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Managing Editor
Scott Harris
sharris@aamc.org

AAMC Reporter: November 2006

A Brain Surgeon's Moment of Clarity:
Q&A With Katrina Firlik

Katrina S. Firlik, M.D.

Neurosurgeon Katrina S. Firlik, M.D., is a private practitioner in Greenwich, Conn., and a clinical assistant professor at Yale University School of Medicine. Firlik is the author of the recently published "Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside," an accessibly written collection of ruminations on the life of a brain surgeon and the brain itself, along with more than a few unflinching tales from the operating room. In the book, Firlik humorously compares brain matter to soft tofu on one page, and offers sobering clinical accounts in the next. "Another Day in the Frontal Lobe" is available from Random House.

In writing this book, you seem to have made a conscious effort to eschew medical terminology and take a slightly irreverent approach.

I thought the best way to write this book was in plain English, the better to reach a wider audience. The style is deliberate, and it wasn't artificial for me. I thought it was not only the best way to reach as broad an audience as possible, but was the best way to get my ideas across. After going through seven years of neurosurgery training, I had a lot of stories to tell. This book is an insider's view of the profession but is written with all people in mind. It also informs people on how the brain works and addresses more scientific types of areas. It covers a broad range of topics, from the serious to the silly.

You write that a brain surgeon is "part scientist, part mechanic." Why is this is an apt philosophy?

People always say 'Wow, brain surgery, the pinnacle of pinnacles, that must be so hard.' And I don't want to downplay it—it is extremely challenging and demanding, and requires you to be very quick on your feet. But in a day-to-day context, we are part mechanic. We're filling holes in people's skulls and cutting out tumors. We're not always dealing in intellectual terms. Just as often as not, we're discussing a blood clot in the brain that we have to suck out.

You have a private practice and are a professor at Yale University School of Medicine. Do you take this sort of plainspoken approach in your daily professional life?

I use the jargon and technical language when I am addressing students and other physicians. But in my day-to-day clinical practice, I do speak plainly with patients. I feel I can explain things to patients pretty well. The ability to use plain English with patients is definitely an asset. For some doctors, their style is to use a lot of the jargon around patients. They don't even realize they're doing it or think of it as necessarily a very big deal. But out of deference to the doctor, people often go along with what a doctor is saying even if they're not getting it, and that can cause trouble.

You mentioned you completed seven years of neurosurgery training not too long ago. Any suggestions or reflections on the medical education process?

If doctors were trained to communicate more clearly, I think it would do a lot of good. I would also think that, in scholarly and scientific journals, doctors could learn how to make the writing simpler. The articles are so technical that, a lot of the time, not even other doctors who are not in a certain specialty can follow them. How has the book been received? A lot of people not in the medical field have told me they liked it, but doctors and neurosurgeons have told me they enjoyed the book, too. People always have a lot of questions for me on the brain and what I do. I think this book is just an extension of that. People see the book as a refreshing way of looking at things, and I think they really appreciate it.