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Neurosurgery Lost a Leader, and I Lost a Dear Friend — Randall W. Smith, MD, FAANS(L)

By Guest Post, Loss of LifeNo Comments

On Oct. 25, neurosurgery lost a leader, and I lost a dear friend. Randy’s accomplishments in organized neurosurgery, especially in California, are too numerous to list and have been chronicled by others in recent days. Today, I want to tell you the main lessons Randy taught me over our decade-long friendship.

  • Your biggest supporters may not be who you think. As a young female neurosurgeon starting in the California Association of Neurological Surgeons (CANS) and the Western Neurosurgical Society (WNS), Randy didn’t care who I was or what I looked like as long as I showed up and worked hard. Once I proved myself, he went to great lengths to support me and promote my career. This is the very definition of sponsorship, which I have found much more helpful than mentorship.
  • Actions speak louder than words. Randy could spot nonsense from a mile away and did not hesitate to call it out. I have met very savvy and politically correct leaders in my time who have done nothing to help foster diversity and inclusion in neurosurgery. When it came to supporting equality, he made the necessary changes in our organizations to make them better.
  • Work-life balance is best when you don’t try to separate them. Randy loved neurosurgery. When he retired from clinical practice in 2004, he was still very engaged in organized neurosurgery. In California, it is no secret that Randy was the backbone of the two influential organizations: CANS and WNS. He attended all the board and executive committee meetings and was part of every critical decision until his death. Randy was constantly curious about the advances in the field of neurosurgery and strived to make the lives of working neurosurgeons better. He involved his whole family — his wife Flo is like a surrogate mom to many of us. Randy taught me that I wouldn’t constantly feel like I had to choose by blending my life and family with my work. He has seen my children grow up and developed an independent friendship with my husband. It well-demonstrated that we are all happier and less likely to develop “burnout” if we feel part of a community.
  • Listen to your instincts. As the COVID-19 Delta variant surge was starting to wane in September, there was still considerable uncertainty about holding an in-person meeting for the WNS. After much planning and consideration, we decided to go for it and held the annual meeting in New Mexico. I do not regret that decision for one minute. It was an engaging, safe and productive meeting and allowed us to connect in person for the first time in nearly two years. This felt even more precious with my older colleagues. I didn’t know at the time that the picture you see here would be the last night I would spend time with Randy. I can just hear him saying: “Just go for it, kid.” Thanks, Randy. I will.

As we get ready to sit down with our families and friends for Thanksgiving, I encourage you all to reflect on how fortunate neurosurgery is to have had such an icon in our field. He will be missed.

Editor’s Note: An issue of the CANS newsletter that will be entirely dedicated to commemorating Randall W. Smith, MD, is planned for mid-December. You are encouraged to submit personal remembrances if you’d like them included in this issue. Please send your memories to or The deadline for submission is Nov. 28. Additionally, we encourage everyone to follow @Neurosurgery and @CaNeuroSurgeons.

Ciara D. Harraher, MD, MPH FAANS
Stanford Department of Neurosurgery
Dominican Hospital
Santa Cruz, Calif.