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AANS Neurosurgeon | Volume 29, Number 1, 2020

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The Incredible Lightness of Breathing

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In cruel April2 this brain surgeon has become an airhead.3 I have neglected to write my essay. The epidemic has rattled my brains like an empty oxygen cannister clattering on the ICU floor. I am gasping for palliative signs as I struggled to write a sentence for my assignment. The shakes that wake me are not COVID, they were caused by the dread of my approaching deadline. Lockdown is a pathetic alibi. 

COVID-19 is a dire metaphor for all that unites us and all that divides us.4-5 Wearing my mask and gloves, wielding a Clorox wipe instead of a scalpel, I don’t recognize myself anymore.  The armored up pedestrian on the street looks more like a surgeon, than this surgeon. I beg for a breather while brooding over the invisible viruses, seeing them everywhere. This virus is carbon monoxide and all we can do is cover our faces. When we are rebreathing our own breaths, breath has become air.6  

My creativity was further diminished by the death of James Goodrich7, a gentleman if ever I cut with. Although renown as a world class neurosurgeon, he was more historian than surgeon. To him contemporary neurosurgery and its history are inseparable twins, safest in his hands. Years ago, he gave me a wooden Polynesian statue from his collection of antiquities. Its dilated pupils spooked me. Fearing bad luck, I gave the wood relic a quiet exit to storage. There “he” remained for 20 years with his eyes turned to the wall. After Dr. Goodrich’s passing, I positioned the piece on my nightstand, in audience to his memory.8 Edgy under its glare, the less I sleep.9 I suspect that heaven is too small a place for someone like Jim. I choke and don’t complete my journal task. His death is a cruel excuse.  

Surgeons are optimists, even with terrible trauma; otherwise we would never make the first cut.  We know that wounds heal. The fortune-tellers predict that the world might be better after COVID, but surgeons do not wait for a crisis to improve. We seek “ better “ even after a perfect operation. When the world is well, we will respect the mysterious exchange of gases that keeps us alive, but we will also fear inhaling because now we know it can kill us. If we want things to remain the same, we will have to change the way we breathe.10 We shouldn’t have to stop breathing to be better.

The artist side of my brain is imagining what a COVID-19 healthcare monument will look like.  Perhaps we can memorialize in one tribute all the infectious risks from air to blood that healthcare professionals have endured. A few diseases ago, I remember standing at the scrub sink with Dr. Goodrich preparing for emergency surgery on a patient infected with blood-borne virus. I was scared, thinking: What if a needle with infected blood pierces my skin?  What if I get the virus?  The risk was breathtaking because there was no antidote, no medication, no cure – we had only our skill and luck. Still, we stayed put. That’s what healthcare professionals do every day and it’s gratifying that the profession is finally getting a well-earned salute for that commitment.

These days the wooden figurine is my confinement companion, changing the air with its Ha (Hawaiian for breath).11 Its odd staring eyes have stirred me. I am reminded that art and science are conjoined twins with their own approaches to the sick. I inhale the wood smell and feel the free-flowing air of the Pacific. An object that once had an aura of ill wind is, on this April night, a touchable remembrance of an esteemed colleague. I take a deep breath and knock wood anticipating a flow of inspiration.  

What an unbearable alibi breathing is. 

Breathing. Kathryn Ko.

A Neurosurgeon’s Lockdown Reading List

1. The Unbearable Lightness of Being
    Milan Kundera, 1984

2. The Waste Land
    T.S. Elliot  1922

3. When the Air Hits Your Brain
    Dr. Frank Vertosick, 1996

4. Death by Water
    Kenzaburo Oe, 2009

5. Illness as Metaphor
    Susan Sontag, 1978

6. When Breath Becomes Air
    Paul Kalanithi, 2016

7. Pediatric Neurosurgery
    James Tait Goodrich, 2008

8. Memoirs of Hadrian
    Marguerite Yourcenar

9. The Less you know the Sounder You Sleep 
    Juliet Butler, 2017

10. The Leopard
      Giuseppe Tomasi di Lampedusa, 1958

11. Hana Hou
      Vol 23  #2, May 2020

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Patricia Sweeney | June 25, 2020 at 8:50 am

Thank you Dr.KO.
You have beautifully told what I wanted know…
Thank you for sharing from a place I can never be..

Barbara Perlmutter | June 26, 2020 at 10:58 am

Thank you Katherine

Jennifer Busto | June 26, 2020 at 11:01 pm

Thank you K, for your brilliant surgeon perspective! You write and create with such great artistic flair. Be well and keep breathing, through a mask for now…hopefully we’ll soon have fresh COVID-free air with lots of molecular oxygen to breathe in deeply. Sigh…

Carole j.Amodeo | July 4, 2020 at 7:32 pm

Thank you for sharing this with us Kay,it is so important to hear your words to understand some of the Drs. feelings and experiences.Riveting, emotional and so brilliantly done. You are truly an amazing woman. Keep on keeping on!