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Off the Top of My Head: Stories from the Operating Room That Will Make You Laugh
Inside every skull is a story of heart, humanity—and the occasional hairball.
You might think brain surgery is all cool precision and high-stakes drama. Sometimes it is. But more often, it's a gritty, smelly, surprisingly absurd job—one that involves titanium screws, tumors the size of grapefruits, and moments so human they'll break your heart or make you snort with laughter behind your surgical mask. In Off the Top of My Head, Dr. Barbara Lazio peels back the sterile curtain of the operating room and shares the unexpected stories that come with a life spent elbows-deep in the human brain.
With warmth, wit, and a scalpel-sharp eye for detail, Dr. Lazio invites readers into her world—where mortality is never far away, but neither is meaning, connection, or the occasional gallows-humored joke.
Inside, you'll
Gripping behind-the-scenes moments from the OR—equal parts miraculous and messyMemorable patients facing the unimaginable with courage, humor, and graceA rare glimpse into the emotional life of a neurosurgeonUnexpected levity in the face of death, grief, and the unknownWhether she's rebuilding a shattered skull or laughing through tears with a family on the edge of loss, Dr. Lazio reminds us that behind every dramatic headline or surgical success is something deeply, beautifully human.
Off the Top of My Head is a book for anyone who wonders what really happens when the brain—and life—hangs in the balance.
You might think brain surgery is all cool precision and high-stakes drama. Sometimes it is. But more often, it's a gritty, smelly, surprisingly absurd job—one that involves titanium screws, tumors the size of grapefruits, and moments so human they'll break your heart or make you snort with laughter behind your surgical mask. In Off the Top of My Head, Dr. Barbara Lazio peels back the sterile curtain of the operating room and shares the unexpected stories that come with a life spent elbows-deep in the human brain.
With warmth, wit, and a scalpel-sharp eye for detail, Dr. Lazio invites readers into her world—where mortality is never far away, but neither is meaning, connection, or the occasional gallows-humored joke.
Inside, you'll
Gripping behind-the-scenes moments from the OR—equal parts miraculous and messyMemorable patients facing the unimaginable with courage, humor, and graceA rare glimpse into the emotional life of a neurosurgeonUnexpected levity in the face of death, grief, and the unknownWhether she's rebuilding a shattered skull or laughing through tears with a family on the edge of loss, Dr. Lazio reminds us that behind every dramatic headline or surgical success is something deeply, beautifully human.
Off the Top of My Head is a book for anyone who wonders what really happens when the brain—and life—hangs in the balance.
251 pages, Kindle Edition
Published September 22, 2026
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Displaying 1 - 27 of 27 reviews
Review of advance copy received from Publisher
Unflinching and vivid, the author brings you into the operating room as she deals with every kind of brain and spinal injury. Sarcastic and blunt, she also keeps the pace hustling along, bouncing back and forth between diagnoses, prognoses, operations and (mostly comic or self-wounding) snippets of her home life.
At times, I felt like I must surely perish. Immediately. Because the delicate mesh of vessels and bone and dura and blood in and around our fragile brains seems designed to fail. Yet most people make it. At least until something else gets them. And as the author soldiers on, from 72-hour on-call periods to sporadic rest to gobbling down whatever food she can find, to delivering the worst news with clinical precision, I find myself along for the ride; gripping the armrests at times, but still there.
This book is a quick trip through a strange and fascinating landscape that most of us will never know on an intimate basis. Thank goodness. And thank goodness there are people like her doing this work. -Eric S.
Thank you to the publisher for the ARC in exchange for our honest review.
At times, I felt like I must surely perish. Immediately. Because the delicate mesh of vessels and bone and dura and blood in and around our fragile brains seems designed to fail. Yet most people make it. At least until something else gets them. And as the author soldiers on, from 72-hour on-call periods to sporadic rest to gobbling down whatever food she can find, to delivering the worst news with clinical precision, I find myself along for the ride; gripping the armrests at times, but still there.
This book is a quick trip through a strange and fascinating landscape that most of us will never know on an intimate basis. Thank goodness. And thank goodness there are people like her doing this work. -Eric S.
Thank you to the publisher for the ARC in exchange for our honest review.
