What sets a Great surgeon apart from a good surgeon? According to Dr. Murari Kaimal, considered one of the most visionary surgeons defining the future of healthcare, it is the commitment to the patient and attention to detail, driven by the spirit of innovation.
Being the Senior Consultant Endoscopic Skull base surgeon and Consultant Advisor for ENT and Surgical services to the Emirates of Afghanistan, under the Ministry of Defence, erstwhile MD & CEO, Senior Consultant ENT – at The New England Medical Centre, and Consultant Specialist AI Trainer of Otolaryngology, at Digituala– most noteworthy among a multitude of his endeavors or titles. Dr. Kaimal believes that any Surgeon’s full potential is brought out only by an equally talented and well-trained team to support them. This encompasses the junior surgeons, anaesthesia team, scrub nurses, theatre staff, and most importantly, the non-clinical and management staff who ensure that everything goes perfectly in the background so that the surgeon can fully focus on his job, i.e., surgery.
“The moment you realize this and put in efforts to raise and maintain your team, whom you can bank on unconditionally on a difficult day, you can see miracles happening.” Making sure updated SOPs and guidelines are in place as per principles of Evidence-Based Medicine (EBM), which ensures- patient safety, minimises incidents or errors, improves efficiency or ease of work, and also making sure that all the staff, including yourself, are trained and familiar with the same.
That is why Dr. Kaimal’s philosophy is simple, effective, and of utmost significance for any healthcare model: Training, Team building, and putting in an enjoyable yet productive patient safety-oriented work culture.
A Calling for Surgical Innovation
Dr. Kaimal’s journey into the intricate and demanding world of Endoscopic skull base and airway surgery was shaped by a profound belief in innovation and the relentless pursuit of precision. He was drawn to the field as technology began to advance, with smaller scopes, clearer cameras, and new methods for tissue removal like improved Coblation and LASER. This technological boom, as he notes, “had also led to surgeons being more adventurous and exploring newer minimal access approaches and procedures.”
His initial training under Brigadier Ramachandran, whom he considers one of the most versatile surgeons and mentors he has known, was inspirational. This was followed by a pivotal advanced training opportunity in the UK at Salford Royal, a world-class hospital. Here, he worked alongside skull base and Endoscopic surgery stalwarts like Prof. Simon Lloyd, Prof. Simon Freeman, Prof. Nirmal Kumar (ENT-UK President), Raj Bhalla, Chaithanya Gadepalli and Rohini Aggarwal, to name a few.
This experience was a turning point, where he learned to merge clinical management, surgical skills, and teamwork to drive cutting-edge innovations in patient care. This holistic approach remains a cornerstone of his practice today.
Evolving from Surgical Skill to Patient-Centric Philosophy
Dr. Kaimal’s surgical philosophy has evolved significantly over his career, a journey he describes as a shift from youthful eagerness to a mature, patient-centric approach. As a young surgeon, he had a ‘higher risk-taking appetite,’ eager to push boundaries. However, as he matured, he realized the need to channel this energy toward the best possible outcomes with minimal failures. He emphasizes that “nothing can substitute meticulous pre-planning and prior mock-up team drills for tackling complex, challenging cases.”
This maturation also reflects a broader global shift in the medical field. While the focus was once on simply removing pathology and saving lives, it has now moved toward maintaining Quality of Life (QOL). This involves meticulous Pre-Operative planning and a Multi-Disciplinary Team (MDT) approach to ensure minimal morbidity and a rapid recovery with best possible results for the patient. For Dr. Kaimal, staying relevant in this rapidly evolving field means embracing technology, including AI and robotics, and committing to lifelong learning.
A Fusion of Innovation and Meticulous Precision
Dr. Kaimal’s surgical expertise extends beyond his surgical skill to his commitment to developing and championing next-generation technologies. He is actively trialing “new and innovative medical devices and approaches, along with AI integration, to bring out the next generation of cutting-edge minimally invasive surgical technology.”
