OUR INTERVIEW WITH DR. KEITH BLACK, AUTHOR OF BRAIN SURGEON AND LEADING BRAIN TUMOR RESEARCHER

Dr. Keith Black Interview with Anat Tour/ East County Magazine

May 10, 2025 (San Diego) – Recently, ECM Bookshelf host Anat Tour sat down for an in-depth interview with Dr.Keith Black on our East County Magazine Radio Show. Dr. Black  A pioneer in brain tumor research and leading neurosurgeon, he is also author of the book Brain Surgeon.

In the interview, Dr. Black talks about his early learning experiences, his pioneering research, how he believes artificial intelligence will influence the field of neuroscience, and more.

You can view a video of the full interview, hear an audio version aired on KNSJ  Radio, or scroll down to read a transcript. To read a review of Dr. Black’s book, Brain Surgeon, click here.

Transcript

You're listening to East County Magazine's Bookshelf. We interview creative minds and share their ideas. Here's your host, Anat Tour. Welcome to East County Magazine's bookshelf. Today I'm honored to speak with Dr. Keith Black, one of the world's leading neurosurgeons and a pioneer in brain tumor research. Dr. Black is chairman of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles.

His groundbreaking work has earned him national recognition including features in Time Magazine's, Heroes of Medicine and Esquire's Genius Issue as one of the 21 most important people of the 21st century. Today, we will be discussing his inspiring book, Brain Surgeon.

AT: Dr. Black, thank you so much for being here.

KB: Delighted to be here. Thank you for the invitation.

AT: Oh, you're welcome. You've been interested in science from a really young age, even dissecting bugs and frogs as a kid. What was it about the brain that drew you in?

KB: So when I was accepted into medical school, I was actually accepted into an accelerated program where they admitted students from high school into both undergrad and medical school at the University of Michigan. So the first year of that program, we had a course in neuroanatomy, the structure of the human brain. And to me, it was one of the most beautiful structures that I'd ever seen. I fell in love with the beauty of the anatomy, the complexity.

It was, the elegance of it was just inspiring. After that, you know, I started learning more about the physiology of the brain and the chemistry. And realizing that this combination of anatomy, physiology, chemistry, created the very essence of what makes us human.

I mean, it gives us our awareness, our consciousness, our ability for language, our ability for language, our ability for vision, our ability for movement, and three and a half pounds of matter. So it was inspiring, and I could not think of anything better to spend the rest of my life trying to learn about it.

AT: That's fascinating. There's a story you tell in your book that I really loved about the time you accidentally blew up the kitchen with your chemistry and your parents have been upset. That kind of response is rare. It's not that I love that you blew up your kitchen, but I love response. How much of an impact do you think their support had on your path, especially so early on?

KB: Well, you know, my mother was a teacher. My father was an educator. He was principal of an elementary school. And, you know, they both, I think, were master educators. What they did most for me was really to understand what I was interested in learning. And I described them as the ultimate educators.

So, you know, that scene in that episode or story that I tell in the book where, you know, I was basically playing with my chemistry set, you know, trying to learn about chemical reactions and accidentally blew up the kitchen could have been a scenario where my desire to actually  learn more of chemistry was squashed. But in their minds, they were not happy about the kitchen being blown up, but they understood that it was doing an active learning where I was basically exploring, trying to understand the basic elements of life and materials and matter. That was okay.

I mean, if you make a mistake doing a process where you're trying to learn and create and understand your environment better, you know, that was a forgivable sin. And that was what was so wonderful about them. I mean, they were ultimately, I think, the best parents, the best educators, the best gift, you know,that I could have ever been given.

AT: That sounds like they truly understood education and you're lucky to have educators as parents. Kids are fortunate when they have good role models. So that was a very inspiring story.

KB: Yeah, and not only that story, but I also tell the story in the book where my father saw that I had an interest in the heart of a chicken that my mother was basically cleaning. And I took the little heart out,after she finished preparing the chicken and was dissecting it. The next week, he went to the slaughterhouse and brought home a cow heart. So I could clearly see the, you know, the heart valves and the anatomy. He just cultivated a passion and a desire, whatever that was within you, to learning from that.

AT: You really nurtured the environment that you were interested in. That's amazing. You've been in some extremely intense surgeries, life or death situation. How do you stay calm and focused when the stakes are so high?

