05/15/15
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Review: Makeup by Robert McCammon

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A helluva feast, like ordering a sirloin and getting a filet mignon…

 

This is one of those stories that’s such a simple concept you have to ask yourself—if you’re a writer like me—why you didn’t think of it. Simple in concept, but masterful in execution. This is an amazingly well done short story.
The writing harkens back to something one might have read in Amzaing Stories or an Isaac Asimov mystery mag in the 1950’s. I was immediately taken back to my childhod, although it’s not a children’s story. It’s about a bottom feeder who steels a makeup case, quite possibly the wrongest makeup case ever made.
The setting is perfect, the characters evoked with a fidelity that had me both seeing and hearing them so thoroughly it was as if I was in the scene myself. When the author told me Marco was three hundred pounds, I already knew it. Not because he had alluded to it, but because I had seen it, because of course a man like him had to be three hundred pounds. Marvelous writing. Simply marvelous.

There are many, many memorable lines in this tale, like “the towering height of him came up like a released spring” and “Marco’s face was the color of spoiled cheese.” You’ll have to read the story to see the others, of which there are so many. When I bought this I thought I was sitting down at the buffet, as it turned out I was seated at a full fledged feast. Delicious.
If you have never read McCammon, this is a great intro. Great writing always leaves you wanting more and after this, you’ll want more, no doubt.
Highly recommended. Five stars. An awesome and fun read.

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05/12/15
OrganTakers

The Organ Takers

The Organ Takers

OrganTakers

Click the image to buy The Organ Takers

Richard Van Anderson paces the narrative so well, the reader’s pulse rises and falls with the action…

I just finished reading THE ORGAN TAKERS by Richard Van Anderson. This is a very good novel, a surgical thriller as the author terms it. It’s a suspenseful tale of good surgeons gone bad while trafficking in the illicit sale of human organs. This is a long review, with several points to make, and most of you probably won’t read the whole thing so I’ll give it away right here: READ THIS BOOK. You won’t regret it and there’s a better than even chance you will have found a new author to add to your must read list.

This is a story that, well told, could contain a great deal of human drama (read that as moral dilemmas, edge-of-your-seat personal conflicts, life and death decisions, heart-breaking loss, and old fashioned revenge-seeking). Anderson is more than up to the task. At every opportunity he ups the ante, whether it be a surgeon making an incision in the bowels of an illicit OR (with his spell-binding narative—not boring and easily understandable to lay folks) or a man on the run from the cops, the Russian mafia, and the homeboys—all at once. Indeed, his realization of these many and desparate individuals is so believable one wonders how much time he spent in the hood, or homeless on the streets of New York, or riding around with the Russian mob.

Anderson is himself a surgeon and his insights on surgical technique and medical knowledge are thus not surprising. What is surprising is his ability to work this knowledge seamlessly into a scene. As a surgeon myself, and a fiction writer as well, I’ve read—or more truthfully attempted to read—a great many “novels” written by physicians. Physicians are, almost to a person, bright folks, and many, if not most, have a story to tell. Unfortunately most don’t have the abilty to tell it themselves, which doesn’t seem to stop them from trying. It’s as if they believe writing is as easy as picking up a pen and laying some ink on the page. Well folks, it ain’t.

A digression: Two folks are at a party. One, a surgeon, asks the other what he does for a living.

“I’m a novelist,” the second fellow says.

“Wow,” says the surgeon, “what a coincidence. When I retire, I intend to write a novel.”

“Oh,” says the novelist, “that is a coincidence, because when I retire I intend to practice surgery.”

Preposterous you say? Yeah, probably. But the thing is, it’s just as preposterous in the other direction. There’s no way the average doc, who has devoted his or her waking time over the years to the myriad intracacies of medicine, can suddenly begin to write with any authority or competency.

To do so, one has to spend hours at the keyboard—hours summing to months and years in the long run. One million words plus on the page. Short stories, novels half written, novels thrown in the drawer that will never see the light of day. Long nights and longer early mornings cooped up alone with just you and your keyboard or yellow legal pad to pass the hours. And enough rejections—this from personal experience—to wallpaper a moderate sized home office (all four walls). This requires a dedication most people in general—and most physicians in particular—don’t possess. A bright individual does not a writer make. Only time and talent and persistence do.

Anderson has an MFA in creative writing, which of course isn’t necessary to be a published author. But it does indicate more than a passing commitment to the cause, a dedication to the written word if you will. A suggestion he might just be worth a read. So I picked him up and I’m very happy I did.

