In This Issue:
- Message from the New President
- Message from the Past President
- Message from the Secretary - Treasurer
- Message from the Newsletter Editor
- Our Honorary Presidents II: Gedeon Mansour Mohasseb
- WALN Homecoming Congress: A Smashing Success!!
- The Denver Meeting
- Upcoming events
- The Arab Board of Neurosurgery
- Historical Vignettes III: Rhazes
- Falah Bechara Maroun
- Historical Vignettes II: Avicenna
- Member Matters
- About Our New President: Mokbel Chedid
- In The Next Issue


WALN President's Message

The WALN Homecoming Meeting in Beirut, July, 1997, was an inspiration, a success and a dream come true. The scientific sessions were outstanding with speakers of international caliber. The friendliness of the meeting was overwhelming. I felt that the World Association of Lebanese Neurosurgeons achieved an important milestone in its history. Most of you are aware of the history of the formation of the WALN six years ago and the obstacles and hurdles that had to be overcome. These were not as smooth as many would think, but with the courageous efforts of many of us who believed in this organization, its value and strength, the nightmares were changed into sweet dreams and the sweet dreams became, at last, a reality.

I was extremely touched with the hospitality we had during our visit to Beirut. I was elated to see the different participants from South America, United States, Lebanon, Canada, France and other colleagues from the Arab world. One could feel an electrifying, emotional touch during these meetings. Every person I talked with was happy. Every place we went to and visited overwhelmed us with warmth and love. Sure, there are still a lot of problems that we need to solve. The road is not completely paved but our foundations are solid and the future will be bright.

There are more than 200 members distributed between Argentina, Brazil, Canada, Columbia, France, Jamaica, Lebanon, Saudi Arabia and the United States. I will continue to pursue other members of Lebanese origin that may have been missed or may have been in other countries. The Lebanese descendants showed a great interest in preserving their traditional Lebanese heritage and culture. Their enthusiasm inspired all of us and will push us to work harder as a group of neurosurgeons with solidarity, loyalty and faithfulness to their home country.

In Dr. Awad's opening statement in the meeting, he stressed that the neurosurgeons abroad are not "a brain drain", but rather a "gift to the world". Our mission is to continue to work hard and strive to prove our contributions to neurosurgery and to our home country. We will continue to prosper and grow, nurtured by our respect and love to each other. One of the main goals of WALN is to develop strong communication between the Lebanese neurosurgeons, communication that will depend on current technological advances and on regular meetings and reunions. For the future, I will strive and work closely with all of the members of the organization to achieve this goal. I will continue with frequent reunions at the national and international neurosurgical meetings as in the past and encourage more neurosurgeons to attend our meetings, usually announced in our newsletter.

The development of an educational, clinical and research joint venture and collaborations between neurosurgeons at home and abroad, is a must. We need to strengthen this bond, nourish it and defend it in every possible way so it becomes a cornerstone of the WALN. We would like to see neurosurgery back home as it has always been, a first class act, supported by state of the art technical advancement.

It is evident that the birth of this organization did not come overnight. It did not happen instantaneously. It is the tireless efforts of several people over many years that made this possible. I cannot forget the efforts of Drs. Fuad Haddad and Gedeon Mohasseb as early pioneers in the formation of this association. Many people came along the way, they worked hard and I would like to take this opportunity to thank every neurosurgeon and every person, who in one way or another, helped in the takeoff of this organization. Since the inception, these people have worked hard in the States and in other regions to bring the dream to a reality. Efforts of Dr. Issam Awad and others members of the organization, including Dr. Kamel Muakkassa are to be admired at all times. Newsletter editors, Dr. Morcos, then Dr. Bejjani, along with the efforts of the regional representatives, Dr. Georges Haddad from Lebanon, Dr. Nilton Latuf from Latin America, Dr. Abbas Srour from Europe, and Dr. Kamel Muakkassa from North America, made this global organization a solid unit. The Homecoming Meeting in Lebanon could not have happened without the greatest efforts of all the organizing committees including Drs. Haddad, Okais and Nashanakian. We are also in great debt to the Lebanese Neurosurgical Society for its help and support as represented by its President, Dr. Afif Alwan Vice President, Dr. Nabil Okais, Secretary, Dr. Farah and Treasurer, Dr. Shaar. Members who also helped included, Drs. Fardounn, Haddad and Saad.

As you are aware, the Lifetime Honorary Presidents of the association are Drs. Fuad Haddad, Gedeon Mohasseb, Charles Fager and Joseph Maroon. During the Homecoming Meeting, we have added another name to this list, in particular, Dr. Falah Maroon of Canada. During the General Assembly, elections and nominations were made. The new Board of Officers will include myself as President, Nilton Latuf, M.D., Representative for Latin American, Abbas Srour, M.D., Representative for Europe, and Dr. Kamel Muakkassa, Representative for North America. Dr. Ghassan Bejjani will be the Newsletter Editor and Dr. Kamel Muakkassa will remain to be the Secretary. Dr. Issam Awad, as you know, had to take over a very important job in the association which will keep him busy. We definitely want to support him in the fellowship program and his advice and wisdom will help guide us in the future. There remains a conflict regarding the Lebanese Representative office held by Dr. Georges Haddad. I was not happy and a bit saddened that we could not resolve this issue during the Meeting, but after prolonged discussions with several people in the United States and abroad, it seems that the best way to resolve this conflict is by an election strictly abiding by the Bylaws of the WALN and submitting nominations and voting in a democratic fashion. I will be consulting with the other members of the Board and will make sure there is communication with our colleagues in Lebanon to resolve this issue.

