Shaad Bidiwala MD PA

09/28/2025

So true, and couldn’t have said it better myself.

I tell any and every medical student that will listen: if you want to truly see patients with your eyes, you must first learn about the little things that make up how they see themselves through their eyes.

Mom. Dad. Brother. Sister. Son. Daughter. Tattoo Artist. Spanish Teacher. High School Linechef. Meticulous Sculptor. Relentless Hellraiser. Ballet Dancer. Do or Die Patriot. Hero Veteran. Rebel With a Cause. The Last Line of Defense for a Family, Community, or Country.

That’s the good stuff. And the stuff that will motivate you to understand and always do your very best for every patient you meet.

I know the exact pressure it takes to crack a rib during CPR. But last Tuesday, I learned a patient’s silence can break a doctor’s soul.

His name was David Chen, but on my screen, he was "Male, 82, Congestive Heart Failure, Room 402." I spent seven minutes with him that morning. Seven minutes to check his vitals, listen to the fluid in his lungs, adjust his diuretics, and type 24 required data points into his Electronic Health Record. He tried to tell me something, gesturing toward a faded photo on his nightstand. I nodded, said "we'll talk later," and moved on. There was no billing code for "talk later."

Mr. Chen died that afternoon. As a nurse quietly cleared his belongings, she handed me the photo. It was him as a young man, beaming, his arm around a woman, standing before a small grocery store with "CHEN'S MARKET" painted on the window.

The realization hit me like a physical blow. I knew his ejection fraction and his creatinine levels. I knew his insurance provider and his allergy to penicillin. But I didn't know his wife's name or that he had built a life from nothing with his own two hands. I hadn’t treated David Chen. I had managed the decline of a failing organ system. And in the sterile efficiency of it all, I had lost a piece of myself.

The next day, I bought a small, black Moleskine notebook. It felt like an act of rebellion.

My first patient was Eleanor Gable, a frail woman lost in a sea of white bedsheets, diagnosed with pneumonia. I did my exam, updated her chart, and just as I was about to leave, I paused. I turned back from the door.

"Mrs. Gable," I said, my voice feeling strange. "Tell me one thing about yourself that’s not in this file."

Her tired eyes widened in surprise. A faint smile touched her lips. "I was a second-grade teacher," she whispered. "The best sound in the world... is the silence that comes just after a child finally reads a sentence on their own."

I wrote it down in my notebook. Eleanor Gable: Taught children how to read.

I kept doing it. My little black book began to fill with ghosts of lives lived.

Frank Miller: Drove a yellow cab in New York for 40 years.
Maria Flores: Her mole recipe won the state fair in Texas, three years running.
Sam Jones: Proposed to his wife on the Kiss Cam at a Dodgers game.

Something began to change. The burnout, that heavy, gray cloak I’d been wearing for years, started to feel a little lighter. Before entering a room, I’d glance at my notebook. I wasn’t walking in to see the "acute pancreatitis in 207." I was walking in to see Frank, who probably had a million stories about the city. My patients felt it too. They'd sit up a little straighter. A light would flicker back in their eyes. They felt seen.

The real test came with Leo. He was 22, angry, and refusing dialysis for a condition he’d brought on himself. He was a "difficult patient," a label that in hospital-speak means "we've given up." The team was frustrated.

I walked into his room and sat down, leaving my tablet outside. We sat in silence for a full minute. I didn't look at his monitors. I looked at the intricate drawings covering his arms.

"Who's your artist?" I asked.

He scoffed. "Did 'em myself."

"They're good," I said. "This one... it looks like a blueprint."

For the first time, his gaze lost its hard edge. "Wanted to be an architect," he muttered, "before... all this."

We talked for twenty minutes about buildings, about lines, about creating something permanent. We didn't mention his kidneys once. When I stood up to leave, he said, so quietly I almost missed it, "Okay. We can try the dialysis tomorrow."

Later that night, I opened my Moleskine. I wrote: Leo Vance: Designs cities on paper.

The system I work in is designed to document disease with thousands of data points. It logs every cough, every pill, every lab value. It tells the story of how a body breaks down.

My little black book tells a different story. It tells the story of why a life mattered.

We are taught to practice medicine with data, but we heal with humanity. And in a world drowning in information, a single sentence that says, "I see you," isn't just a kind gesture.

It’s the most powerful medicine we have.

