In reflecting upon my life as a neurosurgeon, perhaps the most salient feature is that period of history involved. Trained by men who studied under Harvey Cushing, considered the father of neurological surgery, we, as early third-generation neurosurgeons, were held to those rigid standards of academic achievement and physical endurance typical of that time.The reader first identifies with the young child who dreams of becoming a doctor, and then sets out on that long path. He then re-lives the experiences of the student of medicine, and later the rigorous demands placed upon the surgeon-in-training. During the later descriptions of the private practice of brain and spinal surgery, the book transitions into an educational experience. It presents to the reader a multitude of neurological disorders requiring surgical treatment, the relevant surgical anatomy and the operative techniques involved. Often interjected are the intangibles of surgical judgment and philosophy when confronting those in pain or critically ill.Of equal importance were the major scientific advancements which occurred during that period of medical history. No longer did we have to bore a hole in the skull, or inject noxious materials into the head or spinal canal to verify a diagnosis. Rather, we had been privileged to enjoy the development of such remarkable machines as the ultrasound, CAT, and MRI. Descriptions of these devices, among others, and their impact on medical practice should prove interesting to the inquisitive reader. After 21 years in practice, and probably at the height of my career as a surgeon, I contracted hepatitis B subsequent to an accidental needle puncture in the operating room. Forced to lay down the scalpel, I turned to my second childhood dream, cattle ranching, as an alternative vocation. This then becomes a secondary focus of the book. A medical colleague, after learning of my book, expressed an interest in learning the common denominator driving a man to both neurosurgery and ranching. One can summarize with the word, "counterpoise." I had always strived to achieve a balance between the in-hospital, academic, precision-oriented work of the neurosurgeon and the outdoor, physically-demanding life of a rancher― consummating the total American dream.Analogous to surgery I have always enjoyed using my hands in the shop. Throughout the book sections have been devoted to various aspects of woodworking, and an effort not only to share my enthusiasm but also to expose underlying problems and pitfalls; challenges I have encountered in striving to become an artisan of fine furniture.The practice of medicine has undergone significant change during my lifetime. Not only have I witnessed a burgeoning, unsustainable increase in the cost of healthcare, but also major changes in the way in which medicine is being practiced in the new millennium. Having been a proud product of the "Lucky Few" generation, born between the years 1929 and 1945, I am rightfully able to compare today's practice of medicine with those of the latter half of the 20th century.