He’s the real thing all right.

In THE ORGAN TAKERS, as well as his previous short story THE FINAL PUSH, Anderson aptly demonstrates he knows how to tell a story. He doesn’t just recount a scene, he paces the narrative so well the reader’s pulse rises and falls with the action. His descriptions are so spot on the reader never doubts their veracity (as if any of us have ever run down a dark subway tunnel or stood in a lab surrounded on all sides by human organs pulsing and writhing in artificial baths). He evokes human emotions the way a surgeon parts the layers of a wound: with finese and certainty. This is writing folks. This is talent with the written word. This is the real thing.

He’s a little rough in the first one hundred pages, until the story reaches a critical mass or finds its own level if you like (picture water spilling over a cofferdam—it’s unstoppable). There were a few passages that suggest he hasn’t quite found the right mix of medical jargon and lay description, but these are few and never detracted from the story, never took me—the reader—out of the moment. But I’m a surgeon and others will have to decide this for themselves. I’m betting it won’t be a problem. 

As a bonus, there is a glossary of medical terms up at his website. It isn’t necessary for reading the novel, but it’s well worth reading if you’ve ever had any interest in things surgical.

My overall sense of this book was John Grisham meets Robin Cook. It was a bit formulaic in places, and I did get tired of being told what the main character’s goal was at any given moment—the two reasons I give it four stars instead of five. But the sense of drama was fabulous just the same, and the suspense never wavered down to the last paragraph.

I highly recommend this novel. I will read his next work and await it with high expectations. For a first novel, this read a helluva lot like a fifth novel—which is high praise in my book.

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04/19/15
Endless Novella

An Endless Array of Broken Men

Endless Novella

Click book image to go to Amazon page

 

An Endless Array of Broken Men
A novella of Civil War surgery by Edison McDaniels

“It requires a man with a steel nerve and a case hardened heart to be a Army Surgeon…”
—An anonymous soldier of The Civil War

For Josiah Boyd, hell is twenty-four sleepless hours, every one of them scalpel in hand, standing under a cross in a nameless church atop a dusty hill after a pointless battle. For too many good men, this is where the world ends.

The surgeons in this place work at their unpleasant task with a fever matched only by the fervor of those that have inflicted their wounds. This camp of wounded is filled with men of both sides and the surgeons use these men, Johnny Reb and Billy Yank alike, making no distinction as to the color of a man’s uniform—the life-blood being all the same. The men wait their turn with an eerie patience, as if their fate has already been decided and it is the duty of those present in this time and place to carry it out. Arms and legs are parted from each in turn and the pile of disarticulated flesh grows at a hideous pace—eight or ten feet high. The men move on and off the tables with nary a word, except for the occasional groan that can’t be suppressed. Indeed, there is little to be said at such times, each participant in the drama knows his place and the universal language of blood speaks for all.

On this sleepless morning, Josiah Boyd is the embodiment of exhaustion. The blood and sinew that soil his front apron are now a full day old, and he hasn’t had so much as a latrine break in hours. The muck on the altar floor is two parts blood, one part shit from exploded bowels, and one part tobacco juice; Boyd spits frequently. The mothy taste of the chewed tobacco obscures the overwhelming stench of broken bodies and rotted flesh, allowing him to keep working in this seething hell.

Except for the ever present hum of flies (they are everywhere, a constant distress), it is mostly quiet; no sounds of battle breaking the dawn stillness, only an occasional random shot. Outside the church-turned-hospital, those who have survived the night await their turn at the surgeon’s table. They are a quieter lot now, having seen the two extremities of their fate in those that have gone before them.

They will live or die—it is beyond their making now…

This novella is available for 99¢ right now for Amazon Kindle

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04/19/15
MatriarchCover2

The Matriarch of Ruins

Coming this summer from Northampton House Press, the five star follow-up novel to Not One Among Them Whole, the acclaimed story of the surgeons at the battle of Gettysburg…

MatriarchCover2

 

Husbands and wives.

Sons and daughters.

Soldiers and surgeons.

Men and slaves.

Widows and ghosts.

The living and the dead come alive in this epic novel of a widow struggling to keep her family together amid the carnage of the Battle of Gettysburg—and the memories of her dead husband. A story of ordinary folks caught in the maelstrom of an extraordinary time.

