Customer Reviews

Brain Surgeon: A Doctor's Inspiring Encounters with Mortality and Miracles

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BRAIN SURGEON
A Doctor's Inspiring Encounters with Mortality and Miracles
Keith Black, MD with Arnold Mann
Wellness Central
Hachette Book Group
ISBN: 978-0-446-58109-7
$24.99
Reviewer: Annie Slessman

Not being in the medical field, I expected BRAIN SURGEON, A Doctor's Inspiring Encounters with Mortality and Miracles by Keith Black, MD with Arnold Mann to be a hard, dry read. I could not have been more wrong! Dr. Black and Arnold Mann have managed to take a subject matter - brain surgery - from the mysterious to something easily understood by everyone.

Dr. Black uses a series of stories about his patients and their courage and surprising stamina to relate his experiences and inform the reader about the mysteries of the brain. Each story explains the many types of brain cancer and the degree of difficulty that each occurrence requires in its treatment.

For instance, my own daughter was recently diagnosed with a tumor in her liver. We were told the tumor was not cancerous. She had only taken a MRI - how can they tell the tumor is not cancerous by an image test? Well, I got my answer when Dr. Black explained that a tumor which is cancerous absorbs more of the dye making it more prominent in the MRI. Thank you, Dr. Black, I found your book and its ability to explain things in simple terms very comforting.

Dr. Black, early in his career leans toward cardiology. When he took his first neuro-anatomy class, he was hooked. As he states, "the bottom line is that the heart is just a muscle, a pump, to be sure, it's a very elegant muscle and a great pump, but it's still a pump. The brain, on the other hand, is the ultimate reduction of self."

When explaining a specific treatment he likens his vaccine to that of a warrior fighting a terrorist (cancer). This vaccine seeks out the bad cancer cells and "presents" them to the body's killer T-cells. Killer T-cells are a special variety of white blood cells, or lymphocytes. When the vaccine presents these bad cells to the Killer T-cells they know to attack. Don't you absolutely love this analogy? Most everyone can understand this process with the use of this analogy.

Quite often, I donate my review books to the local library. It is my way of giving the gift of knowledge. However, I just cannot bring myself to donate this book. It will remain in my own library.

Dr. Keith Black is the chairman of Neurosurgery at Cedars-Sinai Medical Center in Los Angeles, who specializes in the surgical and medical treatment of brain tumors. He has gained widespread recognition for his clinical skill in treating brain cancers, and has been featured in Time Magazine, CBS News and PBS' The History Makers.

Brain Surgeon is an enjoyable and inspiring story about his career, obstacles he overcame along the way, battles and controversies he has encountered in providing the best care for his patients, and the advances of clinical brain tumor research that are allowing patients to live longer and, in some cases, making disease remission possible.

Although the story centers on Dr. Black's impressive accomplishments, equal billing is given to several patients, who he claims are the true heroes of this book. They are fully engaged in the treatment plan, and the trust and faith that they have in Dr. Black is matched by his respect and desire to help them as best he can.

The book is written for a lay audience, and would be appropriate for high school and college students interested in medicine and neurosurgery, or anyone else interested in stories of faith and inspiration.

Being a patient of his probably makes me an unfair favorable bias towards this great doctor. I read the book in one sitting. I could'nt put it down! It reads like a great movie. Not hard for non medical types like myself. A very interesting life story and everyday life of a top neurosurgeon is revealed here. I highly reccommend it! You wont be dissapionted

I read this book as a person who's needing to select a brain surgeon for a rare type of meningioma. Not only was Dr Black's personal story about how he came to be a neuro-surgeon fascinating, but it was the best source of education I've seen for a patient.

I've gained enough of an understanding about how brain surgery is done, to now ask specific questions of potential surgeons that are critical to my recovery.

Dr Black's personal philosophy about how magnificent the brain is directly correlates with his surgical techniques to do everything possible to not touch any healthy brain tissue. He states his job is "to be a thief in the night, by getting in there to steal the tumor before the brain knows he's even been there".

His compassion and humility are profoundly represented in the stories he shares about his patients. He repeatedly states that "his patients are the real heros not the neurosurgeons". It restores my hope to learn of a doctor who continually asks himself, "is this in the best interest of the patient".

I was also interested in how he explained that the reward system for traditional medical research doesn't always lend itself to a direct usefulness for clinical practice. The research practice he's set-up is looking for direct "bench to bedside" impact, and that is how we'll see advancement to cure brain cancer.

