In reflecting upon my life as a neurosurgeon, perhaps the most
salient feature is that period of history involved. Trained by men
who studied under Harvey Cushing, considered the father of
neurological surgery, we, as early third-generation neurosurgeons,
were held to those rigid standards of academic achievement and
physical endurance typical of that time. The reader first
identifies with the young child who dreams of becoming a doctor,
and then sets out on that long path. He then re-lives the
experiences of the student of medicine, and later the rigorous
demands placed upon the surgeon-in-training. During the later
descriptions of the private practice of brain and spinal surgery,
the book transitions into an educational experience. It presents to
the reader a multitude of neurological disorders requiring surgical
treatment, the relevant surgical anatomy and the operative
techniques involved. Often interjected are the intangibles of
surgical judgment and philosophy when confronting those in pain or
critically ill. Of equal importance were the major scientific
advancements which occurred during that period of medical history.
No longer did we have to bore a hole in the skull, or inject
noxious materials into the head or spinal canal to verify a
diagnosis. Rather, we had been privileged to enjoy the development
of such remarkable machines as the ultrasound, CAT, and MRI.
Descriptions of these devices, among others, and their impact on
medical practice should prove interesting to the inquisitive
reader. After 21 years in practice, and probably at the height of
my career as a surgeon, I contracted hepatitis B subsequent to an
accidental needle puncture in the operating room. Forced to lay
down the scalpel, I turned to my second childhood dream, cattle
ranching, as an alternative vocation. This then becomes a secondary
focus of the book. A medical colleague, after learning of my book,
expressed an interest in learning the common denominator driving a
man to both neurosurgery and ranching. One can summarize with the
word, "counterpoise." I had always strived to achieve a balance
between the in-hospital, academic, precision-oriented work of the
neurosurgeon and the outdoor, physically-demanding life of a
rancher consummating the total American dream. Analogous to surgery
I have always enjoyed using my hands in the shop. Throughout the
book sections have been devoted to various aspects of woodworking,
and an effort not only to share my enthusiasm but also to expose
underlying problems and pitfalls; challenges I have encountered in
striving to become an artisan of fine furniture. The practice of
medicine has undergone significant change during my lifetime. Not
only have I witnessed a burgeoning, unsustainable increase in the
cost of healthcare, but also major changes in the way in which
medicine is being practiced in the new millennium. Having been a
proud product of the "Lucky Few" generation, born between the years
1929 and 1945, I am rightfully able to compare today's practice of
medicine with those of the latter half of the 20th century.
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