KB: Preparation, preparation, training, and more preparation and more training. It's very similar to an airline pilot. On a nice clear day where there's no turbulence, it's fairly straightforward flying a plane. But if you have a problem with your navigation system, or your steering system, or something, or engine goes out, and it's bad weather, and it's a storm, that's when that preparation really comes in critical, right? And it's the same with brain surgery, right? So what you want to do is to prepare for every scenario where the surgery can go wrong. And so when you encounter that scenario, you've already prepared for that and you already know exactly what to do and you can get the patient through safely. When I'm in surgery is almost like a meditative state.

So I'm actually viewing the moves that I make during the surgery, three or four steps before I actually do that move. Before I do the surgery, I basically run through my mind every scenario that can go wrong with the surgery. What could happen? What would I do in that scenario?

So you're prepared so there's no reason to panic. You've already thought every scenario hopefully that you can think about through, so that you can get your patient through the surgery safely.

AT: One thing I loved in the book is how connected you are to your patients. It's not just about the surgery. How has that emotional part shaped your work or stayed with you over the years?

KB: Oh, one of the most important characteristics, I think, of a good surgeon, a good brain surgeon, is really treating every patient like they would treat their mother or their sister or a parent. You can be technically fantastic and you can do some amazing technical things and the MRI scan may look perfect, but if the patient ends up with weakness or visual loss or language difficulty, that's not a success. So you have to delicately weigh the risk versus the benefit in every case that you do, whether the patient is better off with surgery or some other type of treatment, the right type of surgery, making sure that you do not overstep the envelope of risk so that you treat that person like you would treat someone that's close to you and in your family to get them through that case safely.

So there are a lot of surgeons that I've seen that are technically very good, but I would not necessarily want a family member to go to because, you know, they don't treat that individual, they're not making decisions like they would for a mother. And so that connection I think is absolutely critical, right? So if someone trusts you with their life, then you want to treat them like a family member, right? Despite your technical ability. And if you take that point of view, I think your outcomes will be better. I think your outcomes will be better. I think your patients will do better.

AT: That sounds like something I wish every medical doctor and surgeon thought like you. In your book, you write about the chairman asking, what makes you think you'd be a neurosurgeon? How did you feel in that moment? And how did you maintain your confidence despite the subtle discrimination?

KB: So one of the challenges that one has, right? If one is individual or color or a female or, you know, someone that's not mainstream in a particular profession, and a comment is made, you don't know if that's a microaggression, if that's just that person the way they are, or they're actually racist against you, right?

Maybe it was the way he was, but it turns out that he wasn't racist. He didn't like individuals of color. He didn't like women in neurosurgery. And so as a medical student wanting to enter into a very difficult field to enter, it's very competitive, one could really take that as a defeat, right? You can say, well, you know, I'm not wanted here. I'm not accepted here. I could never make it here.

What I try to instill in the students that I speak to, just expect, you know, there to be barriers, just to expect that there to be obstacles in the path of what you're gonna do. Rather than using that as a failure, turn those obstacles into more motivation for yourself to make yourself even better, even stronger. It's what I describe as the art of Tai Chi, right?

So, you know, most of the time, we're gonna be facing forces that are much more powerful than we are, right? We're gonna be the weak force. But in Tai Chi, you take that energy that's against you and turn it back on itself.

So those comments didn't discourage me, it made me study harder, right? I worked harder, I mastered what I needed to master more. It made me better at what I needed to master more, it made me better at what I needed to do.

AT: That sounds very inspirational and very powerful resilience. I love that. Can you give an example in brain research or treatment today that gets you really excited or hopeful?

Well, I think the ultimate objective of neuroscience is to understand ourselves. We are our brains. What is consciousness, right? What makes us us? And understanding how 100 billion brain cells with 100 trillion connections interact to give us that consciousness is I think one of the most fascinating things that we can study. We're just barely in kindergarten right and trying to understand that but we're learning more and more. We're learning more about you know neural networks.

We can study human brains, and we're doing that at Cedars-Sinai in our neurosurgery department, the patients that are undergoing depth electrode implants for epilepsy monitoring or control and movement disorders and how the brain recognizes images and forms memories and makes executive decisions. Well, that I think is truly, you know, I think one of the wonders of the universe.

The other thing that's really happening that's really changing the field is artificial intelligence. We can take huge amounts of information, understand it better, and learn how to treat disorders much better. So I think hopefully in my lifetime, we will have successful treatments for brain cancer. We will have successful treatments for Alzheimer's, stroke, being able to regenerate the human brain. Extremely optimistic, and I think it's a very exciting time to be in.

