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Rating: 
Summary: A stunning exploration of neurosurgery
Review: Ed Sylvester has brought neurosurgery as close and approachable as my easy chair. He has managed, with a mixture of lyrical prose and white-knuckled suspense, to take us into the operating room, even down into the recesses of the brain where doctors are accomplishing medical miracles every day. Most importantly, Sylvester masterfully clarifies and explains surgical and medical principles that had, until now, been murky. For example, his few paragraphs on the cause of stroke made clear to me the malady that has claimed members of my own family, but whose fundamental causes were mired in wive's tales. Not only does the reader follow the surgeon's tools beneath the surface of the brain, but Sylvester draws us into the competitive and demanding world of the neurosurgeon. From the earliest days of this surgical specialty, the men (women are only now beginning to get a toe-hold in the profession, Sylvester tells us) who have populated neurosurgery have been colorful, fierce competitors, seeking academic standing and popular notoriety in what is probably the most demanding field of medicine. Ed Sylvester is a master of explanatory writing. But he also brings us so close to his characters and the life-or-death risks they face under the brain surgeon's knife that "The Healing Blade" reads like a thriller. Not a book to read in bed before retiring; it had my heart pounding and I more than once found that it was the wee morning hours before I could put it down. A highly recommended read.
Rating: 
Summary: The chilled brain
Review: Siamese twins occur only once in 100,000 births. Those joined at the head, like the Guatemalan twins recently separated at UCLA are the rarest of all, occurring in less than one in a million births. UCLA, which has one of the world's leading neurosurgery centers is not the first operating theatre where a successful attempt was made to separate "craniopagus" twins who shared some of their neurological "wetware." That honor belongs to Vienna's university hospital and a team headed by pediatric neurosurgeon, Dr. Wolfgang Koos and American neurosurgeon, Dr. Robert Spetzler. Step by step, "The Healing Blade" describes the operation performed on the conjoined twins. The surgeons had been rehearsing each step, "together and apart, through three months" to acquire the necessary precision of movement. The operation itself took place over a period of days. Sylvester describes the scene before it began: "At the juncture of the twin operating tables lies what appears to be a log of ironwood, dried pale and clean. It is the long, common skull of the twins, shaved of that fringe of curly brown hair. Nearly a foot apart two small [three-year-old] faces appear carved into the wood, one facing straight out, one cast slightly downward, both in slumber, perfect cherubim carved into the column of their skull." Read this fascinating account if you are at all interested in the fate of the Guatemalan twins at UCLA. Unfortunately, the twins who were separated in Vienna later died of infection, so this is a cautionary tale. We must not become too optimistic, even though the surgery was successful: "In 30 attempts worldwide to separate twins joined at the head, from 1928 to 2000, only seven of the 60 children came through the surgery without brain damage; 30 died, 17 were neurologically impaired and the remainder of the cases were reported before the ultimate outcome could be determined, according to the medical journals [NY Times 08/07/2002]." Other operations performed by Dr. Spetzler had more successful, long term outcomes as described in "The Healing Blade." This book focuses on three main subjects: Dr. Spetzler and his contributions to neurosurgery; the history of the Barrow Neurological Institute in Phoenix, where Dr. Spetzler performs the majority of his operations; and a new state of the art procedure called the "Standstill," which is a nickname for hypothermic arrest. In a sense, the patient dies for an hour--no blood and therefore no oxygen can reach his brain while he is chilled down to the point where his heart stops. This book is much more unputdownable than the latest techno-thriller by, say Clancy or Ludlum, because it is true. The author's attention to detail places us right into the operating room with the surgical team, and deep into the magical cavern of the human skull. The only dry stretches of text concern the founding and history of the Barrow Neurological Institute, and they don't take up too much room. The author also works in a brief history of neurosurgery, but none of it is quite as fascinating as the scenes where Dr. Spetzler is poised over his intraoperative microscope, carefully dissecting an aneurysm that threatens to explode through the micro-currents of a human intelligence.
Rating:
Summary: The chilled brain
Review: Siamese twins occur only once in 100,000 births. Those joined at the head, like the Guatemalan twins recently separated at UCLA are the rarest of all, occurring in less than one in a million births. UCLA, which has one of the world's leading neurosurgery centers is not the first operating theatre where a successful attempt was made to separate "craniopagus" twins who shared some of their neurological "wetware." That honor belongs to Vienna's university hospital and a team headed by pediatric neurosurgeon, Dr. Wolfgang Koos and American neurosurgeon, Dr. Robert Spetzler. Step by step, "The Healing Blade" describes the operation performed on the conjoined twins. The surgeons had been rehearsing each step, "together and apart, through three months" to acquire the necessary precision of movement. The operation itself took place over a period of days. Sylvester describes the scene before it began: "At the juncture of the twin operating tables lies what appears to be a log of ironwood, dried pale and clean. It is the long, common skull of the twins, shaved of that fringe of curly brown hair. Nearly a foot apart two small [three-year-old] faces appear carved into the wood, one facing straight out, one cast slightly downward, both in slumber, perfect cherubim carved into the column of their skull." Read this fascinating account if you are at all interested in the fate of the Guatemalan twins at UCLA. Unfortunately, the twins who were separated in Vienna later died of infection, so this is a cautionary tale. We must not become too optimistic, even though the surgery was successful: "In 30 attempts worldwide to separate twins joined at the head, from 1928 to 2000, only seven of the 60 children came through the surgery without brain damage; 30 died, 17 were neurologically impaired and the remainder of the cases were reported before the ultimate outcome could be determined, according to the medical journals [NY Times 08/07/2002]." Other operations performed by Dr. Spetzler had more successful, long term outcomes as described in "The Healing Blade." This book focuses on three main subjects: Dr. Spetzler and his contributions to neurosurgery; the history of the Barrow Neurological Institute in Phoenix, where Dr. Spetzler performs the majority of his operations; and a new state of the art procedure called the "Standstill," which is a nickname for hypothermic arrest. In a sense, the patient dies for an hour--no blood and therefore no oxygen can reach his brain while he is chilled down to the point where his heart stops. This book is much more unputdownable than the latest techno-thriller by, say Clancy or Ludlum, because it is true. The author's attention to detail places us right into the operating room with the surgical team, and deep into the magical cavern of the human skull. The only dry stretches of text concern the founding and history of the Barrow Neurological Institute, and they don't take up too much room. The author also works in a brief history of neurosurgery, but none of it is quite as fascinating as the scenes where Dr. Spetzler is poised over his intraoperative microscope, carefully dissecting an aneurysm that threatens to explode through the micro-currents of a human intelligence.