Review of advance copy received from Publisher
Well this was frickin' delightful. Dr. Barbara Lazio provides a look into our heads (literally) with her hilarious and poignant Off the top of My Head. Yes, the title is an indicator of the overall tone.
Lazio puts together a collection of essays about life, parenting, and, of course, brain surgery. I find that with memoirs an author really needs to know what their tone is going to be and stick to it. Lazio has no problems on this front. I laughed (in my head) at least every other page. (Side note: I almost never laugh out loud when I read something funny. Hear it, yes. Read, no. I'm told that makes me strange.) She consistently gives off the "aw, shucks" vibe, which is a hallmark of non-sociopathic doctors. However, I am married to a nurse so I am obligated at this point to say that nurses do all the hard work.
The narrative is a quick read, and while the stories could easily stand alone as articles, they all fit together in book form. If you want to read a fun, humorous, and sad at times story from a doctor who is a gift from God (without actually thinking she is a gift from God), then this is the book for you.
(This book was provided as a review copy by Sourcebooks.)
Lazio puts together a collection of essays about life, parenting, and, of course, brain surgery. I find that with memoirs an author really needs to know what their tone is going to be and stick to it. Lazio has no problems on this front. I laughed (in my head) at least every other page. (Side note: I almost never laugh out loud when I read something funny. Hear it, yes. Read, no. I'm told that makes me strange.) She consistently gives off the "aw, shucks" vibe, which is a hallmark of non-sociopathic doctors. However, I am married to a nurse so I am obligated at this point to say that nurses do all the hard work.
The narrative is a quick read, and while the stories could easily stand alone as articles, they all fit together in book form. If you want to read a fun, humorous, and sad at times story from a doctor who is a gift from God (without actually thinking she is a gift from God), then this is the book for you.
(This book was provided as a review copy by Sourcebooks.)
September 27, 2026
Well every now and again you come across a book that is written in a voice that you just don't like. I really didn't like the humor that this author had. It simply wasn't for me. Many people like it as you can see by the other reviews, but for me? Nope.
September 25, 2026
“…I am an everyday brain surgeon working in the community, and my world revolves around my patients. While I’m not the academic powerhouse neurosurgeon, with a book called something like Golden Hands Blessed by the Gods, I put my heart and soul into being the one who shows up on a person’s darkest day.”
“You might believe that the journal entries of a brain surgeon would be more erudite and cerebral, like this AI generated entry: ‘Within the delicate architecture of the skull lies the universe of a human being. Each tremor of a hand and every precise incision safeguards the very essence of thought, memory, and life itself. The stakes are always infinite.’ I like pretty words, but come on AI brain surgeon, get over yourself!”
“While I waited for Dee to wake up, I enjoyed a graham cracker/peanut butter/Diet Shasta trifecta.”
“There were choking sounds, followed by some gasps, followed by an announcement. ‘If there is a doctor on board, please press your call button.’ I was on my way to Florida to visit the in-laws with Matt and our two toddlers. I was seated with the girls, focused on distributing goldfish crackers, and queuing up videos. I was in vacation mode, wearing my traveling mom face, and had forgotten I was a doctor for a moment. Matt called the flight attendant over. As I looked at him, puzzled, he shouted ‘My wife is a doctor!’ A young man in the aisle seat several rows ahead of us had slumped over and was shaking, a generalized tonic-clinic seizure. Snapping out of my vacation zone, I shoved a toddler into Matt’s lap, brushed goldfish crumbs off my faded jeans, and rushed up the aisle to check things out.”
“One memorable freshly post-pandemic weekend, the theme was impossible ethical conundrums tainted by methamphetamine.”
“There is something exhilarating about a great save, getting a team together to do something difficult and complicated to help a patient we thought couldn’t be helped. Big cases can be demanding and scary, so who can blame a neurosurgeon for wanting a little pat on the back? The more neurosurgeons gathered though, the more ‘fish stories’ we hear, extravagant, hard to believe tales. One of my professors hated going to national neurosurgery conferences, saying ‘It’s just a bunch of guys with little dicks getting on a stage to tell you how big their dick is.’”
