Free When the Air Hits Your Brain: Tales from Neurosurgery by Jr. Frank Vertosick Page A

to experiment with different spinal stimulation settings. If the patient gets relief, he or she is returned to the OR and the electrode is put under the skin and connected to a subcutaneous antenna. The stimulator is then completely internalized and safe from infection. Stimulating signals are broadcast to the spinal cord electrode via a radio transmitter hooked to the belt or worn over the shoulder like a purse.
    We entered the room. Mr. van Buren, dressed in expensivelooking pajamas, sat in a chair by his bed. He was a large man with a pleasant, ruddy face and coarse black hair cropped short,almost in a crew cut. On his lap lay a small beige box, the size of a pack of cigarettes, with several buttons and dials on one side. Two thin wires sprouted from the top of the box and disappeared into the front of his pajama top. He looked to be deep in concentration as his thick fingers twiddled the knobs on the box.
    “Good morning, Mr. van Buren. Have you had any luck?” asked Gary in his best professional tone.
    “I can get it to buzz a little around my butt cheeks when I use the square wave pulse and turn the frequency to…here.”
    “Does that help?”
    “A little, but it feels like my pants are warm, like I’m pissing myself all the time. I’m not sure that’s any better than the pain.”
    “Mr. van Buren, this is Dr. Vertosick,” Eric spoke, “and he’s joining our team for the next six months. You’ll be seeing him every morning now.”
    The man looked up from his box and smiled politely.
    “Nice to meet you, Doctor.”
    “I understand you have had five disc surgeries?”
    “Yes…the first was in 1974…but here, let me show you.”
    The man reached over to his nightstand, opened the top drawer, and produced a leather-bound folder with the words “Myelograms and records of A. van Buren” stenciled on the front cover in gold leaf. “Have a seat, Dr. Ferblowstick.”
    He proceeded to explain the saga of his many operations in great detail, turning the pages with the slow intensity of a newlywed showing off a wedding album. “Look, here was right after the second operation…there was a little scarring around the fifth lumbar root, but no arachnoiditis yet…My surgeon thought that this might be a disc fragment here, and he looked again in 1981…Here the arachnoiditis got bad…”
    Among the photos of myelograms and CT scans and operative notes were other memorabilia: labels from bottles of narcotics, letters containing second surgical opinions, insurance forms, articles on holistic healing and the power of positive thinking. He grew more excited as he spoke, spouting his tale of vertebral vivisection at the hands of three surgeons with as much glee as a fisherman recounting his battle with a prize marlin. He didn’t seem to be in any pain at all.
    “Mr. van Buren,” Gary interrupted him, “tell Dr. Vertosick what your pain is like now.”
    “Oh,” he replied, still grinning, “it’s awful, excruciating. It’s like an army of red-hot earthworms crawling up inside my leg, wriggling and writhing day in and day out. Occasionally, I get a groin pain, over here, that’s like a C-clamp being slowed twisted down on my pubic bone.”
    “Thanks, we’ll see you this afternoon…try turning the amplitude down and the frequency up. If that doesn’t work, we may have to take you back to the OR and reposition the electrode.”
    We exited the room and walked a little way down the hall. When we were far enough away from room nine, Gary spoke: “Well, class, what did Mr. van Buren teach us?”
    “Ah, that the electrode…”
    “Forget the friggin’ electrode. Is this guy in pain?”
    I was confused.
    “Is he in pain?”
    “I guess so?”
    Gary motioned me over to another room, room eighteen. Lying in the bed was a pale, wasted man. “Hey, Mr. Angelo, it’s Gary. Tell young Dr. Vertosick what your leg pain is like.”
    “I dunno.” The man’s voice was thin, weak. “It hurts like hell is all I can