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The ramparts of the neurosurgeon’s mind were unassailable

Marc Arginteanu, MD
Conditions
September 22, 2022
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An excerpt from Azazel’s Public House.

Pete tried to invade Tommy’s brain and force an oops moment. But the ramparts of the neurosurgeon’s mind were unassailable.

Clancy, unaware he was battling on two fronts, tried to spare any brain that had a vestige of life, but in places, the good brain was so intermingled with the bad that it was impossible to determine where one began and the other ended. Finally, he accomplished his surgical goal. A white glistening cavern remained where the frontal and temporal lobes of Anthony’s brain had been. He may be better off dead, Tommy thought. But that’s not my call. I’m just here to do my job. Tommy sighed heavily, “Ours is not to reason why. Ours is but to do or die.”

“And die,” the anesthesiologist corrected.

“What?” Tommy asked.

“The Tennyson poem: ‘Ours is not to reason why. Ours is but to do and die.’ The soldiers knew they were riding towards certain death. They fought anyway.”

“Hemo-clip,” Tommy said, his voice gloomy. A bleeder let loose in the depths of Anthony’s brain. It was a miniscule branch that had avulsed from the main trunk of Anthony’s basilar artery.

Lee handed him a long, elegantly-tapered instrument. It deployed a tiny steel clip to clamp off the bleeding vessel.

He’s better off dead. Tommy thought as he brought the mouth of the hemo-clip across the hole in the inconsequential vessel. And it would be better for his family. 

The basilar artery, just a few millimeters deeper, looked as big as a garden hose under Tommy’s loupe-magnified vision. It was one of the main sources of blood for Anthony’s brain. If I put the clip across the basilar, he’d surely die. Tommy’s nimble fingers guided the clip back and forth. The mouth of the clip alternated between the tiny branch and the main trunk.

I would be doing him a favor. His family too.

Pete’s spirit huffed, Do it, Tommy-boy.

Back and forth swung the clip, from lethal to lifesaving.

Tommy thought, I sure as hell wouldn’t want to live if I were doomed to be hemiplegic and aphasic.

Pete puffed, You know you want to. Just do it.

Back and forth, from lifesaving to lethal.

Tommy thought, Bumping him off would be a mercy.

Pete boiled in frustration. He couldn’t bash through Tommy’s skull. He was a helpless spectator.

Tommy squeezed the trigger and clamped the tiny tributary. Ours is not to reason why. He withdrew his hand, leaving Anthony’s crucial basilar artery intact.

This damned hospital’s been a thorn in my side since the day it opened, Pete groused.

Marc Arginteanu is a neurosurgeon and author of Azazel’s Public House.

Image credit: Shutterstock.com

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