Gray Matters: A Biography of Brain Surgery

by Theodore H. Schwartz

“If you are at all curious about the brain or the surgeons who operate on it, Gray Matters is a must read and Dr. Theodore Schwartz is the perfect guide, a master brain surgeon and superbly talented writer. I have not read a better biography of our shared profession, and in Schwartz's talented hands, the most enigmatic 3 1/2 pounds of tissue in the known universe comes to light in remarkable and revelatory ways.”
—Dr. Sanjay Gupta, CNN Chief Medical Correspondent, and New York Times and #1 Wall Street Journal bestselling author of Keep Sharp: Build a Better Brain at Any Age

A popular biography of brain surgery, by one of its preeminent practitioners

We’ve all heard the phrase “it’s not brain surgery.” But what exactly is brain surgery? It’s a profession that is barely a hundred years old and profoundly connects two human beings, but few know how it works, or its history. How did early neurosurgeons come to understand the human brain—an extraordinarily complex organ that controls everything we do, and yet at only three pounds is so fragile? And how did this incredibly challenging and lifesaving specialty emerge?

In this warm, rigorous, and deeply insightful book, Dr. Theodore H. Schwartz explores what it’s like to hold the scalpel, wield the drill, extract a tumor, fix a bullet hole, and remove a blood clot—when every second can mean life or death. Drawing from the author’s own cases, plus media, sports, and government archives, this seminal work delves into all the brain-related topics that have long-consumed public curiosity, like what really happened to JFK, President Biden’s brain surgery, and the NFL’s management of CTE. Dr. Schwartz also surveys the field’s latest incredible advances and discusses the philosophical questions of the unity of the self and the existence of free will.

A neurosurgeon as well as a professor of neurosurgery at Weill Cornell Medical Center at New York Presbyterian Hospital, one of the busiest and most highly ranked neurosurgery centers in the world, Dr. Schwartz tells this story like no one else could. Told through anecdote and clear explanation, this is the ultimate cultural and scientific history of a literally mind-blowing human endeavor, one that cuts to the core of who we are.

Genres: Nonfiction, Science, Medicine, Medical, History, Memoir, Neuroscience

512 pages, Hardcover

Published August 13, 2024

Reviews

[Scottsdale Public Library · Rating 4 out of 5]

There is a lot of information to unpack in Gray Matters, however this Biography from renown neurosurgeon Theodore Schwartz manages to break down some of the most intricate parts of brain surgery in a way that the typical person can comprehend. He evaluates some famous cases of people both past and present, such as Robert F. Kennedy, Abraham Lincoln, Gabby Gifford, and Emilia Clarke (Daenerys in Game of Thrones), just to name a few, who suffered a brain injury and breaks down the probable causes, treatments and outcomes in an educational way. Delving into the history of brain treatments for ailments like epilepsy and mental illness, he candidly describes where it went drastically wrong, as well as celebrating the many advancements in this field that have occurred as a result. – Pam B

[TL *Humaning the Best She Can* · Rating 5 out of 5]

*This only took so long to read cause I had some... personal stuff going on that slowed my reading progress *

This was a really interesting book. I can see myself coming back to it from time to time.

There was one chapter where I wanted to highlight the whole thing.. that especially made me think.. (anyone know how to highlight passages in Play Books? Couldn't figure it out. )

The information was presented in a way that was easy to understand and he didn't talk down to his audience. (I could definitely enjoy a class taught by him if I was on that career path)

This book is one where I think it's better to read some at a time and let your brain absorb it before you pick it up again.

Would recommend 👌.

Hopefully will get a physical copy one day as well, it isn't small print:).

Side note: faceless covers are creepy to me, couldn't look directly at it.. a me thing.