At this point, I would like to project some of my future thoughts for the WALN. I would like to see this association grow bigger and stronger as one solid unit. It is against my principles to allow any misunderstandings to go on and become a problem. Our goals will be set as follows:

1. We would like to enlarge and strengthen our newsletter and make it very important and encourage all of the members to submit their ideas and thoughts in writing. It will be an open forum for publications and will cover different topics and convey the message to all of the members without any bias. I am working at this present time with Dr. Bejjanni and the other Baord members to finalize our Fall issue so it will be available before our next WALN meeting in New Orleans during the CNS meeting.

2. Our next goal is to strengthen and enlarge the fellowship program. Dr. Awad, along with other members, will be working on this. This is an extremely important project.

3. Dr. Muakkassa has been working on establishing the tax-exempt status of WALN. We will keep you informed on this matter.

4. We would like to encourage direct communications between all the members of WALN on a continuous basis, exchanging scientific material, discussing social problems, exchanging clinical and research ideas, to keep all the roads open between all the different members because we feel this is one of the best ways to keep this organization strong.

5. We will start preparation for the next WALN International Meeting. We feel this will happen in two years. We are looking at different sites to hold the meeting, though most of the members I have talked with indicated to me that another meeting in Beirut will probably be the most appropriate and here I will take any suggestions from any member.

6. Once, most of our goals are established, then we will probably divert our attention to forming sub-committees that will be working on different projects, including a publication sub-committee, a resource sub-committee, a clinical sub-committee, an educational sub-committee, and so on to handle these different projects. This will make it much more productive and insure the achievement of our goals.

7. The most important goal during my term as President, is to protect this organization to keep its unity and work hard in resolving any conflicts between members or groups and to instill the spirit of brotherhood, friendship and support one another because this will be our main source of strength and power. A broken unit is powerless, a solid unit is powerful.

Dear Friends:

The World Association of Lebanese Neurosurgeons is not a product of a natural accident. It is the result of perseverance, faithfulness, and hard work of those who believe and aim for excellence. The work of our predecessors should not be forgotten, but we cannot sit and look at the past, glorify what we have done and admire it. We should take it and make it our torch in pushing forward and strive for better paths to keep this organization glowing at all the world stages. I need the cooperation of all of the members. I need all your support, ideas and thoughts to continue paving the road and building a future that we will be as proud of as we are now of our past. Let us join together to keep this organization spreading the Lebanese spirit all over the world.

God Bless You All!

Sincerely,

MOKBEL K. CHEDID, M.D.
Section Chief, Neurosurgery
Genesys Health System
President, World Association of Lebanese Neurosurgeons


The WALN Past President Message

"It was the best of times..."

It was the best of times... Over one hundred registrants participated in the Congress. There were no less than fifty neurosurgeons in attendance. Half were practicing in Lebanon and the other half came from overseas and the Arab world. Large delegations represented Lebanon, the U.S., Brazil, and France- reflecting the mix of WALN members. There were absolutely outstanding presentations covering every field of neurosurgery. The scientific standard and the level of credibility of the lectures compared or exceeded those of most neurosurgical meetings. In every field of neurosurgery, the talent of yesterday evoked pride, that of today radiated credibility, and the neurosurgeons of tomorrow gave us reason for confidence. We had a serious WALN Assembly, elected officers and thanked the workhorses who made the meeting possible. We also had splendid social time in every corner of Lebanon, and for many this represented a first homecoming to one's country of roots and heritage. For others it was an occasion to visit family and renew friendships.

We were well received at the personal and official levels. The meeting was conducted under the official Patronage of His Excellency the President of the Republic. We were honored by extensive media coverage on television and the written press, and by a magnificent banquet hosted by The Hon. Deputy Mrs. Bahia Hariri. It was "a dream come true" as expressed by Prof. Fuad Haddad, and in large part because of tireless organizational and executional labor by Georges Haddad aided by a local staff and organizing committee, and the officers of WALN. It was what was promised of this first Homecoming Congress. Every member of WALN should share in the pride and credit for its success.

But it will not always be the best of times if we stop here. It would be a shame to betray this splendid momentum by losing sense of our identity or purpose. Lebanon is an extraordinary cradle of neurosurgical talent. But neurosurgical work in Lebanon does not reflect that wealth of talent nor its quality. We have more neurosurgeons per capita than in most developed and industrialized countries. Some have achieved international reputation and stature, but not as many as those who are overseas. Others are encountering difficulties in maintaining credibility and sophisticated expertise upon return home. The technical conditions are to blame in part. Lack of organization and cooperation have become endemic. Case volume per surgeon and is so low and socioeconomic competition for cases so tight that quality of neurosurgical care has become at best inconsistent. There is no uniform outcomes monitoring, no quality assurance to speak of, and no true incentive or organizational mechanisms to introduce new advances. The Lebanese Order of Physicians is neither qualified nor empowered to impose meaningful standards. The government certainly cannot either. It will be up to Lebanese neurosurgeons themselves to chart a course of quality for the future, based on their true potential, and the incredible wealth of neurosurgical talent.

