Gray Matters: A Biography of Brain Surgery

Neurosurgeon Schwartz’s excellent debut intersperses details about the history of brain surgery with background on what it’s like to perform the procedure. He traces neurosurgery’s origins to Yale University doctor Harvey Cushing’s pioneering operations in the early 20th century; chronicles the development of stereotactic radiosurgery (targeting tumors with radiation), hemicraniectomies (removing part of the skull to accommodate brain swelling), and other techniques; and highlights horrific methods from the field’s past (early lobotomies involved blindly swiping a “butter knife–like instrument” back and forth to disconnect the frontal lobe from the rest of the brain). Discussing the difficult decisions neurosurgeons face daily, Schwartz recounts making tough calls about how aggressive to be during surgery, noting that attempts to remove tumors in sensitive areas risk causing “blindness, deafness, or an inability to swallow.” Schwartz’s frank reflections on the devastation he feels after unsuccessful procedures attest to the psychological toll of the profession (“I know I did my best for her at the time. It’s just that my best wasn’t good enough”), and he cleverly elucidates various procedures with celebrity case studies. For instance, he uses actor Michael J. Fox’s thalamotomy to discuss how the operation inserts electrodes into the brain to disrupt misfiring neurons in people with Parkinson’s disease. Sweeping and consistently captivating, this impresses. Photos. (Aug.)