Books and more...

Founder Starter

Here is a book suggestion, that shows the beauty and pain of a neurosurgeons job through exciting examples.

2019-04-02 10:06:14

The author of the book, worlds best known neurosurgeon Henry Marsh, studied political science, economics and philosophy for three years in Oxford before starting studying at the medical school. The book was originally published in 2014.

Brain surgery is very dangerous and modern technology has managed to reduce the risk only to some extent. In the brain surgery, something similar to GPS is used, a computer navigation system, where infrared cameras surround the patient's head. They see the instruments, with small reflective beads, in the surgeon's hands. The computer screen shows on a picture, done  before surgery, the position of the instruments in the brain. The surgery can be done with local anesthesia, where the patient is conscious.
In the book the doctor tells, how he came up with the idea of choosing a neurosurgeons profession. He had got a medical diploma one and a half year before and had already been disappointed, no longer having any illusions about his medical career. He was working as a practicing doctor, when one anesthesiologist, who noticed his boredom, suggested that he would help him to prepare a patient before surgery, after which he could look at the operation of a brain aneurysm. These are small balloon-like brain artery extensions, that cause catastrophic bleeding when they burst. During the operation, a small spring-loaded metal clip is placed on the few millimeter long neck of the aneurysm, to prevent its rupture. There is a very high risk of accidentally braking the aneurysm during surgery, in result of which the patient usually dies or gets a major stroke, which may be worse than death. Neurosurgeons compare this operation with deactivating a bomb. The surgery, our doctor was observing, was not a passionless technical act, but rather resembled an exciting hunt for dangerous aneurysm - the surgeon sneaked to the aneurysm, which was hidden deep under the patient's brain, trying not to disturb it. And then the culmination came - it was time to catch it and kill it with a sparkling spring-loaded titanium clamp and this way save the patient's life! The surgery had been elegant, precise, dangerous, and extremely meaningful, so seeing it, brought the realization "What could be better than becoming a neurosurgeon". When he told his wife at home about his decision, she considered it reasonable. Neither of them at that time knew, that man's affection for work, long working hours, and high self-esteem due to his profession would lead to the end of their marriage 25 years later.
30 years later, after hundreds of the aneurysm surgeries, just a few years to retirement, the skills of an aneurysm operating surgeon, that he had acquired with a big effort, became useless due to new technology. Instead of an open cut, now a radiologist leads a catheter and a metal coil through a probe, put into the patient's groin, to thigh artery and from there up to the aneurysm, which is now mostly blocked from the inside, not clipped from the outside. This is a less unpleasant experience for the patient than a normal surgery. Although neurosurgery is no longer as exciting as before, patients have won from it. Now, most of the work of this writer-neurosurgeon was related to brain tumors, which he describes in his book with great excitement.
If a surgeon should happen to go to surgery table himself, which also happened to our surgeon, he feels a great deal of reverence towards his colleagues, that are treating him, knowing that they, in the other hand, are afraid of him, because the usual mechanisms of professional impartiality sink when a patient is a colleague. No wonder surgeons hate operating another surgeon. Even worse is, when the patient is your own child. Most surgeons probably trust their child in the hands of their colleagues, rather than risk doing it themselves, because their nerves would not resist.
After another nervous working day, the surgeon stopped to buy some food on his way home and took a place in a long queue, annoying that an important neurosurgeon like him had to wait in the queue after a victorious working day. "And what did you do today?", he would have wanted to ask those people there. Such and several other humorous statements made the book an exciting and good reading, not to mention the occurrences, that are a part of everyday of the neurosurgeons work.
Here's one more case I remembered. Although the surgeon usually went to work on a bicycle, not to search for a parking space, he was called from the hospital for a quick and dangerous thing. It was cold outside, windy and rainy, so he went back to work by car in the evening. As he was hurrying, he parked the car on a goods pick-up place, which actually was not allowed, but in the evening it didn't seem to bother anyone and so he got to the operating room much faster. When he came back to the car, a big warning label was on the windscreen: "The wheels are locked", followed by a long series of accusations in negligence and disrespect etc., and finally told to contact the security team and pay a high fine. "This is really the last drop!" the doctor shouted out of anger and despair, but then noticed, that down there was a small writing "next time !!"