[izzy ❆☃︎ · Rating 5 out of 5]

Alright, I’m giving this book a proper review for the fun of it…

🩺🩻🧑‍⚕️
ᴺᴼᵂ ᴾᴸᴬᵞᴵᴺᴳ♫♬♪:
Thousand miles by the kid laroi
▶︎ ─•────
↻ ◁ | | ▷ ↺


──── ୨ৎgray matters ୨ৎ────
⋆౨ৎ˚⟡˖ ࣪ ╰┈➤ by theodore h. schwartz

☑ spoiler filled review 🫶

°❀⋆.ೃ࿔*:･°❀⋆.ೃ࿔*:･

★ ★ ★ ★ ★/5

⋆⭒˚.⋆narration ⋆⭒˚.⋆

➤ theodore
this narration was good. It made sense, I could read it whilst NOT being in med school, and he actually did mention a few interesting stories.

⋆⭒˚.⋆Plot ⋆⭒˚.⋆

➤ how does one spilt the brain in half…

➤ shaking baby syndrome??? wtf man 😭😭😭

➤ the end was unreadable

➤ I’m never going bald

➤ concussions sound fucking scary

➤ humans are fragile

⋆⭒˚.⋆overall ⋆⭒˚.⋆

I’m so proud guys I pushed through!!!!!!!!!!! Aghh

➤Age recommendation: anyone in med school

➤interest level: 3/5

➤Age level of reading: smart people

➤What to expect

⤷ weird things

⤷ scary things

⤷ hot doctors

⤷ brain cutting




450 Pages of Medical Nonsense
Have you ever read a book that you can’t quite enjoy, but still find interesting? I read the book Gray Matters: A Biography on Brain Surgery by Theodore H. Schwartz. Not exactly an eye-catching read, but I still had to read a nonfiction book over the summer.
There’s really no plot to this book - it mostly consists of different short stories; concussions, aneurysms, and cutting the brain in half. This “summary” mostly consists of the most interesting stories that I can remember. Here’s my first one: A lobotomy. Severing the frontal lobe and other parts of the brain. It was once used to help people, but in contrast, wealthy people started asking for doctors to do lobotomies on their daughters; to make them more obedient. Obviously we don’t perform this surgery for “obedient daughters” anymore, but this was just one of the truths about the darker side of intrusive surgeries. There are so many more different elements of neurosurgery. For example, SBS. Shaken Baby Syndrome. It happens when a baby is just, you know, shaken. Maybe a parent was frustrated at the baby, and shook the baby, but the result is the same. There are fluids inside your skull that hold your brain, but when you shake the baby’s head, you essentially move the skull, but the brain doesn’t have time to catch up, so it slams up against the sides of the skull. An aneurysm (an-nyr-ism), is essentially a big balloon inside your brain. A blood clot, or any sort of change in blood pressure, can cause this. Picture a hose, with water running through it. But a rock clogs in, therefore creating more pressure. That pressure has to go somewhere, so it creates a balloon of somewhat, coming out of the artery.

Their solution, of course, is to create a clip, to prevent the aneurysm to keep it from growing, and popping. In the book Not Quite Dead Yet by Holly Jackson (which I also recommend), it talks about a girl, hit in the head with a hammer causing an aneurysm, and a shard of bone touching it. It was really interesting reading Not Quite Dead Yet because I understood so much more about the book - her injury and all the mental things going on inside her head. The author also talks about how people often refer to brain surgery as “it’s not brain surgery,” or “it’s not as hard as brain surgery!” When in reality, it’s not “brain surgery,” it’s “neurosurgery.” Most neurosurgeons end up operating on the brain, more the spine - although they spend most of their years in medical school and as a resident, maybe about 10 years in total, or more. There are also so many celebrities that have died from gunshot wounds to the head: President Lincoln, President Kennedy, and a ton of football players.
This book is kind of susceptible to controversy. Some find it interesting, some don’t. Personally, I did find this interesting, but it was also recommended to me by a 13 year old who has his sights set on being a neurosurgeon and spends his summer in a surgery camp at a college with a bunch of high school seniors, who has definitely influenced me that being a doctor is kind of interesting. I would recommend this book to anyone who wants to go through the wrath of medical school, is stuck in medical school, wants to have self-induced-book-induced tormenting, or is an absolute sweat at life. Overall, this book was written the same as a dictionary - similar to 1984 - dense, descriptive, and very very time intensive. It took me a whole two weeks to read, and it might not seem like a long time, but for comparison, in the summer, it took me only about 2-3 days to finish a book. Aside from being a little long, it was interesting to pick up a nonfiction book for once in my life, and so I would give this book a 5/5 stars.

