Working in a Very Small Place: The Making of a Neurosurgeon [Paperback]

Mark Shelton (Author)

Book Description

Publication Date: May 12, 1990

The little-known world of neurosurgery is dramatically revealed through the story of Dr. Peter Jannetta, who invented a simple yet miraculous cure to an excruciatingly painful brain disorder.

Editorial Reviews

From Publishers Weekly

Shelton here probes the career of brain surgeon Peter Jannetta, who invented a controversial but now internationally acclaimed operation to relieve a cranial nerve disorder. "This affecting, rousing account portrays the maverick, engaging surgeon's battle to acquaint the medical profession with his discoveries and achieve acceptance for his innovation," commented PW.
Copyright 1990 Reed Business Information, Inc.

From Library Journal

Author Shelton takes the reader inside the world of Peter Janetta, a neurosurgeon at Pittsburgh's Presbyterian University Hospital. For the past 20 years, Janetta has been developing and refining a surgical procedure known as vascular decompression. Used in the treatment of trigeminal neuralgia and other afflictions, the procedure basically involves opening the skull and stuffing a bit of felt between the affected cranial nerve and the compressing vessels. This seemingly absurd solution has been demonstrated to be effective, but Janetta's battle for acceptance of the procedure by the medical community, particularly by "the grand old men of the profession," has not been easy. The author's controlled, subdued prose complements the intensity and ambition of his subject. Highly recommended.
- Laurie Bartolini, Lincoln Lib., Springfield, Ill.
Copyright 1989 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

Product Details

• Paperback: 315 pages
• Publisher: Vintage (May 12, 1990)
• Language: English
• ISBN-10: 0679728155
• ISBN-13: 978-0679728153
• Product Dimensions: 7.9 x 5.2 x 0.8 inches
• Shipping Weight: 8.8 ounces
• Average Customer Review: 4.0 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #907,300 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

8 of 8 people found the following review helpful:

4.0 out of 5 stars A peek into the world of a neurosurgeon, September 12, 2004

By 

dr_sasp (England, UK) - See all my reviews

This review is from: Working in a Very Small Place: The Making of a Neurosurgeon (Paperback)

Shelton writes as an outsider - albeit, as a science journalist, a very informed one - looking in on the world of neurosurgery. Specifically, he looks in on the world of neurosurgeon, Peter Jannetta.

Jannetta is a bold, charismatic man who has made his name despite detractors and carved out a subspeciality where others had failed to do so. Based on a few subtle observations, Jannetta revitalised a theory of microsurgical decompression for cranial nerve disorders such as trigeminal neuralgia, a condition of excruciating facial pain that drives some sufferers to suicide. Jannetta, against the tide of opinion, chose to go into tiger country at the cerebellopontine angle deep within the brain and lift tiny, sometimes microscopic, vessels away from the nerve and hold them away with small pieces of fluff. Established contemporary neurosurgeons were largely up in arms that a young upstart resident would perform potentially dangerous surgery when a safer alternative (of destroying the nerve distally) existed. Jannetta, with charm, stubbornness and unshakable self-belief held onto his view and over a period of years forced his procedure to be accepted. Sheldon documents his persistance with admiration and recognition of the historical context of this work.

In explaining this neurosurgeon's world, Sheldon explains to those on the outside the terminology, anatomy, clinical process and US referral system. Although his explaining these things in explicit detail slows the pace at times, it is probably better that he occasionally bores a few cognoscenti than baffles or alienates the lay reader.

In the best part and heart of the book, Sheldon has been invited into the inner circle and in his apparent shadowing of Jannetta, has built up a brilliant picture of a brain surgeon's daily work. Sheldon describes conferences, tutorials and closed-door morbidity and mortality meetings in an engaging and intriguing way. With the vitality of Jannetta central to the story, it is an entertaining coffee- and cigarette-fuelled rollercoaster ride. Sheldon has crammed a vivid personality, a packed daily schedule and the painful experiences and desperate histories of patients into a powerfully-told, brilliantly-painted portrait.

In the brain-book genre, this is most similar to A Scapel's Edge, describing another neurosurgeon (whom, I think, specialised in aneurysm surgery), rather than When the Air Hits the Brain, or the general surgery based Complications, which were written by surgeons themselves rather than journalist observers. Whilst probably not stealing the podium from my favourite brain-book, this is certainly an intriguing, enlightening, and most importantly, entertaining read.


dr_sasp

9 of 10 people found the following review helpful:

3.0 out of 5 stars Well written, provides insight into neurosurgical practice., August 18, 1999

By A Customer

This review is from: Working in a Very Small Place: The Making of a Neurosurgeon (Paperback)

Mr. Shelton has written a well researched book. I find it specifically interesting in the fact that the doctor, Dr. Jannetta, allows the author a glimpse into the admitted as well as the often unadmitted; the surgical practice of "ghost surgery". (I no longer have the book so I may be wrong about page citiation but I believe it is approximately page 252.) The author relates an anecdote told by a resident about the time he wanted to operate on a woman with a brain tumor who had just given birth. Although Dr. Jannetta at first tells the resident not to operate because of the potential danger to the patient the resident persists and Dr. Jannetta relents. The author goes on to tell how the patient died and Dr. Jannetta, who had not been in either the O.R. or the hospital, comes in in the middle of the night to commiserate with his resident. It is not often, if ever, that a doctor admits publicly that he, by his actions, endorses 'ghost surgery'. This book gives the reader an entry into an often secretive and closed world. Neurosurgery seems to be the most highly regarded, feared and unknown of the medical specialties. For anyone curious about the life of a neurosurgeon, this is one of the books I would recommend.

1 of 1 people found the following review helpful:

5.0 out of 5 stars About Jannetta, June 9, 2010

By 

Jane Uitti "Jazzviolin" (Boulder, CO) - See all my reviews
(REAL NAME)   

This review is from: Working in a Very Small Place: The Making of a Neurosurgeon (Paperback)

This book hits the courageous and compassionate side of Dr. Jannetta spot-on. I had 2 of these surgeries with Dr. Jannetta, and Mark's book is factual, humorous, and intensely personal. This is a great read about the practice of neurosurgery, as well as about Peter Jannetta's work with the rare but very painful condition of trigeminal neuralgia. Tho published in 1989, its references and observations are still current, and would be informative to anyone considering the field of neurosurgery, or considering getting this procedure done.