EURURO Vol. 72 No. 4

482 656

Platinum [2_TD$DIFF]Opinion
If You Want to Make an Important Discovery, Listen to Your
Patients
Patrick C. Walsh
James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD, USA
Young people frequently ask, ‘‘What does it take to make an
important discovery?’’ I tell them, ‘‘To make an important
discovery, you must pick an important problem’’. This was
Dan Nathans’s advice, who was a Johns Hopkins Nobel Prize
winner. Of course the next question is, ‘‘How do you find the
important problems?’’ There are many approaches, but the
one I personally have found successful was to listen to my
patients. If they tell you something that sounds incorrect, or
if they ask you a question for which you have no answer,
this may be your opportunity for discovery.
Forty years ago, shortly after I developed the technique
for controlling blood loss from the dorsal vein complex, a
patient told me that he was fully potent following his radical
prostatectomy. At that time, because every patient was
impotent following surgery, it was widely believed that the
cavernous nerves ran through the prostate and for this
reason it would be impossible to preserve potency. However,
from that one patient I knew that this was incorrect, and I
embarked on a search to discover where the cavernous
nerves were located and if it was possible to preserve them.
Thirty years ago, a 49-yr-old man asked me if prostate
cancer was hereditary. When I questioned why he wanted
to know this, he told me that his father, his father’s three
brothers, and his grandfather had all died from the disease.
At that time, everyone knew that if a woman’s mother or
sister had breast cancer, her risk of developing the disease
was increased twofold. However, this information was not
available for prostate cancer. Once again, I initiated a series
of investigations to determine the risk and identify the
factors responsible.
No one knows more about certain aspects of a disease
than the patient who has it. Yes, they can be wrong, but they
can also be correct. So, listen to your patients and they may
lead you in a direction in which no one else is going. Albert
Einstein once said, ‘‘The one who follows the crowd will
usually go no further than the crowd. Those who walk alone
are likely to find themselves in places no one has ever seen
before.’’ You can be that person.
Conflicts of interest: The author has nothing to disclose.
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* Corresponding author. James Buchanan Brady Urological Institute, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
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0302-2838/# 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.