Free Another Day in the Frontal Lobe by Katrina Firlik

explain to their spouse why they won’t be home, while the other one works. To many young residents, this complex and demanding field can be quite attractive…at first.
    Radiosurgeons are in a rarefied class of their own. They perform stereotactic radiosurgery, a slick noninvasive technique that involves focused radiation to treat brain lesions. Their patients are usually quite pleased because they avoided having their heads opened—the more traditional alternative. Their procedures are not performed in the OR, so they have certain liberties that other neurosurgeons cannot share, like drinking specialty coffees during their cases. They’re often the smartest ones around, partly because they have time to read.
    The wide spectrum of technical approaches in our field, from minimally invasive to maximally invasive, and even noninvasive, inspired one graduating resident to offer this tribute at his graduation speech: “I thank Dr. X for teaching me to operate through a keyhole, Dr. Y for teaching me to operate through a manhole, and Dr. Z for teaching me to operate through no hole.” This quote has been passed down, year after year, at my training program and I can’t even remember now who should get the credit.
    Neurosurgeons of all types, nationwide and even worldwide, convene at our annual neurosurgery conventions. These meetings are designed to strengthen our social bonds and keep us up-to-date on the latest scientific advances (in that order). Our two major organizations, the AANS (American Association of Neurological Surgeons) and the CNS (Congress of Neurological Surgeons), each hold a separate meeting. Most neurosurgeons belong to both.
    Each organization has it own corresponding journal. The AANS publishes the
Journal of Neurosurgery
and the CNS publishes
Neurosurgery.
Although both are equally well regarded, the younger
Neurosurgery
is more colorful and has more pictures, provoking the nickname “the cartoons” by its rival. Among the more senior neurosurgeons, the older journal is known as the “white journal,” based on the cover, and the newer one is the “red journal,” further reflecting the divergent emphasis on color.
    My first annual meeting was in Chicago, when I was a junior resident. Finally, after hearing about all the big names in neurosurgery around the country, I was able to match faces with names. (Their faces are not exactly featured in
People
magazine; neurosurgery is a very small sea. Once the big names set foot outside of the convention center, they become relatively anonymous again, unless they forget to remove their convention badges.) As I went up escalators and walked down hallways, the senior residents would lean over and whisper to me:
The guy with the mustache is Spetzler…that older guy is Yasargil…the big guy over there is Rhoton.
These were the neurosurgeons typically asked to give the “How I Do It” talks, like “How I Do It: Giant Aneurysms,” or that type of thing. The same talks tend to be featured year after year, which didn’t dawn on me until my second or third meeting.
    One of the most unusual aspects of these gatherings is the massive, open, sterile convention room filled with specialty vendors. I’m not talking about food vendors. I’m referring to companies that sell things like surgical instruments, medications, textbooks, and multimillion-dollar pieces of capital equipment. They vie for attention with colorful, educational displays and freebies such as pens, candy, customized Post-it notes, and squeeze toys in the shape of a brain. At some of the booths, you can try out the equipment. If you’re so inclined, you can, for example, test the performance of a cautery device on a piece of raw steak. You can look at fine newsprint through the lens of the latest surgical microscope. You can peruse the gamut of OR tables that fold over, orgami-like, in various ways. These tables often feature live models in black leotards lying motionless, simulating a patient