[Keri Karman · Rating 5 out of 5]

In "Gray Matters". Theodore Schwartz delivers a masterclass of neurosurgery 101. Schwartz tells the story of the past, present, and future of neurosurgery, including portraits of the pioneers of the field, including Cushing, Dandy, and Penfield, to a look into the future of visual prosthetics. Through case studies (including Presidents to Schwartz's own family) and strange cures (including the ingestion of seal genitals, hippopotamus testicles, tortoise blood, and crocodile feces for epilepsy), Schwartz keeps the reader engaged throughout this book.

Schwartz beautifully illustrates the dichotomy of being a neurosurgeon by writing, "At the end of the day, while the doctor in me requires deep wells of empathy and heart, the surgeon in me must be able to turn off the heart and focus solely on one thing: flawless execution." It seems that in the history of neurosurgery many wrong turns occurred when the surgeon focused too strongly on the surgical aspects of their job, leading to surgeries such as the frontal lobotomy. However, by including the pitfalls of the field of neurosurgery, Schwartz is able to give the reader a more accurate representation of neurosurgery, without painting his field in rose covered glasses.

After reading "Gray Matters" I am even more thankful that I live in a world where neurosurgery is much improved and continues to improve rapidly. We are lucky to have neurosurgeons, such as Schwartz, that have the courage to learn from the past and create a better future in a field where anyone may need services at any time (have you checked your arteries lately?).

Thank you to NetGalley and the publisher for this ARC!

[Stetson · Rating 5 out of 5]

This is an entertaining must-read book for general interest readers. Not only does it provide a breezy tour of all major domains of neurosurgery, including accessible yet detailed descriptions of advanced techniques and celebrity/historical case studies - but it also covers some recondite medical history that should be more culturally salient, such as Harvey Cushing's pioneering role.

There is some naïve sociopolitical handwringing about the paucity of women and minorities in the field of neuroscience, but I don't expect neurosurgeons to be astute political commentators. One of the most amusing aspects of the book, near the end, is when Dr. Schwartz argues that neuroscientists are no smarter than anyone else it is just their grueling training that sets them apart. This bit is hard to be credulous about. Certainly, Schwartz is well aware that humans vary naturally in intellect but also other abilities we often refer to as executive function. In fact, this conclusion necessarily falls out of the science he presents.

I found it interesting but unsurprising that Schwartz leaned fairly heavily into a determinist reading of modern neuroscientific evidence, citing split brain studies, deep brain stimulation work, and famous case studies like Phineas Gage and other types of brain disorders or the effects of TBI on personality and cognitive abilities generally. However, I was surprised that Schwartz was implicitly a strong proponent of "regionalism" - the theory that different regions of the brain specialize to do fairly high order tasks. However, his discussions of consciousness and free will stay fairly general, avoiding deep dives into the topic. I'd have to return to the debate in neuroscience between regionalism and more distributed theories to assess whether Schwartz's implicit claims jive with some of the latest research or what opponents of regionalism would argue.

Regardless, the weaknesses of this book pale in comparison to the shear entertainment and educational value it contains. Schwartz is also very candid about his professional training (successes and failures) and how his personal life has been affected by brain diseases (both of his parents and some close friends have been affected).

[Jackie Sunday · Rating 5 out of 5]

I went to the largest bookstore in town to search for this new release on brain surgery. Couldn’t wait to read it. I found it in the back of the store on the lower shelf shoved between a few other medical books. It amazed me that this remarkable book of one of the most important parts of our human anatomy was no where near the best sellers.

I wasn’t sure what to expect – another dry publication? Not at all. Dr. Schwartz engages the reader from the start. He described the grueling process of becoming a brain surgeon and what happens during the surgery. He said sometimes it's helpful for the patient to be awake during the procedure and explained that there are no pain receptors within the brain. While the patient is in the operating room, the team has to be careful what they say. He said no one can say, “oops.”

