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The story of one man's evolution from naive and ambitious young intern to world-class neurosurgeon.
With poignant insight and humor, Frank Vertosick Jr., MD, describes some of the greatest challenges of his career, including a six-week-old infant with a tumor in her brain, a young man struck down in his prime by paraplegia, and a minister with a .22-caliber bullet lodged in his skull. Told through intimate portraits of Vertosick’s patients and unsparing yet fascinatingly detailed descriptions of surgical procedures, When the Air Hits Your Brain―the culmination of decades spent struggling to learn an unforgiving craft―illuminates both the mysteries of the mind and the realities of the operating room.
- Sales Rank: #98597 in Books
- Brand: Vertosick, Frank T.
- Published on: 2008-03-17
- Original language: English
- Number of items: 1
- Dimensions: 8.30" h x .70" w x 5.50" l, .48 pounds
- Binding: Paperback
- 272 pages
Amazon.com Review
For the patient, an operation is a single defining moment. For the neurosurgeon, each moment in the operating room represents the culmination of decades spent struggling to learn an unforgiving craft. When these two join there is drama, often too much of it. This book tells the story of Frank Vertosick's metamorphosis from naive intern to neurosurgeon through intimate portraits of his patients and nerve-jangling descriptions of surgical procedures. Riveting, poignant, and sometimes shockingly funny, When the Air Hits Your Brain is a remarkable account of the mysteries of the mind and the operating room.
From Publishers Weekly
Instead of offering a collection of bizarre medical cases, brain surgeon Vertosick presents a set of harrowing clinical tales that highlight neurosurgery as risky, messy and often frustrating. The result is a riveting report that shatters the mystique of the brain surgeon as a wizard of technical prowess. Many of the patients profiled here die-an outcome not representative of neurosurgery at large, the author reassures us. The cases are drawn from Vertosick's six years of internship and residency. Among the most memorable are Andy, a Down's syndrome sufferer with multiple head and neck abnormalities who chose euthanasia over a life imprisoned in bed. We also meet Sarah, a pregnant homemaker with a malignant brain tumor who refuses radiotherapy and a therapeutic abortion. Vertosick is associate chief of neurosurgery at Western Pennsylvania Hospital in Pittsburgh.
Copyright 1996 Reed Business Information, Inc.
From Booklist
Vertosick's is not the usual how-I-got-through-my-residency-and-aren't-I-smart? account. Rather, Vertosick shows how a steelworker--himself--successfully became a neurosurgeon. He includes the events that shaped his feelings and emotions and his growing knowledge of himself, his patients, and his colleagues, and the fact that some of those incidents seem outwardly minor indicates that Vertosick is a perceptive individual capable of seeing the humanity of both his patients and himself. So his account of his three months in London emphasizes his ability to recognize that there are more aspects to his specialty than just the high-tech ones. And what does such a specialist typically do? Vertosick points out that two-thirds of neurosurgical operations are for the alleviation or control of pain. The neurosurgeon must always assume pain is organic, although this neurosurgeon neatly draws the distinctions between pain and suffering. An engaging and refreshing book. William Beatty
Most helpful customer reviews
2 of 2 people found the following review helpful.
At times it's sad. At other times it's unsettling
By QuantumGhost
At times it's sad. At other times it's unsettling. Parts even make you laugh. It's as much a journey into the humanity of the world of neurosurgery, and the path to becoming a neurosurgeon, as it is a foray into the raw experience of the operating room. The fragile tissue that houses the self is exposed at the risk of irreversible, terminal consequences, a risk that's overshadowed enough by the alternative to make it worthwhile. Well written. Gripping.
1 of 1 people found the following review helpful.
And I’m glad I did
By Allyson M. W. Dyar
When the Air Hits Your Brain: Tales from Neurosurgery
by Dr. Frank Vertosick Jr., M.D.
Tales from Neurosurgery
I took a break from my quest to re-read my library of books with an eye towards reviewing them on my blog, Amazon.com and Goodreads to venture into the realm of a new book. I chose When the Air Hits Your Brain: Tales from Neurosurgery not from any specific recommendation but because of the reviews on Amazon.com. I normally don’t do this but I figured it was worth a shot.
And I’m glad I did.
Dr. Vertosick is a great author (or he has a damned good editor; either one will do) and has a very inviting style of writing about very complex subjects. He doesn’t go into great medical details, instead, he gives you enough to understand the problem the goes into what was done and how he felt about it.
