brain surgeons are crazy smart

This morning I went to “Tumor Board” for an hour and a half, which is a weekly meeting where several doctors, neurosurgeons, RNs, and various brain experts discuss cases individually and decide what kind of radiation, chemotherapy, or surgery to use. There were about ten people there, seated around a big table in a conference room. For each case they projected MRI images onto a big screen and there was a microscope feeding images of tumor samples onto another big screen.

It was a very efficient and professional meeting but there was a pleasant casual atmosphere too, which helped dissipate some of the stress of trying to figure out how to save these patients. There was a tray of donuts and fruit and plenty of coffee. Everyone called everyone else by their first name, and at one point one of the neurosurgeons joked to a neuropathologist that he was so quick to diagnose tumors, he should just open a kiosk at the mall. They were all amazingly quick though – they could tell what grade (how severe) a tumor is just by looking at how many of the tumor cells are going through mitosis at a given time. All of them were also able to distinguish abnormalities on the MRIs, which looked to me just like more shadowy blotches.

What was especially cool though, I thought, was how well the RNs and doctors knew all of the patients. They went through maybe 10 or 15 cases this morning and for each one they took into account the little personal details. For instance, one patient wants to wait until after her daughter’s wedding this summer, one lives far away and can’t afford the gas to come to doctor’s appointments all the time, and another is too claustrophobic to do an MRI without being sedated. They knew all this without even looking at charts or notes or anything, just remembered it. It was really impressive.