I admittedly went into this book biased in a good way towards Dr. Lazio. I work in one of the community hospitals that she spent a portion of her career at, and remember her for her unimpeachable clinical competence, her especially caring bedside manner, and for the fact that she was never scary for the nurses to approach (although I’ve only ever worked day shift there and would like to mark myself safe from ever having paged her in the middle of the night to request an order for an enema). But bias aside, I found Dr. Lazio’s accounts of straddling family life/wife and motherhood and a demanding career to be entertaining, refreshing, surprisingly relatable, and written with an impressive amount of humility, not at all what I would expect from someone of her stature (which I think was one of her main points in publishing this). While wouldn’t have minded some more inward-focused essays to better round her out as a person for the reader, overall, I found this to be an engaging and thought-provoking read about an “everyday brain surgeon” and the patients she serves.
“You might believe that the journal entries of a brain surgeon would be more erudite and cerebral, like this AI generated entry: ‘Within the delicate architecture of the skull lies the universe of a human being. Each tremor of a hand and every precise incision safeguards the very essence of thought, memory, and life itself. The stakes are always infinite.’ I like pretty words, but come on AI brain surgeon, get over yourself!”
“While I waited for Dee to wake up, I enjoyed a graham cracker/peanut butter/Diet Shasta trifecta.”
“There were choking sounds, followed by some gasps, followed by an announcement. ‘If there is a doctor on board, please press your call button.’ I was on my way to Florida to visit the in-laws with Matt and our two toddlers. I was seated with the girls, focused on distributing goldfish crackers, and queuing up videos. I was in vacation mode, wearing my traveling mom face, and had forgotten I was a doctor for a moment. Matt called the flight attendant over. As I looked at him, puzzled, he shouted ‘My wife is a doctor!’ A young man in the aisle seat several rows ahead of us had slumped over and was shaking, a generalized tonic-clinic seizure. Snapping out of my vacation zone, I shoved a toddler into Matt’s lap, brushed goldfish crumbs off my faded jeans, and rushed up the aisle to check things out.”
“One memorable freshly post-pandemic weekend, the theme was impossible ethical conundrums tainted by methamphetamine.”
“There is something exhilarating about a great save, getting a team together to do something difficult and complicated to help a patient we thought couldn’t be helped. Big cases can be demanding and scary, so who can blame a neurosurgeon for wanting a little pat on the back? The more neurosurgeons gathered though, the more ‘fish stories’ we hear, extravagant, hard to believe tales. One of my professors hated going to national neurosurgery conferences, saying ‘It’s just a bunch of guys with little dicks getting on a stage to tell you how big their dick is.’”
I admittedly went into this book biased in a good way towards Dr. Lazio. I work in one of the community hospitals that she spent a portion of her career at, and remember her for her unimpeachable clinical competence, her especially caring bedside manner, and for the fact that she was never scary for the nurses to approach (although I’ve only ever worked day shift there and would like to mark myself safe from ever having paged her in the middle of the night to request an order for an enema). But bias aside, I found Dr. Lazio’s accounts of straddling family life/wife and motherhood and a demanding career to be entertaining, refreshing, surprisingly relatable, and written with an impressive amount of humility, not at all what I would expect from someone of her stature (which I think was one of her main points in publishing this). While wouldn’t have minded some more inward-focused essays to better round her out as a person for the reader, overall, I found this to be an engaging and thought-provoking read about an “everyday brain surgeon” and the patients she serves.
Want to Read
July 24, 2026Thank you so much to Sourcebooks and NetGalley for a DigitalARC of this often funny and quite intriguing autobiographical collection of short essays.
Obviously a neurosurgeon's life isn't all brain surgery - there's a lot of spinal surgery also. Which often brings a tremendous amount of relief from pain. There's quite a bit of cancer and tumors both benign and malignant. And we learn about her supportive husband and lovely daughters.
She sprinkles quite a bit of humor throughout. It's interesting - I recently read 99 Ways to Die and How to Avoid Them by Ashley Alker, MD and I get the feeling that if you are a woman and make it through all the rigors of medical training to become a respected, top-tier surgeon or doctor - you are going to need quite a bit of humor and a healthy dose of snark. Alker is an ER doctor who also sees a fair share of trauma involving the brain and spine.
