we're in. And it takes a certain mindset, a certain passion for it, not a shift worker's mentality. Like, oh, my shift is done, I'm gonna leave no matter what's going on in the hospital. There's a balance, obviously, and I may be a little crazy, but 

Zibby: Not at all.

Miriam: Mm-hmm. 

Zibby: Um, you talked in the book too, about. How sometimes as a doctor you essentially have to play God in one of those situations. Miriam was there for, and you wanna describe what he was saying in the book? 

Miriam: Well, in the book you were, and this, this is something that I met you at that moment there and I was so impressed with everything that you were doing for those children.

I did not have the background information of all the other children you were unable to help and knowing what their destiny would be and having to say no and move on, and that is something that I'm not sure. How do you. Compartmentalize that. How do you move forward? 

David: Yeah. I mean, first of all, Mim, I wanna thank you for being kind to our team when we were down there, kind to me, um, bringing us food that we desperately needed to do surgery after surgery, after surgery.

And you were just incredibly kind to us, and I'll always remember you, and I'm grateful for that in terms of, you know, quote unquote playing God. When you go to a lower middle income country and do these trips and the poorer the country, the worst of situations. So in Haiti, there was such an overwhelming need. Yeah. And there would be maybe a hundred patients who would come to. Be evaluated. Some would come from far away villages. 

Zibby: Yeah. 

David: And we could only stay for a certain number of days, and we could only do a certain number of surgeries, maybe 25 surgeries. A lot of the patients were not good candidates for surgery or they were too sick.

Zibby: Mm-hmm. 

David: They had malaria, they had other illnesses that made surgery unsafe. Some children were excellent candidates and we made sure that they were, their surgeries were done. There were others that were kind of good in some ways, bad in some ways. Very complicated to explain how we would choose, but we basically had to play God and choose which patients would get surgery and which wouldn't. And it is an awful feeling. 

Zibby: Yeah. 

David: And I talked about it with my team all the time. We talked about it in meals, we talked about it beforehand. We talked about it during and after, and we all talked about how awful it was, but the alternative was, you know, not helping anybody. And so it's a feeling I've never gotten used to and never want to have.

Miriam: I do wanna also mention that this was for you and your team, your personal time off, and then for you to choose to go to countries like Haiti and Guatemala and everywhere else that you've been, makes you and your whole team, each one of you heroes. 

David: I don't know if we're heroes. We're passionate about what we do.

I mean, in terms of time off, you know, during the residency years we were, I was working so many hours. I chose to, we, we used to get a one month block of vacation all at once and then just work for 11 months. It was just easiest for scheduling. Mm-hmm. They don't do that anymore. It's kind of stupid. But in any case, I went for one of those years.

I went to Honduras for my month of vacation to do neurosurgery. It was a joy. It was an amazing experience. I wouldn't trade it for anything else. It's a privilege to be able to go down to these countries and help other people and teach other people how to do these surgeries so that they can do them when you're gone. Yeah, and it's so rewarding. It, it's a, it's an incredible gift. 

Zibby: So you are married to a college friend of mine, Amy Scheffler, and I was delighted to see her picture at the book, at your wedding, and the amazing story of the, of the girl that you helped, it was her and her sister were.. 

Miriam: Mm-hmm. 

Zibby: In your wedding and all of that. But you did share the story of when she was with your daughter Dalia, who fell off the bed and became a potential patient of yours. Can you just talk about the fear and how that moment affected you as a doctor and a dad? 

David: Yeah, I'm very lucky to have met your friend Amy and married her. She is the woman of my dreams and she's incredible. 

Zibby: Aw, that's so sweet. 

David: You know, I, I had a few moments I shared in the book where the tables were, were turned very briefly and I got a glimpse of what my patients go through. We take care of so many. Patients who have head and spine trauma, and it's traumatic not only for the patient but for the family and the parents.