Rating:
Summary: Former patient of Dr. Spetzler and Barrow
Review: This book gives a compelling and realistic look into Barrow Neurological Institute and its leader, Dr. Robert Spetzler. And I should know. I was on Dr. Spetzler's operating room table less than two years ago and am yet another of his miracles. Anyone considering any kind of neurological surgery should read this book before doing anything.
Rating:
Summary: An Excellent Overview
Review: This work grabs you immediately with its description of the "standstill" procedure. A patient is placed into a coma, the blood and body chilled and then the heart actually stopped while the surgeon skillfully digs around in the grey matter. Fascinating stuff.
The author is a journalist obviously awed by Dr. Spetzler and all that he (and others) have accomplished at the Barrow Institute in Phoenix--the book is primarily a story of Dr. Spetzler's career and secondarily the developing science of neurosurgery. The reader is treated to descriptions of the daily life of residents--rounds, M&M conferences, surgical procedures, etc. There are the obligatory descriptions of the hideously expensive gadgetry and imaging technology that has made modern neurosurgery possible. But something was missing.
In attempting to simultaneously cover the entire field of neurosurgery (as well as a curious diversion into the history of Phoenix) this book lost some of its punch. This could easily have been an incredibly interesting biography of Dr. Spetzler (and if anyone writes one--I'm buying it), or a surgical techno-thriller about standstill procedures curing otherwise hopeless cases . Better yet, a treatise on the cost/benefit tradeoffs presented by modern medicine with its increasing dependence upon pricey machines. Not to mention the peculiar danger of saving a patient from a horrible aneurysm only to find that his or her personality is irrevocably changed--and not for the better. Unfortunately, the work was somewhat diluted by its lack of focus. Nevertheless, highly recommended.
Rating:
Summary: One of my all time FAVORITES!
Review: Very few books actually make my all time favorite list (I'm not big on James Joyce, by the way) but this book did, and how! It reads so smoothly because it introduces you to the director of the Barrow's Neurological Institute by literally bringing you into a very complex surgery of clamping a middle cerebral artery aneurysm by using a makeshift heart lung bypass machine to cool the person's body and brain to 61F to literally shut down the metabolism of the brain to prevent anoxic damage when the blood is pumped out of the body to deflate the aneurysm so that the surgeon can dissect out crucial small blood vessels away from the aneurysm before clamping the aneurysm. And that's just the first chapter! There's great historical reference to Harvey Cushing and Walter Dandy. There's a "who's who" of neurosurgery (including Charles Wilson from UCSF). There's an insider look at the political side of academic neurosurgery as well as an impromptu history lesson of both the Barrows Neurological Institute and the Phoenix, AZ region. You will learn a lot about the techniques and personalities in the world of neurosurgery. It's an amazingly quick read...I can't put it down. After reading this book, go and buy Frank Vertosick's When the Air Hits Your Brain as well as Mark Shelton's Working in a Very Small Place.
Rating:
Summary: One of my all time FAVORITES!
Review: Very few books actually make my all time favorite list (I'm not big on James Joyce, by the way) but this book did, and how! It reads so smoothly because it introduces you to the director of the Barrow's Neurological Institute by literally bringing you into a very complex surgery of clamping a middle cerebral artery aneurysm by using a makeshift heart lung bypass machine to cool the person's body and brain to 61F to literally shut down the metabolism of the brain to prevent anoxic damage when the blood is pumped out of the body to deflate the aneurysm so that the surgeon can dissect out crucial small blood vessels away from the aneurysm before clamping the aneurysm. And that's just the first chapter! There's great historical reference to Harvey Cushing and Walter Dandy. There's a "who's who" of neurosurgery (including Charles Wilson from UCSF). There's an insider look at the political side of academic neurosurgery as well as an impromptu history lesson of both the Barrows Neurological Institute and the Phoenix, AZ region. You will learn a lot about the techniques and personalities in the world of neurosurgery. It's an amazingly quick read...I can't put it down. After reading this book, go and buy Frank Vertosick's When the Air Hits Your Brain as well as Mark Shelton's Working in a Very Small Place.
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