AANS Neurosurgeon | Volume 28, Number 4, 2019


What is Neurosurgery Like?

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What is neurosurgery like? As a new medical student, I had no idea. I had no exposure to the field: media representations and rumors were all I knew. Noting my enthusiasm in anatomy dissections and my background as a neuroscience major, my advisory dean suggested I attend the neurosurgery department’s weekly Grand Rounds. I was unsure what to expect, stepping into the darkened conference room full of white coats. Neurosurgery is mythic in popular culture and only mentioned in hushed tones by my classmates. I had heard that neurosurgeons were cold, demanding and uninterested in medical trainees. However, as the attending surgeons led discussion of recent cases and highlighted important teaching points for the residents, my views changed. Their heated debated concerned whether one spinal approach or another offered the best quality of life for suffering patients. They did not sound cold, demanding or unwelcoming after all.

By the end of my first year, I had started clinical research in neurosurgery. My mentor encouraged me to shadow the residents, and I vividly remember my first time scrubbing into a subdural hematoma evacuation. The PGY-2 on night call showed great compassion and understanding as he spoke in the emergency department with the patient, a hemophiliac certain he was going to die. Why do students think neurosurgery lacks empathy?

In the OR, I was apprehensive, afraid of bumping into anything. The PGY-6 leading the case gestured to me, “You’re scrubbed in; don’t be afraid to stand up close. Take a look.” I cautiously moved closer. “This is a brain. You’ve probably heard of it,” he deadpanned. “And now you’ve seen it.” I was in awe as he pointed out gyri. Later, the PGY-2 sent me home, welcoming me to shadow again. “The more we see you show interest, the more we’ll want to teach you,” he said. True to his word, I eventually learned to tie a secure knot and to use electrocautery, suction and craniotomy drills.

Since those first experiences, my interest and involvement have only grown. With incredible support from our program director, attendings and residents, a classmate and I developed a pre-clinical neurosurgery elective course. Many students have asked me in amazement how I convinced neurosurgeons to participate in the course, teaching medical students how to interpret MRIs or place external ventricular drains. There was no convincing to be done — they were eager to teach those who showed interest.

What, then, is neurosurgery like? It is a unique field, full of fascinating anatomy and daring procedures. It is compassionate, not cold. It is demanding, but only to achieve the best for patients. And, it is certainly welcoming of students who express a desire to learn. Above all, neurosurgery values motivation and initiative. Medical students who know neurosurgery only through whispers and popular media, as I once did, are missing out on a deeply engaging world.

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John | May 25, 2018 at 4:36 pm

Being able to see a brain seems like a really cool experience. I guess it becomes old hat to surgeons eventually though. I heard neurosurgery could even deal with neck and back pain.