The WALN can help, and should insist on helping. Tough love is meant for family. The WALN should aim to create educational opportunities, facilitate program development, and most importantly help define and maintain a standard of quality. The WALN brothers overseas care and want to help. Lebanon needs all the strength of its sons. Let the WALN become a paradigm of bridging the needs of the home country with the brain talent of the Lebanese Diaspora.

It has been an honor and a privilege to serve as the Founding President of WALN since 1992. The helm now is in the hands of President Mokbel Chedid who has the vision, character, and strength of purpose to help us realize our true Mission. Mokbel, we are with you. Good Luck. To more splendid times in Lebanon and abroad as fellow WALN members. To a true future for WALN, with an honorable sense of purpose.

Issam A. Awad, MD, MSc, FACS, MA(hon)
The Nixdorff-German professor of Neurosurgery
Yale University Medical School
Past President of the WALN


Message from the Secretary - Treasurer

Dear WALN Members

A great thank you to all those who attended, supported, encouraged and made successful our first Lebanon WALN meeting. Thanks to the Brazilians, the French, the Americans, the Argentineans, our friends from Jordan and Syria, the Lebanese contingency, and the Lebanese people. Another great thank you to the organizing committee in Lebanon headed by doctors Alwan and Haddad. I personally thank Drs. Fuad and George Haddad for their kindness and their hospitality to me and my wife The reverberations of our meeting have been stunning. Let's do it again.

We know you looked up old family relations and dug a little in the past. We know you partied with old friends, relatives, distant cousins, and unknowns to you. It was an unforgettable rekindling of the"old country" .We are happy you all enjoyed the Mezzas, the Taboulehs, the Kibbehs, the grape leaves, the Arak, the Kafta, the lamb, the Shish Taouk, the Fatayers, the Shawarma the Falafels, the delicious fruits, the Nargileh puffs, and more than this page can list. Some could even dance after they had a feast. Never mind the transient GI troubles I guess we all had.

We hope the program was enjoyable to all of you. I know the Ladies and our children basked in the sun and looked at the shops while we were "talking medical", but then all were reunited for the unforgettable bus trips in the afternoons. No one can have enough of the touristic Lebanon in such a short trip, but the ruins of Jbeil, the Jeita Caves, the Castle of Sidon, Baalbeck, and Beirut were fulfilling. I know many of you saw and visited much more. How about the restaurants and the splendid food, and the night clubs that start their shows and Arabic dancing and singing at two or three in the morning!!

WALN was very pleased with the attendance, the paper presentations, the speakers, the before and after lunch and dinner discussions and the knowledge gained by the interactions amongst the all of us. Thank you to our neurologists and our neuroradiologists who could join us. We were honored and happy to have them.

Now to business. I'll make it short. We need you first and foremost to remain committed to helping WALN grow and become more fun. Yes the word is FUN. Whether we do it with learning, teaching each other, helping each other, socializing , meeting more friends and families, or just to keep a link to the "old country", let us do it with fun and respect to all. Let us keep politics out, and let us keep companionship, love, friendship, trust, sincerity, happiness, and beautiful memories in.

For those of you who can attend our yearly meeting , we will see you in New Orleans. Our agenda will include the dinner, our president's remarks, the secretary and treasurer report, the newsletter report and the election of the Middle East region representative. I have had some recommendations for the position, but all interested should and can still submit names before or at our meeting in September. Please fax them to me (330-376-1599) or our President. I reemphasize to you that our bylaws allow you to input your concerns, ideas, recommendations, by fax or at the meeting and even vote them at the same meeting. Let us hear from you.

Our membership fee is very little and yet many of you have not paid the dues. To expand our newsletter, to improve our internet, to help in our bigger projects, we need to build a nest of money. Please send your dues in US$ directly to me or through your regional represantive. I would like to personally thank Drs. Suhail Haddad and Ali Khrist for their monetary contribution qualifying them to become Cedar Class Donors.

This newsletter will hopefully find you all in the best of health for you and your families and I hope you all had safe trips home. I know the Ablas had a burning plane engine that necessitated an emergency landing, and restart of the trip; but thank God all were safely home in Pittsburgh.

I want to mention a very special thank you. It goes from all of us to our hardworking , enthusiastic, caring, wise, resourceful, and continuing staunch supporter of WALN, our past President, Dr. Awad. Thank you Issam for all the energy , time and advice you have given WALN and myself. We hope to see you one day as President of the World Congress of Neurosurgeons. Good Luck.

Finally, welcome to our new president Dr. Chedid. I know Mokbil will carry the torch well. I wish him success and we give you all our support and help.

Kamel Muakkassa MD
Secretary, WALN


Message from the Newsletter Editor

Dear Friends

"A Dream Come True" is the title I chose for this issue. Because it is a dream come true. A dream that every one of us had for a long time, especially our dean, Dr Fuad Haddad, who had this dream since 1973. These three words are the essence of what WALN has come to be. WALN is now a reality, stronger than ever. Stronger because its members are united, and because they believe in it, and the First Homecoming meeting is the proof. Members from across the Atlantic, members from Europe and members from Lebanon came to our Congress to gather and celebrate Lebanon and Neurosurgery or should I say: Lebanese Neurosurgery.