All in all - a great reminder to NOT climb those teetering ladders in the fall no matter how often your significant other begs you to get out the decorations. Find somewhere to store them that does not involve climbing. Plus - your brain shrinks as you get older so bleeding from a traumatic brain injury that might have killed you earlier now has a little bit of leeway. But if you fall and hit your head, please go to the doctor. Also - drugs and alcohol do bad things to your brain and body. And don't give up hope.
Obviously a neurosurgeon's life isn't all brain surgery - there's a lot of spinal surgery also. Which often brings a tremendous amount of relief from pain. There's quite a bit of cancer and tumors both benign and malignant. And we learn about her supportive husband and lovely daughters.
She sprinkles quite a bit of humor throughout. It's interesting - I recently read 99 Ways to Die and How to Avoid Them by Ashley Alker, MD and I get the feeling that if you are a woman and make it through all the rigors of medical training to become a respected, top-tier surgeon or doctor - you are going to need quite a bit of humor and a healthy dose of snark. Alker is an ER doctor who also sees a fair share of trauma involving the brain and spine.
All in all - a great reminder to NOT climb those teetering ladders in the fall no matter how often your significant other begs you to get out the decorations. Find somewhere to store them that does not involve climbing. Plus - your brain shrinks as you get older so bleeding from a traumatic brain injury that might have killed you earlier now has a little bit of leeway. But if you fall and hit your head, please go to the doctor. Also - drugs and alcohol do bad things to your brain and body. And don't give up hope.
October 8, 2026
Barbara Lazio is an actual brain surgeon. You would think that someone of that caliber would be entirely serious and rigid, but this neurosurgeon proves that stereotype wrong. She comes in hot with some great stories that will make you laugh. She peels back the curtain of the operating room, giving us insight into what actually goes on. It's insightful, but also very funny and at times a bit sad. I'm glad she can find some humor because the emotional toll of working with the people that NEED brain surgery sounds so difficult.
October 7, 2026
I gobbled this book up in less than two days. I adore the realness and humor that is intertwined with some of the most emotionally difficult situations we face in healthcare. Great work Dr. Lazio, and I hope you have another one in the works!
Review of advance copy received from Publisher
review upcoming
August 23, 2026
Off the Top of My Head is an interesting and humorous look inside the operating room, offering a fascinating glimpse into neurosurgery while never losing sight of the humanity behind the medicine. I enjoyed the stories, the humor, and the reminder that even in such a serious setting, there is so much heart and humanity.
#OfftheTopofMyHead #NetGalley
#OfftheTopofMyHead #NetGalley
September 23, 2026
Enjoyed this on audio. As with most medical memoirs, this was packed with fascinating medical conditions and left me once again with admiration for people who work in health care.
As the cover is 😍
As the cover is 😍
September 30, 2026
Related with candour and wit, neurosurgeon Barbara Lazio invites us into her professional and personal life in a series of entertaining and fascinating essays in Off the Top of My Head.
I really enjoyed the personable tone and accessible writing in this short but lively memoir. Lazio’s humour is self-deprecating in the main, and there is very little medical jargon.
Lazio’s medical anecdotes are drawn from her career of nearly three decades working primarily as an emergency neurosurgeon among hospitals in small communities and her private clinical practice. With all the usual disclaimers in place, Lazio centres the patient as much as their treatment which varies from boring holes in someone’s skull after a fall from a ladder, resecting a grapefruit sized brain tumour from a 50 year-old woman on the verge of being committed to a memory care facility, to freeing the compressed spinal cord of a hardworking lumberjack. The stories are interesting, the patients relatable, and while she focuses largely on the successes, Lazio also humbly acknowledges the failures, and the limits, of her profession.
Surgeons, especially brain surgeons, have a reputation for a lack of humility and Lazio gently pokes fun at some of her more ego-driven colleagues. She believes that ‘being an every day person helps [her] to be a better everyday brain surgeon’, a refreshing perspective in a profession where confidence is essential but arrogance is common. Though she makes light of it, Lazio’s career has also required considerable personal sacrifice, and she candidly explores the challenges of balancing physically and emotionally demanding work with her own needs and those of her family.
