PROFESSOR Brian Owler is drilling into the skull of mother of three Silvanna Mazzacuva as he prepares to remove a 4cm brain tumour lodged deep in her brain.

The Eagle’s “New Kid in Town” plays in the background, and he’s using a computerised image guidance system linked to an MRI of the patient’s brain to precisely locate the tumour.

He removes a triangular piece of her cranium, pares back the lining of the brain and reveals the organ pulsing as her heart pumps.

Over the next three hours and forty minutes he will painstakingly use a thin, tweezer-like instrument that delivers an electrosurgical current to carefully cauterise the veins linking the tumour to healthy tissue.

He uses an ultrasonic tool to shake the tumour and break it apart and soaks up the blood with a neuropatty, a tiny swab attached to a string.

In laymans language, he says the job of the electrosurgical tweezers is to “cook the tumour basically”.

“You have to break it apart and remove it,” Professor Owler says.

To one side of where he is working is the part of the brain that controls movement, on the other side is the part that controls vision. Any slip would be devastating for the patient.

It is difficult, detailed work that requires enormous focus and as he pulls out the tumour, and holds it high in the air like a trophy, you can see why neurosurgery is hailed as one of the most difficult jobs in the world.

As the newly elected AMA president, Owler has been applying the same focus on detail to rework the government’s controversial, proposed $7 GP fee. Owler defends doctors who charge their patients copayments, and has no issue with the concept of a charge.

But he has taken a plan to Health Minister Peter Dutton he hopes will protect the vulnerable from the $7 charge and ensure doctors who continue to bulk bill don’t suffer a pay cut.

Professor Owler, the son of a fitter and turner, was elected AMA president in May.

His mother was the principal of a school that cared for severely intellectually disabled children.

He attended De La Salle Catholic High School in Revesby, named after a French priest born into privileged circumstances, who believed it was important to provide Christian education to the poor.

The 42-year-old father of three made his decision to become a doctor at a Year 11 careers day but he says neither his parents nor his teachers thought he would get the marks he needed.

“I didn’t want to be a lawyer, piloting was not for me. But the thought of being a doctor, I liked the idea of the study of science,” he said.

“Then I had to get the marks and a lot of people were sceptical I’d do that.”

News Corp Australia spent a day in the operating theatre with Professor Owler this week as he successfully performed three complicated surgeries. He removed a small piece from the top of the spine of a young man, to relieve a condition that was interfering with the flow of fluid between the brain and the spinal cord.

Owler inserted and neatly stitched into the cavity a small gortex patch to solve the problem with neat, tapestry like needlework skills he said he learnt at primary school.

He then removed a tumour and related haemhorrage from the brain of an elderly lady that was related to her melanoma.

But his longest case was the job of removing Silvana Mazzacuva’s benign brain tumour.

The 56 year old primary school teacher was hoping to put off the operation until after her youngest daughter’s wedding in November but the tumour was growing too fast.

Three days after the major surgery Mrs Mazzacuva was up and walking, and had no doubt that Owler’s promise she’d be dancing at the wedding would come true.

Putting your brain in someone’s hands is something most people would do with great trepidation but Silvana says Brian Owler “put us so much at ease, he spent a lot of time with us, I only have positive things to say about him”.

Prof Owler says he plays soft music in the operating theatre to relax and throughout the surgeries at Sydney Adventist Hospital his iPhone was plugged into the sound system to play his hits and memories selection of pop music that included the Eagles, the Beatles, Missy Higgins, Funky Town and even some rap music.

His staff say if the operation gets serious they turn off the music, and they humorously complain there is no democracy in the choice of music which has not changed in the nine years he has been a neurosurgeon.

Owler - who says he has never lost a patient on an operating table as a result of his surgery - says the confidence for drilling into someone’s skull is all about “experience, setting up, planning and positioning the patient the right way”.

“You have to be able to think in three dimensions because neuroanatomy is so complex, you need the ability to know where the margins are,” he says.

Surgery on children is the job that worries him most because he thinks of his own three kids — two daughters aged six and four and his five year old son.

The immediate past AMA president Dr Steve Hambleton worked closely with Owler, who previously led the AMA’s NSW branch.

“He’s a very intelligent man, very capable of seeing the big picture, quick and decisive, surgical, but prepared to listen,” he says.

“In meetings he was never someone who agreed to a course of direction without challenging it in a constructive way”.

Owler has unusually introduced background reading and footnotes to some of the AMA’s press releases.

“I think it helps people understand, we want decisions to be based on the evidence,” he says.

“A lot of fluffy stuff gets floated in political discussions and when you break it down it doesn’t stack up,” he says.

Politicians’ claims that the health system is “unsustainable” is ideology not fact, he says.

The gospel that the states’ entire health budgets will be swallowed up by health funding by 2030 is also rubbish, he says.

Anyone who has driven on the Hume Highway will recognise Brian Owler, dressed in medical scrubs, his face staring down at them from roadside billboards warning them of the consequences of not being safe on the road.

His passion for health advocacy was ignited on a long weekend when in a 24 hour period he perated on a driver whose actions had not only left him with a brain injury but claimed the lives of three others.

“I remember driving home and thinking that, if people could see what I had seen, perhaps they would change their behaviour, make better decisions,” he told the National Press Club recently.

“I took my ideas to the NSW Government and the result was the “Don’t Rush” road safety campaign in NSW.”

Last year he began a similar campaign to have high rise buildings forced to install safety measures after a spate of children were injured falling through windows.

His next mission is to work on reducing alcohol advertising in sport.

Owler says it’s not because he’s a wowser but because as a doctor he has to treat the head injuries alcohol related violence causes.

The AMA is often called the doctors’ union but it’s a title Owler won’t have a bar of.

“People like to paint us that way because it’s easy to take cheap shots and claim we are selfish and greedy but a lot of what we do is not about doctors but our health system,” he says.

Owler describes former AMA president and Howard Government Minister Brendan Nelson as “someone I admired”.

The ear-ringed former AMA president went into politics and became Defence Minister in the Howard Government and Owler refuses to rule out a similar path for himself.

“It’s silly to say you’d never do it but any thought about that is some time off,” he says.

He’s not a member of any political party and says the AMA is not politically aligned.

“I suspect I’ll go back to clinical medicine, I’ve got a busy practice,” he says of his longterm plans.

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