I was shocked to realize that out of the 5000 licensed neuro-surgeons in the US, 4900 of them are dedicated to spinal surgery and of the remaining 100, 50 of those are vascular surgeons. That leaves about 50 docs who are completely focused on brain tumors. Statistics don't lie about the best surgical outcomes for ANY type of surgery is related to how often a surgeon does a specific surgery.

Bottom line is, every brain tumor patient and the people that love them, should read this book!

Trust me, Dr Black has set my expectations high for a Neuro-surgeon and he's at the top of my list of docs to interview.

Gina Graf

I happen to have met Dr. Black in person...he was my neurosurgeon. Dr. Black at Cedars-Sinai was my second opinion, and I was afraid that I would go through the same inpersonal experience, that I had with the first neurosurgeon . When Dr. Black walked in the room...he leaned against the wall...and actually looked into my eyes...and said "Tell me what is going on with you..." (and he listened) I had his full attention as he patiently answered all of the questions I had. He even brought a 3-D model of a brain to explain everything to me. He was a very gracious and unassuming man. He gave me hope during a time that I felt no hope.

So, what I have to say about this book is...that it was nice to get an inside look at how Dr. Black grew up, what's important to him and most of all ... how his mind works. I never knew any of this, because when I spent time with him, it was "all about me". I take his book for what it is...a gift to those of us that he gave so much to. A chance to get into his brain. Thank you Keith Black...

I'm the founder and moderator of the Yahoo! Brain-Research Group which focuses on researching and discussing treatments for brain tumors, I've developed a related website (brain-treatments.net), and I've myself lost a loved one to a brain tumor. I therefore read this book with a great deal of personal interest.

Perhaps the first thing to note is that Dr. Black has a coauthor, so it's not clear to what extent the book is written in Dr. Black's own voice. I would have preferred his not having a coauthor but, regardless, the book is well written, with clear discussions of medical issues, and is also somewhat of a page turner, so it doesn't take long to finish.

Dr. Black is clearly a very skilled neurosurgeon and a brilliant person overall, so I don't think that criticisms regarding his having a big ego are justified. I instead find his level of self-confidence to be appropriate given his accomplishments, and I don't see a need for him to display false modesty. I would be happy to have him as my neurosurgeon if I had a brain tumor. And the fact that he's an inspiring role model as a highly-accomplished black American is icing on the cake.

Because of Dr. Black's experience and skill as a neurosurgeon specializing in brain tumors (more than 5000 operations), I found the most educational part of the book to be its detailed descriptions of specific brain tumor resection (removal) cases. However, I would caution that the resection descriptions tend to be pretty graphic, so readers who are squeamish or prone to anxiety may want to skip the book. The most important lesson from these case descriptions is that it's very important that brain tumor patients choose a neurosurgeon who's highly experienced in tumor resections, including very difficult resections, and only a small minority of neurosurgeons have that level of specialized expertise. A second key lesson is that it's highly preferable to remove all visible tumor whenever it's possible to safely do so.

My major criticism of the book, which applies to the neuro-oncology establishment in general, is that brain tumor specialists (neurosurgeons, neuro-oncologists, neuropathologists, neuroradiologists, radiation oncologists, clinical researchers, and basic researchers) do a very poor job of coordinating their efforts and genuinely collaborating with colleagues around the US and the globe, and they instead tend to parochially focus on treatment approaches favored at their own institutions, even though clearly better treatments may be available elsewhere. As part of this problem, brain tumor specialists tend to ignore and dismiss treatments they're not familiar with, rather than keeping an open mind and diligently learning more about them. Financial considerations surely play a major role in this (as some of Dr. Black's comments attest), but I think that a sort of intellectual myopia is also a key factor. All of this does a huge disservice to patients, not to mention wasting a huge amount of money and other social resources. Let me give just a few examples of what I mean:

1. Dr. Black supports use of melatonin, but advises against using it during radiotherapy. However, peer-reviewed studies clearly show that adding melatonin during and after radiotherapy provides a major increase in survival rate (eg, see PMID 8570130), and I'm not aware of any studies showing that avoiding melatonin during the radiotherapy phase improves this survival benefit further.

2. Dr. Black suggests that the best way to use natural products which have anti-tumor benefit (like herbs) is to identify, extract, refine, and concentrate a single active ingredient, which is tantamount to searching for a magic bullet. While this strategy is sometimes effective, it's well known among experts in this area that most natural products contain a variety of active compounds, each often with multiple mechanisms of action, so these compounds will often work synergistically, and therefore trying to isolate a single compound is often the wrong approach.

3. Dr. Black discusses the dendritic cell vaccine therapy being studied at Cedars-Sinai as though no one else has considered this approach, whereas several other institutions are studying dendritic cell vaccines, some of which may be more effective than the Cedars-Sinai version.

