"Another Day in the Frontal Lobe" - in brain surgery, location is everthing

Hi, I'm Nick Huhn and I'm passionate about ideas. I'm attending a few sessions at IdeaFestival 2008 over the next two days and I'll capture my thoughts and experiences on this blog and - like several others - by twitter.

Katrina Firlik is one of around 200 female neurosurgeons in the country, so in addition to developing a unique outlook on her practice of neurosurgery, she's also become interested in medical innovation and entrepreneurial activities.  She warns at the beginning of her talk, "brain surgery is not exactly rocket science," but after hearing this talk I know that it is assuredly more involved than the typical dialog of McDreamy and his cohorts in Grey's Anatomy.

Firlik offers us an opportunity to think like a brain surgeon with these simple rules:

  • location is everything
  • the brain is not the only thing in the skull

She shared an interesting anecdote about a patient's cancer that led to chronic depression.  Pharmaceuticals and therapy proved unhelpful in alleviating the depression, so a psychiatrist recommended a neurologist's assessment.  We come to discover that a tumor in her brain had exerted pressure on the frontal lobes that - as the emotional hub of the brain - were going haywire.  In fact, she had lost her sense of smell.  [More about smell, emotion and depression... interesting!] 

While the surgery was a technical success overall, the patient ultimately had numerous complications that led to her unfortunate demise. Note: even the most perfect surgical execution can have unfortunate secondary effects or complications: welcome to the intricately complex human body.

Choc-full of photos that definitely would have been blurred out on Rescue 911, Firlik's presentation discussed another patient that was in a car accident and experienced slurred speech and other complications afterward.  A single brain hemorrhage took a precipitously downhill course in which more internal bleeding in the brain stem emerged. 

Just when it started to get a tad morbid, the speaker held the interest of the audience as she meandered into stories of the composition and characteristics of that noggin perched on our shoulders. While a medical transcriptionist would have been handy at this point, I did learn some interesting neurology trivia, and more about how cerebrospinal fluid, subdural hematomae, and aneurysms can get nasty. Ask Joe Biden.

After meandering into some interesting cerebral conditions and complications, Katrina led us back to the story of the patient with the brain stem aneurysm and how the alleviation of afflictions like these often lead to moral and ethical questions. Again, the second second and third order effects and they way they can impact mobility and cognition are always considered. Confirmed: being a brain surgeon can often be depressing. So, Firlik moved on to some more uplifting stories from patients...

Rather than transcribe or recount the rest of the speaker's talk, I might just summarize with a hearty affirmation of Katrina Firlik's command of neurosurgery and the English language. I'm certain her book would offer an entertaining and elucidating journey into the various dimensions of neurosurgery, the moral and ethical considerations of the esoteric specialty, and the distillation of this fascinating science into easy - well, easier than rocket science - to understand concepts. Great job and thank you for contributing to IdeaFestival 2008, Dr. Firlik!

Nick