We’ve all heard the phrase “it’s not brain surgery.” But what exactly is brain surgery? It’s a profession that is barely a hundred years old and profoundly connects two human beings, but few know how it works, or its history. How did early neurosurgeons come to understand the human brain—an extraordinarily complex organ that controls everything we do, and yet at only three pounds is so fragile? And how did this incredibly challenging and lifesaving specialty emerge?
 
In this warm, rigorous, and deeply insightful book, Dr. Theodore H. Schwartz explores what it’s like to hold the scalpel, wield the drill, extract a tumor, fix a bullet hole, and remove a blood clot—when every second can mean life or death. Drawing from the author’s own cases, plus media, sports, and government archives, this seminal work delves into all the brain-related topics that have long-consumed public curiosity, like what really happened to JFK, President Biden’s brain surgery, and the NFL’s management of CTE. Dr. Schwartz also surveys the field’s latest incredible advances and discusses the philosophical questions of the unity of the self and the existence of free will.  
 
A neurosurgeon as well as a professor of neurosurgery at Weill Cornell Medicine, one of the busiest and most highly ranked neurosurgery centers in the world, Dr. Schwartz tells this story like no one else could. Told through anecdote and clear explanation, this is the ultimate cultural and scientific history of a literally mind-blowing human endeavor, one that cuts to the core of who we are.

Thanks to NetGalley the author, and Dutton for this review copy!

GRAY MATTERS is a fascinating exploration of the brain’s potential, expertly balancing scientific insight with philosophical contemplation. As a practicing neurosurgeon, Schwartz has a unique vantage point into the wonders and mysteries of the human brain, which he translates into an engaging and accessible narrative. The book dives deep into the gray matter—the seat of human cognition, emotion, and identity—and asks profound questions about the nature of consciousness, technology’s impact on the brain, and the future of neuroscience.

One of the strengths of this book is its ability to make complex medical concepts accessible to a general audience. Schwartz explains the anatomy and physiology of the brain in clear and concise terms, making it easy for readers to follow along. He also delves into the history of neurosurgery, tracing the evolution of the field from ancient times to the present day.

Through his writing, the author conveys a deep sense of empathy and compassion for his patients and their families.

Some of the cases he describes are:

  1. The Musician’s Tumor: Schwartz recounts the case of a professional violinist who had a brain tumor. The surgery was particularly challenging because it was crucial to preserve the patient’s fine motor skills and musical abilities. During the operation, the patient was kept awake and played the violin, allowing Schwartz to ensure that the areas of the brain responsible for these skills were not damaged.
  2. The Young Athlete: Another compelling case involves a young athlete who suffered a severe head injury. Schwartz describes the delicate process of removing a blood clot from the brain and the subsequent rehabilitation that allowed the patient to return to sports. This case highlights the resilience of the human brain and the importance of timely medical intervention.
  3. The Phantom Limb: Schwartz also delves into the phenomenon of phantom limb pain through the story of a patient who experienced severe pain in a limb that had been amputated. The case explores the brain’s complex relationship with the body and how neurosurgery can sometimes alleviate such mysterious conditions.
  4. The Epilepsy Patient: One of the most intriguing cases involves a patient with severe epilepsy. Schwartz performed a surgery to remove the part of the brain causing the seizures. The case is notable for the precision required and the dramatic improvement in the patient’s quality of life post-surgery.

 

The personal stories of patients provide a humanizing touch to the hard science, making it clear that the brain is more than just an organ—it’s the core of who we are as individuals. These stories give weight to the philosophical questions Schwartz raises: How far can we push the boundaries of human cognition? What are the risks of tampering with the essence of humanity? The discussion of the challenges of making life-and-death decisions and the impact of brain injuries on individuals and their families is unsettling and thought-provoking.

In addition to its medical and personal insights, GRAY MATTERS offers a valuable perspective on the future of neurosurgery. Schwartz discusses emerging technologies, such as brain-computer interfaces and gene therapy, and their potential to revolutionize the treatment of brain disorders. He also addresses the ethical concerns that may arise as these technologies become more advanced.

While the book is primarily focused on the medical aspects of neurosurgery, Schwartz also touches on the personal toll that this demanding profession can take on practitioners. His reflections on the emotional challenges of dealing with life-and-death situations provide a valuable perspective on the human side of medicine.

This is an intellectually stimulating read that merges science and philosophy seamlessly. The book is a compelling blend of memoir and textbook and is a highly recommended read for anyone interested in the brain, medicine, or the human condition. However, those looking for a purely philosophical or speculative work might feel that the book is too grounded in clinical reality.

Regardless, Schwartz’s expertise and passion for his field shine through on every page, making this book a fascinating and informative exploration of the complexities of the human mind and the incredible advancements that have been made in the field of neurosurgery.

Want your own copy? You can pick it up here.