This visionary work involves designing intuitive patient profiling and decision-making models capable of supporting and augmenting both young trainees and experienced surgeons in managing complex cases.
By integrating machine learning with endoscopic and narrow-band imaging, as well as other imaging technologies, he aims to improve diagnostic accuracy and ensure surgical clearance for even the most difficult-to-access tumours, establishing himself as a pioneer in the technologically advanced future of surgery.
The Power of Collective Wisdom
For Dr. Kaimal, consistent, predictable results in intricate procedures are achieved not by individual skill alone, but through a structured, collaborative approach. He believes that while following established guidelines and SOPs is essential, each case demands a fresh strategy that draws from the collective wisdom of available research and years of acquired knowledge. He is a steadfast champion of a Multidisciplinary Team (MDT) approach, which he finds “helps in minimizing the risk and improving patient outcomes.”
The advent of AI and cutting-edge diagnostics has only strengthened this methodology, providing robust pre-operative insights that ensure a customized, patient-centric approach with an additional layer of safety. Dr. Kaimal proves that the future of surgery lies in the seamless integration of individual expertise, collaborative wisdom, and advanced technology.
The Art of Patient-Centric Care
For Dr. Kaimal, true patient care transcends technical excellence, focusing on the human element. He believes the only way to genuinely connect with his patients is to “put himself in the situation of the patient”, providing clear, simple, and open communication. He ensures patients receive comprehensive information, including all available options and their probable outcomes, by drawing on the extensive latest research database and his experience.
To make this process less intimidating, one can provide audio-visual and written materials. He also advocates for psychological support and peer group references, empowering individuals to assimilate the news and make informed decisions. “Ultimately, it is their body and their choice,” he says, with his team’s sole purpose being to provide unwavering support regardless of the patient’s decision or outcome.
Pioneering the Age of AI in Surgery
Dr. Kaimal is a pioneer in the integration of AI into surgical practice, viewing it as a technology in its ‘baby steps’ stage, and growing up amazingly fast with immense future potential. He is at the forefront of this evolution, holding hands, nurturing and guiding appropriately, believing that AI and Machine learning will soon become indispensable. He notes the promise of AI-guided imaging modalities intra-operatively in cancer surgery, which can help surgeons detect tumor extension and margins more precisely, ensuring complete margin clearance.
This minimizes collateral tissue damage while ensuring complete removal of the pathology. This technology, when integrated with endoscopic or robotic platforms, will lead to more robust, objective and comprehensive interventions with predictable outcomes, underlining his role as a forward-thinking visionary innovator.
The Ethical Compass of Innovation
While championing the technological boom, Dr. Kaimal is equally committed to the ethical responsibilities that guide its implementation. He acknowledges that this is an ongoing debate with no foolproof solutions, but believes that the potential benefits of AI in surgery far outweigh the risks. He emphasizes that better industry practices, accountability, and robust legal frameworks are making these technologies safer and more reliable.
Dr. Kaimal ensures fairness, transparency, and patient privacy by openly discussing technology with all stakeholders, including the patients themselves, to empower them to make educated and informed decisions. His approach is a powerful example of balancing technological advancement with the core principles of human-centric care.
A Legacy of Transformative Impact
Dr. Kaimal’s ultimate legacy is his unwavering commitment to his core guiding principle: ‘keeping the patient as the centre of your universe.’ He has consistently bridged the gap between cutting-edge research and practical application in the operating room, transforming complex surgical paradigms to prioritize patient safety and quality of life.
A prime example is the shift in treating skull base and brain tumors like meningiomas and pituitary adenomas. These were once managed by conventional Open neurosurgical approaches, which carried significant morbidity and mortality.
Thanks to visionary surgeons like him and global advancements, the majority of these cases are now treated with minimally invasive endoscopic approaches, which he champions as the new ‘Gold standard’ due to their promising results. This legacy of surgical innovation, patient advocacy, and ethical leadership solidifies his position as a true luminary in healthcare.
