Future doctors, be kind to patients, says distinguished anatomy representative, professor Ali Mirjalili

Professor S. Ali Mirjalili, from University of Auckland in New Zealand is a very important representative of contemporary world anatomy, specialist in clinical anatomy. Professor Mirjalili is the editor of the section focused on clinically relevant surface anatomy in the world-famous textbook Gray's Anatomy. Ali Mirjalili is also the editor and author of the textbook Last's Anatomy. Professor had a lecture ´Revisiting the Human Surface Anatomy in the light of modern imaging in Gray's Anatomy´ at the Faculty of Medicine of Comenius University in Bratislava.

15. 01. 2024 09.00 hod.
Od: Naša univerzita magazine staff

Professor Ali Mirjalili started his research 15 years ago and he is currently doing his research in Austria. He is also a great innovator in teaching anatomy and medicine. He discovered, that some of the parts at the world´s famous medical textbook Gray´s Anatomy are not correct. The biggest problem was that, the findings described in the book, preceded the research on dead bodies. He used living individuals using CT-scans and ultrasounds to do his research.

The differences of surface anatomy were, for example, in the positions of the organs. For example, as he stated in his study A reappraisal of adult abdominal surface anatomy, “the renal arteries were most commonly at the L1 vertebral level (left 55 %, right 43 %) the 11th rib was a posterior relation of the left kidney in only 28 % of scans; and the spleen was most frequently located between the 10th and 12th ribs (48 %) with its long axis in line with the 11th rib (55 %)”. He presented his findings to the students of the faculty of medicine Comenius university in Bratislava.

What was the most interesting about anatomy? Why did you choose it?

Probably, my anatomy was not my strong part when I was a medical student in first or second year. So, I had to come back to anatomy, and I appreciate it better, I stayed with it, that is why anatomy is my passion and I love it as a clinician.

What does it mean to you that you published an article in the world-famous Gray's Anatomy textbook?

Personally, it does not mean anything. I think, it means, that I can contribute to science and also I could change some of those wrong information in the textbook. My aim was to make something correct.

Can you explain some mistakes that you had to correct?

The area that I contributed to Gray´s, is surface anatomy. It means - what is under the skin. It could be in the chest, in the abdominal, where is the liver, when you look at someone´s body. So, that projectional surface of internal organs. When you look at their roles in surface anatomy, the used dead bodies. But what I did, I used living individuals – a human, who is still alive – and I used ultrasound, CT-scans and more to revisit the surface anatomy, to make it more accurate and better. The reason is, today, we are operating minimally in visit surgery. Hundred years ago, you just cut the abdominal and opened it. But today, we make two holes and go there with the camera to the abdominal and do operation there. For example, the laparoscopy. Now you need to know the details. That´s why we have to make anatomy more accurate every day, because the technology is advancing.

What was the most difficult for you as a participant in this research?

I think that the most difficult part was not doing the research. The most difficult part was changing the wrong information in the textbook, the dogma. Lots of old anatomies or academics resist it. But luckily, the author of Gray´s, she was opened to make the big changes.

How long did it take to do the research and rewrite the mistaken parts at Gray´s anatomy?

The research took 8 years, writing that surface anatomy part in the book took 3 or 4 months and with the communication with the authors it took like 3 to 6 months, with the changes.

professor S. Ali Mirjalili, MD., PhD., PGDipSurgAnat, PGCertCPU, PGDipSci
Professor Ali Mirjalili is a Clinically Oriented Anatomist at the Faculty of Medicine and Health Sciences at the University of Auckland, New Zealand. This university was founded in 1883, and according to several rankings, it is among the 100 best universities in the world. Professor Mirjalili is the head of the Department of Anatomy and the responsible person for the medical study program BMedSci (Hon). Professor is the editor of the section focused on clinically relevant surface anatomy in the world-famous textbook Gray's Anatomy. Ali Mirjalili is also the editor and author of the textbook Last's Anatomy. His book on surface anatomy, called: "Pocket Tutor Surface Anatomy" was selected as a UK based medical book in 2012 and 2013 and was translated into Japanese, Portuguese and Spanish.

From which version of the textbook are the students learning now?

It depends on, what version they are reading. I am trying to rewrite the most of textbooks, like for example Gray´s, for students or clinically oriented anatomy. I wrote to the author, that these changes need to be correct and if you feel free, please change it.

Can you tell us, what are the latest research trends in anatomy and how they can be used in practice?

I think, in Australasia, we are pretty much using imaging – translational anatomy. We are trying to do an anatomy; we can translate and use it in clinic. It´s translational research, the research, which you can improve patients' safety.

What was the most difficult for you as a doctor?

Decision making. When you have to decide about the clinical diagnoses or the operation. Decision making is the hardest part of medicine. Medicine is not black and white area, it is grey. You have to make decisions based on your knowledge and based on the patient. So, I think, that the hardest part in medicine, especially surgery, where you are going to do a complex operation, is the decision making.

Grey´s Anatomy is also a title of a long-running American TV show? Do you watch it? What do you think of it?

I have watched it. Usually it is what I say first day to my students – Gray´s anatomy – they think about the movie. Even doctors, when you talk to them. It is very popular.

Have you ever been asked to be a consultant for this TV show?

No, never. The book is not related to the show, because Grey´s Anatomy textbook and Gray´s Anatomy TV show are complete different things. The show is not really relevant, they use that title to attract people.

What are you trying to do with your research in Slovakia, why are you here?

Ivan Varga (the vice dean for science, research and PhD. studies at Faculty of medicine CU) invited me, and he is a great academic. He comes to conferences and presents great works. I think you are lucky to have these good academics.

Did you visit the Slovakia for the first time?

No, I was here once with my family, because in New Zealand, we do not have snow. My kids saw snow for the first time in Bratislava and I think, this city will stay in their hearts forever. Right now, they are in Australia.

What do you like the most about Bratislava?

The castle in Bratislava is like a diamond. When I was in Austria, I saw the lights from 30 km and I was asking myself, what was that? Also,  that people are really nice there and I like them. I really like your traditional food – halušky, it is very good. You also have good wines here and I think, Slovakia is great country.

What is your best advice for future doctors?

I think, the only advice that I learned in medicine, is that you have to be kind to patient. Do not compete with your colleagues. Every morning, when you go to work, think about how to help people and be kind to them. Unfortunately, some doctors forget, that they are in the hospital to help patients and be kind to them. The first day, when medical students come to college in New Zealand, and again when they leave the school, we remind them to be kind.

Radka Rosenbergová