When the air hits your brain: Tales of Neurosurgery By Frank Vertosick, Jr (review)

time that returning foragers must wait to regurgitate their load of nectar to other workers who carry it to empty cells. When resources are scarce and many cells are empty, returning foragers can immediately unload their nectar, which serves as the cue for increasing foraging effort. Even the physical architecture of the hive, such as the location and dimensions of the dance floor, honey comb and brood chambers , has been shown to play an important role in the cognitive architecture of the hive. Seeley recounts these and other experiments with the loving detail of a person who has devoted his life to the subject. His book is an excellent example of how fascinating natural history can be combined with cutting-edge science. The significance of The Wisdom oftheHive extends beyond the social insects to the more general subject of evolution acting at multiple levels of the biological hierarchy. The basic concept of a group mind might even be applicable to our own species, in which individuals also seem to exist within highly integrated social groups. David Sloan Wilson Department ofBiological Sciences Binghamton University State University ofNew York Binghamton, NY 13902-6000 When the air hits your brain: Tales of Neurosurgery. By Frank Vertosick, Jr. New York: Norton, 1996. Pp. 288. $23.00. "Well, it isn't brain surgery. ..." This flip phrase has been repeated to the point of cliché, indicating that many Americans regard neurosurgery as an ultimate occupation . The continuing popularity of the Frankenstein legend suggests that layfolk also see something spellbinding and weird in people who open up other people's heads. The fascinating, strange land of neurosurgery is the subject of When the Air Hits Your Brain (You Ain't Never the Same) by Frank Vertosick, Jr. Dr. Vertosick, himself a neurosurgeon in Pittsburgh, is a superb guide to this remote, sometimes nightmarish territory. Unfolding a personal bildungsroman, with intimate portraits of surgeons and patients and detailed descriptions of procedures , Vertosick describes his residency training as seven years of "the most arduous apprenticeship on earth." So arduous because the brain is so unforgiving—a tiny slip in the operating room may rob the patient of speech, vision, or life itself. The book is a good introduction to medically correct brain structure and function , as well as clinical neurosurgery. But When the Air Hits Your Brain is no dry-asdust textbook—instead this chronicle roars through ER, OR, and hospital wards with the residents, encountering brain tumors and aneurysms, paralysis and aphasia , and an array of suffering human beings. Gary the Chief Resident initiates Vertosick the rookie into neurosurgical residency . Gary's smart-ass humor has the team in stitches, but "in tense situations, [his] flippant facade was jettisoned, exposing a tenacious and humorless professional beneath." Gary is a heavy smoker and glutton for pizza, but also "a sort of surgical savant." This young man has the brains to diagnose a rare spinal blood clot as cause for quadriplegia—then he has the guts to remove it without an x-ray. 306 Book Reviews When the young patient eventually recovers and walks, it is exhilarating: "Now who wouldn't want to do that for a living?" The Chief of Neurosurgery, "the Boss," is the classic silver-haired, tough-guy surgeon . In a memorable OR scene, the Boss leads young Vertosick through a difficult tumor case. The tumor is huge, the bleeding profuse. The anesthetist reports falling blood pressure. The Boss commands him to "fix it," urges his resident to "keep working, we're almost home," and soon the great mass of tumor is out. The Chief has the confidence in his resident and the good grace to say, "Nice work . . . you're really one of us now." Dr. Frank Vertosick has been inducted into the elite order. Case by case—that's how Vertosick weaves his neurosurgical tapestry. Each case has its own emotional center of gravity. Elation flows from the spectacular successes now expected from modern surgery: the woman whose vision is restored after pituitary tumor surgery, the "Alzheimer's patient" whose mind returns after removal of an unsuspected tumor. And depression comes with the turf when you deal with malignant brain tumors. But if the surgeon...