AANS Neurosurgeon | Volume 28, Number 2, 2019

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On Intuition

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Intuition is supple, science muscular and the relationship slippery. This unease contributes to the tendency to dismiss intuition as junk. Yet, intuition is thicker than a guess. It is the unscientific belief in an internal GPS, despite no apparent coordinates. This ethereal guidance system can neither be fully trusted nor totally ignored, leaving one unsure if the trail is authentic. Either way, the scent keeps us up at night questioning the importance of intuition in neurosurgical practice. 

It is an exquisite experience to assist a senior surgeon confidently move through a crisis without a word. In the quiet OR he seems guided by an inner whisperer only he hears. Later, Chief explained his surgical decisions by saying, “Because it works.” Hoping for a meatier explanation, we residents rolled our eyes. He knew what to do based on his “gut feeling,” a wordless process difficult to articulate. In time, his intraoperative instinct was proven; morphing from intuition into science. I now understand that his method was more than just a “feeling.” What for his generation was intuition is for mine science. 

One must live and operate with the chatter of intuitive notions while on guard, waiting for science. Relaxing in the certainty of facts ‘til the new whispers wake you again, wondering if the vibe in the air is revelatory or merely overthinking. There’s no explaining intuition, but thanks to my chief, the master intuitor, I know it when I smell it. Stay the course or abandon the trajectory, but do not fear it. Something tells me that a finely sharpened neurosurgeon’s intuition is the highest instrument in our art.

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