The meeting was a complete success. And this success we owe to all of our members who believe in WALN, but especially to Dr Georges Haddad, who invested a tremendous amount of time and energy to make this meeting succeed. To Jirgi I say: Congratulations!!

And to our founding President, Dr Awad, who is stepping down, I say: Thank you for giving WALN the strength and unity it has. Thank you for your wisdom and guidance. Thank you for making WALN what it is now. WALN has become the model of association envied by everybody else: individuals from all over the globe, speaking different languages, holding different passports but all united by the pride of being Lebanese and the privilege of being Neurosurgeons.

We should not forget also Drs Muakkassa and Morcos, and our Regional Representatives, Drs Latuf and Srour who spent limitless time and effort to keep the association cohesive and to spread its news around the world.

For the Newsletter, we have made some progress. We now have a website, although modest. The topics in the Newsletter are more varied. We are getting more contributions from different members especially Dr. Farid Haddad. I hope I will be able to have more participation from other members, from you my friends. Openness is in our bylaws. The Newsletter is yours. Any contribution is welcome: Social News, Professional News, Historical Vignettes, Geographical Vignettes,etc. We are planning to print the Directory in the near future. We may even have copies for the New Orleans meeting. We have gathered a significant amount of biographical data. If you have not submitted yours yet, please do so, and ASAP.

Finally, as Dr Chedid takes over, I wish him the best of luck in achieving the goals he set in the message published in this issue.

Ghassan K. Bejjani, MD
WALN Newsletter Editor


Our Honorary Presidents Part II: Gedeon Mansour Mohasseb

By Ghassan K. Bejjani, MD

Gedeon Mohasseb was born on May 12, 1927 in Ghosta, a village nested in Mount Lebanon. He studied at the College des Apotres in Jounieh. In 1947, at the advice of his uncle, a priest in Alexandria, he decided to head for Montpellier, in France, to study Medicine. There, he spent the next 14 years of his life.

Shortly after arriving in Montpellier and enrolling in the PCB, the premedical school year of those days, he was introduced to neurosurgery. It was during a lecture by Professor Claude Gros, his future teacher, at the Catholic University Center. The lecture was on frontal lobotomies: he was impressed by the marked personality change induced by lobotomy. During his medical school years, he was further impressed by the rigorous systematization of the nervous system, and he decided to go into neurosurgery. In 1954 he obtained his M.D. degree at Montpellier, and in 1956 he passed the Concours d'Internat, that allowed him to start his residency. He trained in Neurosurgery with Gros between 1956 and 1961. These were very fruitful years in his career. Finally Gros helped him obtain a fellowship grant to spend six months with Guiot at Hopital Foch, from July until December 1961. It is there that he learned the transsphenoidal approach, approach that he introduced later to the Middle-East.

On December 24, 1961, he returned to his homeland. He practiced neurosurgery in numerous Lebanese hospitals. His first operation was on a patient with a herniated lumbar disk on January 8, 1962, at the hospital Rizk, in Achrafieh. He was also appointed in 1962, with the help of the Jesuit father Madet, as neurosurgical consultant at the Hotel Dieu De France. Before that time, neurosurgical cases at the Hotel Dieu De France were operated by Dr Ciaudo, a general surgeon. The latter did not see a need for a neurosurgeon, because there was not enough cases. However the case load was bigger than expected: 80 cases in 1962. Thanks to the efforts of Dr Fuad Haddad, who started practicing neurosurgery in Lebanon seven years earlier, patients were now more receptive to the idea of having brain surgery. The number of neurosurgeons in the country was still very limited: 2.

He introduced stereotaxy to Lebanon in 1963, when he performed it at the Hopital Rizk for Parkinson's Disease, and he kept on doing until 1969.

In 1966 he passed the Concours d'Aggregation in Paris. He became Professeur Agrege at the Faculte de Medecine, Universite Saint Joseph.

In 1967 he performed for the first time in the Middle East a transsphenoidal approach. The patient, YM, harbored a chromophobe adenoma. He is still alive and well now, 30 years after his surgery.

In 1972, he became Professor and Chairman of the Department of Neurosurgery at the Hotel Dieu De France, in Beirut. His first resident was Dr Dakar, a Syrian, who spent one year with him (1971-72) before leaving to France. He took then Dr Okais, the present chairman at the Hotel Dieu De France, as resident, and trained him for two years (1976-78) before the latter finished his training in France in 1980. He organized in 1987 a congress of neurosurgery at the Hotel Dieu De France, that attracted internationally known neurosurgical lecturers.

He was an active and a founding member of the Lebanese Neurosurgical Society. He became its president from 1991 to 1994. Along with Dr. Haddad, he helped establish WALN. During the Middle East Neurosurgical Society meeting in Beirut in May 1992, both men entrusted Dr. Awad to found WALN. Over the years both men had kept lists of neurosurgeons of Lebanese origin. These lists were the original roster of WALN.