Funny, poignant and insightful, Off the Top of My Head offers an engaging glimpse into the world of neurosurgery, reminding us that behind the extraordinary science and technical skill are ordinary people, both treating and being treated. It’s a wonderful read, and if I ever need a neurosurgeon, I hope it is someone just like Barbara Lazio.
I really enjoyed the personable tone and accessible writing in this short but lively memoir. Lazio’s humour is self-deprecating in the main, and there is very little medical jargon.
Lazio’s medical anecdotes are drawn from her career of nearly three decades working primarily as an emergency neurosurgeon among hospitals in small communities and her private clinical practice. With all the usual disclaimers in place, Lazio centres the patient as much as their treatment which varies from boring holes in someone’s skull after a fall from a ladder, resecting a grapefruit sized brain tumour from a 50 year-old woman on the verge of being committed to a memory care facility, to freeing the compressed spinal cord of a hardworking lumberjack. The stories are interesting, the patients relatable, and while she focuses largely on the successes, Lazio also humbly acknowledges the failures, and the limits, of her profession.
Surgeons, especially brain surgeons, have a reputation for a lack of humility and Lazio gently pokes fun at some of her more ego-driven colleagues. She believes that ‘being an every day person helps [her] to be a better everyday brain surgeon’, a refreshing perspective in a profession where confidence is essential but arrogance is common. Though she makes light of it, Lazio’s career has also required considerable personal sacrifice, and she candidly explores the challenges of balancing physically and emotionally demanding work with her own needs and those of her family.
Funny, poignant and insightful, Off the Top of My Head offers an engaging glimpse into the world of neurosurgery, reminding us that behind the extraordinary science and technical skill are ordinary people, both treating and being treated. It’s a wonderful read, and if I ever need a neurosurgeon, I hope it is someone just like Barbara Lazio.
September 22, 2026
I have a unique perspective on brain injuries and neuro docs, but this set of essays was subjectively entertaining, smart, and witty!
October 10, 2026
I honestly didn’t know what to expect but it certainly wasn’t this!
I went into Off the Top of My Head expecting something quite different, but I found myself thoroughly enjoying it. Dr. Barbara Lazio offers a fascinating glimpse into the world of neurosurgery. The messy, sometimes bizarre, often funny, and deeply human side.
What I particularly enjoyed was the balance between the medical side of things and the stories of the people behind the diagnoses. There’s plenty to make you wince, moments that make you laugh, and others that remind you just how fragile life can be.
The humour, even though it might not be for everyone, brings a sense of humanity to a profession where life and death are often separated by the smallest of margins.
A very enjoyable read that surprised me in the best possible way.
Thanks to NetGalley and the punisher for the ARC.
I went into Off the Top of My Head expecting something quite different, but I found myself thoroughly enjoying it. Dr. Barbara Lazio offers a fascinating glimpse into the world of neurosurgery. The messy, sometimes bizarre, often funny, and deeply human side.
What I particularly enjoyed was the balance between the medical side of things and the stories of the people behind the diagnoses. There’s plenty to make you wince, moments that make you laugh, and others that remind you just how fragile life can be.
The humour, even though it might not be for everyone, brings a sense of humanity to a profession where life and death are often separated by the smallest of margins.
A very enjoyable read that surprised me in the best possible way.
Thanks to NetGalley and the punisher for the ARC.
October 17, 2026
fascinating read
I loved this book from beginning to end. She tells fascinating stories about difficult procedures together with a fabulous sense of humor.
Loved it!
I loved this book from beginning to end. She tells fascinating stories about difficult procedures together with a fabulous sense of humor.
Loved it!
October 7, 2026
Very well written! So interesting to read about these stories! The short stories kept me hooked and intrigued.
Review of advance copy received from NetGalley
Thank you NetGalley for the ARC.
4/5.
I like the cover. I went in to this knowing it was a collection of stories from Dr Barbara's life and it was interesting. I just wish there were more details provided. I know she couldn't share information about the patients because of patient confidentiality reasons but I think it would've been nice to get stories about the other medical professionals she worked with as well. Maybe more details about surgeries or the ORs themselves (idk I might be over thinking this).
