Put Down the Knife

Modern adult brain surgery is a very new discipline. While many would consider the fathers of modern neurosurgery to be people like Victor Horsley, Harvey Cushing, and Walter Dandy, they all worked in the early 20th century, in an era before the creation of equipment now considered to be “game-changers” in the field of neurosurgery. Only towards the end of the 20th century did we see such critical advances as the operating microscope, the wide availability of CT and MRI imaging, neuro-endoscopy, stereotactic neuro-navigation, stereotactic radiosurgery, interventional neuro-endovascular techniques, and intra-operative neuromonitoring. It is not just that these advances occurred only recently, but it is even more recently that they have become accessible to many neurosurgeons. Furthermore, the scientific evidence for adult brain surgery in this new era is itself extremely new and a work in progress.

There is certainly both an “art” and a “science” to the practice of medicine andalso to the practice of adult brain surgery. Furthermore, there is also a wide range of acceptable practices in regards to adult brain surgery, ranging from the most conservative/minimally invasive options to the most aggressive approaches. The author of Put Down the Knife, neurosurgeon Dr. Michael Brisman, is of the belief that the pendulum in medicine has swung way too far to the “art” side and away from the “science.” Furthermore, given the very high risks associated with adult brain surgery, the default choice of treatment should be the more conservative/minimally invasive options when possible. This book explores adult brain surgery from a more conservative vantage point, highlighting potential errors in thought related to decision-making and rationales for brain surgery as well as interpretation of the surgical literature. Focused chapters then dive into considerations of less invasive and even non-invasive approaches for various conditions of the brain, including tumors,cysts, hematomas, pain and movement disorders, skull base disorders, and much more. 

“Put down the knife is a well written compilation of personal approaches employed by an experienced neurosurgeon, when considering adult brain surgery for a number of conditions. Considerations are based on the recent availability of minimally invasive approaches and alternative therapies including stereotactic radiosurgery as an alternative or adjunct. The approach which is advocated is one of avoidance of complications, by limiting the use of more invasive techniques, when a combination of safer ones can be justified. It includes key references, to serve as a resource for medical professionals as well as those considering treatment for the variety of conditions seen by adult b rain surgeons in practice.” (David W Newell MD, Former Professor of Neurological Surgery, The University of Washington School of Medicine Seattle, Washington)

“Put Down the Knife is a very rational approach to indications of surgery on the brain. The philosophy is of special importance and is a great read for anyone operating in this discipline.” (Aaron Cohen-Gadol M.D.   Neurosurgeon, Founder/President Atlas Meditech and Neurosurgical Atlas)

“Put Down the Knife: A Fresh Look at Adult Brain Surgery is a fantastic book in which Br. Brisman convincingly explains why, in many instances, a minimally invasive neurosurgical approach is superior to open surgical intervention. Dr. Brisman thoughtfully and thoroughly analyzes the medical literature regarding a whole host of neurosurgical maladies.” (Marc Arginteanu M.D.    Neurosurgeon, Author of The Mind Unlocked: Neurological , Nutritional, and Behavioral Paths to Free your Brain’s Potential)

“A beautiful book! It should be required reading for all first-year neurosurgery residents.” (William S. Sonstein M.D.    Neurosurgeon, President NSPC Brain and Spine Surgery)

“The book is well-researched and thoroughly supported by extensive citations and references, making it  an indispensible resource in the neurosurgical domain. It is deemed an essential reference of neurosurgery  and merits a place on the bookshelf for both neurosurgical residents and practicing physicians.” (Mike Win  President, Chief Technologist, Satellite Data Systems (Denver, CO))

“The content of the book was incredibly straight forward reading and very enjoyable from a clinical and informative perspective. I highly recommend this book to anyone who works in the healthcare field as well as anyone who has suffered brain disease or has relatives who may suffer from one of the many conditions outlined and discussed in  this remarkable book.” (William S. Adam BS CRT BASOA Senior Advisor, ISG Hospitalists Group, Author/Editor, Good Morning HealthCare Newsletter)

“Put Down the Knife is a very rational approach to indications of surgery on the brain. The philosophy is of special importance and is a great read for anyone operating in this discipline.” (Aaron Cohen-Gadol, MD, Department of Neurological Surgery, Indiana University School of Medicine, USA)

Michael H. Brisman, MD, FACS, NSPC Brain and Spine Surgery, Rockville Centre, NY, USA