Special Publication of the Brazilian Society of Neurosurgery - SBN

Edição 01 • Setembro de 2018

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Pioneers of neurosurgery

“There was a stone in the middle of the way. In the middle of the way there was a stone”- Excerpt from the poem ‘In the middle of the way’ by Carlos Drummond de Andrade

The Brazilian modernist poet Carlos Drummond de Andrade wrote in 1928 the poem described in the previous page, considered a scandal at the time to contain numerous repetitions. Ninety years later, the phrases of the famous writer show that in life there is always an obstacle. All the people who have had to deal with the unexpected and overcome a challenge see themselves in the words of the poet. Cleyde Cley, M.D., from São Paulo, and Noya Chaves, M.D., from Rio de Janeiro, were two of these people who could have inspired the brilliant Drummond. Both challenged everything that was around them and decided to venture into neurosurgery. In the 1970s, when they chose to pursue their specialty, neurosurgery was a male profession, and women attending medical school at the time were encouraged to pursue careers in obstetrics, pediatrics, or general medicine.

Challenging this common sense, they became reference in the pioneering of women in this medical field. And they serve even more as an example when they tell the main motivation to choose the specialty: to help those who need it. At that time, there was no equipment to assist in surgery like today’s tomography, resonance or ultrasonography. Diagnoses were made by angiography with direct puncture of the carotid arteries and craniotomies were done with a manual trephine. Opening a skull, for example, required much more physical strength and endurance. As expected, they had no benefit in physical activities, and the same tasks men performed were performed by them. Few believed that they would persist, but they remained strong and became great examples in the history of neurosurgery.

Noya Rocha da Silva Chaves, M.D.

On July 20th, 1940, Noya was born. The youngest daughter of a humble couple who lived in Rio de Janeiro but came originally from a farm in Espírito Santo State, Noya had a simple childhood next to her older sister, but her adolescence was a period that reserved the first challenge in the life of the future doctor. As a young woman, for four years, she suffered from ganglionic tuberculosis. “When I entered the first year of college, I was much debilitated due to the intense menstrual bleeding that I presented for not ovulating.”

Although it was difficult to her body to follow up her mind, Dr. Noya resisted and insisted on medical studies at UEG [Guanabara State University] – which later became UERJ [Rio de Janeiro State University]. She was one of six women in the class, which had 70 men, and in the first year she met Victor Leonardo, who was in his second year of medical school, and after six years he would become her husband. The desire to specialize in neurosurgery came from the wonderful classes taught by Professor Pedro Sampaio, in the fifth year of medical school, and her hand skills. Noya has always been very good at working with her hands. But when choosing her career, it caused some amazement in some people. “When a colleague of Leonardo’s class knew I was going to do neurosurgery he questioned my husband – boyfriend at the time –”Will you let it happen? This is not a woman’s specialty”. My husband said: “She will do whatever she wants, and I will support her”, she recalls fondly. In 1967, Dr. Noya received a scholarship in the Emergency Room (ER) of the Municipal Hospital Miguel Couto – RJ. She spent two years working in the ER. During this period, she talked to the professor, chief of the neurosurgery department of the hospital, whether she could help the neurosurgeon on duty after her working hours and assist him in the activities, and the professor allowed. “Years later, a neurosurgeon told me that this professor answered my request by discrediting that I would succeed. I did not suffer direct prejudice, but I was discredited on some occasions”, she said. In 1968, in the sixth year of her studies, she would have to do the “boarding school” in the chosen specialty. “I looked for the professor of the neurosurgery department of HUPE [Pedro Ernesto University Hospital] – Professor Ribe Portugal – and asked if I could attend his service. I was very well accepted and encouraged. At the time, the head of clinical care was Professor Pedro Sampaio”, she recalls. In 1969, Dr. Noya became the first female resident in neurosurgery at Pedro Ernesto Hospital. In 1970, she was hired as an attending doctor and, in 1974, she applied to specialization tender and was approved. She continued her career at the institution as a neurosurgeon and medical professor at UERJ. After the departure of Professor Portugal from the chair and the entry of Professor Pedro Sampaio, she became the head of clinical care where she remained until 1997, when she retired. She also worked in emergency service at the Getulio Vargas Hospital and then at the Bonsucesso General Hospital. She says, however, that her real “home” was at HUPE [Pedro Ernesto University Hospital], because it was there that she became a doctor, learned and taught neurosurgery. “The career’s challenges, however, were huge, not only for me but for the other colleagues. In a time when there were few specialists and less technology, the day to day was very intense. At that time, we did not have all the technology of health equipment that would help us to identify the diseases and help us with the treatments and, the complementary tests, such as myelography and pneumoencephalography, provided us indirect data and the arteriography was done by direct puncture of the carotid. After going into surgery and then visiting patients in the ward, I would go to the radiology department where I would help and learn to perform the neuroradiological exams. Due to the intense work, sometimes I broke two or three ampoules of hypertonic glucose and drank it to replace the lunch time”, she recalls. Even with a busy life, the neurosurgeon affirms with certainty that she did not have to give up anything to move on. On February 13th, 1969, she married her college boyfriend, Leonardo, who had specialized in psychiatry. “Because of ovarian problems, I could not have children. Then, as we settled into the profession, and after many conversations, we decided to adopt an 11-day-old girl, Tatiana, now 44 years old. The following year, we adopted the second girl with a month and a half, Cristiane, now 43 years old”, she says. Dr. Noya had a brilliant career and mastered the profession she has chosen. In 1997, she retired and is now dedicated to family and health. She does water aerobics, painting, walks with her two grandchildren, loves technology and, in February of this year, has completed 49 years of marriage. For young neurosurgeons, the doctor advises: “I’m pro of the examples. I learned a lot from the examples I had. Persistence, courage, and the will to succeed is the secret to any career. I never ran away from my obligations. I have always followed the residents in the surgeries and I am happy to see that I left something because I set a good example, not only in personal life but also in professional life”, she concludes.

“I did not suffer direct prejudice, but I was discredited on some occasions.”

Sociedade Brasileira de Neurocirurgia
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