I especially enjoyed his time in England and really appreciated the differences between the two views of medicine. I had to laugh when one of the senior doctors talked in disparaging ethnic terms about a patient, something Dr. Vertosick said wouldn’t fly in America. I appreciated his comment because I found that some of the European sports commentators would say things that would have gotten them yanked off the air in the US.
I found myself reading his chapter on his pediatric patient Rebecca twice because it touched my heart. His other patients were equally fascinating including the Viet Nam vet with the blown aneurism.
This is a highly recommended book. It’s an easy read (as compared to the previously reviewed book When Illness Strikes the Leader: The Dilemma of the Captive King by Professor Robert S. Robins and Dr. Jerrold Post M.D. written more for the academics in us) and a compelling read. I found it hard to turn away when lunch time was over.
I read the electronic version mostly on my iPad mini and my iPhone. I’m assuming that W. W. Norton did the electronic version, which I found (as opposed to Treating the Brain: What the Best Doctors Know) to be fairly decent though I really hated the fact that it was justified text and wished publishers would not do this – it makes reading difficult and hyphenation impossible. I did find a few mistakes such as run on words, but nothing was a show stopper such as with the aforementioned book.
I’d recommend this book to anyone who is interested in first-person accounts of “How I became a Doctor,” those interested in surgeons and surgery, brain surgery and some neurology thrown in for good measure. I give this book 4.5 stars – a good solid read for those of us who enjoy this kind of tome.
My next foray is back to my library and hardcover books is A Brief History of Disease, Science and Medicine by Michael T. Kennedy. I really enjoyed it the first time and am curious as to how it stands up to time and a second read.
28 of 31 people found the following review helpful.
An engaging but disturbingly inaccurate read
By Kenneth Saladin
I bought this book to preview as a recommended reading for my premedical seminar students and as a source of ideas for clinical case studies that I write for a medical physiology course. I found it a very engaging read, hard to put down. Vertosick has an admirable flair for medical writing for a lay audience, and the book bears abundant fruit as a source of case studies to be read for general interest or to be fleshed out with thought questions for students. I will certainly recommend it to my students. For my premeds, it is a good companion to Ellen Rothman's "White Coat," which chronicles her four years of medical college, and Michael Collins's "Hot Lights, Cold Steel" on his four-year orthopedic surgery residency. Any high-school or college premedical student in need of a clearer vision of the path from there to independent-practice physician or surgeon would do well to read Rothman followed by Collins and/or Vertosick.
That said, I recommend it only with a caveat emptor, for I am astonished at Vertosick's egregious errors of human anatomy and evolutionary reasoning. He writes (p. 185) of surgery for a pituitary tumor, "The pituitary, an embryonic relic of the nasal passages, lies buried in the hard palate, just above the uvula." That's three major anatomical errors in one sentence! (1) The pituitary is in no way a relic of or derived from the nasal passages. About 2/3 of it arises in the embryo as an upward growth from the throat (pharynx) and 1/3 as a downgrowth from the floor of the brain. (2) The hard palate is not above the uvula, which is part of the SOFT palate posterior to the hard palate. (3) The pituitary is not even remotely embedded in the hard palate. The hard palate forms the FLOOR of the nasal cavity, and to get to the pituitary a surgeon has to go through the ROOF of the nasal cavity, then through an air space called the sphenoid sinus, and finally to the pituitary in a bony pit at the base of the brain. Another person with whom I shared this quote said he wouldn't want someone like Vertosick doing a vasectomy on him, because he would probably approach it through the navel! I would not accept Vertosick's version of perinasal anatomy even from a sophomore prenursing anatomy & physiology student.
Vertosick's evolutionary conjecture about the cancer (pp. 234-237) ("Cancer evolved for precisely this reason--to destroy the host.") is ludicrous on so many levels it would require a longer essay than a book review to explain it. Cancer cannot be explained as a natural, evolved mechanism for population control. Vertosick's thinking rests on completely fallacious reasoning about natural selection, with some resemblance to an old discredited "group selection" theory that evolutionary scientists dismissed many decades ago.
Yet another (p. 261): "Meningiomas...arise from the outer surface of the skull." Nonsense! A meningioma (tumor of the meninges) occurs in the membranes that lie between the brain and the skull, not between the skull and scalp on the outer surface of the skull.
I would still recommend the book as an engaging read for anyone and enlightening for premedical and other health-science students, but again, I find its scientific inaccuracies appalling and would forewarn my students accordingly.
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