The Scribe of Siena

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The problem with being a neurosurgeon is that when the telephone rings, you have to answer it. When the phone by my bed went off at 3:00 a.m. I went straight from sleep to standing. The emergency room attending sounded like he was having a bad night.

“Dr. Trovato? Dr. Green here, Area A. We’ve got an old lady with a cerebellar hemorrhage—she’s unresponsive, and the CT scan looks nasty. How soon can you get in?”

“Eight minutes. Call the OR.”

The pocket of skull housing the cerebellum is a dangerously small space with rigid walls; there is no room for an explosion of blood. The consequence is disaster—the brain gets pushed in the only direction possible: down through the foramen magnum, the big hole in the bottom of the skull, crushing the brain stem, the control center for all basic life functions. Unless a surgeon gets there in time. I drove to the hospital in the dark, planning my approach. Amsterdam Avenue was quiet, with a few yellow cabs roaming for nonexistent fares. I pushed my speed to hit all the green lights.

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