The patient is wheeled into the metal elevator and the nurse presses the
button for the third floor. She pats him on the shoulder. "It'll be just
fine," she says. "Just you wait and see."
The elevator bell rings and the doors slide back. The patient peers up
from his bed to see the operating room doors swinging open before him.
It's one of most frightening moments of his life. Soon he'll
be on the operating table having his skull opened to reveal a cerebral aneurysm.
"This is often a life-and-death situation," says Dr. Michael Lusk, a neurosurgeon
in Florida who performs this type of operation.
A cerebral aneurysm is a bulge in a blood vessel in the brain. Aneurysms
are dangerous because they can break open and bleed into the brain, causing
a stroke or even death. Although no one is entirely sure why they develop,
it's agreed that in many cases operating is the best way to treat them.
The neurosurgeon comes in to greet the patient. No one in the operating
room seems nervous, except for the patient.
"When somebody's life is on the line, it's selfish to be too
nervous," says Lusk. He's prepared to step up to the challenge.
"Procedures in this field can be very challenging," agrees neurosurgeon
Dr. Andrea Halliday. "The margin of error is so small. If something doesn't
go well you can leave the patient severely disabled or worse." However, the
thought that you can go in and heal someone makes it all worthwhile, she adds.
The surgery lasts a few hours. "Getting into the brain takes a while,"
says Dr. Robert Fink. "That's what makes these procedures longer than
other types of surgery."
When Fink was six years old, he had already decided he was going to operate
on people for a living. "I had several rather serious throat surgeries when
I was young. You'd think that would have scared me to death, but it didn't,"
he says. "I just knew right then I wanted to do this."
By the time Fink reached his first year of medical school, he hadn't
changed his mind. He chose to specialize in delivering babies. "But then I
found out that it was a rather routine field with not a lot of challenging
surgery."
At the end of the year, he was left wondering what kind of doctor he would
become. "I had the most inspiring professor," says Fink. "He was one of those
people who could really affect you." He was also a professor in neurology.
Fink decided then to become a neurologist and spent the summer working as
a clerk in a neurology department.
"It's a very scholarly and intellectual field, and their diagnoses
are very accurate," he says. "But the treatment aspect isn't as great."
Neurology doesn't involve surgery to solve problems -- that's left
to neurosurgeons. Fink finally found his calling.
Neurosurgery requires a combination of a great deal of intellect and surgical
dexterity. The old saying that you have to be a brain surgeon to solve difficult
problems just might be true.
"Over the years, I've met some neurosurgeons that I didn't like,"
says Fink. "But I'd have to say I've never met one I thought was
stupid. People who go into this tend to be the type who like deep thought."
Because it is such a challenging profession, Fink admits that most neurosurgeons
are overachievers.
As well as being an intellectual profession, it's a stressful one.
"It's a scary profession," says Fink. People depend on neurosurgeons
to save their lives, and in some cases the operations are risky and extremely
complex.
"There's added pressure because when someone hears you're a brain
surgeon, they show a certain awe." This respect carries over from the general
public to the medical profession.
A few years ago, Fink worked on trauma cases that usually involved people
seriously injured in accidents. The victim often had injuries to many other
parts of the body as well as to the head. "Even if that's the case, they'll
usually ask the neurosurgeon to take the entire case," says Fink.
The survival odds aren't great for some people who are seriously injured.
"You run into people who are desperately ill and you know you can't cure
them," says Fink. "You have to be able to admit to yourself that there are
a certain number of people who are going to die in your care."
It can be a difficult fact to swallow. "You have to be satisfied that you
will be able to improve their quality of life, even if you can't cure
them."
Some people can't take this kind of pressure. "They feel terrible
when they lose a patient," Fink says. "You have to understand that you will
lose a few, and it's OK as long as you have done the very best that you
can.
"Most of the time you can make an accurate diagnosis, find what you expected
when you operate, and fix the problem," says Fink. "That's a good feeling."