You can only imagine very severe head traumas minor, everything in between. In this circumstance, I was at work, we were in Miami at the time. I was on the faculty at the University of Miami and working at Miami Children's Hospital, and I'll never forget the call from Amy. And I could hear Dalia, my 2-year-old daughter, screaming her head off in the background.

She was like, you know, Dalia fell off the bed. We had a high bed. She hit her head on the post. It happened so fast. I turned my head for a second and she sprinted off the bed and fell. She was two years old and she has a big goose egg under her skin and I was like, bring her to the hospital right now. We brought her in and we got a CT scan and I was like, oh my God, my daughter is gonna have a blood clot in her brain that needs to be removed.

I can, I can't believe this. Who am I gonna get to do the surgery? Is she gonna be okay? And as it turns out, we got a CT scan and it was absolutely fine. There was nothing there. And she was fine. But I, it was good for me as a doctor. I enabled, it, enabled me to experience for two minutes. What the anxiety is that my families go through.

Miriam: Yeah, so originally I'm from Holland and after reading this book, I literally wanna go out and hand out helmets to everybody, all the Dutch people, because they are biking everywhere and no one wears a helmet, not a child, not an adult. And it's shocking to me. It's absolutely shocking. How can that message be put out?

David: Yeah, I've been a pediatric neurosurgeon for a long time. As I said, I have never seen, I've seen a lot of kids who are riding bicycles who are hit by cars. Right. It happens all the time. 

Miriam: Yeah. 

David: And I've never seen one who's wearing a helmet have a serious head injury. I've seen some minor traumatic brain injuries with helmets, but I've seen so many children who have died, who have had life changing severe.

Brain injuries when they're not wearing helmets. Parents that tell me sometimes, you know, but he won't wear it. She won't wear it. 

Zibby: Yeah. 

David: Wear the helmet. I was like, I'm like, you're the parent. Take away the bicycle. They can only ride the bicycle if they wear a helmet. It's that important. 

Miriam: They, especially now with the electric bikes, goes even faster.

David: Correct. Yeah. 

Miriam: Okay. 

Zibby: And you also said that you wouldn't let. Your children play football. I have a son who plays tackle football, and I'm embarrassed to tell you that, but now I'm rethinking my decision. 'cause you're like, this is the worst idea ever. Which of course I've heard a million times, but just say it in a new way.

David: No, I mean, let's be honest here. There are some things that there's no controversy about for head trauma. If you have a gun, you gotta lock it up right there. There's no controversy about that. For, for neurosurgeons would tackle football if you get a bunch of neurosurgeons in a room. Some of them would have no problem having their own children play tackle football and others would feel strongly against.

You know, it's, it's a judgment call for me personally. You know, I tell my own son who wants to play football and I don't let him, you're gonna make a living during the week, not on Sundays. You're not gonna be a professional football player and. The risks are what I've seen. I've seen, you know, some high cervical spinal cord injuries from tackling, and those patients can't walk and they're never gonna walk.

And it's not that many of them, but it's enough. And the concussions and the chronic traumatic encephalopathy that you see in the professional athletes and we see it, we see long-term effects in some of the high school athletes too. It hasn't been studied well enough. There's controversy surrounding it and most people, most kids who play tackle football are fine.

So, and it's a great sport and there's a lot of team building and you know. It. It's a hard decision. I've made the decision for my son that I wouldn't let him play, but that's 'cause I'm biased by all the bad things that I've seen. 

Miriam: Mm-hmm. Yeah. 

Zibby: So this is sort of a random question. Your sister is Cheryl Sandberg, obviously. Yes. Who is so accomplished and doing so much by the way, for the Jewish people, which is. Amazing. So that's wonderful. What, and you're obviously just so incredibly successful, what are the secrets, what did your parents do right that raised you two to be such kind, giving and also brilliant people? Some genetics obviously, but like, is there anything looking back that you took from your parents and maybe you're using for your kids?

David: My parents are amazing. They're, they're wonderful parents. I don't think there's some magic formula. I, I'll tell you what they did. They were, compared to other parents, I think they were on the stricter side when we were young, and as we got older, they were among the most lenient. Um, we didn't have curfews or things like that.

