One of the best parts of my job is interviewing physicians about the work they love. I recently spoke to Michael Edwards, MD, a neurosurgeon at Lucile Packard Children's Hospital, about a recent traumatic brain injury case he handled. The patient, 15-year-old Spencer Morse, was hurt July 7 when he flew off his motocross bike in a race in his hometown of Sonora, Calif. Spencer's injury was too severe for the local hospital to handle, so he was flown to Packard Children's in a Life Flight helicopter.
My Inside Stanford Medicine story describes Edwards' first assessment of the injury:
An operating room was waiting when Spencer arrived at Packard Children’s. [Edwards] could immediately see two things: the location of Spencer’s injury was lucky but his life was still in danger.
“He had a severe open injury to his skull,” Edwards said. The wound was just above Spencer’s hairline on the right side of his head. “Because it was in the right frontal lobe, he had no paralysis, and was talking and following commands. But the obvious risk was that he would continue to hemorrhage and would die.”
Even if he lived, the bleeding could cause lasting brain damage, and infection was also a significant concern, Edwards added.
As Edwards described the case to me, it became clear that he loves treating trauma patients. Although many people (me included) would be unable to stomach the prospect of cleaning dirt and bone fragments from a child's injured brain, our conversation helped me realize why top neurosurgeons like Edwards might relish these cases.
First, there's the adrenaline rush: A kid arrives at the hospital in the middle of the night, badly in need of help. The wound looks awful (Edwards, who has seen plenty of trauma, said it was "pretty nasty - I can't describe it") and yet there's a good chance that, with the right care, this kid will be OK. (The location of Spencer's wound meant that he had better long-term prospects than many traumatic brain injury patients. Edwards said he was "very, very lucky - by a matter of inches.") In the OR, the team uses lots of painstaking work plus nifty surgical innovations (instead of implanting a metal plate in his skull, Spencer's larger bone fragments were soaked in antibiotic solution and returned to his head, saving him a return trip to the OR) to help the patient. And if everything comes together, the best part is the payoff:
Today, in spite of the severity of his traumatic brain injury, Spencer’s life is back to normal. He recently started 10th grade and has returned to many of his favorite activities, including playing golf andworking at the local skateboard and snowboard shop. But he chose not to go back to motocross racing. His bike is now up for sale on eBay.
“He came through this pretty unscathed,” Edwards said.
In our conversation, Edwards added: “You just never know with a big, open injury.” He was clearly very happy to have helped Spencer get back to normal.
Photo of Spencer Morse and a visitor courtesy of Lucile Packard Children's Hospital