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Brain Surgeon

The Real Poop

Careful…steady now…make sure you cut the right one, or it could be all over….

Diffusing a bomb? Nope—performing brain surgery. It's a little scary how many similarities there are between the two though. Both take a deft hand and unwavering nerves, both can result in the loss—or preservation—of life, and both make great primetime TV drama. The Cutter, coming to CBS this fall.

You really do have to be part robot to perform this job—first, because you need all your movements to be precise and mechanical, and second, because when you screw up royally, your lack of a human heart will make it easier to look your patient's wife and three kids in the eyes and tell them daddy didn’t make it.

Unfortunately, you likely do have a human heart, and suffer common human failings, which makes being a brain surgeon difficult indeed. You are always within a hair's breadth of killing someone, so if you have serious designs on a career in this field, you're going to have to find a way to be at peace with that fact. You aren't 007, cutting red and blue wires, but slicing through human wires is just about as nerve-wracking.

Now say you do make a major boner and the guy on your operating table never takes another breath. In that case…you may discover that there are things worse than death. Like this guy's insanely rich family suing you for all you've got, the hospital you work for assigning the case to their legal risk manager, who determines that you exhibited gross negligence, losing your license to practice or professional blackballing, humiliation and mortification galore. Now you have 16 years of massive student loan debt and no way to pay it off. Your wife, who has gotten accustomed to a certain way of life, leaves you—she says it's because she can't stand the thought of you killing someone, but really it's because she doesn't want to have to put out all her Manolo Blahniks at a garage sale.

Starting to envy the guy on your table who is no longer with us?

Okay, enough for the scary part. The other aspect of this profession is that you are saving lives a heck of a lot more often than you are exterminating them (hopefully). We are privileged to live in a time with advanced medical science—a few hundred years ago, if they wanted to remove a tumor, they'd throw a few eyes of newt into a steaming cauldron and recite a magical incantation. Or something like that.

Oh, yeah. We're sure you’re just making some beef stew.

Believe it or not, patients are generally awake during certain types of brain surgeries, like tumor removals. The awake craniotomy technique is helpful for doctors when working near areas of the brain that are related to speech. Talking to their patients during surgery helps them understand how much of the tumor or brain to remove. If they take out too much, their patient won't be able to talk. So if they suddenly start speaking in grunts and whistles, chances are you've done something wrong. Better put back whatever you just removed, and quick.

Brain surgery has been used as a unit of measurement for comparing any difficult task. Ever hear "it’s not brain surgery?" Apparently, the only thing that rivals brain surgery as a measurement of difficulty is rocket science.

Is brain surgery really that difficult? When you have the skills and know-how that a zillion years in medical school will give you, it really shouldn't be too difficult—it's more about the impossibly high stakes and pressure you're under that make your job so unenviable by most. If a brain surgeon or neurosurgeon botches the surgery, the patient may suffer brain damage, infections, bleeding, seizures, or death. You need steadier hands than a hand model for this career.

Neurosurgeons are not just "brain doctors." In fact, they treat diseases of the nervous system, which includes the spinal cord and spine. Most of their patients have had strokes, arm or neck pain, trauma to the brain, abnormal blood vessels in the brain, or brain tumors. In fact, many patients do not need surgery. However, they visit a neurosurgeon to get a medical opinion or discuss non-invasive treatments—like using radiation—to treat lesions of the nervous system. You won't hear too many patients complaining of non-threatening health issues. Brain surgery is a little more serious than treating a bad case of brain freeze from an ice cream cone. And the after-effects are not nearly as delicious.

Neurosurgeons are not the lone horsemen of the medical world. They work with other types of specialists such as neuroradiologists, neurologists, ophthalmologists, orthopedic surgeons, electrophysicologists, and rehabilitation physicians. This team atmosphere gives patents a treatment plan that covers their needs before, during, and after surgery or any other type of treatment. They are kind of like the cool kids on the hospital floor gossiping about the newest endoscope. We realize the idea sounds like a bit of an oxymoron, but stay with us on this one.

Technology in this field changes rapidly. Neurosurgeons must take continuing education classes to keep on top of the latest scientific news or advances. Brain surgery has come a long way from the archaic practice of drilling a hole in someone's head. Okay…they still drill holes, but they use drills that can electronically sense when they have drilled through bone, which is a feature most patients are super-duper excited about. Archeologists have found human remains over 4,000 years old that indicate a successful surgery. The individual they found probably had a few more years of life left—until they were eaten by a wooly mammoth (the cause of death is still being debated, but the "mammoth" version of the story certainly sounds like the most thrilling one). 

Today, neurosurgeons use endoscopes equipped with fiber optics, probe attachments that have the ability to vaporize diseased brain tissue, and radiation beaming knives called gamma knives.

Before you can pop open someone's brain like a can of soda, you must go through extensive medical training. We are talking the Olympic training of medicine. Expect to spend four years getting an undergraduate degree, four years earning a graduate degree from medical school, and eight years training in a residency program. It takes around 16 years of training before you can use a knife to do more than cut butter.

If you are lucky you'll be done with training in your mid-30s. Training programs are highly selective. Most of them accept one to three people a year. Time to get cracking on those medical books. These training programs only accept those who rank at the top of their class. Don't know the difference between the Hypothalamus and Medulla Oblongata? Here's a hint: One regulates appetite (among other things) and the other controls breathing. Giving a patient's brain a "bad haircut" will not lead to many more chances at surgery. Unlike hair, the brain cannot just "grow out."

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