Customer Reviews

When the Air Hits Your Brain: Parables of Neurosurgery

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The 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 a very 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 unputdownable read. I've been through it twice now---once during a night where I couldn't sleep anyway. 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."

A baby's brain is very hard to operate on: "At six weeks of age, the unmyelinated brain is thick soup which can be inadvertently vacuumed away by operative suctions. Moreover, nerves the thickness of pencil lead in adults are little more than a spider's web in a baby."

Dr. Vertosick doesn't spend the whole book wisecracking. He ends the chapter on Rebecca: "I am not particularly religious. In fact, the birth of children bearing cancers I find difficult to reconcile with a merciful God. Nevertheless, there must be someplace where Rebecca now laughs in the bright sunshine, finally free of her ventilator and gastrostomy."

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.

I'm in the process of donating all of my books to the library that I know I won't read again. "When the Air Hits Your Brain" is not one of the donations.

A compelling story of a physician's journey to become a neurosurgeon. I was engaged after the first paragraph, and had a hard time putting the book down thereafter. Vertosick's style is fluent, straightforward, and without the literary flare that so often clouds books. Within the two days that it took to read this book, I became medical student, patient and neurosurgeon. This was an experience that I shall remember 'til I die.

The author says the first rule of neurosurgey is "You're never the same once the air hits your brain." Full of the type of dark humor you would expect from medical profesisonals, this book chronicles the experiences of a neurosurgeon from his days as a medical student to his present day practice in Pittsburg. It is very well-written and is intended for the layman (my guess is that fans of the TV show "ER" would love this book). But be warned, emotionally it is a very hard book to read. Take for example the story of the woman who is diagnosed with a terminal brain tumor while early in a pregancy. The author's story of her fight to live just long enough to deliver her child cannot help but reduce the reader to tears. The book also forces the reader to realize how quickly the body can betray and fail to function. It can be a scary realization when the neurosurgeon makes clear how quickly life can end. This book is an overlooked treasure. But keep your Kleenex close at hand, especially parents

Neurosurgeon Frank Vertsoick Jr.'s memoir opens with the five rules enumerated on his first day of a six year residency and never forgotten:
"Rule number one. You ain't never the same when the air hits your brain....It was built for performance, not for easy servicing.
"Rule number two: The only minor operation is one that someone else is doing.
"Rule number three. If the patient isn't dead, you can always make him worse if you try hard enough.
"Rule four: One look at the patient is better than a thousand phone calls from a nurse.
"Rule five: Operating on the wrong patient or doing the wrong side of the body makes for a very bad day."

These pretty much sum up the tone and gravity of Vertosick's rivetting, harrowing and touching book. The son of a steel worker, Vertosick came to neurosurgery almost by accident. His memoir focuses primarily on the years of training from medical student through chief resident.

Vertosick's first anecdote, from his first operating room observation, will have readers grabbing their throats - literally - in shock. His mentor, Gary (who becomes a familiar chain smoking, fast-talking irreverent character) picks up a drill. Vertosick asks how it knows when to stop before plunging through the skull into the brain and is told it has an automatic clutch mechanism. Only the mechanism fails. Those who continue reading once their heart rates return to normal will be hooked.

In an arrogant profession, Vertosick is an appealing narrator. He can also write. His descriptions of hospital routine and crisis, pecking orders and interdisciplinary rivalries are frenetic and often hilarious.

But his portraits of individual patients bring them to poignant life and often death. There are happy endings - the young, virile accident victim whose progressive paralysis indicated spinal damage, but who was saved by a risky diagnosis and fast surgery. But there are many others - the retarded man whose aneurysm became something worse through a slip of the knife,or the pregnant woman with a brain tumor who refused to abort her baby and therefore refused treatment in medicine's litigous atmosphere.

But Vertosick's memoir is not just a string of anecdotes. It's a portrait of his profession and its effect on a doctor's psyche. He first tasted "the intoxicant of power" after botching a routine procedure on a veteran and being thanked for it. "On the street, this would not be called a medical procedure but assault and battery - with witnesses, no less!"

There's the exhiliration of saving life. One of those was a man pronounced brain dead and delivered as an organ donor. Thanks to Vertosick and an observant junior, the man walked out of the hospital a week later and lived another two years.

While Vertosick's subject is inherently fascinating, it's the author's ability to convey his exuberance, fear, anguish and joy that leave the reader hoping he'll trade scalpel for word processor again.

This stands out in the field of medical literature. By definition, there are a very select number of people who could have written this book. Firstly, the number of brain surgeons is strictly limited (duh) for reasons that become apparent as the book progresses. Secondly, and most importantly, I think only a small minority of them can be as bloody good writers as Vertosick.

The book conveys pathos, humour and a dramatic shift in mindset experienced by our author as he is initiated into neurosurgery...from intern to surgical psychopath. This journey takes him several years and a number of lifetimes to complete. The lifetimes are those of the patients and their relatives that he (and we) are priviledged to be invited to share. Naturally, not all the stories have a happy ending and whilst it is clear that Vertosick cares, so, you will find, do you.

I wanted this book to go on and on. Dr. Vertosick's writing is interesting and funny, and he doesn't exhibit the typical neurosurgeon's complete egocentricity. Anyone who works with neurosurgeons will enjoy this. A great book for all of us surgery junkies!

Just as the opening incanatation states, "You're never the same when the arir hits your brain," the same is true for readers of this book. To all aspiring medical students a warning! After reading Dr. Vertosick's enthralling tales you will never aspire to be anything but a Nuerosurgeon.

The title of the book really caught my eye. I had brain surgery about 2 years ago and it's true, you never are the same, physically or emotionally. While reading this book I was reminded of the incredible respect I developed for the skills, commitment and bravery of these surgeons. I learned a lot, too!

The book is also very effective at reminding one that life is very precious and can quickly change when you least expect it.

Some of the stories Dr. Vertosick tells are truly gut-wrenching and some,believe it or not, are quite entertaining. It just goes to show you that the best fiction cannot compare to real life!

This is a wonderful, hilarious, moving account of how Dr. Vertosick progressed(or regressed?) from a mere mortal of a junior medical student to a god of Neurosurgery. It is filled with comedy and tragedy--both of which are chronicled by the author with uncompromising honesty and compassion. A great book for the non-medically-inclined reader!

The book starts out a little slow, but it does pick some speed. This is a narration of the life of a young (and naïve) neurosurgeon in residency. Frank Vertosick shares some profound experiences in this unsparing book, which will be particularly useful to those who want to know what residency entails - it's challenging and interesting points.

Among Vertosick's stories is one about a young man taken into the hospital with the then-unknown disease of AIDS. He became the first person reported to that particular health department with the strange new illness. We are also told heart-wrenching stories of human struggle, like the story of Shirley, who dies after numerous hours of fighting a damaged aorta and brain. There is also a touching story of Andy, who happens to have "trisomy 21" (Down syndrome), and is also deaf, blind, mute, and has a brain hemorrhage.

The book is quite shocking in some parts, and educational too. Where you imagine a triumphant ending, the unexpected (and sad) happens. It's a book of triumphant stories, and disappointing ones. The stories all move at a decent, likable pace. The book leaves you with the feeling that physicians are in fact very human as Vertosick tells the story of Charles, who has an uneventful aneurismal tear while in his hands. Not all is victory as a neurosurgeon. A surgeon often has to deal with death and mistakes.

Some parts were fictionalized to enhance the story, but still a good book nonetheless. Enlightening.