Similarly, I would've liked some kind of background story that tied the book together more nicely than just feeling like I'm reading a bunch of disconnected stories that happen in an unknown time/year/month. But that's more of me thing--wanting a clearer timeline. I haven't read anything else from her so I don't know anything about her, so for me, I feel like I'm just dropped into her life and there's a lot of talk about moving houses and gardening but the patients pass by in a blur. It's an interesting set of stories I just would like more details.
Also, sorry, but why the AI?
4/5.
I like the cover. I went in to this knowing it was a collection of stories from Dr Barbara's life and it was interesting. I just wish there were more details provided. I know she couldn't share information about the patients because of patient confidentiality reasons but I think it would've been nice to get stories about the other medical professionals she worked with as well. Maybe more details about surgeries or the ORs themselves (idk I might be over thinking this).
Similarly, I would've liked some kind of background story that tied the book together more nicely than just feeling like I'm reading a bunch of disconnected stories that happen in an unknown time/year/month. But that's more of me thing--wanting a clearer timeline. I haven't read anything else from her so I don't know anything about her, so for me, I feel like I'm just dropped into her life and there's a lot of talk about moving houses and gardening but the patients pass by in a blur. It's an interesting set of stories I just would like more details.
Also, sorry, but why the AI?
This entire review has been hidden because of spoilers.
Review of advance copy received from Publisher
A book of well-written vignettes about a neurosurgeon's life, both personal and about the cases she dealt with. Well done and easy to read, but it could have had more to it. Our book club enjoyed this book and liked her sense of humor. It worked well for a weekly reading since each chapter was a different story, so people would not miss out if they could come for a week. There were sad chapters and funny chapters, and it was the type of book that made you care about people who you've never met. Overall, one of the better book club books we read this year.
Review of advance copy received from NetGalley
Well, I wasn't sure a book about a neurosurgeon would be a ton of fun to read, but this one was. Of course still sad things happened, but this was a delightful collection of stories illustrating life and medical practice and I thoroughly enjoyed it. This author is a very good writer! I really like the programs that support and encourage doctors to write.
Review of advance copy received from Edelweiss+
I downloaded this from Edelweiss immediately because I love memoirs from doctors! This is a great one if you have never read one before. Lazio is funny, and the essays are both short and meaningful. It is also a quick read overall. I recommend!
November 5, 2026
Frankly, this book did very little for me. I didn't find it particularly engaging, and despite the humor it may have intended to convey, I didn't find anything genuinely funny. Overall, it just wasn't a book I enjoyed.
Review of advance copy received from Publisher
3.7
A quick read. Well written with humor. I tend to like more detailed or grittier type medical books, so I didn't love this, but it's more of a me thing and not the book thing.
A quick read. Well written with humor. I tend to like more detailed or grittier type medical books, so I didn't love this, but it's more of a me thing and not the book thing.
September 24, 2026
Lots of very interesting stories from inside the operating room.
September 25, 2026
Shocking what can happen to a brain.
November 3, 2026
I really enjoyed this book. This book is not just well written but funny.
November 13, 2026
Super good book. Restoring my faith in modern technology and doctors.
Review of advance copy received from NetGalley
Thanks to NetGalley and the publisher for providing a free digital review copy. All opinions are my own.
This was a fascinating read and very well written. What drew me to the book was the opportunity to glimpse the day-to-day life of a neurosurgeon, something most people will (hopefully) never experience firsthand. I especially enjoyed the behind-the-scenes look at the challenges, responsibilities and decisions that come with working in such a high-stakes field.
This was a fascinating read and very well written. What drew me to the book was the opportunity to glimpse the day-to-day life of a neurosurgeon, something most people will (hopefully) never experience firsthand. I especially enjoyed the behind-the-scenes look at the challenges, responsibilities and decisions that come with working in such a high-stakes field.
Review of advance copy received from NetGalley
This was not at all what I expected. I was on a roller coaster of emotions and the author left me with so much admiration for working moms and in a very taxing admirable field. I laughed more than I expected and they were parts that left me quite sullen. It will definitely leave people thinking about this world and our place in it. I highly recommend it. #NetGalley Pub Date: Sep 22 2026
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