Changing Hands: Why Being Ambidextrous Is a Trait That Needs to Be Acquired and Nurtured in Neurosurgery Harsh Deora 1 , Manjul Tripathi 2 , Nishant S. Yagnick 3 , Sonali Deora 4 , Sandeep Mohindra 2 , Aman Batish 2 INTRODUCTION In 2005, guitarist Billy McLaughlin was struggling. This award-winning and sensational finger-style player known for his signature technique of tapping on strings started having problems control- ling his left hand and missing notes. After his first single, “Finger-dance,” peaked at number 7 on the Billboard charts, he was performing in hundreds of shows a year and was planning another album. How- ever, now audiences thought he was drunk on stage, and he himself had no clue of what was wrong. Gone were his trademark “hammer-ons” and “pull-offs” that used to create a harplike effect on the acoustic guitar. This period of confusion and depression continued for more than 2 years and he struggled with unexplainable muscle spasms and contractions. Often unrelenting in nature, the muscle spasms and contractions grew worse until he was unable to perform his own songs. Finally, after several consultations, focal dystonia was diagnosed. He was advised to look for other career options. He started song- writing and released another album with his band in 2002, but it was clear that his days as a virtuoso guitarist were over. Without his music, he was lost. Not one to give up, he began, in what can only be described as one of the greatest comeback stories of all time, to play left-handed. He had his 2 guitars refitted and restrung for the left hand and began practicing. Finally, in 2007, he released “Into the Light,” his first piece as a left-handed guitarist. His story has been the subject of an award-winning documentary titled Changing Keys—Billy McLaughlin and the Mysteries of Dystonia. 1 HISTORICAL EXAMPLES Billy McLaughlin’s story is nothing less than extraordinary and, for the neurosur- geon, brings to light a quaint yet essential aspect of our profession: the dependency on fine motor skills. Dexterity comes from the Latin word dexter, meaning right, as the right hand is dominant and therefore more skilled in the most people. Very few people use both hands equally well, whether surgeons, athletes, or artists. This is a skill not limited to surgeons or mu- sicians but also required in other pro- fessions, such as magicians, basketball players, orchestra conductors, and chefs who manage multiple pots and pans at once. In an editorial, Wilder, 2 a professor of surgery at Mount Sinai Hospital, described the need to train ambidextrous surgeons; he stated that the ability to let go of one’s ego and the incentive to train were lacking. McLaughlin stated in the documentary of his life, “The biggest hurdle initially was me allowing myself to sound like crap. I’m a beauty addict, and to not be able to create anything that sounded beautiful was difficult to get through.” Similarly, whenever a neurosurgeon learns a new procedure, he undergoes a phase of relearning, for example, placing the first external ventricular drain, performing the first craniotomy, or even more advanced procedures such as the first intradural drilling or the first sylvian split. He must shed his ego then and be willing to make mistakes and learn from them. The sec- ond obstacle pointed out by Wilder is incentive. 2 When McLaughlin lost his fine motor skills, he lost everything. A basketball player must improve his game or risk nonselection. We as neurosurgeons have the luxury to plateau. We can either choose to remain stagnant or be willing to raise the bar. - OBJECTIVE: The aim of this article is examine the issue of ambidexterity under the neurosurgical lens and demonstrate its need, its validity, and its ad- vantages to neurosurgery as a whole. - METHODS: Inspiration can be derived from extraordinary circumstances that shaped ordinary people into legends. There have been instances in history where highly skilled professionals relying on hand motor skills had the misfortune of having to relearn their skill set with the other, less dominant hand. - RESULTS: We as neurosurgeons have always been ahead of the curve. It is only natural for us to understand the need and advantages of using both our hands with equal dexterity. Whether ambidexterity is an inherited trait or one that can be taught and, if practiced, mastered has been controversial. - CONCLUSION: These remarkable individuals from history demonstrate that if one is willing to practice without ego and one has the right motivation, one can use both hands with equal dexterity. Key words - Ambidexterity - Neurosurgery - Surgical skills From the 1 Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Education and Research, Lucknow; 2 Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh; 3 Department of Neurosurgery, Paras Hospitals Gurgaon; and 4 Department of Radiodiagnosis, Narayana Hruduyala Hospital, Bangalore, India To whom correspondence should be addressed: Manjul Tripathi, M.Ch. [E-mail: drmanjultripathi@gmail.com] Citation: World Neurosurg. (2019) 122:487-490. https://doi.org/10.1016/j.wneu.2018.11.106 Journal homepage: www.journals.elsevier.com/world- neurosurgery Available online: www.sciencedirect.com 1878-8750/$ - see front matter ª 2018 Elsevier Inc. All rights reserved. WORLD NEUROSURGERY 122: 487-490, FEBRUARY 2019 www.journals.elsevier.com/world-neurosurgery 487 Historical Vignette