Brain Cutting

Emma Samelson-Jones

The page came to my resident, who grinned and looked over at me, his hovering medical student. “You should go to this.”

I looked down at the pager.

“Brain Cutting. 2:30 PM. Room B157.” 

Text pagers are the indifferent bearers of all news. Emergencies–“Smith, BP 60/30, Room L721”–appear in the same font as messages seemingly borrowed from a teenager’s cell phone: “OMG, the harpist in the hospital lobby is playing ‘My heart will go on’ from Titanic. WTF?”

I dutifully took the elevator down to the hospital basement and opened the door to the morgue. The medical examiner and a group of neurology residents and students were gathered around a steel table, its sides sloping gently down to a central drain.

As more people arrived, the residents repeated the patient’s history. Adrenoleukodystrophy–a rare genetic defect, marked by progressive brain damage. Same disease as in that movie Lorenzo’s Oil. A freak traffic accident involving a train had been followed by worsening weakness. Unsteady gait. Seizures. Personality changes. Death.

Most of the residents had cared for this patient over the previous year. We flipped through a pathology book with autopsy photos of another adrenoleukodystrophy case, then reviewed the brain MRIs that …

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