03/20/2025

It was an Autumn morning towards the beginning of my sixth and final year of neurosurgery residency. Today’s patient had a large right frontal meningioma, a brain tumor causing her to have not only headaches, but weakness on her left side. I had spoken with the patient and her family in the preoperative holding area, waited patiently by the patient’s side as the anesthesiologist put her to sleep, carefully positioned her delicate body on the table so that her tumor would be facing up towards the ceiling, marked and draped the incision, numbed it up with 10cc of Lidocaine with epinephrine, and began the exposure with a fifteen blade scalpel.

“Dr. Bidiwala has started the operation, sir”, I heard the circulating nurse say peppily on the phone to Dr. Young, my attending for that case, and my mentor for the past five years. As the tan blush of the tumor was beginning to show itself through the thin bone above it, Dr. Young entered the room, got gowned and gloved, and approached the operative field that I had dutifully demarcated with four clean blue surgical towels with their creases perfectly positioned towards the soon to be exposed tumor.

“Nice job, Shaad.” I beamed under my mask because I knew that Dr. Young was not one to compliment anyone often, much less me.

Dr. Young held his right hand out to the scrub nurse. “Bipolar electrocautery.”

“Sh*t.” I thought to myself. I had forgotten to test the instruments. “Sh*t!” My silent hysteria was interrupted by the lonely clanking of the bipolar pedal without the familiar tone that the electrocautery unit emitted when it was in fact up and running.

Dr. Young shot a searing glance at me and let out an intentionally audible sigh. I was one thousand percent certain of what was going to happen next. Here it went. “Now Shaad, if you were an airline pilot, and you didn’t test the electrocautery…” His words were momentarily drowned out in my mind as I wondered why Dr. Young liked airplanes and checklists so much, and if there was still time to cut my losses and join the circus. “.. the plane would’ve crashed, right?”

It had taken me five and a half years of hearing this analogy to figure out that the answer to this particular question was always “Yes sir.” It didn’t matter if my hypothetical crew was a lot of lazy imbeciles, the air traffic controller was a drunken Russian spy, or if the plane’s wings were made of wicker and fell off through no fault of my own. Hell, it didn’t even matter that there wasn’t an electrocautery on any airplane, as a resident once pointed out before being summarily remanded to ICU pencil-sharpening duty for a week. The answer was always “Yes sir.”

“Yes sir.” I responded. Satisfied, Dr. Young smiled back from behind his mask before reaching for a now-functioning electrocautery.

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Alfred Byron Young MD was the Founding Chairman of the Department of Neurosurgery at the University of Kentucky Medical Center, and one of the most profound influences on not just my career, but my life, and well as those of the numerous neurosurgeons that received their wings before and after me. Looking back on my neurosurgical training that began almost thirty years ago, I can say that Dr. Young taught me much more than how to remove a brain tumor, implant a functioning brain machine interface, clip an aneurysm, or take the pressure off of a horribly compressed nerve in the spine. He taught me about life. Not just about my life, but about the lives of the numerous other people that I would affect in what would, to date, be my two-plus decade long career as a neurosurgeon.

Aside from the immense value of always checking the surgical instruments before making an incision – a lesson that my scrub nurses rue to this very day - Dr Young taught me that being a doctor, and, especially a neurosurgeon, meant putting your patients’ lives – and their families’ lives - above your own. He believed to his core, as I do now, that there was simply no better way to be an excellent physician or surgeon without putting your own needs aside in the service of someone who was in more immediate or critical need. This meant always pushing yourself to the limit to be better, and with less. Less food, less sleep, and less attention to the way you felt – angry, sad, tired, hungry - it didn’t matter when you had made a decision to serve the greater good. Young residents – present company included – initially found Dr. Young’s expectations to be daunting, intimidating, even paralyzingly impossible. But as we surprised ourselves by meeting those expectations, and making the impossible possible more and more often, a strange thing happened. We became the competent surgeons that Dr. Young intended us to become – and at the same time we learned a compassion and humility that was uncommon for neurosurgeons at the time, and still is.

If a patient that we had operated on ever had an adverse outcome, no matter how minor, Dr. Young would delight in making an invitation that we residents dreaded: “Why don’t you give us a talk about that on Saturday morning?” Dr. Young’s infamous several hour-long Saturday morning conferences were held every week, and would involve a handful of us presenting the week’s haul of the good and the bad, but mostly the ugly. We would describe the complication that we had experienced and then propose ways in which we could have averted it. But without any excuses whatsoever. If one of us dared to blame the patient’s diabetes for their complication, we would quickly find ourselves being “invited” to present a detailed review of the medical management of diabetes the next Saturday. If we complained that an instrument had malfunctioned, we would be giving a talk about the circuitry of that instrument and how it could be repaired the very next week. Until I came to accept and embrace that blame and excuses were not refuges that were available to neurosurgeons, I would routinely find myself booked for speaking arrangements at several Saturday conferences in a row.