The brain – unlike other parts of the body -- is in its own league. There can’t be any mistakes. Dr. Schwartz told the story of a surgeon who insisted upon a very quiet operating room to concentrate and complained when the nurse was breathing too loudly.

There’s a lot of fascinating information in this book. Every time I read about lobotomies, I am shocked. They were performed in the 1940s and 50s on unruly children, mentally ill patients, disobedient wives, disrespectful teenagers. Other subjects include child abuse, ski accidents, gunshot wounds, brain tumors, strokes, dementia and seizures. Sports enthusiasts are well aware of the effects of brain trauma and the changes made with skull protections.

Technology has provided surgeons with more advanced equipment to save patients. Dr. Schwartz said it wasn’t that long ago when magnifying lenses weren’t available in the operating rooms. Robotic technology is moving at a quick pace. One wonders if it’s possible in the future to read minds.

Dr. Theodore H. Schwartz has an impressive career as a leading neurological surgeon and professor at Cornell. He gives lectures all over the world and published numerous articles and books. This book is informative, enjoyable and it relates to all of us. The audible is excellent with his voice although the book includes various useful pictures related to the brain.

[CanadianReader · Rating 2 out of 5]

As far as I read (which, I admit, was not very far), Gray Matters was a dull book, presenting information I really had no interest in: the public perception of neurosurgeons; the sort of individual who chooses to enter the specialty; the way in which neurosurgeons are presented in film media; women and minorities who have entered the field; and a brief summary of the life of Harvey Cushing, the father of modern neurosurgery. I understand that Schwartz goes on to document details about operations performed on celebrities (I have zero interest in celebrities) and that he also presents some of his own surgical cases. Based on what I read, I couldn’t imagine spending a couple hundred pages more with him. His writing reads like a very extended dry encyclopedia entry. There was little to engage with emotionally or philosophically. I found I simply did not care. I appear to be in the minority in my response to this book. I have liked the autobiographical works of other neurosurgeons—Henry Marsh, Rahul Jandial, Frank Vertosick Jr., and Christopher Honey—and recommend those over this one.

[Leah · Rating 5 out of 5]

I may be a bit biased because Dr. Schwartz was the neurosurgeon who removed my pituitary tumor, but I thought this was excellent. So interesting to read about the skull based surgeries and how they have evolved. Slightly triggering for those of us that have been through it, but so cool at the same time.

[Cheenu · Rating 3 out of 5]

This book is an overview of the field of neurosurgery by a neurosurgeon - descriptions of conditions requiring neurosurgical interventions, descriptions of their interventions themselves and famous celebrity cases.

The language is simple and the topics are not explored in any sort of depth, probably intentionally, to keep the book accessible to a wide variety of readers.

You could get all the content in the book by just asking ChatGPT on the topic i.e. conditions, interventions and the celebrity cases.

However, it is nice to have them all compiled in one place.

I recommend this if you mostly have no idea about neurosurgery beyond an image of a surgeon sawing the skull. If you already well read on the field, there probably won't be anything much new.

(I'm not really sure how to classify this book as, for me, it just doesn't have enough depth to be a popular science book. For the lack of an better alternative, I am classifying it as popular science.)

[Kayla · Rating 2 out of 5]

DNFed @ 40%

The content of this book was extremely interesting, but it was very poorly structured. I thought I was going to get more from the perspective of the author and his own experiences, rather than just explanation and analysis of different brain injuries to famous people and the way they were handled. Still, I did find the cases interesting. However, the format of this book describing case after case grew tired in a hurry. It was just too dense and an information overload.

[Sarah John · Rating 4 out of 5]

4.5⭐️ this book was written so well, in a way so accessible that anyone could read it

[Shennybook · Rating 5 out of 5]

Best book ever

[Nina · Rating 5 out of 5]

Really, really engaging. The author gives a history of approaches to treating disorders of the brain and describes the personalities of the people who made incredible contributions to the field of neurosurgery. All I can say, is thank goodness there are people with enough smarts, eye-hand coordination, physical stamina (you have to be able to operate all day without food or a bathroom break), and passion for non-stop learning so the rest of us can benefit when we need help. They often sacrifice their family lives; the divorce rate is high. ("The suicide rate for male physicians is 40 percent higher than the general population, and for women it's 130 percent greater)"!