He was also active internationally during several missions to various Arab and African countries, the main one being a mission to Zaire in 1983, sponsored by the Union Libanaise Culturelle Mondiale. He was also The WHO expert for Africa in 1990, when he was asked to evaluate neurosurgery in the African continent.

He has multiple studies in neurosurgery, mainly on open cranial trauma (his famous "regle des 4 D" for Delai, Debridement, Duroplastie, and Detente, that he presented in 1988, was based on his experience with 400 gunshot wounds to the head), meningiomas, spine trauma and cauda equina tumors.

A great teacher and considerate physician, Dr Mohasseb is known as a friendly and humble person, inspiring respect and admiration to his patients and students. He welcomes you with a smile on the face and a quiet voice, always willing to help. He has influenced generations of medical students at Saint Joseph University and inspired many of them to go into neurosurgery.

Dr Mohasseb married Layla Khoury in 1963. She is a reporter and a poet who has recently published two books: "Capucine Actualite" (1988), and "Le Bonheur des Mots" (1992). They have four children: Sabine, Claudine, Elie and Georges.

Dr Mohasseb is one of the pioneers of Lebanese and Middle Eastern neurosurgery, who introduced many techniques to the area, and trained many of the young Lebanese neurosurgeons. In recognition to his numerous contributions to Lebanese neurosurgery, Dr Mohasseb received the medal of the Lebanese Order of the Cedar (commander) in 1992. He is also a honorary president of WALN.


WALN Homecoming Congress: A Smashing Success!!

The meeting was started on Sunday evening with an opening ceremony during which there was representation from the Lebanese Government. Several speeches were made and this was followed by a cocktail party attended by many of the physician's spouses.

Monday, July 14, 1997, the scientific session started at 8:00 a.m. and extended all the way until 12:15 p.m. Several abstracts were presented. Dr. Haddad, for example, summarized his 40 years experience in Hydatid disease of the brain. There were very interesting discussions on medulloblastomas and metastatic malignant melanomas along with skull tumors. Skull base surgery was discussed by Dr. George Nohra and was followed by several interesting skull base abstracts. Dr. Al-Mefty gave a beautiful presentation on skull base surgery in regards to lessons and pitfalls. Dr. Maroon discussed orbital, pituitary and intrinsic brain tumors. Physiological and cortical mappings were discussed. A round table discussion was then done with Dr. Oussama Al-Mefty, Dr. Fuad Haddad, Dr. Joe Maroon, and Dr. Raymond Sawaya. The number of abstracts presented that day was close to 17.

In the afternoon there was an organized tour to Beit Eddeine followed by a dinner at one of the beautiful mountainous Lebanese areas.

Tuesday, July 15, 1997. There were two sessions; the morning session was moderated by Dr. Youssef Comair and the following session by Dr. Nabil Okais. There were abstracts on epilepsy and functional neurosurgery, Pallidotomy surgery and endoscopic ventriculostomies. The following session included discussions of surgical lesions of the spine from the cervical to the lumbar spine along with several interesting topics. This was followed by a round table discussion by Dr. Awad, Dr. Fager, and Dr. Hitchon. During that day, the general assembly took place. This was supposed to happen Wednesday, however, it was moved to Tuesday and the election of the new President and the Regional Representatives took place.

This was followed by a lunch at the Century Park. Then a tour bus went to visit the beautiful Jeita Grotto. We then went to the city of Byblos. Dinner was at a local restaurant.

On Wednesday July 16, 1997, there were two sessions. First there was a neurovascular session moderated by Dr. Afif Alwan followed by a session on trauma and critical care that moderated by Dr. Saad Farah. Several abstracts were discussed in regard to intracranial pressure monitoring and spinal trauma, and spontaneuos intracerebral hemorrhages along with the critical care of neurovascular patients. Also were discussed cerebro-vascular disease and subarachnoid hemorrhage and new therapies for ischemic stroke treatments along with discussion of giant aneurysms and endovascular therapy for vertebral fistulaes. An update on therapy in cerebral vascular disorders was presented by Dr. Mawad along with the surgeon's point of view as discussed by Dr. Awad. There were also abstracts discussing the microdissection techniques for safe aneurysm clipping and approaches for aneurysms in different locations and giant AVMs. This was followed by a round table discussion by Dr. Awad, Dr. Jaafar, and Dr. Mawad. This was followed by lunch at the Century Park Hotel and a visit to the city of Saida along with site seeing of the old town of Saida and the castle. There was also a quick visit to the Green Peace Boat and visit to the city of Saida along with site seeing of the old town of Saida and the castle. The Green Peace Boat was quickly visited. In the evening there was an official dinner under the Patronage of Mrs. Bahia Hariri, member of the Parliament and President of the Parlimentary Educational Committee. Many local physicians were invited. Several speeches were given by Dr. Awad, Mrs. Hariri, and several others. Artistic displays included a band and dancing with swords and music. This was an enchanting evening.

