This question was originally posted on Quora.com and was answered by Laszlo B. Tamas, Neurosurgeon, 21 years practicing in Bay area. Sure we make mistakes. Why just the other day, my wife sent me to the supermarket to get some items. I made the mistake of buying Mill King milk (it’s a real brand) instead of our usual Maple Hill brand. “How thick-headed can somebody be … don’t you know we’ve been buying Maple Hill for years?” But I did buy all the correct items for our granddaughter’s birthday party, down to the correct number, shape and color of candles. Nothing to do with neurosurgery? Think again. Like in any human endeavor, we humans make mistakes. So in approaching a difficult brain surgery, for example, we have to know where to “put those mistakes” - meaning in what part of the procedure is there some leeway. It doesn’t really matter whether we use Rainey clips or coagulate the scalp edge; whether we use the Midas drill system or the Stryker; whether we close the galea with Vicryl or other suture. We also have to know in what part of the procedure is there no forgiveness. Have I visualized the perforators before applying an aneurysm clip (occluding these can cause coma)? If I remove more of this tumor, will it rip the carotid artery (uncontrolled bleeding)? Does the position of primary motor cortex as shown by the image-guided navigation system I am using make sense - or could there be some technical problem I am missing (might cause hemiplegia)? As for “How difficult is neurosurgery?” Some of it is not so difficult, some insanely difficult - and everything in between. The misunderstanding people sometimes have is that the difficulty is not in the “athletics” - it’s not a drama, with a beginning, middle and victory at the end (actually, the only drama is when a problem one has not prepared for happens, which is far from a “victory”). The challenge is to keep an enormous amount of complex information peacefully in your mind in the operating room, and make the right surgical decisions most of the time. As I often say, my job is to make the surgery boring. If at the end of a difficult case the anesthesiologist is yawning and the nurses are talking about their plans for the weekend, I have done my job. Source