This taught me that the patients and families that called upon us in their time of desperation didn’t care about excuses, nor was it their function or job to do so. It was our calling – and we had all accepted it – to do the very best we could, and to not stop until every possible option had been exhausted, and without excuses. It was our calling to care for the sick – who were, many times, weaker or less able to comprehend their situation than we were – and to treat them with the kindness and dignity that all human beings deserved. It was our duty to do everything we could to make the impossible possible. And if we failed, it was our job to explain what had happened to the best of our ability and without blame, and to accept that that family may harbor anger and resentment towards us in perpetuity, even if we had nothing to do with the failure.

I realized the value of this lesson the first, and thankfully the last, time I was sued for medical malpractice two years after I had graduated residency. A young lady had jumped from a balcony, and my team and I had unfortunately been unable to save her. As the plaintiff’s attorney hammered away at me for almost eight hours during my turn on the stand, I offered every intervention that we tried, why we tried it, what the outcome was, and what we did next. But not once did I take the bait of blaming the patient, the other doctors, or even myself. The deceased patient’s mom and her attorney didn’t care, and I did not expect them to. I couldn’t expect them to because they were both dealing with the fresh loss of a young soul. Even though they were suing me, I did my best to explain everything I could to them and the jury, without acrimony but with compassion, because that’s what this young lady’s family needed whether they realized it or not. The jury decided in my favor 12-0 in just eleven minutes of deliberation after a nearly two-week trial. All of the times Dr. Young had hammered away at me at Saturday morning conference suddenly made sense after that two weeks in court.

When I told him that at his retirement party years later, he turned to me with an all-knowing smile on his face and nodded without a single gloating word. Instead, he looked at me with a kindness in his eyes and said “I think you did the right thing, don’t you?” That’s the kind of man and teacher Dr Young was, and the kind of man and teacher I aspire to be.

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Dr. Young passed away peacefully in his sleep on January 31st 2025. I think I can speak for all of the residents that Dr. Young taught when I acknowledge that, while Dr. Young was teaching us, he was also away from his family. During the thousands of hours I spent with Dr. Young, he spoke with immense and infectious fondness about Mrs. Young, their two sons and their families. I would like to thank them for sharing Dr. Young with us. His skill, compassion, and acumen have left an indelible mark on the lives of so many surgeons, and perhaps more importantly, the patients whom we have cared for while remembering his wisdom. His legacy will always be cemented in the center of the University of Kentucky Neurosurgery family, and something that I will always be proud to have been a part of.

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It had been a long day at work, especially for post pandemic. A brain tumor, a lumbar fusion, a fractured neck, then a mad dash to the airport to meet my family for a wedding. I flew through security, boarded the plane, and made my way to my requisite window seat, where I dozed off with my face uncomfortably against the cold inner shell of the plane’s cabin. I awoke as the lights flickered and the pilot’s upbeat but apologetic voice came in abruptly on the PA. We would be returning to the terminal. Something about a door not closing.

For a brief second, my sleep-deprived mind wandered into a fantasy. I pictured myself getting out of my seat and making my way up to the cockpit. When I got to the cockpit’s open folding doors, I would read the pilot’s name badge, channel the great Dr. Young, and say in his precisely metered words: “Now, Rick, if you were a neurosurgeon, and you didn’t check the cabin door, the patient would’ve died, right?” My heart raced as I pictured the young pilot looking back at me quizzically from his instrument panel, with one eyebrow raised, motioning to the flight attendants behind me, one on each side, as they prepared to grab my arms.
Now fully awake and thankful that I was still in my seat, I chuckled to myself. “Absolutely sir, he would have,” I imagined the pilot saying.

“Absolutely. Yes sir, Dr. Young.” I let my face fall back against the cold off white plastic and fell fast asleep.

Alfred Byron Young, MD, FACS, former chair of the UK departments of surgery and neurosurgery, died peacefully in his sleep at his home in Westerville, Ohio on January 31st, 2025. 

09/24/2024

Minimally invasive lumbar fusion that we perform through two approximately one-inch incisions.

07/21/2023

One of the most challenging things we do - and much of what we do do - is to salvage surgeries done elsewhere when things didn’t go quite as expected.

This is a 60YO lady with a fracture of the T10 vertebra that resulted in severe back pain. A surgeon at another hospital had tried to fix this by doing a vertebroplasty - that is, injecting cement into the vertebral body - hoping to cement the bone fragments together and stabilize the fracture.

