Monday Mornings: A Novel Read Online Free PDF

affectionate moniker for anesthesiologists—pick. In addition to Mason, a nurse stood behind Ty and slightly to his right, next to a tray of instruments. A resident stood on the other side of the operating table, studying every move of a surgeon considered one of the greatest natural “athletes” ever at Chelsea General.
    Ty had cut through the thick, fibrous outer layer of the brain, the dura, with his usual quip: “That’s one tough mother.” The name for this outer membrane of the brain came from the Old English dura mater or “tough mother,” a piece of medical arcania passed along by his chief resident during training. The chief resident, now a full professor of neurosurgery at UCSF, where they had both trained, also made this quip at the start of every operation. Ty had performed more than a thousand operations on the brain since training. Still, at the start of each, he’d say, “That’s one tough mother.” It was now part ritual, part homage to his mentor.
    Looking through the microscope, Ty could see the optic nerve, a thick white filament stretching toward the back of the skull. Nearby was the carotid artery, one of the major vessels supplying blood to the brain. On the other side of the artery was another nerve, a thread-like strand, almost imperceptible, even with microscopic magnification. “Gotcha,” Tyler whispered to himself. Between the two structures deep in the brain, Ty found what he was looking for, the ballooned side of a blood vessel or aneurysm that had bulged and then burst with such catastrophic results. It looked every bit like a blood blister. Just as Villanueva suspected, the aneurysm was big enough to put pressure on that small strand, the oculomotor nerve, as it exited the brain stem. That was why her pupil had been dilated.
    The brain was such an elaborate organ, there were times Ty wondered how it managed to function without complications for as many people as it did. So many things could throw the brain’s delicate mechanisms out of balance, with lifelong, disastrous effects. A vessel could blow and spray blood across the delicate, spongy matter, the command center that controlled everything from breathing to consciousness. A single cell could grow out of control, squeezing out sight or memory or life itself. Lead in the blood, courtesy of a few chips of old paint, could dampen a child’s learning for the rest of his or her life. A shortage of serotonin could result in crippling depression. A blow to the head could cause a bruise to the soft loops and folds of the brain and affect balance, speech, or judgment. The inability to produce enough dopamine resulted in the tremors of Parkinson’s. A severe vitamin B 12 deficiency could cause dementia. The list was almost endless. Protected by a helmet of bone, the brain was an organ of mind-boggling complexity and ability.
    During his training, Ty’s chief resident had challenged Ty and the three others who had made the cut into one of the smallest and most challenging subsets of modern medicine. He asked them why they thought they were good enough to operate on “the most complicated structure in the known universe.” That phrase, too, stuck with Ty: the most complicated structure in the known universe .
    Why, indeed. Ty’s thoughts returned to the page he had received earlier: Room 311. Six o’clock in the morning.
    Quinn McDaniel’s mother had not asked him why he felt qualified to operate on her son’s brain. She saw a confident, handsome surgeon, the very picture of what a surgeon should look like. She saw an attending neurosurgeon at a large teaching hospital with an international reputation. She figured everything would be fine. Before walking into surgery, the boy’s mother had called after him, “Doctor. Take good care of him. He’s my…well, everything.” She smiled when she said it, a look of pride on her face.
    Ty studied the woman’s aneurysm.
    “Straight clip.”
    “Straight clip,” the surgical nurse