Another Day in the Frontal Lobe Read Online Free

neck” and may even be a victim yourself. Arthritis of the spine (or degenerative spine disease, as we like to call it), unlike brain tumors,
is
a public health menace.
    Because of this broader focus on both the brain
and
spine, we don’t refer to ourselves as “brain surgeons.” The term is too narrow. Also, it sounds silly for some reason, so it’s hard for us to say it with a straight face (although I have heard of neurosurgery residents using the term as a pickup line in bars). Likewise, rocket scientists don’t actually call themselves rocket scientists, but I’m not clear on what they do call themselves.
    One man is historically credited with having inspired the enduring “brain surgeon” image in the public eye. Harvey Cushing is the widely acknowledged father of neurosurgery. To give you a sense of the field’s youth, Cushing was born in 1869 and died in 1939. He was really the first person to perform brain surgery in a thoughtful and systematic fashion despite the overwhelming surgical mortality rate at the time. Most surgeons were intimidated by the thought of operating inside the skull. Cushing, though, was a pioneer and a bit of a renegade. The techniques he developed and the rigor he brought to the discipline made brain surgery a reasonable endeavor for others to pursue. Neurosurgery is its own specialty largely because of Cushing.
    What made Cushing even more remarkable, though, was that he was more than just a pioneering neurosurgeon. Although his clinical skills made him famous among physicians, it was his literary skill that was instrumental in his recognition by the larger public. He won a Pulitzer Prize for a biography that he wrote about another famous physician, William Osler. This and his later writings made him a well-known entity in the literary world and gave him coverage in popular publications like
The New York Times, Newsweek,
and
Time.
1
    After Cushing’s death, his own biography was written by one of his protégés, John Fulton. I have an original copy of the book, published in 1946. I bought it at a used bookstore in Cleveland—my hometown—the city that Cushing grew up in. 2   On the inside cover, written in pencil, is the following: “Abram Garfield, from Hope & Ted, Xmas ’46.” On a whim, I looked up Abram Garfield in the index when I bought the book, and noted four separate pages listed after his name. The former owner of my book was Cushing’s friend.
    Cushing’s biography is over seven hundred pages long. Although I have never read through the entire tome, I did make sure to read the last couple pages which, I discovered, are of particular significance to neurosurgeons. In true surgical style, Fulton describes Cushing’s autopsy in a fairly matter-of-fact clinical fashion:
    “Drs. Milton Winternitz and Harry Zimmerman reported that the brain showed no sign of atrophy but the arteries were here and there sclerosed; and in line with the superstition that physicians sometimes fall victim to the diseases in which they specialize, a small colloid cyst, one centimeter in diameter, was found in the third ventricle.” 3
    A colloid cyst! Harvey Cushing, father of neurosurgery, harbored a colloid cyst deep within his own brain. (I don’t think even many neurosurgeons know this.) A colloid cyst is a quirky little entity. It’s completely benign in the sense that it’s not a tumor or cancer, but it is associated with the possible risk of sudden death. It sits at a critical crossroads of cerebrospinal fluid circulation in the brain such that if the cyst grows large enough, it can block this flow and cause a dramatic and rapid increase in the pressure inside the head. Luckily, colloid cysts are pretty rare. In Cushing’s case, the cyst was an incidental finding. He probably died of a garden-variety heart attack. He was a smoker.
    Colloid cysts are fun to remove. A gelatinous goo often oozes out from the center after you pop through the cyst wall. I say this with the realization