100 Stereo-EEG Cases at the Alfred (A Reflection) - Ceclia Harb

Hi everyone,

As we approach an incredible milestone — 100 SEEG cases at The Alfred. This milestone feels like more than just a number to me. It feels like a collection of friendships, memories, moments, experiences, challenges all of which that have shaped not just this program….but all of us in it.

When I think back to how it all began, it feels like a completely different time. We started with the CRW frame — a process that was equally long, tedious, and yet one of the most memorable experiences I have ever had in theatre. I still remember standing in the corner, calling out coordinates, checking every measurement in with what I’m sure the surgeons would describe as my slightly piercing voice. “That is correct…” At times it felt endless. Like we were stuck in this loop of measuring, adjusting rechecking repeatedly. But looking back now, that was where everything really started.

There were the finer details too — the ones people don’t always talk about. Like braiding patients’ hair. It turns out that was a skill, one that required patience, creativity, and a surprising amount of pride. Eventually, Martin joined in… and I think it’s fair to say he didn’t just learn — he elevated it to an art form. Some of those braids were nothing short of masterpieces. These small moments were significant for the patient.

Then came the COVID years — a time none of us will ever forget. While the world slowed down, we didn’t. Through some of the strictest lockdowns, we kept going. We showed up, we adapted, and we made sure our patients continued to receive the care they needed. Many late nights, despite the restrictions reflected the hard work we put in. That resilience — that quiet determination — is something I will always be proud of.

And then, of course, came robotics. A turning point. The role in theatre changed almost overnight. I’ll admit, there was a sense of relief… but also a sense of loss. I do miss being there, assisting, being part of that immediate rhythm of the room. But that’s the nature of what we do — medicine evolves, and so do we.

When I look back, it’s not just the big milestones, but the moments in between — the late nights of thermocoagulation, pushing through fatigue because the work mattered. Or that time driving to Melbourne Airport to pick up electrodes so a case wouldn’t be cancelled — because cancelling simply wasn’t an option. The time when I literally ran out of theatre jumping into a taxi to St Vincents hospital in the middle of a case to replace a piece of equipment that had been dropped. That level of commitment wasn’t extraordinary for our team — it was just what we did.

We’ve come so far. From those early days with the frame, to where we are now. But more than the technology, more than the techniques, what stands out to me is the people. This never felt like just a team — it felt like a family. A group of good people who supported each other, challenged each other, and grew together.....and we’re still growing. The learning and teaching never ends.

A significant part of my experiences over the years, were my interactions with our epilepsy fellows — past and present. We’ve shared the long days that turned into even longer nights, and the early mornings that came far too quickly after. We’ve wrestled with challenging cases, and yes — had our fair share of disagreements over SEEG interpretation. But those discussions, those different perspectives, are exactly what pushed us to think deeper, to question more, and ultimately to deliver better outcomes for our patients. It hasn’t always been easy, but it has always been worthwhile.

A special mention as well to our scrub nurses — always attentive, always one step ahead, and incredibly patient… especially when it came to labelling electrodes. I know my attention to detail may have bordered on obsessive at times, but you managed it well with good humour, and I’m very grateful.

And to our neurophysiology scientists — I want to say how proud I am to work alongside you. Your expertise, technical skill, motivation to learn, care for our patients and support underpin everything we do. Quite simply, I couldn’t do what I do without you, and I hope you know how valued you are. I’m incredibly proud of the high standard you bring to work every day.

And finally, (drum roll) I want to thank our wonderful epileptologists — for believing in me. That belief made more of a difference than you probably realise. And to our Neurosurgeons — thank you for putting up with me in theatre… and I suspect, not missing me calling out coordinates quite as much as I might like to think…… but I certainly miss working alongside you both.

And that’s what makes this milestone so meaningful.

As we look ahead, I hope the next generation carries that same spirit forward — the curiosity, the dedication, the willingness to go the extra mile (sometimes literally). Because what we’ve built here isn’t just a program — it’s a legacy.

And I have no doubt it’s in very good hands.

Cecilia Harb