AT: That ties into my next question that I was going to ask you about the excitement of artificial intelligence in medicine. So from where you stand, how do you see AI changing the future of neurosurgery?

 KB: I think AI is going to be very disruptive. If you think about neurosurgery, it's a very young field, right? It's less than a hundred years old. But in the last few years, with the introduction of AI, AI will tell us exactly the right decision, exactly the right treatment for exactly the right patient. It's going to be able to do that, I think, better than physicians or surgeons. So you're going to know exactly the right operation to use, exactly when. When we we're going to know exactly how much tissue to remove. Once we take that tissue and analyze it we're going to know exactly what to treat it with.

And the acceleration of that information is going to be faster than we've ever imagined. So where it used to take 10 years to make an advance, it's now going to take two or three months. And that's going to be very disruptive. In terms of our ability to more effectively and more precisely, you know, treat the right patients with the right treatments. And more importantly, the acceleration of discoveries into new drugs and new treatments is going to be faster than we've ever seen any time in history.

AT: That sounds very exciting, especially from where you are, because you understand it more. What do you think about Neuralink and the idea of using technology to modify or enhance the brain?

KB: So I think it's an exciting area because Neuralink is a company that Elon Musk started. It gets much more attention than a lot of the other types of technology like that that's available. So Neuralink is one of many technologies that are basically linking the human brain with machines and computers and devices.

We've been doing this for more than two decades. A lot of advances that have been made, our ability to do it in a much more complex fashion is beginning to vary. What Neuralink does is that it basically takes the robot so that you can put the electrodes in a little bit more precisely.

But the big advances are gonna come, I think, when we're no longer gonna be using electrodes to link with the brain, but you can use external fields, electrical fields, magnetic fields, to integrate in a way that doesn't require us to drill holes in the skull and implant electrodes. That would be a huge inflection point. And I think it would essentially be a game changer, right, in the way that the human mind can integrate with devices that can make us better and restore function in a way that we can only begin to sort of dream about and think about that.

AT: Very exciting field. It kind of reminds me, I was searching the Internet and I saw an interview of you talking about Star Trek and an episode a long time ago where the doctor, Bones, travels back to Earth and he's witnessing a brain surgery and he's like, what are you doing? You're cutting them open.This is so barbaric. Is that what inspired you to go into neurosurgery? Was it before or after that you saw this clip?

KB: No, I think, yeah, I think, I think that episode came out after I had already decided I wanted to be in neurosurgery, but the little device that Bones had was a tricorder. And it's the way that I think neurosurgery should be. So we shouldn't have to drill holes in the skull to treat disorders of the human brain. And developing external devices that can put magnetic fields into waves and other types of energy to restore brain function. I think it's going to be the way that we do it in the future.

AT: I'm looking forward to that. You mentioned staying calm even in chaos. Is that something you have to learn or did it come naturally to you?

KB: I think it comes more naturally to me. I tend not to get excited about things. Some people are more excitable. I tend to be more matter of fact. And that's probably a good trait to have in neurosurgery. You don't wanna have a lot of ups and downs and you wanna be like that captain of a boat, just keep a rudder steady and just hold the course in the storm. It served me well and just stand calm when there's chaos all around you.

AT: It sounds like an amazing skill to have. So I have a last question for you. With all the advances we've made in neuroscience, how much of the brain do you think still remains a mystery? I know you were mentioning we're in kindergarten right now, but what would you say about that?

KB: I think the most exciting components of it remain a mystery. So I think we deceive ourselves if we believe we know a lot about the brain currently. We know a lot about the anatomy. We know a lot about the chemistry. We know a lot about how nerve cells communicate with each other through electrical impulses.

What we don't know is how that anatomy, that physiology, that chemistry, those electrical impulses, and particularly areas of the brain, translates to what you are experiencing now when you're looking at your computer and we're having this conversation. How does that take place? What is that? It has to be more than just electrical pulses, right? So we know basically what is happening. We know there's a car, but we don't understand much about the driver, you know, that's behind the wheel.

AT: So fascinating and interesting. I probably could ask you so many more questions, but I want to thank you so much for being on East County's magazine's bookshelf and for sharing your inspiring and incredible life with us and you really make the world a better place. I want to mention again the book, Brain Surgeon, with Dr. Keith Black. Thank you so much Dr. Keith Black.

Thank you.