The Homecoming Meeting was filled with outstanding scientific abstracts and presentations, of social activities and interactions between members, their spouses, and the different guests. It is important to note the quality of the speakers and the abstracts that came from all over the world including Brazil, France, the United States, Lebanon, and Jordan. The meeting was organized by the WALN with the help of the Lebanese Society of Neurological Surgeons and organizing committee. The WALN wishes to thank His Excellency - The President of The Lebanese Republic, Mr. Elais Hraoui for his Patronage of this Homecoming Meeting. We also give special thanks to Mrs. Bahia Hariri for her hospitality and excellent tour that she gave the group to the Hariri School. We thank also our sponsors mainly the two people who believed in the meeting since the beginning of the preparations: namely Doctor Ashraf Hassan from Codman and Ms. Sahar Itani from Novartis. We should also thank Mr Midhat Miski from PMS for helping to organize the meeting, as well as all our sponsors.

After the meeting was complete, several members attending the meeting from abroad had other social plans, one touring different parts of Lebanon and some even went to Damascus, Syria. In general, there was a feeling of warmth, love and affection. Everyone was happy with the meeting. It was a smashing success.

In preparation for the upcoming meeting in two years, we would urge all of the members that attended and those who have not attended, to send any suggestions or ideas to improve on the pitfalls that we had during this meeting and make the next meeting an even greater success.

Mokbel K. Chedid, M.D.
President, WALN


The WALN Reunion in Denver: Scientific Panel on the Website and Cedar Class Donors

WALN members met in Denver on Tuesday April 15th. After dinner, the business meeting was held. Many members attended our reunion for the first time like Drs. Iskandar and Abbood. It was decided to create a scientific panel for the webpage.This panel will be made of eminent members of WALN. This panel is for neurosurgical discussion. It will help the members who need some advice for patients under their care. The exact composition was left to be decided in New Orleans Reunion. The membership fees were kept at US$ 25 for practicing members. Membership is still free for Residents in training. Additional donations are welcome. A donation in the amount of US$100 will qualify the donor to the Cedar Class Donor category. It was also decided to sollicit nominations for the position of Co-ordinator for the Associate members.


Upcoming Events

- The CNS meeting in New Orleans: The parallel WALN Reunion will be held at Mulate' Restaurant located at 201 Julia Street in Downtown New Orleans (Phone number 504-522-1492). Dinner will be served at 8:00 PM on Tuesday, September 30th. The business meeting will follow. If you will be attending, please fax your confirmation to the Newsletter Editor at 202-994-9944.

- The IXth European Association of Neurosurgical Societies Pan-Arab Course will be held in Beirut between October 23rd and october 26th, 1997. Speakers from japan (Dr Hakuba) and Europe (Prs Samii, Pernezcky, George, Sengupta, etc..) Those interested should contact Professor Antoine Nachanakian:
Hopital Saint Georges, Achrafieh, Lebanon
Phone: 961-3-278-818, Fax: 961-582-560

- The Societe de Neurochirurgie de Langue Francaise will hold its fall meeting in Paris on December 1-3, 1997. Those interested should contact Professor Lagarrigue. Service de Neurochirurgie, CHU Rangueil, 1 avenue Jean Poulhes, 31403 Toulouse CEDEX 4.


The Arab Board of Neurosurgery

Ghassan K. Bejjani, MD

The Arab Board for Medical Specializations (ABMS) has recently started certifications for Neurosurgery. Dr Fuad Sami Haddad, our honorary President had a major role in the initiation and the completion process. He had suggested to the ABMS the implementation of an Arab Board of Neurosurgery prior to 1993. The Board was finally started in 1995. There is one member from each participating Arab country in the Board. The Certificate of Arab Board of Neurosurgery (CABNS) will be issued to trainees who have met the training and examination requirements. These requirements have some similarities with those of the American Board of Neurological Surgery.

The training has to be spent in a medical center accredited by the ABMS. The duration of training is six years including one year of internship with a minimum of six months of general surgery. Six months of neurology, three months of neuroradiology and three months of electives are included in the second year. This is followed by four years of neurosurgery. A minimum number of specific neurosurgical operations is required.

The examinations is divided in two parts: A written exam is required during prior to starting the third year. The areas tested are the basic sciences: Anatomy, Physiology, Pathology, Surgery.. The second part of the examination is done after completion of six years of training. It consists of three parts: oral, written and bedside.

A dissertation suitable for publication should be prepared in the last year of training.

The implementation of the CABNS is an important step towards assuring appropriate qualifications of future neurosurgeons in the Arab World.


Historical Vignettes: The Contributions of alraAziy [Rhazes] (842?-932 AD) to the Neurological Sciences

Farid S. Haddad, MD FACS
Phoenix , AZ

alraAziy [Rhazes in Latin] is one of the most splendid clinicians that ever lived. He is one of the very few illustrious physicians who founded Arabic Medicine and whose figure appears in Christian Churches. A stained glass window representing alraAziy writing the title and the first introductory words of his masterpiece "kitaAb alHaAwiy" adorns the vestibule of the chapel at Princeton University (figure) [1].

"alHaAwiy" [ which means the comprehensive and all inclusive encyclopedia] is a 24-volume encyclopedia of Medicine which contains all medical knowledge up to his time, including the medical knowledge of the Greeks , Hindus and the Arabs, as well as his original observations, experiments, ideas, and thoughts. In 1279, it was translated into Latin as the "Continens". It was still on the medical curriculum of the University of Montpellier in 1643 [2,3].

alraAziy also wrote over 200 other medical books, among which is his famous monogram entitled "aljudairy walHaSba" [Smallpox and measles]. His book on Neurology, mentioned by Ibn Juljul, the Andalusian Historian of Medicine, is unfortunately lost [3].