Unfortunately the patient not only experienced worsening of the back pain after surgery, but also developed a searing pain that wrapped around her rib cage on the left hand side.

A CT showed the cause of her problem immediately. The cement had leaked out of the bone and had “set” into a rocklike mass pushing against her spinal cord and nerve roots. To make matters worse, the fracture was still unstable, accounting for her persistent and worsening back pain leaving her unable to stand upright, let alone walk.

At surgery we first placed screws and rods to stabilize the fracture. Then we exposed the spinal cord, the nerves, and the rocklike mass pushing against both. To reduce the risk of paralysis that could result from retracting the spinal cord, I used a high speed drill to “core out” the cement mass, and then gently pulled the resulting hollow shell away from the spinal cord:

The patient had excellent relief of her back pain and was able to walk a few days after the surgery. A few months later she still reported some residual nerve pain in her ribs but it had improved dramatically and we expect it to continue disappearing as the nerve heals.

Our patient is accustomed to being the best of the best in everything she does. It was truly an honor for our entire team to be a part of her recovery and we wish her the best of luck during the process.

*exact demographic details altered to protect anonymity.

02/27/2023

Though most of what we do as neurosurgeons is spinal surgery, occasionally we are called to match wits with much more complex situations involving the brain.

One such call came at 1230AM from an emergency room that I cover: a patient who had lost a fight with a nail gun.

As tempting as it was to simply pry the nail out of this patient’s skull through the hole in the skin and go home, the appropriate process took approximately seven hours longer.

We began by obtaining a CT of the patients head to make sure there wasn’t an active hemorrhage that would have required a larger, more urgent surgery.

The CT did not show a significant hemorrhage, so we obtained a four vessel angiogram - a roadmap-like picture of the blood vessels in the brain, obtained by one our expert neuroradiologists - to see if there had been damage to any of the major blood vessels of the brain, so that our team could be prepared to repair them if necessary.

The nail had miraculously *missed* every major blood vessel in this patients brain. We proceeded to surgery with a sense of relief but caution.

At surgery, I first exposed the patient’s carotid artery in the neck, just in case there *was* a vascular injury that the angiogram had missed. I identified a point on the carotid artery that I would close off with a metallic clip in case uncontrollable bleeding occurred while removing the nail.

After this, I incised the skin around the nail, removed bone around the nail, opened the covering of the brain, and removed the nail carefully and slowly, *under direct visualization* so that I could identify and fix any bleeding in case it occurred. After removing the nail, only minimal bleeding was seen and this was stopped by injecting a hemostatic gel into the hole left by the nail. To finish, we irrigated throughly, placed a mesh over the skull defect and closed. the muscle and skin tightly with suture.

We were grateful that the patient came out of surgery without skipping a beat. There were no neurological deficits and the patient was discharged home several days later.

**Pictures were shared with the patients permission, but all identifying information has been removed.

07/25/2022

This is a nice 70YO lady who had a several year history of severe back pain and right leg pain.

She tried and failed medical management, physical therapy and injections. Her MRI showed a grossly misaligned spine with a spondylolisthesis of L4 on L5 in which the L4 vertebral body was literally slipped forward on the L5 vertebral body with compression of the nerve roots in between, explaining both her mechanical back pain and leg pain.

At surgery we performed a minimally invasive MAS-TLIF. We made two small 1.5-inch incisions and implanted Nuvasive ReLine screws. The screws were used to distract across the malaligned vertebrae, while we removed bone and disk and implanted a Nuvasive titanium CoRoent TI spacer - or “cage” filled with the patients own bone. Surgery took approximately 2.5 hours and the patient went home two days later.

At several months out, our patient is doing wonderfully. Xrays show normal alignment and her back pain and leg pain have resolved. We wish her much luck in getting back to her normal life and are excited and honored to be a part of her recovery!

04/16/2022

Dr Bidiwala is one of the 10-15% of neurosurgeons who take neurotrauma call at one of the 190 top-tier “Level One” Trauma Centers designated by the American College of Surgeons. Though the random and urgent nature of brain and spinal trauma is a challenge, it keeps our team on the cutting edge and always thinking outside the box.

This is a nice 19 year-old woman who was involved in a high speed motor vehicle accident in which she sustained a “Hangman’s” fracture in which the C2 vertebra was forcible split in half. The result was a highly unstable configuration that could have paralyzed her if not treated carefully.

