Frank Vertosick Jr describes his personal voyage from eager medical student to board certified neurosurgeon. By turns comic and tragic, this memoir has similarities with Samuel Shem’s The House of God and is a must read for neurosurgeons but also of interest to most clinicians. Dr Vertosick provides, from an American perspective, a keen insight into a specialty which is often regarded with suspicion by other doctors. He did not initially intend to become a neurosurgeon, but “strayed too close to a dangerously seductive profession and became stuck for good like a fly in a spider’s web.”
On his first day as a neurosurgical resident, a cynical and weary chief resident takes him aside and outlines the “Rules of Neurosurgery.” The first of these provides the title of the book: “You ain’t never the same when the air hits your brain.” A worrying proposition to those with no background knowledge, nevertheless this maxim pithily sums up the subtle, intangible change that often occurs after cranial surgery, but which cannot be neatly recorded on a chart. The other rules include such useful aphorisms as “the only minor operation is one that someone else is doing” and “if the patient isn’t dead you can always make them worse,” a contemporary variation on the Hippocratic motto: primum non nocere.
You are viewing: When The Air Hits Your Brain
Read more : When Is Scallop Season
Though lighthearted in tone, the book addresses serious points that are relevant to the practice of neurosurgery in particular and medicine in general. Medical careers tend to be dominated by anecdotes. Clinicians all remember their first times, the medical curiosities they have encountered, and, perhaps most importantly, their mistakes. Dr Vertosick leads the reader on a tour of neurosurgery via a series of memorable cases, charting the vicissitudes of the patients, his changing relationships with colleagues, and the progress in his own knowledge and acumen. From the young trauma patient who dies quickly in the emergency room to the child with an incurable brain tumour and the young man rendered tetraplegic with a spinal epidural haematoma, each case provides important challenges to the author both as a doctor and as a human being. The clinical detachment and sangfroidthat are necessary to function as a neurosurgeon can be taken to extremes as his colleagues metamorphose into “surgical psychopaths.” The difficulty is to “care but not too much.” Dr Vertosick’s trial by fire comes during a craniotomy and clipping of aneurysm. At first the case progresses well, but suddenly he is faced with a “crimson flood” as the aneurysm ruptures, with catastrophic results for the patient. It is the maturity required to deal with the impact of his own complications that identifies him as a well rounded surgeon.
In the author’s words, neurosurgery can occasionally resemble Shakespeare’s Hamlet ‘‘in that nearly everyone dies in the end.” Dr Vertosick challenges this perception but does not seek to avoid the many highs and lows of a neurosurgical career.
Source: https://t-tees.com
Category: WHEN
