Brain and Heart: The Triumphs and Struggles of a Pediatric Neurosurgeon
“a compelling, personal, and deeply moving look behind-the-curtain of the rarified field of pediatric neurosurgery, and one compassionate doctor’s lifelong mission to save childrens’ lives.”
In Brain and Heart: The Triumphs and Struggles of a Pediatric Neurosurgeon, Dr. David I. Sandberg takes readers into places the average reader can only imagine, but where he has spent a good deal of his career: into the actual brains of young people, whose lives Dr. Sandberg is trying to save. It is a harrowing journey, with sometimes joyful results to the often touch-and-go procedures, yet other times tragedies that are life-shattering to families. In Sandberg’s world, the terms are just this stark: life and death, on a daily basis.
“On some days, I am the bearer of the very worst news imaginable to parents,” he writes, “that a child has died or has no hope of surviving from a devastating car accident or a gunshot wound to the head or spontaneous bleeding in the brain.” And yet, not all days are so solemn: “I also have the great joy of celebrating the most wonderful news with parents—that their child has made a remarkable recovery after a serious surgery or is cured of her brain tumor.”
Sandberg’s account opens with a case study of a 15-year-old boy with a severe traumatic head injury after being thrown from an ATV. He tracks the moments from the boy’s arrival via Life Flight, to assessment, to the agonizing decision about what to do next; the delicate surgery might save the boy, or cause further, irreparable damage. The account is gripping, nerve-wracking, and frightening. “Garrett was alive but just barely,” he writes. “And now I had to decide what to do. Should I operate or not? The decision had to be made immediately.”
Readers are now inside Dr. Sandberg’s head as he evaluates the complex case and ponders how to articulate the risks to the parents. He decides to move ahead with surgery. “I performed a hemicraniectomy on Garrett, removing the left side of his skull . . . I removed the clot and placed a small electrode into the frontal lobe of Garrett’s brain so that we could monitor the pressure,” Sandberg writes. The results are not immediately clear: “Garrett’s parents prayed he would wake up, but based upon my past experience, I had little hope that he would do so.”
In that case, the teenager miraculously recovers. Even so, Sandberg second-guesses his decision. “Garrett’s case haunts me,” he writes. Sandberg came close to not doing the surgery, as Garrett had not shown signs of life—no neurological response to stimuli, which indicated brain death at least until Sandberg “pinched him one last time as hard as I could.” That time, Sandberg saw a small reaction, and based on that alone, he proceeded with the surgery and saved the boy’s life.
After this dramatic opening to the book, Sandberg relays his path to becoming a pediatric neurosurgeon. He knew he wanted to follow in his father’s footsteps, though not in the field of ophthalmology. He’d accompanied his father on charity missions to help patients in underdeveloped countries and saw the joy his father felt in helping others. But pediatric neurosurgery is a far more demanding discipline than his father’s. “I was well aware that I was choosing brutally long working hours, sleep deprivation, and huge personal sacrifice. . . . my days would be long and stressful.” He knew, though, that he was embarking on “an exciting and meaningful journey” that would yield “tremendous rewards.”
Readers see every bit of that journey—from the long, arduous years of schooling (15 years of education beyond high school) to the emotional, physical, intellectual and even spiritual challenges. One chapter provides a typical “day in the life” of a pediatric neurosurgeon; it’s almost exhausting just to read about the constant pressures, rapid changes, and frequent agonizing decisions he must make in a short time frame.
Sandberg has a passion and deep commitment to his work, not only as a neurosurgeon, but as a pediatric brain cancer researcher, a teacher, and a volunteer. On one four-week vacation, he treated patients in the overcrowded and ill-equipped hospital in Tegucigalpa, Honduras. This was one of many such humanitarian medical missions he’s undertaken, and they are filled with heartbreaking stories. “I have seen patients die because the elevator is broken, and the patient cannot be transported from the emergency room on the ground floor to the operating room on a higher floor.”
Throughout the book, Sandberg unflinchingly informs readers about the brain injuries children can suffer, including damage from diseases like cancer, and injuries sustained from abuse and violence, from auto accidents, or falls from bikes when the child was not wearing a helmet. He is just as honest when talking about failures in the medical system, including his own less-than-ideal outcomes. “I will never forget seeing James walk into my office. The reason I will never forget is that after the surgery I performed, James never walked again for the rest of his life . . . It is something that I have had to live with ever since.”
In the end, readers will be left with a sense of awe at both the fragility of our tender brains and bodies and the remarkable, seemingly miraculous ability to heal and recover. Between these two poles are people like Dr. Sandberg, who dedicate their lives to a practice that takes enormous skill and intellect, steely nerves, seemingly endless energy, and emotional investment. As Sandberg states, “I have learned time and time again that my profession requires not only my brain but my heart as well.”
Brain and Heart is a compelling, personal, and deeply moving look behind-the-curtain of the rarified field of pediatric neurosurgery, and one compassionate doctor’s lifelong mission to save childrens’ lives.