This inspiring young lady was destined, and determined, to beat the odds. We initially placed her in cervical traction, and then took her to the operating room where we carefully, using live X ray and continuous spinal cord monitoring, fixed her in place with plates and screws from the front and rods and screws from the back.

Three months later, she is almost completely healed and neurologically intact! Kudos to this amazing young woman for working hard to get her life back. We are proud to be a part of her recovery and her return to normal!

01/30/2022

Here I am, almost fifty years ago, with the first ever Dr. Bidiwala, a general surgeon and internist in Mumbai, India, known for his commitment to his patients above all else.

When I was older I would find my grandfather’s prescription pads, cross off his first name, and write mine instead, imagining what it would be like to be even half the person or doctor that he was.

We truly stand on the shoulders of giants.

12/16/2021

Merry Christmas, Happy Hanukkah, and Happy Holidays from Team Bidiwala at Texas Neurosurgery!

May the New Year bring prosperity, happiness, and health to you and your families in 2022!

09/26/2021

Neurosurgery is a team sport, and this is my team, wearing, for my birthday, shirts with my favorite quotes from “Talladega Nights” on them!

Tammy is my Office Manager who, in addition to running the show and keeping everyone in line, schedules surgeries, often spending hours on the phone getting them approved by insurance companies and making sure all of the patients get exactly what they need before surgery.

Nicole is my Medical Assistant who sees patients in the office before I do so that she can give me an idea of what we need to focus on during our visit. Behind the scenes, she takes care of a mountain of paperwork from work releases to prescription refills.

Lizzie is my Physician Assistant, and right hand. She spends long hours assisting me in surgery, helping me round on patients in the hospital, seeing patients in the clinic with me so that we come up with the best plan for each patient, and, behind the scenes, answering any questions they may have before or after surgery.

Chelsea is my Checkout Receptionist and is the one who makes sure that the plan that we discuss, whether it is for physical therapy or a referral to another physician, actually happens.

Amy is my Intake Receptionist who is the one that patients usually speak to when they schedule appointments on the phone, and the first one they see when they come for their visit.

My shirt says “If you ain’t first, you’re last.” I am blessed to have the best team in Neurosurgery anywhere! I am so proud of each and every one of them for their expertise and the compassion that they have for our patients. It is what makes our team what it is and what makes coming to work every day not only rewarding, but a blast!

Thank you so much, guys!

01/25/2021

In neurosurgery, less is often more, but sometimes more is necessary, especially in patients with severe arthritic disease of the spine that spans multiple levels.

This is a nice 55YO gentleman with a long history of neck and left arm pain. His MRI showed a slip, or “listhesis” of C4 on C5, with disc space collapse at C56 and C67, resulting in a reversal of the normal “C” shape curve of the cervical spine into an “S” shape with painful spinal instability and compression of the nerve roots.

At operation, we removed the discs of C45, C56, and C67, and reconstructed the patient’s cervical spine with three titanium spacers, or “cages’ (4Web, Frisco, TX), and a titanium plate {Nexxt Spine, Noblesville, IN). The result was excellent decompression of the affected nerve roots and restoration of the patient’s normal cervical curve.

Postoperatively, our patient reports resolution of his arm and neck pain. We will be following him carefully as he returns to a normal life over the next several months. We will be pulling for him every step of the way, and are thankful to him for the trust he has placed in us to get him past the finish line.

As always, surgery takes a team, and we are grateful to the nurses, scrubs, doctors, radiology techs, and numerous others for their expertise in making great results possible.

01/12/2021

Neuromodulation is a specialty within neurosurgery that marries implantable sensors and microcomputers with the brain and spinal cord to enhance and, in many instances, restore neurological function. As an electrical engineer, a neurosurgeon, and a childhood fan of the Six-Million Dollar Man (!!) I dedicate much of my time to finding new ways of using these types of cutting edge technological advancements in my practice.

Below is the top view of a Responsive Neurostimulator (NeuroPace, Mountain View, CA) that we implanted in a nice lady who had been having as many as a hundred incapacitating seizures every month in spite of treatment with several antiepileptic medications at a time in an effort to stop them.

A depth electrode (top left) was precisely placed through her skull deep into a pea-sized bundle of gray matter called the centromedian nucleus of the thalamus. The stimulator itself (bottom) is implanted into a hole patterned in the skull, and houses an electronic neural network that “learns” how to detect when a seizure is about to start and then delivers a current through the same electrode to stop it before it even starts.

It has been a long journey for our patient and we hope that this revolutionary technology will make her life a little more normal. So far, results have been promising and we hope to see her in the “win” column soon!