Only a few contributions of alraAziy, some of those which have enriched the neurological sciences will be mentioned here:
· alraAziy was the first to recognize and describe the pupillary reaction to light [3,4]
· He was the first to describe the recurrent laryngeal nerve [3,5,6]
· He was also the first to describe brain abscess following otitis [7]
· He described bladder paralysis caused by a spinal cord tumor in a patient named "qaTTaAn" [8]
· He described a very interesting neurological case of paradoxical paralysis [9]. He wrote: "Half the body of Abu nu Sayr was warm and the other half as cold as ice; no pulse could be felt in the cold half, whereas, in the warm half, the pulse was rapid; the neck muscles were contracted in the cold half and there was severe enophtalmos". What is the diagnosis in this case? One has to entertain one of several possibilities: embolus to the subclavian artery, Pancoast syndrome, or occlusion of the posterior cerebellar artery [3].

For lack of space the reader is referred to other sources [1,3] for a more detailed discussion of alraAziy's contributions to almost all other branches of medicine for which he has earned the title given to him by Sarton, the eminent American Historian of Medicine, who called him "perhaps the greatest clinician of all times".

References
1-Haddad FS:
a) Razy on a glass window at Princeton. Ann Rep Orient Hosp 1971 24 0
b) Rhazes (842-932 AD). J Lab & Clin Med 1991 Apr 117(40) 339-40
2-DuLieu L: La Medecine a Montpellier. Les presses universelles 1983, TIII p231.
3-Haddad FS:
a) a(l)Razy [Rhazes] (c 842-c932 AD). JIMA 1986 Jan Jun 18 22-9
b) Clinical sketches from Arab Medicine. Actas CongresIntern Hist Med 1974 II 1359-1365
4-Elgood C: Medical History. Cambridge: Cambridge University Presss, 1957
5-Cumston CG: An introduction to the history of medicine. London: Truber & Co, 1926
6-Keys TE, Wakim Kh: Contributions of the arabs to medicine. Proc Staff Meet Mayo Clin 1953 28 423
7-alraAziy: alHaAwiy. Hyderabad, 1963-71 vol 16 p 191-2
8-idem p 194
9-idem p 296


Falah Bechara Maroun: Our Newly Elected Honorary President

Dr Falah Bechara Maroun was born on January 25, 1936 in Beit Mery, Lebanon. He completed his secondary education at Al Hikmat School in Beirut. He obtained his MD degree from Saint Joseph University, Beirut, Lebanon, in 1960. He interned at the Orient Hospital under the direction of Fuad Haddad, MD, the father of Lebanese neurosurgery.

He then moved to Montreal where he trained in Neurosurgery at the Montreal Neurological Institute. He obtained his Canadian Fellowship in 1965 and his American Board of Neurological Surgery (Foreign certificate) in 1966 and has always wanted to return to practice neurosurgery in Lebanon.

He has been Chief of the division of Neurosurgery since 1970 in St. John's, Newfoundland (Canada) and has been actively involved in clinical practice and in teaching at Memorial University of Newfoundland. He is currently Chairman of Surgery and Clinical Chief of Surgery for the Health Care Corporation of St. John's. In addition, he is President Elect of the Canadian Neurosurgical Society.

Dr. Maroun has 52 publications and has presented 125 papers and posters at national and international neurosurgical meetings. He also produced a movie on Epilepsy and has written a book on Diastematomyelia. He was awarded the medal of "Merite Libanais" in 1958 and is also Knight of the Order of Cedars of Lebanon (1974).

Dr. Maroun and his wife Bonnie have a 22 year old daughter, Rindala. He has an enduring love of Lebanon that he has been visiting at least once a year for over 30 years, and his interests include fishing, gardening, reading and writing.


Historical Vignettes: Avicenna

The Father of Arab and Middle Eastern Medicine
The Prince of Physicians

Farid Sami Haddad BA, MD, FACS

Up from the Earth's Center through the seventh gate
I rose, and on the Throne of Saturn sate
And many a knot unravel'd by the Road
But not the Master Knot of Human Fate
Avicenna

Avicenna (980-1037 AD) was the most famous physician between Galen and Harvey. Through his book "The Canon", he exerted the greatest influence on world medicine all through the first half of our millennium.

He was surnamed The Chief (ar-Rais), The Dean (ash-Shaikh), The Prince of Physicians.

A versatile mind and a universal intellect, he epitomized the knowledge of his age in all various branches of learning: Medicine, Philosophy, Theology, Mathematics, Astronomy, Poetry, Music; and is even considered the father of Geology and Mineralogy.

Born near Bokhara and buried in Hmadan where one can still visit his mausoleum, he spent his short life (57 years) learning, writing and dabbing in different political and administrative jobs that tormented his years and caused him to be imprisoned more than once.

A precocious prodigy, he had learned and memorized the Koran and a good deal of the humanities at the age of 10; at 16 he had learned arithmetic, logic, mathematics, astronomy and medicine; and at this early age, patients including princes and kings, began to seek his medical wisdom.

An intellectual phenomenon, he left more than a hundred books treating all subjects, forming a real encyclopedia of the knowledge accumulated up to his time.

