I have a friend who underwent brain surgery last year for a tumor. He had a fifty/fifty chance of recovering without complications, and thankfully that was the case. It could have very well been otherwise. I thought about that a lot as I read this book. It’s authored by a neurosurgeon who works in the NHS- so a lot of details about the system and management were a bit different than what I’m used to, but all the same in a way- frustrations caused by things out of his control, for example. Like sending away for a test while the patient is waiting for their operation and something happens so the test never comes so the procedure gets delayed to the next day- resulting in a very upset patient of course. The surgeon was usually kind and apologetic, but at the same time he often came across as arrogant or dismissive, as when he waved aside someone’s concerns that they woke up from surgery with huge bruises on the face (doctor knew it would go away quickly, patient was very alarmed). The book is full of individual stories about different cancers and injuries he treated- sometimes with descriptive details on how the procedures are performed, other times with more about the patients as people, or the circumstances surrounding the surgery, or how the surgeon felt himself about it all. The tricky balance he had to keep between caution and confidence, to do such delicate and dangerous things inside people’s heads. Some of the stories have good endings, some are terribly tragic, and occasionally there’s one where he never hears of the patient again. As many of the people seeking treatment (or their families) were elderly suffering from brain tumors, there’s also things about end-of-life care and decisions- brought to mind Being Mortal. And purely from the descriptions of the physical art and skill, I was reminded of Mortal Lessons. I also had in mind the few Oliver Sacks books I’ve read- when Marsh explained how specific damage to the brain would affect certain parts of the body or abilities. I think what struck me most about this account, is how acutely honest the surgeon was about his mistakes. It’s rather terrifying to think that if you need brain surgery done, it is, after all, another human performing the operation.
Rating: 4/5
291 pages, 2014
4 Responses
I met Eddie Adcock at a music festival around 2010 and had a long discussion with him about the brain surgery he had had a couple of years earlier. Eddie is a world class banjo player who has made his living in music since he was a kid. But his hands had the shakes and he was losing the ability to play the way he wanted to…so he opted for brain surgery to fix the problem. In order to do it in one surgery, he had to be kept away while it was done – and he had to have his banjo in hand. So as they tinkered with his brain, Eddie was asked to pick on the banjo after each adjustment until they got it right. He told me at the time that he might have to be fine-tuned again sometime, but I don’t know if that ever happened. As I recall, the surgery was videotaped and it was featured on 60 minutes at some point. It’s probably still out there on YouTube somewhere.
Oh, he talked about that kind of thing in here- why patients are sometimes kept awake during the surgery, which sounds frightful to me, honestly. But he explained that the brain itself doesn’t actually feel pain, and it was often necessary to avoid damaging certain areas of the brain- so during the procedure his nurse would ask the patient to move a foot, or hand, etc- to make sure that part of the brain wasn’t getting damaged in the process. It sounds so complicated and alarming, but also fascinating.
Ooh, sounds really interesting! I wonder if my mum would like this — she and I both love hearing about gory medical details, and we always feel like we’ve added tools to our hospital-sitting arsenal when we know those stories. The thing about the bruising really irritates me, because I’ve encountered it so much before — you have no idea whether you need to be worried, and if the doctors don’t seem to be paying any attention, it’s just like, well, I *still* don’t know if I need to be worried, and now I also don’t trust my doctor!
Exactly- the doctor has seen it so many times before, they have a hard time realizing how upsetting and alarming it is to the patient for whom this is a new and frightening experience. He talks a lot about how he has to coax patients into have confidence in him so he can do the needed surgery, but at the same time he knows himself how badly it could go. Sounds like an incredibly difficult job, to say the least.