Hard to believe the number of traumatic brain injuries out there (69,000 TBI-related deaths in 2021 alone, which would be an average of 190 a day). Then there are the brain tumors. And the aneurysms. And the strokes. And epilepsy, and Parkinson's, and concussions. [Interestingly, although boys' football is the sport most likely to result in a concussion, girls' soccer is a close second, followed by girls' basketball. What? ]

Lot's of case studies were included, which I really like. He talks about historical cases (like Lincoln and JFK), as well as sports figures (like Mohammed Ali), and celebrities (like Michael J. Fox and Natasha Richardson). And I wish this book had been published before my brother had deep brain stimulation for Parkinson's. There are a lot of questions I didn't know to ask.

I also really liked the chapter that focused on the concept of free will, and what brain research tells us about it. Since the author's undergrad degree was in English and Philosophy, he has a good basis for talking about it). All in all, really good stuff.

[Emmet Sullivan · Rating 4 out of 5]

Wide-ranging, insightful, and written in a smart and approachable way.

[Smjohns78 · Rating 4 out of 5]

I found the history and technical aspects fascinating. However, the attempts at moral or ethical discussions fell a bit flat for me.

[Grace Gendron · Rating 4 out of 5]

This book honestly was fascinating- it was engaging while also being incredibly informative. Covering everything from the history of neurosurgery to modern day advances it was a captivating read!

[Cara Spencer · Rating 5 out of 5]

She was a dense read but she was a fascinating read

[Morgan Kreh · Rating 5 out of 5]

WVU mentioned

[Christina · Rating 4 out of 5]

Fascinating read. Excellent analogies. Started to drag a bit toward the end.

[Philip · Rating 5 out of 5]

Excellent, excellent, excellent - at once dense and informative, but also fascinating, entertaining, enlightening -

[J. Joseph · Rating 5 out of 5]

Thank you to Dutton and NetGalley for the uncorrected e-galley in exchange for my honest feedback.

How many times have you heard "Yeah, but it's not brain surgery!"? Well, in Gray Matters, Schwartz meticulously escorts the reader through the science and people of neurosurgery so that they can get a better understanding of this field. Each of his chapters focus on a specific diagnosis or development, ranging from the field's history, to aneurysms, to brain-computer interfaces. Within each chapter he masterfully, and compellingly, covers: biographies of important figures, the specific history of that chapter's topic, standard and developmental techniques used to treat the affliction (or at least alleviate some of the suffering), multiple real-world case studies (sometimes with well-known individuals you never knew had brain surgery), and his own personal autobiographical encounters with the topic.

There's too much in this book to highlight all of what I enjoyed in each chapter. Schwartz was able to take a difficult field and render it easy to comprehend while simultaneously adding in tension and drama. He presents not just a narrative of the topic, but also vital statistics and information that allows the reader to increase their scientific literacy by engaging with his writing. As a healthcare specialist who also engages with the public (or, well, tries to!), this is no simple task. Yet the book manages exactly this.

As for negative points, there's really only two more minor elements I'd want to highlight for folks before they start reading. First, there are a small handful of sections where Schwartz ventures into "we could do this" territory, rather than "we should do this" territory. Working in Ethics, this is a common flaw I see among other healthcare providers. Simply because something could be done doesn't license us to do it, because we need to consider more than just the medical outcomes when discussing someone's life. Generally speaking, though, he's rather good at sticking to the "should" rather than the "could".

The second negative I want to highlight is that, for someone who engages in a lot of philosophy in this book, Schwartz tends to stick to the older canon. The field of philosophy of mind often works alongside neuro-folks (neuroscientists, neurosurgeons, and neurologists) on projects involving cognition, the mind's architecture, and so forth. I wished I'd have seen more of that, and less of Descartes.

