Brainworks: Brain Surgeons Give Glimpse of the Inner Sanctum
When Keith Black was a kid, his mom caught him dissecting a chicken heart by the side of the house. He was 8, and such behavior might have worried some parents. But Black's father, a school principal, recognized the boy's curiosity. The next week, he brought his son home a cow heart.
By the time Black was in eighth grade, he was observing surgeries at university labs near his home in Ohio. By the time he was in 10th grade, he was performing them. At age 17, he performed his first organ transplant, on a dog, and published his first scientific paper, "The discocyte-echinocyte transformation as an index of human red blood cell trauma," about the damage artificial heart valves do to red blood cells.
He left for college, blasted through undergrad and medical school in six years, became a doctor, began researching the brain, made a bunch of discoveries in brain-tumor biochemistry and now is one of the world's pre-eminent neurosurgeons. Midway through a long and distinguished career, Black decided it was high time to pay that cow heart forward.
These days, when he isn't performing 250 to 300 brain surgeries a year (most neurosurgeons top out at 100), Black is in charge of a program called Brainworks at Cedars-Sinai Medical Center, where he also happens to be director of the neurosurgery division. Schoolkids make a pilgrimage to see what it's like to work in medicine. They scrutinize sheep brains, play with operating room instruments, have their vital signs taken, learn how to use stethoscopes, peer at slides under a microscope and squirt DNA into test tubes.
"I tell kids it's important to be aggressive and persistent," Black said at this year's gathering. Dressed in scrubs, he stood off to one side of the auditorium, arms folded. He is 53 now, clean-shaven, tall and with a confidence that makes him seem even taller.
One kid, asked if he would want to be a brain surgeon, replied: "For the money, yeah."
Indeed, the money is not inconsiderable. Each child that day walked away with a pamphlet detailing the earning potential of various health-field disciplines. It placed the national median annual salary of neurosurgeons at $468,406.
"The money fades away," said Dr. Ali Shirzadi, one of the neurological surgery senior residents. "If you go for money, you're in for a surprise. It's not worth the suffering."
Shirzadi picked up an electric drill, felt the heft of it in his palm and put it down. He prefers a manual drill, he said. "I like to feel the bone in my hand."
Being around so many young people contemplating careers put Shirzadi in mind of his formative years. Shirzadi, whose dad is also a physician, knew from an early age that he wanted to be a surgeon. He wasn't freaked out by his first surgery, though some of his friends in medical school were by theirs. He remembered one classmate who passed out when he saw the blood pouring out of a pregnant woman during delivery. "And that guy eventually became an OB-GYN," Shirzadi said with a good laugh.
Some parents on this day maintained a strictly laissez-faire attitude with respect to their offspring's career choices. "It's too soon to think about medical school," one grandfather said. "Right now he's doing good handling middle school." The boy, at Walter Reed, was silently screwing a star-shaped titanium plate into a plastic skull. "Level it off," said Grandpa, unable to resist a bit of side-seat surgery. "Good."
"If I chose to be a doctor, maybe I'd be this kind of surgeon," said Jaren Savage of Curtis School on Mulholland. "Maybe a spine doctor. 'Cause I can't deal with the brain."
Savage was an exceptionally polite, enthusiastic and composed young man of 12 whose favorite words seemed to be "Thank you very much." In white V-neck cable sweater and khakis, he already was looking like a miniature doctor -- the only thing missing was a set of diminutive golf clubs. He and his identical twin brother, Jared, took turns extracting cherry tomatoes from a triangular hole someone had cut into another plastic skull. The tomatoes represented tumors. The brain was represented by pink Jell-O.
You had to wonder where technology would be when these kids were ready to graduate from medical school. "We're now at the stage where we can go in and zap a tumor with microwaves," said a technician at the Stealth Station surgical imaging demo area. "It's called ablation. We're already using wireless navigation systems. It's like the Wii system of surgery."
After locating an imaginary patient's imaginary brain tumor on the surgical Wii, the Savage twins ambled over to the next table to poke at slices of preserved brain tissue. Neuropathologist Dr. Serguei Bannykh regaled them with tales that sound like science fiction but are really science fact. If you shoot an elephant in the head, for instance, the skull is so thick it would simply absorb the bullet. The elephant would be fine, though Bannykh allowed that it probably would wake up with one hell of a headache.
The entire room was a-twitter with such nerdy non sequiturs. "Don't squeeze the brain or it's gonna explode in your hand." And: "This is how the brain is connected to the eyeballs. We took off the eyeballs because it'd be kind of gross to have them hanging down."
"A lot of students here would make good doctors," Black said, surveying the place. "If I had to guess, I wouldn't be surprised if 40 percent end up in science and medicine."
With Jaren and Jared, that percentage might be slightly higher. "Jared is actually the scientist engineer," said their mother, Sharoni Little. She met Black at a previous event, was impressed and thought her sons might benefit from his example. "Jaren wants to be a writer," she said. He writes screenplays with science themes. They usually involve someone being gravely injured and a hero rushing in to save them.
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