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When the Air Hits Your Brain: Tales from Neurosurgery Paperback – March 17, 2008

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Editorial Reviews Review

For the patient, an operation is a single defining moment. For the neurosurgeon, each moment in the operating room represents the culmination of decades spent struggling to learn an unforgiving craft. When these two join there is drama, often too much of it. This book tells the story of Frank Vertosick's metamorphosis from naive intern to neurosurgeon through intimate portraits of his patients and nerve-jangling descriptions of surgical procedures. Riveting, poignant, and sometimes shockingly funny, When the Air Hits Your Brain is a remarkable account of the mysteries of the mind and the operating room. --This text refers to an out of print or unavailable edition of this title.

From Publishers Weekly

Instead of offering a collection of bizarre medical cases, brain surgeon Vertosick presents a set of harrowing clinical tales that highlight neurosurgery as risky, messy and often frustrating. The result is a riveting report that shatters the mystique of the brain surgeon as a wizard of technical prowess. Many of the patients profiled here die-an outcome not representative of neurosurgery at large, the author reassures us. The cases are drawn from Vertosick's six years of internship and residency. Among the most memorable are Andy, a Down's syndrome sufferer with multiple head and neck abnormalities who chose euthanasia over a life imprisoned in bed. We also meet Sarah, a pregnant homemaker with a malignant brain tumor who refuses radiotherapy and a therapeutic abortion. Vertosick is associate chief of neurosurgery at Western Pennsylvania Hospital in Pittsburgh.
Copyright 1996 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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Product Details

  • Paperback: 272 pages
  • Publisher: W. W. Norton & Company; Reprint edition (March 17, 2008)
  • Language: English
  • ISBN-10: 0393330494
  • ISBN-13: 978-0393330496
  • Product Dimensions: 5.5 x 0.7 x 8.3 inches
  • Shipping Weight: 8 ounces (View shipping rates and policies)
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (189 customer reviews)
  • Amazon Best Sellers Rank: #33,470 in Books (See Top 100 in Books)

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57 of 58 people found the following review helpful By CHEN SHANG CHI BRUCE on September 12, 2005
Format: Mass Market Paperback
I'm a neurosurgeon myself.I'm still so moved by the stories told by the author.They reflected the true life in my daily practice and circumstances.They seems funny but actually sad inside, filled with sorrow and tears of both the patients and doctors. I strongly recommend this book to those who would like to participate in this field of medical speciality and to those who would like to understand the real life of a neurosurgeon!
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34 of 35 people found the following review helpful By C. Middleton on January 10, 2006
Format: Mass Market Paperback Verified Purchase
The history of neurosurgery is a fascinating one, however, even more interesting is to see how it has developed over the last century since, for example, the legendary Dr. Harvey Cushing forged the techniques of brain surgery over seventy years ago. `When the Air Hits Your Brain - Tales of Neurosurgery' is a compelling collection of tales written with erudition and sensitivity with at times gruesome detail of brain operations that sometimes were successful and other times not. As Dr. Vertosick proposes in his introduction, that, for the most part, a surgeon learns more from the failures than the successes; therefore most of the stories within are tragedies - failures that paved the way to future successes. For those interested in the world of neurosurgery, this book should more than satisfy as it covers a vast array of different cases as well as the general ambience and culture of this very specialized profession.

The author begins his tale as a burgeoning medical student, internship, ending with his last year as Chief Resident. Interestingly, his last year, from his perspective was his worst. He explains that being a Chief Resident is a precarious position, because you have to continue to cow tow to the attending staff and the junior residents continue to look upon you as just another taskmaster, a kind of in-house bully, ensuring the skills required are learned. Vertosick explains the position as "straddling two worlds, "...a sergeant in the surgical military, friend to neither enlisted man nor officer, endowed with great responsibilities but given little true authority." (P.254)

There are many miraculous and downright bizarre cases chronicled throughout the text. One of the strange cases was the woman who had been shot between the eyes by her drunken and irate boyfriend. Dr.
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57 of 62 people found the following review helpful By ealovitt HALL OF FAMETOP 100 REVIEWER on July 25, 2003
Format: Mass Market Paperback
This author has an edgy, sleep-deprived, wisecrack-a-minute style that makes me glad some states at least, have reduced the number of hours per week a medical resident must work, from one hundred to eighty. Neurosurgery is an unforgiving craft, and not all of the stories in this book have a happy ending. Neurosurgeons must tackle some pretty hopeless cases, and the human brain is a very unforgiving operating theatre.
Nevertheless, "When the Air Hits Your Brain" is an exhilarating read. I've been through it twice now---once through a night when I had pretty much given up on sleep. If you do intend to sleep, don't read it right before going to bed.
Here are the author's five rules for neurosurgery interns:
1. You "ain't never" the same when the air hits your brain.
2. The only minor operation is one that someone else is doing.
3. If the patient isn't dead, you can always make him worse if you try hard enough.
4. One look at the patient is better than a thousand phone calls from the nurse.
5. Operating on the wrong patient or doing the wrong side of the body makes for a very bad day--always ask the patient what side their pain is on, which leg hurts, which hand is numb.
Emotionally, Dr. Vertosick's worst rotation was to the local Children's Hospital. A child who was born with an inoperable brain tumor is the focus of the chapter entitled "Rebecca."
Read how the author strays into the 'inferno of overconfidence' as a chief resident, and comes "perilously close to emotional incineration." Follow him into the operating room as a patient's brain oozes through his fingers, where he is squirted in the eye by an AIDS patient's spinal fluid, and where he cures a woman who was misdiagnosed as an Alzheimer's patient when what she really had was a brain tumor.
Dr. Vertosick has written another, equally interesting book, "Why We Hurt," on the 'natural history' of pain.
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19 of 19 people found the following review helpful By E. Bukowsky HALL OF FAMETOP 500 REVIEWERVINE VOICE on April 5, 2008
Format: Paperback
Originally published in 1996, "When the Air Hits Your Brain," by Dr. Frank Vertosick, is a mesmerizing insider's look at "an arrogant occupation" whose practitioners operate on the spinal cord and the human brain ("a trillion nerve cells storing electrical patterns more numerous than the water molecules of the world's oceans"). A neurosurgeon must be supremely confident in his ability to get the job done; if he were to dwell on everything that could possibly go wrong during a procedure, he would be too terrified to operate. Because of the high potential for missteps, neurosurgical training is an arduous seven years of hell. Before he starts treating "brain cancers, spinal cord injuries, head trauma, [and] lethal hemorrhages," a trainee must endure a grueling regimen of study which includes repeated humiliation at the hands of verbally abusive mentors. This is not a profession for the faint-hearted, for when neurosurgery is unsuccessful, the results can be catastrophic. Even if the patient survives, his cognition, speech, movement, and vision may be forever compromised. In the words of Gary Stancik, a sardonic chief resident, the brain is like a '66 Cadillac: "It was built for performance, not for easy servicing."

Vertosick fell into neurosurgery by happenstance. He spent some time as a steelworker, majored in theoretical physics, and wound up choosing medicine by default. In the years to come, he would have to adjust to impossibly long hours, inadequate sleep, and hit-or-miss meals. He would become adept at performing quickly and efficiently under pressure. However, none of his earlier experiences would fully prepare him for the emotional roller-coaster that lay ahead.
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