Fostering a Culture of Excellence
Dr. Kaimal believes that surgical success is a collaborative effort that hinges on a culture of excellence and seamless teamwork. He emphasizes that specialists must view themselves not as competitors but as “warriors on the same side fighting for the best interest and outcome for our patients.”
To foster this environment, he recommends organizing workshops and team drills, an idea borrowed from the corporate sector to improve coordination, understanding and encourage open exchange of ideas and research. This collaborative mindset, combined with free flow of information and continuous learning, ensures his diverse surgical teams achieve the best possible outcomes for their patients.
Overcoming Systemic Challenges
Dr. Kaimal identifies several significant systemic challenges in delivering specialized surgery, including a shortage of skilled staff, steep training curves, and high costs, which limits access in developing countries. He believes visionary surgeons must address these issues by finding cost-effective alternative practices or approaches and training local surgical teams to be more self-sufficient.
His work in Afghanistan, for example, has provided him with key insights into training local surgeons to perform advanced procedures with limited resources, making a positive impact on the region’s healthcare landscape. He believes that early detection and management can also help reduce the financial and resource burden on healthcare systems.
Beyond the Operating Room
Dr. Kaimal’s impact extends far beyond his direct surgical practice. He is a pioneering advocate for the safe implementation of AI-based systems in healthcare, advising MedTech startups and global advisory bodies on developing robust and reliable systems.
He firmly believes that access to quality healthcare is a basic human right and has been instrumental in advocating for this on a global stage through his collaboration with the Global Human Rights Trust under the aegis of the UN.
His experience in resource-strained environments has provided him with a unique perspective on how to make the best use of available resources without compromising the quality of care, a philosophy that is reshaping healthcare systems to be more robust and evidence-based for the future.
Navigating a Future Shaped by Technology
Looking ahead, Dr. Kaimal foresees a future where AI, quantum computing, and advanced imaging take on a central role in surgery, making procedures more autonomous and standardized.
He compares this to new-generation fighter jets, where the human in the cockpit is the main strength and also the main limiting factor. He stresses that for this vision to be realized, the surgical field needs a new generation of ‘tech-savvy and AI-intuitive surgeons’ who can guide and utilize these powerful systems to their full potential.
For Dr. Kaimal, early adoption, continuous training, and the judicial integration of these technologies are key to staying relevant. He believes that this technological revolution will be even more significant than the digital revolution, and that surgeons must either evolve or be left behind.
The Wisdom of a Visionary
Dr. Kaimal’s advice to young medical professionals is both practical and philosophical. He urges them to ‘be hungry, focused and adventurous,’ and to follow their passion. He highlights the importance of learning from mistakes and being open to criticism from both patients and colleagues. He also recommends integrating AI and technology into their practice, as it can open up exciting new opportunities.
However, he offers a crucial reminder: “Always remember you are a Human first and then a surgeon/clinician, be humane, empathetic, and supportive, as it is something that no machines can do better than you.” This simple yet powerful statement encapsulates his belief that no matter how advanced technology becomes, the human touch remains irreplaceable in medicine.
A Legacy of Purposeful Action
Dr. Kaimal believes that his legacy will not be defined by accolades, but by his ‘Karma’—his actions, his work, and his interactions. He hopes that his Karma will ‘vocalize’ for him long after he is gone, guiding others not only in the surgical field but in the broader sphere of life.
This is also reflected in his work as a published author of two bestselling fiction novels― ’Whispers of the Enchanted Breeze‘ and ‘Last Flight of the Dreamliner‘―a testament to his creative spirit beyond his clinical practice.
His legacy is one of unwavering commitment to improving the world, whether through groundbreaking surgical techniques, pioneering the ethical use of AI, or advocating for human rights. He aims to leave behind a body of work that makes life and world ‘a tiny bit better’ for everyone, a truly powerful and enduring legacy.
