Free Another Day in the Frontal Lobe by Katrina Firlik Page B

easier. The warning is pure enticement.
    I was in the more introspective camp. Unfortunately, though, the warning continued to haunt me even after I had made up my mind, extending my introspection through seven years of residency (and beyond). I am convinced that most neurosurgery residents question their decision at least once or twice during the prolonged training period. Regarding those who didn’t—the ones who claimed an unwavering confidence in their career choice—my feelings alternated between suspicion and jealousy. Some seemed to have been born into the role. I, on the other hand, smiled and got through the training just as deftly, not so much because of a natural fit, but, at least partly, because of my innate tolerance (and, usually, fondness) for hard work. I took it in stride but I didn’t always like it.
    The decision to become a neurosurgeon places you on a track that runs, unabated, through a seven-year tunnel. This begins only after completion of the prerequisite four years of college and four years of medical school. This means that the average neurosurgeon is in his or her early thirties by the time the “real job” begins as a fully fledged surgeon with a decent salary and independent decision-making. If you tack on a one- or two-year fellowship (or worse—a Ph.D.), then you’re talking mid- or even late-thirties. (By that time, a good deal of interest has piled up on student loans.) At the end of the tunnel, the formerly undifferentiated M.D. emerges as an exquisitely super-specialized neurosurgeon, squinting at the rest of the world—a rare animal dominating a small niche within the ecosystem of medicine. At that point, you feel unqualified to do anything else, even if you had any lingering thoughts about a career change. It pays to listen to the elders before entering the tunnel in the first place.
    Neurosurgery is marked by labor-intensive routine sprinkled with brief highs. The highs keep us going, so we hope they aren’t too brief or spaced too far apart. Popular portrayal of surgery on television usually focuses on these highs: saving a life, removing an ugly tumor from an otherwise young healthy brain, separating conjoined twins fused at the head. The laborious routine is far more representative, but not as enticing. (Only a very small handful of neurosurgeons, by the way, have ever separated conjoined twins, including one who wrote a book entitled
Gifted Hands,
about himself.)
    In the traditional culture of neurosurgery, the puritanical work ethic reigns supreme. Our routines require long hours, especially during residency. Because we’re stuck with these long hours, we turn the long hours themselves into a source of collective pride. We tend to make fun of the “softer” specialists who never get called to the ER and who make it home in time to help their spouses chop vegetables for dinner.
    One morning during residency, at our usual post-rounds seven a.m. team breakfast (after arriving for duty a couple hours earlier), my colleagues and I were joking around—and fantasizing—about the life of dermatology residents. One of the more contentious members of our group decided to put them to the test. He called the hospital operator and requested a stat overhead page to the dermatology resident on call.
    Five seconds later, to the amusement of the entire hospital, the unprecedented page came through: “Stat page, dermatology resident on call, 4072. Stat page, dermatology resident on call, 4072.” We erupted into uncontrolled laughter. Assuming that the dermatology resident was still at home (making pancakes?), we laughed even harder when he actually called back, promptly. According to my colleague, the guy on the other end of the line displayed a mixture of confusion and excitement in his voice, and was genuinely disappointed to learn that there was no dermatologic emergency.
    Although team camaraderie, in addition to the brief and scattered highs, helps get us through the routine,