Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

The ramparts of the neurosurgeon’s mind were unassailable

Marc Arginteanu, MD
Conditions
September 22, 2022
Share
Tweet
Share

An excerpt from Azazel’s Public House.

Pete tried to invade Tommy’s brain and force an oops moment. But the ramparts of the neurosurgeon’s mind were unassailable.

Clancy, unaware he was battling on two fronts, tried to spare any brain that had a vestige of life, but in places, the good brain was so intermingled with the bad that it was impossible to determine where one began and the other ended. Finally, he accomplished his surgical goal. A white glistening cavern remained where the frontal and temporal lobes of Anthony’s brain had been. He may be better off dead, Tommy thought. But that’s not my call. I’m just here to do my job. Tommy sighed heavily, “Ours is not to reason why. Ours is but to do or die.”

“And die,” the anesthesiologist corrected.

“What?” Tommy asked.

“The Tennyson poem: ‘Ours is not to reason why. Ours is but to do and die.’ The soldiers knew they were riding towards certain death. They fought anyway.”

“Hemo-clip,” Tommy said, his voice gloomy. A bleeder let loose in the depths of Anthony’s brain. It was a miniscule branch that had avulsed from the main trunk of Anthony’s basilar artery.

Lee handed him a long, elegantly-tapered instrument. It deployed a tiny steel clip to clamp off the bleeding vessel.

He’s better off dead. Tommy thought as he brought the mouth of the hemo-clip across the hole in the inconsequential vessel. And it would be better for his family. 

The basilar artery, just a few millimeters deeper, looked as big as a garden hose under Tommy’s loupe-magnified vision. It was one of the main sources of blood for Anthony’s brain. If I put the clip across the basilar, he’d surely die. Tommy’s nimble fingers guided the clip back and forth. The mouth of the clip alternated between the tiny branch and the main trunk.

I would be doing him a favor. His family too.

Pete’s spirit huffed, Do it, Tommy-boy.

Back and forth swung the clip, from lethal to lifesaving.

Tommy thought, I sure as hell wouldn’t want to live if I were doomed to be hemiplegic and aphasic.

Pete puffed, You know you want to. Just do it.

Back and forth, from lifesaving to lethal.

Tommy thought, Bumping him off would be a mercy.

Pete boiled in frustration. He couldn’t bash through Tommy’s skull. He was a helpless spectator.

Tommy squeezed the trigger and clamped the tiny tributary. Ours is not to reason why. He withdrew his hand, leaving Anthony’s crucial basilar artery intact.

This damned hospital’s been a thorn in my side since the day it opened, Pete groused.

Marc Arginteanu is a neurosurgeon and author of Azazel’s Public House.

Image credit: Shutterstock.com

Prev

How to change your specialty during residency

September 22, 2022 Kevin 0
…
Next

An awkward conversation with a friend might just save someone's life

September 22, 2022 Kevin 0
…

Tagged as: Surgery

< Previous Post
How to change your specialty during residency
Next Post >
An awkward conversation with a friend might just save someone's life

ADVERTISEMENT

More by Marc Arginteanu, MD

  • Psychedelics and neuroplasticity are rewiring the brain

    Marc Arginteanu, MD
  • How blood-based brain biomarkers predict Alzheimer’s progression

    Marc Arginteanu, MD
  • How junk food shrinks your brain and fuels depression

    Marc Arginteanu, MD

Related Posts

  • Corruption in health care: when the mice mind the cheese

    Anonymous

More in Conditions

  • Health care worker burnout doesn’t end at retirement

    Phyllis DiSalvo Katz
  • ICU nursing did not return to normal after COVID

    Viksit Bali, RN
  • The Goldwater Rule and the cost of psychiatric silence

    Timothy Lesaca, MD
  • GLP-1s and neurotech are colliding over chronic pain

    Amir Friedman, MD
  • Physician contract review is about what is missing

    Vikram Chahal, CFA
  • Why protein timing after bariatric surgery matters

    Kevin Huffman, DO
  • Most Popular

  • Past Week

    • Metrics got you into medicine and are making you unhappy in it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Violence against doctors: 5 forces that ignite it

      Timothy Lesaca, MD | Physician
    • 3 fixes for primary care access in the ChatGPT era

      Payam Zamani, MD | Tech
    • Why does post-discharge care keep breaking down?

      Katherine Owen, RN | Conditions
    • The residency personal statement is an identity problem

      Kathleen Muldoon, PhD | Education
    • GLP-1s, weight loss, and the inflammation tests your patient needs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care crisis requires new training and skills

      Justin Oldfield, MD | Physician
    • Polycystic ovary syndrome is more than ovarian

      Oluyemisi Famuyiwa, MD | Conditions
    • How corporate medicine is eroding truth and patient dignity

      Ronald L. Lindsay, MD | Physician
    • Why bipolar II is not just a milder version of bipolar I

      Ethan Evans, MD | Conditions
    • Opt-out states and physician-led anesthesia care explained

      Michael Beck, MD | Physician
  • Recent Posts

    • Health care worker burnout doesn’t end at retirement

      Phyllis DiSalvo Katz | Conditions
    • Why HIPAA settlements hit independent practices

      GetPracticeHelp | Finance
    • 5 ways drug ads mislead patients on TV

      M. Bennet Broner, PhD | Meds
    • ICU nursing did not return to normal after COVID

      Viksit Bali, RN | Conditions
    • The Goldwater Rule and the cost of psychiatric silence

      Timothy Lesaca, MD | Conditions
    • A letter to my future self, the team physician

      Sarah Haugh | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Metrics got you into medicine and are making you unhappy in it [PODCAST]

      The Podcast by KevinMD | Podcast
    • Violence against doctors: 5 forces that ignite it

      Timothy Lesaca, MD | Physician
    • 3 fixes for primary care access in the ChatGPT era

      Payam Zamani, MD | Tech
    • Why does post-discharge care keep breaking down?

      Katherine Owen, RN | Conditions
    • The residency personal statement is an identity problem

      Kathleen Muldoon, PhD | Education
    • GLP-1s, weight loss, and the inflammation tests your patient needs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care crisis requires new training and skills

      Justin Oldfield, MD | Physician
    • Polycystic ovary syndrome is more than ovarian

      Oluyemisi Famuyiwa, MD | Conditions
    • How corporate medicine is eroding truth and patient dignity

      Ronald L. Lindsay, MD | Physician
    • Why bipolar II is not just a milder version of bipolar I

      Ethan Evans, MD | Conditions
    • Opt-out states and physician-led anesthesia care explained

      Michael Beck, MD | Physician
  • Recent Posts

    • Health care worker burnout doesn’t end at retirement

      Phyllis DiSalvo Katz | Conditions
    • Why HIPAA settlements hit independent practices

      GetPracticeHelp | Finance
    • 5 ways drug ads mislead patients on TV

      M. Bennet Broner, PhD | Meds
    • ICU nursing did not return to normal after COVID

      Viksit Bali, RN | Conditions
    • The Goldwater Rule and the cost of psychiatric silence

      Timothy Lesaca, MD | Conditions
    • A letter to my future self, the team physician

      Sarah Haugh | Education

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...