Careful...steady now...make sure you cut the right one, or it could be all over...

Diffusing a bomb? Nope—performing brain surgery. It's a little scary how many similarities there are between the two, though. Both require a deft hand and unwavering nerves, both can result in the loss—or preservation—of life, and both make great primetime TV drama...The Cutter, (not actually) coming to CBS this fall.

You practically have to be part robot to perform this job—first, because you need all your movements to be precise and mechanical; and second, because when the surgery doesn't go well, your lack of a human heart will make it easier to tell your patient's family that they didn't make it.

Unfortunately, you likely do have a human heart, and suffer common human failings, which makes being a brain surgeon very difficult indeed. You're always within a hair's breadth of killing someone, so if you have serious designs on a career in this field, you're going to have to find a way to be at peace with that fact. 

You aren't 007 cutting red and blue wires, but slicing through human wires is just about as nerve-wracking. And all those nerves will be wracked on the daily for a mere $393,000 per year.

Okay, so a six-figure salary sounds pretty good. Good enough to make up for the stress? Consider the following worst-case scenario:

You make a major mistake and the guy on your operating table never takes another breath. His insanely rich family sues you for all you've got. The hospital you work for assigns the case to their legal risk manager, who determines that you exhibited gross negligence and takes away your license to practice, which results in professional blackballing, humiliation, and mortification galore.

Starting to envy the guy on your table who's no longer with us?

 

Oh, yeah. We're sure you're just making some beef stew.

Okay, enough with the scary stuff. Brain surgery isn't all bad news. You'll be saving lives a lot more often than you'll be exterminating them (hopefully). We're privileged to live in a time with advanced medical science—a few hundred years ago, if they wanted to remove a tumor, they'd throw a few eyes of newt into a steaming cauldron and recite a magical incantation.

Or something like that.

Believe it or not, patients are awake during certain types of brain surgeries, like tumor removals. (This doesn't hurt as much as you'd think; the brain has no nerve endings and can't feel pain. Crazy, right?) The awake craniotomy technique is helpful for doctors when working near areas of the brain that are related to speech. 

Talking to their patients during surgery helps them understand how much of the tumor or brain to remove. If they take out too much, their patient won't be able to talk. So if the patient suddenly starts speaking in grunts and whistles, chances are the surgeon's poked an important area. Better not remove that.

It's tricky stuff—so tricky that brain surgery has been used as a unit of metaphorical measurement for comparing any difficult task. Ever hear, "It's not brain surgery?" Apparently, the only thing that rivals brain surgery as a measurement of difficulty is rocket science.

Is brain surgery really that difficult? When you have the skills and know-how that a zillion years in medical school will give you, it really shouldn't be—but those impossibly high stakes and insane amounts of pressure you're under still make this job unenviable to most folks. 

If a brain surgeon, or neurosurgeon, botches the surgery, the patient may suffer brain damage, infections, bleeding, seizures, or death. You need steadier hands than a hand model for this career.

 

Most people would rather have the ice cream headache. (Source)

Neurosurgeons aren't just "brain doctors." They treat diseases of the nervous system, which includes the spinal cord and spine. Most of their patients have had strokes, arm or neck pain, trauma to the brain, abnormal blood vessels in the brain, or brain tumors—stuff that may not require surgery. In fact, many patients don't need surgery at all. However, they visit a neurosurgeon to get a medical opinion or discuss non-invasive treatments—like using radiation—to treat lesions of the nervous system. 

Still, brain surgery is a little more serious than treating a bad case of brain freeze from an ice cream cone. And the after-effects aren't nearly as delicious.

Neurosurgeons aren't the lone horsemen of the medical world. They work with other types of specialists such as neuroradiologists, neurologists, ophthalmologists, orthopedic surgeons, electrophysicologists, and rehabilitation physicians. This team atmosphere gives patients a treatment plan that covers their needs before, during, and after surgery or any other type of treatment. 

It also gives them somebody to gossip with about the newest endoscope. Believe it or not, that's an important part of being a brain doc.

Technology in this field changes rapidly, especially nowadays. Brain surgery has come a long way from the archaic practice of drilling a hole in someone's head. Not that that wasn't successful—archeologists have found human remains over 4,000 years old that indicate a successful surgery. 

The individual they found probably had a few more years of life left...until they were eaten by a woolly mammoth (the cause of death is still being debated, but the "mammoth" version of the story certainly sounds like the most thrilling one).

That was a long time ago. Neurosurgeons must take continuing education classes to keep on top of the latest scientific news or advances. Sure, they still drill holes, but they use drills that can electronically sense when they've drilled through bone, which is a feature most patients are super-duper excited about. 

They also use endoscopes equipped with fiber optics, probe attachments that have the ability to vaporize diseased brain tissue, and radiation-beaming knives called gamma knives. It's all very Batman/Iron Man/techy-superhero-of-your-choice.

Before you can pop open someone's brain like a can of soda, you have to go through extensive medical training. We're talking the Olympic training of medicine. Expect to spend four years getting an undergraduate degree, four years earning a graduate degree from medical school, and eight years training in a residency program. It takes around sixteen years of training before you can use a knife to do more than cut butter.

If you're lucky, you'll be done with training in your mid-thirties. Training programs are highly selective; most of them only accept a whopping one to three people a year. Time to get cracking on those medical books. 

These training programs only accept those who rank at the top of their class—the ones who know the difference between the hypothalamus and medulla oblongata (among other things). Giving a patient's brain a "bad haircut" will not lead to many more chances at surgery. Unlike hair, the brain can't just "grow out."

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