4. Dr. Black doesn't mention other important treatments which provide benefits which may be comparable to or better than dendritic cell vaccines. For example, a device called Novocure treats tumors with electric fields and has shown impressive benefits with minimal toxicity. As another example, the anti-malaria drug chloroquine is already FDA-approved, inexpensive, and relatively safe, and adding it off-label to standard chemotherapy (BCNU) has been shown to increase median survival for GBM patients from about 1 year to instead 2 or 3 years, which is a large benefit, yet chloroquine isn't even mentioned in this book.

5. Dr. Black has generally positive comments regarding the drug Avastin, and he notes that his patient William Tao, who was treated with Avastin and other treatments, experienced tumor recurrences distant from the original tumor. He offers no explanations and draws no implications from these distant recurrences, which suggests that he isn't aware of studies in animals and humans going back several years which have been showing that Avastin (and other anti-angiogenic treatments) substantially increase the rate of tumor invasion and distant metastases within the brain, resulting in recurrences which can be especially difficult to treat.

Overall, I still think that this is a valuable book for people dealing with brain tumors, mainly because of the lack of other similar books, so I do recommend it. I've even rated it four stars. But readers should remain keenly aware of the limitations and biases of this book, since they result in the book painting a very incomplete and sometimes inaccurate picture of the treatment options available to brain tumor patients.

For anyone dealing with a brain tumor, my favorite book is Surviving Terminal Cancer: Clinical Trials, Drug Cocktails, and Other Treatments Your Oncologist Won't Tell You About by Ben Williams, which I very highly recommend.

If I ever have any kind of issue with my brain, tumor or otherwise, I will go to the ends of the earth to find this man and no one else.That's how much this man knows about defeating brain tumors. He started blazing his trail early in life, while he was still a teenager. He started in the research laboratory originally working with hearts. Then he found his true calling working with the brain. He has such a passion for his work! He has contributed so much to his patients, their families and countless other souls whose lives will forever be altered due to this man's work and skill both in the operating room and research lab.

I thoroughly enjoyed reading about his patients. I especially was moved by the two brothers from Ireland. His description, while he said may be grotesque to nonmedical people, was correct. He did send me over the edge on that one. His description was so clear I am having a hard time getting it out of my head.

You learn quite a bit about different brain tumors, and cancers in general. It was fascinating. I also couldn't help sadly thinking that I wished this man, so gifted with his skills in conquering/ extending the life of someone with a deadly glioblastoma multiforme, had been around decades earlier when young Johnny Gunther
had died from it. John Gunther wrote the book Death Be Not Proud and it details the life of his young son Johnny who died from a Glioblastoma tumor in his brain. He was so intelligent and wanted nothing more than to continue his studies at Harvard University. How different things might have been if Dr. Keith Black had been around.

I thoroughly enjoyed this book. I am a brain tumor survivor & I could relate to a lot of the stories. I also found the descriptions of the medical procedures to be very fascinating. I didn't agree with all of the author's viewpoints, but overall I enjoyed hearing his story. I would recommend this book to anyone who has gone through brain surgery, knows someone who has gone though brain surgery, or who wants to hear some inspiring stories.

To tell the truth, i was completely sold when i read all the good reciews. Basically all of them were 5 stars. So i bought the book. Read it yesterday.
OMG! You can't even imagine the EGO this guy has unless you've read his book. The book contains some good but limited amount of information about the brain and the surgeries. But every word in this book shows what kind of ego this doctor possesses. So it's hard to read on. He thinks of himself as god and walks several inches above the ground. He tells us how he is almost, ALWAYS correct and how he is the BEST there is. He goes on saying that his patients do alot of research into the field and finds that he is the best there is. And he mentions that alot.
He maybe an excellent doctor. But this book is not. Don't get fooled by the reviews or the cover. It's almost like a promotional booklet.
There is a HUGE difference between finding a good doctor for your surgery and reading a good book.

An excellent book, I will give this book to the college students
and high school students interested in a career in medicine. By telling the stories of seven patients, Dr. Black provided insight into the political, academic, and clinical world of medicine. From a political perspective, the readers gain an understanding of who gets awarded National Science Foundation grants. From an academic view, Dr. Black allows the reader to peek into the university and see its prejudices, bureaucracy, and intellectual silos. With personal stories, the author takes the reader into the hospital, the organization that has to decide which uninsured patients get treated, how much information it discloses to the patient, and the disparities of care between rich and poor. Policy makers and citizens interested in making informed judgments on health care should take the time to read Dr. Black's book.