Thursday, October 8, 2009

Another Day in the Frontal Lobe

Katrina Firlik, a brain surgeon has written a book about her profession, aimed at the lay person. It is a very easy read and I can’t recommend it enough. Books such as these are the closest that most of us will ever get to understanding a neurosurgeon’s life and thinking.

Dr. is smart, witty, has a very wry sense of humor and is disarmingly down to earth.

Dr. Firlik could have assumed one of several tones as the author: she could have come across as authoritative (“I am a brain surgeon, and you’re not”) or been didactic, or she could have taken a chummy tone. She doesn’t do any of this. With a well poised sense of balance, she comes across as a very capable and smart person, who is confident enough about sharing her vulnerabilities when warranted. She is able to convey the complexities involved in decision-making around different procedures regarding the brain, showing us that there are no black-and-white solutions

The book is structured to roughly parallel her life, taking us along as she chooses neurosurgery, goes through the seven years of residency and becomes a full-fledged practicing surgeon. There are numerous real-life anecdotes –funny ones as well as heart-rending ones.

I found Dr. Firlik’s way of giving advice, with a very light touch to be really effective. She has many examples of how huge personal catastrophes (and lives) could have been saved simply by the use of a helmet or a seat-belt. She is also not above adding “Nice” after a horrifying 2am drunk driving, no seat-belt disaster. I wish some of my college friends who still smoke would read this book. She casually mentions the havoc that the smoking habit unleashes on the brain in later years.

From time to time, she shares with us some of the black humor that the doctors, residents and nurses resort to about the patients. Dr. Firlik manages to pull these off, without ever giving the impression that any of the doctors are being callous. It is simply a coping mechanism for those who work long hours in grim circumstances.

There is a great line in the book which I know I will be quoting soon. When patients ask “Why me?” one of Dr. Firlik’s mentors says, “There are three possibilities. It could be bad genes, bad habits or just bad luck.”

I am very glad that I took the time to get hold of the book and read it. For those of you who just don’t have the time, I’d still recommend that you borrow the book from your local library and at least read the chapters titled ‘Scientist and Mechanic,’ ‘Traces of Thought,’ and the final chapter ‘Brainlifts,’ in which she speculates about what the future in her profession holds for enhancing brain and memory power.

Every profession should be fortunate enough to have someone write about it in an accessible and smart manner. For neurosurgery, it is Katrina Firlik. Don’t miss this book.

A Few Random Excerpts from the book that I jotted down: [On the fact that 15,000 people are affected every year] In short, a brain tumor is the fault of no person or thing. As with a deadly hurricane, nature is often both powerful and indifferent.

[Lesson learned as a junior resident] A lesson learned early on is that a sin of commission is better than a sin of omission. Better to do too much than too little. If you appear weak or indecisive, people will walk all over you.

[On why doctors are forced to be extremely cautious about possible litigation] At $106,000 per year, my malpractice premium is already high enough.

[One preventative idea] An idea I’ve had off and on during late-night treks to the ER. Everyone past a certain age – it’s hard to be exact here and I’m not being ageist, really – should consider sleeping on a traditional Japanese-style futon, the real kind, frameless, right on the floor. I can’t tell you how many ER visits for injuries to fragile parts – heads, necks, backs, limbs – could be prevented if simple falls out of bed were curtailed.


Chris said...

Ram - Your post reminded me of Atul Gawande. He's a surgeon who teaches at Harvard and writes regularly for the New Yorker. He's written a couple of books, and here's an interesting piece he wrote on aging:

Ram said...

Thanks, Chris. Yes Gawande is on my "to read" list, especially his book "Better."

Too many books, too little time. The reason I posted about Another Day in The Frontal Lobe is that this book and its author are not as well-known.