I don't know if that matters in terms of the values they taught, honesty, hard work, service to others. We were constantly being told how lucky we were. We were constantly being taught by their example of service in various ways. They were activists in the Soviet jury movement, helping Jews who were persecuted get out of it.

Soviet Union. My dad took me with him on three medical missions to Jamaica, the Dominican Republic and Antigua. Those were eye-opening for me in high school and college, and solidified my desire to become a doctor. They're wonderful parents and wonderful people. 

Zibby: Amazing. All right. Just hoping for some hacks. Gotta get my kids to turn out okay. Really. And I understand, I don't know if this was a, a public that Amy put in her email that you have your own health issue going on at the moment. Can you talk about that or not? 

David: I do. So I'm 53 years old. I'm at the peak of my career, um, and unfortunately I've recently been diagnosed with Parkinson's disease.

I started developing a tremor of my right hand some months ago. It was, and still remains very mild and very intermittent. Hasn't affected me doing surgeries, but you know, you see professional athletes who stay on the field too long and people think, oh, they were amazing, but they should've. Gotten out early, while their skills were still at their peak.

I decided that I wanted to be one of those athletes who got out early. Not that I'm an athlete, but I decided to stop during neurosurgery at the peak of my career because I don't know what's gonna happen and I don't want. To harm a patient or even have the perception that I would even consider entering an operating room if I could possibly harm a patient.

So I kind of shocked the world over the last few months, starting in January, and basically I stopped doing surgery cold Turkey. I'm finishing my neurosurgical practice at the end of June, mostly saying goodbye to patients and families and making sure they're set up for care. Wrapping up research studies. And yeah, that's where I am. 

Zibby: And so what are you going to do? And I'm so sorry that this is happening, by the way. 

David: No, you know, you know, you, you don't have to be sorry. Look, you know, it was, it was hard to come to that decision 'cause my surgeries were going great and I loved doing surgeries and it was hard telling my children, telling my parents, my sisters, my patients, their families, my colleagues.

And I had to do that kind of all at once. So it was hard, but. Once I got through that, I have so much gratitude, gratitude that this happened in my fifties, not my thirties or forties. I've had a wonderful career gratitude for the thousands of children. I've been able to help gratitude that my symptoms are relatively mild and hopefully I'm gonna live a long time and do good things.

So the things that I love most about my job, one of the surgeries, the other, the only thing that trumps that is the relationships with families. And I can still have that, and I can still do good in the world. I've decided to go back to school and get a Master's in social work. I'm gonna be University of Houston to get a Master's in social work starting in August, and my goal is to do something related to childhood poverty. You know, work with homeless children or children in the foster care system. I haven't defined it perfectly, so that's, that's my plan. 

Miriam: Wow. I told you he's a hero. 

Zibby: I know. You feel like you need that. 

David: I'm not a hero. 

Zibby: Do you feel like you, you feel like you need the degree to help? I feel like you could just like get out there.

You've already been so helpful. 

David: It's kind of a stalling mechanism because I don't know exactly what I want to do yet. 

Zibby: Mm-hmm. 

Okay. 

David: Um, you know, I'm kind of a one trick pony. I've been doing neurosurgery for 27 years, so what I know how to do well is neurosurgery. I wanna learn ways to help people. I like learning. I'm a good student, so I wanna. Go back to school and just kind of look around at different options and figure out what I wanna do. 

Zibby: Well, your classmates are really lucky that you were gonna be in their class. That's all I can say. These like 22 year olds. 

Miriam: Can you imagine? 

David: I'm sure I'll meet some amazing people.

Zibby: Do you have other questions, Beth Wick? 

Miriam: Um, how has writing this book influenced you and work? Because when I guess you're writing things down, you're seeing it from a different perspective. Has it changed anything for you? 

David: I mean the, the biggest thing has been the timing, which is crazy. I never thought I was gonna be retiring at the time I wrote this book, and it is a memoir.

