Enjoying the Challenge of Neurosurgery

When Mitchell Levine, MD — highly regarded neurosurgeon specializing in minimally invasive spine surgery — talks about his choice of medical career, he uses an interesting mix of words.

“I had rotations in neurosurgery when I was in school, and it just seemed like fun,” says Levine, director of the Spine Center at the Cushing Neuroscience Institute, part of the North Shore-LIJ Health System in Manhasset, N.Y. “So, that’s why I chose it. It was something I could do for the rest of my life and enjoy it.”

Fun? Enjoy? Not your typical use of words, but then Levine isn’t your typical neurosurgeon. Oh, he takes the work he does most seriously, no question. But he also enjoys life, as evidenced by the farm he owns in Bevagna, Italy, where he produces his own organic extra olive oil called Antonietta, named after his wife.

“I think if I retired I’d probably end up living there,” he says. “It’s a really beautiful place to live.”

A focus on life

Levine says that as an adolescent, he was always interested in anatomy and physiology of the nervous system. And as he made his way through medical school, he found himself drawn more toward surgical specialties rather than medical specialties. So, he combined his interest in the nervous system with a desire to be a surgeon and came up with neurosurgery.

“I didn’t ever feel that I was making a hard choice, in terms of doing something that was particularly more difficult than something else,” Levine explains. “Other areas of medicine just didn’t seem too enjoyable to me.”

But that doesn’t mean he doesn’t take his work seriously — his work requires that he is very focused.

“There is a general skill set for being a surgeon, and then there is the focus required for operating on very small surgical areas and being meticulous,” he says. “There’s less room for error. If you don’t want to pay attention to little details, then [neurosurgery] is not what you want to do.”

A welcoming influence

Levine recalls that Leonard Malis, MD, his original chief of neurosurgery at Mount Sinai Medical Center in New York City, had a huge influence in his career. When Levine was a first-year medical student looking for an elective, he knocked on Malis’ door, introduced himself, and asked if he could observe the work Malis and his colleagues did.

“He was completely open,” Levine recalls. “He was a world-famous neurosurgeon at the time, and he just sat me down and talked to me for about an hour. Then he called in the chief resident and said, ‘Take this guy and put him on the service,’ and that was it. He was my hero forever.”

Levine has seen many changes in neurosurgery since then. When he first began his career every surgery involved large incisions. Today, the focus is on navigational tools, imaging tools and instruments to affect “big operations on the inside, but small operations on the outside.”

He says that the industry has responded well to physician requests for good tools and for good technologies. Hand-in-glove process, Levine calls it. As a result, the last 10 years have seen “a complete revolution in the way surgery is done.”

Down on the farm

So how does a neurosurgeon from New York end up working an olive oil farm among the rolling hills of Bevagna? Levine says it started about 20 years ago during a trip to Italy. A friend’s father, who lived in Italy, told Levine that the house next door to his was for sale. Levine and his friend purchased the house pretty much as a summer home, and would alternate spending months there in July and August.

Over time, however, Levine decided he wanted a more substantial investment than half a house. That’s when he came across a farm for sale.

“The property was unusual,” Levine recalls. “It was property that had been in a local family for a couple of generations, and the Italians rarely sell property. They’ll be glad to sell you their house with a little piece of land around it, but they’ll keep the family land. But this family just sold off everything. When I bought it, I had basically 60 acres of land and olive trees and a house. I was the owner of an olive farm.”

A learning curve

Then the process began. Levine says that back then, he may have been able to tell good olive oil from bad, but he knew nothing about making olive oil, much less running a farm. It wasn’t a simple process to learn, and he admits that 10 years later he’s still learning.

“You have to find trustworthy people to help you do it, and you have to hire people to take care of all the land around the trees, which is very hard to do in Italy,” Levine explains. “Most people who do these things in Italy do it themselves, or with their family. Hiring someone is not that straight forward.”

Levine lists pruning the trees, including when to prune them, how to prune them, how to fertilize them, and how to interact with the government for things like subsidies and permits, as critical elements to learn.

“How to make the olive oil — it’s really a big process,” he says. “And it took me, I’d say, three years of doing it before I could say I kind of know how to do it.”

Rewarding feeling

Back in New York, Levine enjoys going to concerts and frequenting restaurants. A collector of art, he also spends time at museums—all packed into a busy schedule that includes four or five trips a year to his farm. But when he’s able to step back, he recognizes what stands head and shoulders above everything else as being most important to him.

“It sounds infantile, but when you make someone better, that’s the most rewarding thing,” he says. “When you work hard and you make someone better, it feels good. And it’s nice to have people say, ‘Thank you.’ That’s a good feeling.”