Another Day in the Frontal Lobe: A Book Review
If you were asked to describe the consistency of the human brain, how would you describe it? Like jelly? Cottage cheese? Dr. Katrina Firlik would say tofu—the “soft variety.” In her book, Another Day in the Frontal Lobe (Random House, 2006) Dr. Firlik, a practicing neurosurgeon, offers an insider’s perspective on the world of neurosurgery and recounts the journey that got her where she is today. Through her biting wit and the compassionate nature with which she describes her many patients, Firlik paints a vivid and engaging picture of a field about which many know only a little.
Of the approximately 4,500 neurosurgeons in the United States, only about 200 of them are women—a fact that Dr. Firlik confronts head-on when describing her experience in the seven-year neurosurgery residency program at the University of Pittsburgh Medical Center. In fact, Firlik was the first woman to be admitted into the program—the largest and one of the most prestigious in the country. However, it is evident that she did not let the fact that she was a minority effect her in a negative way.
Much of the book is filled with Firlik’s accounts of the many cases she encountered during her lengthy time as a resident—from a carpenter who was shot in the head with a nail gun to a man with a gaping infectious wound on his forehead (one of the more gruesome encounters of her career), Firlik profiles numerous interesting patients and their prognoses.
Each case is filled with compassion and intrigue, as well as a handful of clever analogies to illustrate her points—for example, the comparison of glioblastoma multiforme (GBM) tumor to a spilled bag of popcorn kernels. It is incredibly difficult (if not impossible) for a neurosurgeon to remove an entire GBM in the course of a surgery because of its diffuse nature. As for the popcorn, she says, “the relatively focused part of the mess would be easy to clean up. Over the next few days, though, you would be amazed to discover individual kernels that made it all the way […] into the living room. That’s what a glioblastoma is like.”
Dr. Firlik also provides insight on the incredible number of technologies available for use in neurosurgery today, from high-tech 3D imaging systems and expensive drill bits to less complex but equally important suction devices and clamps. She discusses the cutting-edge techniques that are gaining popularity in the field, for example, the Gamma Knife, and also makes predictions about the not-so-distant future of neurosurgery. It’s entirely possible, she postulates, that it will soon become the standard for patients to elect to undergo procedures to enhance their cognitive abilities beyond the societal norm—“brainlifts,” as she refers to them.
Whether you are interested in becoming a neurosurgeon, or you are simply intrigued by the intricacies and pathologies of the brain and the many ways of treating them, Dr. Firlik’s book is a fascinating look into the world of neurosurgery through the eyes of someone who’s seen it first-hand.