It's been a time of transition and definitely a time of reflection for me writing down the stories and writing down the things I've learned over my career. It's just made me more. Enthusiastic about teaching the next generation of people to do things the way I think they should be done. For example, surgical complications. Every surgeon has them, right? The best surgeons have complications. The question is how you handle them. Yeah, and I think I've accumulated some wisdom over the years. About how to handle them. So I share that in the book in great detail. That's how I would answer. 

Zibby: The trial was so interesting that you were, during one time when something went wrong due to not, not your fault, obviously, and years later you were sued.

You were encouraged by peers to settle and you were like, I can't do that. That's admitting fault, and I was not at fault. And so you went to trial, which sounded incredibly stressful and is sort of a commentary on what is happening with all of these medical malpractice lawsuits. Like what is the path going forward when. At the drop of a hat, people are suing doctors. Like how does a doctor continue to do all the great work with fear? 

David: Yeah, it's a major problem. You know, luckily I moved to Texas, and in Texas there's tort reform and it's actually a better environment for a. Physicians, you know, it's very variable state to state in New York, you know, you're in New York.

In New York there there's, it's terrible for doctors and they're getting sued all the time. And I mean, I think there are mistakes that are made in medicine and there is a role, I assume, for the medical malpractice system that we have, but there is a lot of defensive medicine practice as a result.

Unnecessary tests that are ordered, which can have harm, some things that are invasive, and it creates a. Climate of mistrust. 

Zibby: Mm-hmm. 

David: Most, I, I don't, I don't know any doctors who do things that are egregious, like, don't come see a patient who's deteriorating or don't do the very best they can. You know, there are always examples in the media and things like that, but most what, what I see are people doing the very best with the training that they've received, that they can.

But, you know, as I described in the book, after that trial went to. We, after it went to trial and after the verdict was returned in our favor, I, I didn't have an overwhelming sense of victory or relief. I felt that we had all lost, you know, I felt bad for the child, you know, who had a surgical complication, who's gonna have weakness over?

Hand, you know, for the rest of her life. And I wish I could have done something differently. I certainly did the best I could. It's a tough problem. So 

Zibby: One of my four kids is applying to college now and he's pre-med. He's gonna like do a whole medical program this summer and he wants to be an orthopedic surgeon.

David: Yeah. 

Zibby: What do you say to the next generation of doctors and people in the medical industry with the rise of ai, with all of the new reforms and all of that? Like do you have hope for them? What's your advice? 

David: I mean, there are some people who are pessimistic about medicine. I, I think that it is such an honor to be a doctor.

What I would say to your son if he were my trainee, is I would say, you know, you might be fascinated by the surgeries that you're gonna do. You're gonna learn to do all these complex surgeries, replacing knees and hips and you know, shoulders and doing all these amazing surgeries. Remember, you're not operating on a knee or a hip or a shoulder.

You're operating on a person and that person has a family who's in the waiting room and they are scared to death about what's going on behind these closed doors in the operating room. And just treat them as though they're your family member and you know, give them your love and your time and listen to them.

Miriam: Yeah.

David: That's what I would tell your son. 

Miriam: Thank you. That's really nice. 

Zibby: Any last questions from you? 

Miriam: No. 

Zibby: No. David, this has been such a joy. I'm such a huge fan of yours. I can't wait to see what you do to change the world. You've already affected so many people's lives, and I hope that this book and the messages really hit home and that the personal care that you show to patients and the respect with which you treat everyone is something that can be contagious and that can be taught, so thank you.

David: Zibby, thank you so much for having me on your show. It's so nice to meet you. And Miriam, it's so nice to see you again. Wonderful surprise. 

Miriam: It is. It is. Absolutely. 

Zibby: All right. Congratulations. Thank you. 

David: Thank you very much. Take care. 

Zibby: Okay, Say hi to Amy. 

David: Sure will. 

Zibby: Okay. Bye-bye.