In medicine, his "Canon" stands out , as it played a singular role in the history of medical literature and medical education. A comprehensive and concise medical work of 1,000,000 words, covering the theory and practice of medicine in a classified, ordered and systematized manner; it is a vast compendium, an immense mini-encyclopedia.

In the East, every medical author who came after Avicenna, felt compelled to write either a commentary on the Canon or an abridgment thereof, a summary or a commentary on the commentary; so that in the space of about 400 years, there accumulated at least 62 Arabic medical books related, in one way or another, to Avicenna's Canon.

In Europe, "The Canon" was translated into Latin by Gherardo the Cremonese (1114-1187). It was one of the first books to be printed after the invention of the printing press in 1436. The first Latin edition appeared in 1473. The book went through thirty Editions, fifteen of which were Latin and the last being the English translation of volume I which appeared in 1966. The publication of the original Arabic version in Rome in 1593 was a veritable tour de force of printing. One of the most influential books in the history of our procession, the Canon superseded previous texts (Rhazes' book and Majusi's al-Malaki), held the field both in the East and in Europe, and dominated, not only the teaching but also supreme medical authority in European universities alongside with Hippocrates, Galen, Rhazes and Abulcasis for over six centuries; and in many areas of the world it continues, till present time to enjoy the position of the favorite text, not only in medical schools in vast areas of Asia, but also in the hands of village doctors and innumerable homes. The book served as a medical bible for a longer period of time than any other work. Osler (1849-1919) wrote that Avicenna is "the author of the mots famous medical textbook everwritten".

Recently, Saton, the well-known historian of medicine, has rightly said that Avicenna was "the most famous scientist of the Arabs and one of the most famous of all races, places and times".

References
Gruner, OC: Treatise on the Canon of Avicenna, London, 1930
Haddad, Farid Sami: Ibn Sina, al-Urwat al-Wuthqa 1946 11(4): 38-44
Haddad, Farid Sami: Avicenna, Ann Rep Orient Hosp 1962 15: 31 and 43-45
Haddad, Farid Sami: Pioneers of Arabian Medicine. Leb Med J 1968 21: 67-80
Sarton G: Introduction to the History of Science, 1928, page 709


Member Matters

- Dr Joe Maroon donated US$ 1,000 to WALN to start the drive for the WALN International Fellowship Program. Many thanks to Dr Maroon for his generous contribution.

- Dr Falah Bechara Maroun was elected as lifetime Honorary President during the WALN homecoming Congress in Beirut. His Biographical sketch is enclosed in this issue.

- Dr Issam Awad will be the Chairman of the Scientific Committee of the CNS Meeting in Seattle in 1998.

- Dr Ghassan Bejjani was given the Al-Razi Award for the Best Clinical Paper during the meeting of the Arab American Medical Association in Washington DC, on August 30, 1997.

- Dr George Haddad wishes to step down from his position as Regional Representaive for Lebanon. Nominations and Proxy votes should be addressed to Drs Chedid or Muakkassa. Nominations are also requested for the position of Associate Members Co-ordinator. The candidate should be an Associate Member (ref. Issue#6, Page 7).

- Drs Ali Krisht and Suheil Haddad contributed $100 each to WALN. They are our first Cedar Class Donors. Thanks to both of them.


Our New President: Mokbel Chedid

Mokbel Chedid was born in Marjoyoun, In South Lebanon on May 15, 1955. He obtained his MD degree from the American University of Beirut in 1981. It is also at the AUBMC that Mokbel did his neurosurgical residency finishing it in 1985. After completing residency in Lebanon, he came to the USA where he did fellowships in microneurosurgery and lasers, clinical neurophysiology and intraoperative monitoring, and general surgery (Allegheny General Hospital, Pittsburgh, PA, 1986-1989). He also furthered his neurosurgical training at the Medical College of Georgia, Augusta, GA, where he was on staff in 1994-1995. In July 1995, he moved to Genesys Regional Medical Center, Grand Blanc, Michigan where he established single-handedly one of the fastest growing neurosurgical divisions in the area, of which he became section Chief in November 1996. Along with two other neurosurgeons and, in less than three years Dr. Chedid was able to build a neurosurgical division with over 1200 cases per year.

Dr Chedid is member in over ten medical societies. He has worked and has publications in multipe areas of neurosurgery: Lasers in neurosurgery, head injury, genetic manipulation of brain tumor cells in culture, CNS transplantation and spine surgery, among others.

Mokbel is married to Mrs. Nuha Chedid, They have two children Khalil and Fuad.

A man of much expertise and strong determination, Dr. Chedid is our newly elected President for the next term.

You can email Dr Chedid at Mikecmd@aol.com or mchedid@pop.net


In the Next Issue

- WALN, A Historical Note
- Our Honorary Presidents Series Part III: Charles Fager, MD
- Geographical Vignettes
- And more Historical Vignettes

For More Information Contact:
World Association of Lebanese Neurosurgeons
Tristate Neurosurgical Associates, 200 Lothrop Street, Suite 5C
Pittsburgh, PA 15213
Tel: 412-647-3604
FAX: 412-647-3605
Internet: bejjanigk@msx.upmc.edu


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