[Allyson Dyar · Rating 5 out of 5]

I knew this was going to be a great book when Dr. Schwartz started off with an explanation as to why Dr. Harvey Cushing was such an important influence in American neurosurgery. In fact, most if not all neurosurgeons who trained in American schools can likely trace their training back to Dr. Cushing because, when it came to neurosurgery training, there was no other.

I really enjoyed how Dr. Schwartz was able to weave the history of neurosurgery against his history as a neurosurgeon—from what it takes to be a great neurosurgeon to what the surgeon needs to consider before operating on the brain.

He also discusses the subject of chronic traumatic encephalopathy (CTE) a subject that is near and not so very dear to the heart of many players and fans of contact sports such as American football and soccer (football in other countries). CTE has been in the news lately because so many football players have shown the effects of a constant barrage to the head causing nerve cell death and resulting in a gradual decline in cognition. Unfortunately, some of these former athletes have resorted to suicide and for those who manage to live out their lives, the symptoms of memory loss, confusion, anger, etc., have caused a great concern for their families.

The only part of the book I really wasn’t as interested in was the philosophical discussion of brain versus mind (what makes us human, etc.). But that’s just me—other readers may find it fascinating.

I highly recommend Gray Matters: A Biography of Brain Surgery to anyone who has an interest in medical history—there’s plenty of solid history here—or interested in neurosurgery. I will caution the potential reader that this is a seriously long book, but, in the end, the read was a satisfying one.

5/5 stars

[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion, which I have given here.]

[Christie Bane · Rating 5 out of 5]

Who would have ever thought that a book about brain surgery (the history and the current state) would be so engrossing to someone who has no aptitude for science? But this book is! Interestingly, the fact I remember the most from this book is this: in a study done to determine average IQs of brain surgeons, rocket scientists, and "normal people," there was... no difference. Brain surgeons and rocket scientists are NOT smarter than normal people. What they are is more dedicated and more willing to sacrifice the stuff that normal people are not willing to sacrifice (family time, leisure time, etc). That's interesting. Anyway, the rest of the book is also interesting. It is a rare author who can make a book about something as complicated as brain surgery totally readable, and I was impressed. Pop science at its best. Also, the brain is really, really interesting. (Understatement of the century.)

[Jenny · Rating 4 out of 5]

The author skillfully navigates the blending of fairly technical descriptions of the brain with anecdotes about various patients that he, or other surgeons, have treated. What most struck me was the fact his discussion of whether we truly have free will. Neurons are firing well before our even becoming conscious of having a particular thought or intention. I relinquished the idea of being able to control most functions of my body - or mind! After all, we still don't know where thoughts come from!

[Lori · Rating 4 out of 5]

Excellent book that is very accessible even for lay people. Lots of nitty gritty scholarly info, but still fascinating to get a deep look at what makes the brain tick. It took me a while to read it as I had to periodically take a break to digest the information. Really enjoyed the many case-studies cited and especially enjoyed his discussion about his mom and dad as both had neurological issues.

[Alice Gallo · Rating 5 out of 5]

This is a great book! This is an awesome leisure read, that will share with any reader (in healthcare or not) how and when things can and have gone wrong in Neurosurgery.

As a physician, I loved Dr. Schwartz’ predictions for the future of neurosurgery. Great cases chosen for illustration throughout the book as well.

[Angelica Cuany]

I normally love books written by medical professionals. Since my grandfather died of a glioblastoma, neurosurgeons especially fascinate me. However, this over-500-page book isn't so much a biography of a neurosurgeon as much as a very detailed history of the profession. While parts were definitely interesting, especially the case studies, some of the jargon definitely made the book drag. Thank you, NetGalley, for a copy of this book in exchange for an honest review.

[W · Rating 5 out of 5]

What an outstanding book. Written by a brain surgeon whom writes in a manner that a lay person can understand and enjoy. It is a fascinating book that would have relevance in some way to everyone. I hope Dr Schwartz will continue to write; much can be learned by him!

[Deborah · Rating 5 out of 5]

Fascinating!

[Katie · Rating 5 out of 5]

This was fascinating! The science and evidence presented were really cool. Those last 4 chapters blew my mind. I highly recommend this book!