I recently finished my 10 weeks in Internal Medicine and have moved on to 1 week each of Ophthalmology, Neurosurgery, Anesthesiology, and Otolaryngology. This week: brain surgery. (Tomorrow, the world.)
In 3rd grade, I wrote “I want to be a brain surgen [sic].” Ever since, it’s been a goal of mine to be a neurosurgeon. Well, until college … when other interests and the anticipated reality of a 7+ year residency and you-have-no-life lifestyle. But this week has been my chance to fulfill a lifelong dream as I rotate through the surgical subspecialty for a week, hanging out in the OR, watching brain tumor removals, huge sections of the skull being chiseled out, filamentous nerves being freed, arterial aneurysms being clipped, and other unbelievably precise procedures.
I don’t do the surgeries, obviously. The most I get to scrub in for is to suction blood away from the site or maybe put in a few stitches. What I do is watch…or at least try to watch. These surgeons are tall, broad-shouldered men, crowded over a 4x4cm hole in the skull. The only way I see something without a camera feed or them moving out of my way is if I crouch down and try to look up between their arms. So…I don’t see much. But I hear plenty — drills, cauteries cutting through connective tissue (nothing quite like the smell of burning flesh), and the conversations about and around the surgeries. (I never thought I’d get into a policy debate with a world-renowned neurosurgeon while he has his fingers’ in someone’s brain.)
Surgery is a team sport. A patient’s life and well-being hangs in the balance, and you better not screw it up. Everyone in the OR has a job, and if they don’t know it or do it well enough, the surgeon *will* get pissed. The anesthesiologist enters first, during the overture, putting the patient to sleep. Then the opening act, the senior resident, who positions the patient, preps and opens. And only then does the main act begin, with the attending surgeon breezing in, clipping the aneurysm or taking out the tumor or whatever, and running right back out after the climax, leaving the resident to close. The scrub nurse is like the stagehand in the operating theater, keeping sterility, knowing and anticipating what comes next, handing items to the cast on stage and making sure to get all the items back (if you don’t count the sponges and needles you send out, you might leave some in the field). We med students are, of course, the audience for this foreign-language opera. We aren’t sure exactly what’s going on, we can’t see the details from our cheap seats (“cheap” as in lacking in years of training), but we’re captivated by the performance anyway and will leave the show knowing we’ve seen something amazing.
Because the cast is comprised of real-life celebrities. Who’s cooler than a neurosurgeon? “Oh, I cut into the human brain for a living. What do you do with your day?” And they have incredible technology to play with, including this unbelievable device for stereotactic guidance, where you triangulate your exact location in the brain and correlate it with an MRI so you know exactly where the lesion is under healthy cortex.
I’m in awe of what neurosurgeons do. They are ballers. And I am so not baller enough to be one of them.
Suchita Shah is a medical student who blogs at University and State.
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