When the Air Hits Your Brain: Tales from Neurosurgery, by Frank T. Vertosick, Jr., MD

This is the second edition of a book that came out about 20 years ago. The latest eidition came out about 10 years ago with some minor updates in the epilogue regarding the changing nature of neurosurgery.

Frank Vertosick was born into a working class family. He excelled in school and managed to enter medical school where he found himself studying neurosurgery because another class he wanted was full. He went through his education and residency at a time before residents were limited to 80 hour weeks and before some of the more refined microsurgery equipment used today was developed. He says that his journey to surgeon included several moments when he wished he had become a steelworker like his father.

I picked up the book partially because it was on sale and partially because I’ve watched videos of neurosurgery with fascination since high school. I was a little surprised in a couple of ways. First, Vertosick’s descriptions are graphic enough to have made me a little squeamish. What they don’t show you in National Geographic specials are incidents like residents drilling too deep into the brain while prepping a patient or the shocks the brain can take after a traumatic car accident. It says a lot about his writing skills that he can put you next to him in these situations.

But I was also surprised by the number of stories that brought me to tears near the end of a chapter. The woman who refuses to abort a child to take the needed radiation and chemotherapy to treat a brain tumor, the baby with an untreatable tumor who lives a year and a half in a children’s unit abandoned by parents, the man with Down’s Syndrome who wants to die when he’s no longer able to work at his local parish. These are told with a sensitivity to the people and their faiths that is nearly surprising in contrast to doctors I’ve met through my life.

He’s still able to intersperse these moments with humor regarding the trek from medical intern to fully-accredited surgeon, along with descriptions of some truly unsympathetic senior surgeons.

In the introduction he fully admits that this is a fictionalized memoir. The patients he describes are an amalgam of his experiences, with names changed to protect both the innocent patients and sometimes guilty surgeons.

A truly interesting book for anyone interested in medicine or science with some amazingly touching stories along the way. As he says, no trysts in the janitor’s closet but some drama that surpasses anything fictionalized in medical shows.