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

  • How junk food shrinks your brain and fuels depression

    Marc Arginteanu, MD
  • Music and brain plasticity: How sound rewires your mind

    Marc Arginteanu, MD
  • Coconut oil’s role in Alzheimer’s and depression

    Marc Arginteanu, MD

Related Posts

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

    Anonymous

More in Conditions

  • Living with numbness after mastectomy: the unseen impact on survivorship

    Emily Hansen
  • The physician-in-triage model and rapid evaluation in emergency medicine

    Marilyn McCullum, RN
  • Why bariatric patients struggle with protein and how to fix it

    Kevin Huffman, DO
  • A patient’s poem on invisible illness and trauma-informed care

    Michele Luckenbaugh
  • How a minor dry cough amplifies caregiver burden in home health care

    Gerald Kuo
  • How to treat sacroiliac joint pain effectively today

    Kayvan Haddadan, MD
  • Most Popular

  • Past Week

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Why we need a new medical specialty to fix corporate medicine

      Allan Dobzyniak, MD | Physician
    • A physician’s poem on burnout and end-of-life care

      Nisha Punatar, MD | Physician
    • Why resilience is not the cure for physician burnout

      Lisa Rubiano, DO | Physician
    • The hidden costs of diffuse accountability in medical teams

      Gus W. Krucke, MD | Physician
    • How medical education debt drives the physician shortage

      Michael Jerkins, MD, MEd | Finance
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • The Platinum Rule in health care: Moving beyond the Golden Rule

      Harvey Max Chochinov, MD, PhD | Conditions
  • Recent Posts

    • A physician’s poem on burnout and end-of-life care

      Nisha Punatar, MD | Physician
    • How the opioid superagonist DFNZ challenges pain medicine

      Olumuyiwa Bamgbade, MD | Meds
    • Artificial intelligence in surgery: Balancing precision with clinical wisdom

      Anastasios Papadonikolakis, MD, PhD | Tech
    • Confronting the reality of bullying in medicine today

      Muhamad Aly Rifai, MD | Physician
    • Living with numbness after mastectomy: the unseen impact on survivorship

      Emily Hansen | Conditions
    • The clinical evidence and reality of peptide therapy

      Shiv K. Goel, MD | Meds

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

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Why we need a new medical specialty to fix corporate medicine

      Allan Dobzyniak, MD | Physician
    • A physician’s poem on burnout and end-of-life care

      Nisha Punatar, MD | Physician
    • Why resilience is not the cure for physician burnout

      Lisa Rubiano, DO | Physician
    • The hidden costs of diffuse accountability in medical teams

      Gus W. Krucke, MD | Physician
    • How medical education debt drives the physician shortage

      Michael Jerkins, MD, MEd | Finance
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • The Platinum Rule in health care: Moving beyond the Golden Rule

      Harvey Max Chochinov, MD, PhD | Conditions
  • Recent Posts

    • A physician’s poem on burnout and end-of-life care

      Nisha Punatar, MD | Physician
    • How the opioid superagonist DFNZ challenges pain medicine

      Olumuyiwa Bamgbade, MD | Meds
    • Artificial intelligence in surgery: Balancing precision with clinical wisdom

      Anastasios Papadonikolakis, MD, PhD | Tech
    • Confronting the reality of bullying in medicine today

      Muhamad Aly Rifai, MD | Physician
    • Living with numbness after mastectomy: the unseen impact on survivorship

      Emily Hansen | Conditions
    • The clinical evidence and reality of peptide therapy

      Shiv K. Goel, MD | Meds

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...