It is 1863 and the war has come home to the Gamble farm in Southern Pennsylvania. With her husband buried under the willow tree in the back yard, and only four months in the ground, the widow Purdy Gamble must cope with losing him all over again when a rebel surgeon conscripts her farm—and Purdy’s growing respect despite herself. Hannah Gamble Griel, Purdy’s daughter, disappears into the chaos of war to chase her own ghosts, both imaginary and real. And then there are the twins Loli and Coal, just fourteen. One, struck dumb by a mule kick at age five, will find a disturbing peace amid the flames of war. The other will twice save a man’s life, unburying a horrid family secret in the process—a secret at once as alive as warm flesh and as dead as cold bones mouldering under the earth. 

The Matriarch of Ruins is a haunting story of lost love, moral dilemmas, and psychological traumas amid the ruins of war, by the author of Not One Among Them Whole, which told the story of the surgeons at Gettysburg. This is a vivid, suspenseful tale, told with heart-breaking empathy and stunning detail.

Available this summer for the Amazon Kindle & soon in paperback as well. From Northampton House Press.

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03/24/15
back is killing me

9 Reasons Back Surgery Might Help

9 Reasons Your Back Pain Might Improve With Surgery—Or Not

back is killing me

Back pain is a fact of life—if you are a human being (and presumably if you are reading this you are) sooner or later you will have back pain. That’s the bad news.

The good news is that for most of us, it will run its course and we will be none the worse for it. Most of us will have a single bout, perhaps two, lasting a few hours to several days, and that will be it. Some of us will have more, and sometimes that will be recurring pain (every few months or once every few years as an example), or chronic low level discomfort that’s just enough to interfere with life’s enjoyment but not at all incapacitating.

Others will be saddled with incapacitating pain, though even then most folks will find a happy medium and be able to function with certain accommodations, as with any other chronic illness (diabetes, heart disease, kidney failure) or condition (rheumatoid or osteoarthritis, fibromyalgia, emphysema).

But for an unlucky few, and unfortunately the masses of people on this earth mean the numbers work out to hundreds of thousands each year, back pain just might be an indicator for back surgery. This sort of back pain typically doesn’t get better without surgery—or at least doesn’t get better quickly enough for we busy humans. That’s the bad news.

The good news is that for these few, back surgery is overwhelmingly successful.

Here are nine reasons your back pain might need to be treated with surgery.

1. If it’s associated with leg pain.

Back pain that’s associated with leg pain may indicate a pinched nerve. Although even then most of these won’t need surgery, if the pain becomes unrelenting or lasts more than two months, see a physician. This kind of pain generally responds well to surgery, especially if the leg pain is worse than the back pain.

In the overall scheme of things, back pain that is purely and truly back pain is rarely an indication for surgery, though there are always exceptions. There are hundreds of ligaments, bones, and nerves in the back and any one (or group) of them can be a pain generator. This sort of pain might be from a stress fracture, a pulled ligament, a small muscle tear, or any of a thousand other sources—most of little consequence in the long run and most of which will heal and resolve on their own, though it will almost always take longer than you would like or expect.

2. If it’s off the midline to one side or the other.

Back pain that’s off the midline may indicate a pinched nerve or arthritic joint on one side of the back. If it’s always in the same place, it might respond to fusing the joint, deadening the nerve, or decompressing (unpinching) a pinched nerve.

3. If it’s always in the same place and does not roam around.

Pain that will respond to surgery does not roam around. The intensity may vary, and frequently does, but the location of the pain is a constant. Usually it is one sided and off the midline of the spine.

Roaming back pain rarely responds to back surgery and seems more likely related to muscle strain or spasm, or perhaps has no relation to the back at all. 

4. If it’s associated with leg weakness as opposed to pain or numbness.

One of the most frequent back problems is a pinched nerve, and while these don’t always require surgery they certainly can. Leg weakness with back pain is one indication of a pinched nerve and generally indicates that surgery should be strongly considered, especially if it is severe or not getting better with time. In general, if weakness is present, see a physician sooner rather than later.

5. If it’s been present for more than 6-8 weeks and doesn’t seem to be getting better.

Most back pain is self-limited and improves even without therapy, though it takes time since something is wrong and that something takes time to heal. Sometimes pain itself is a diagnostic tool though, and pain that isn’t obviously improving after two months is such a tool and should be thoroughly investigated. 

By the same token, chronic back pain that has been present for more than 2-3 years and is stable is generally unlikely to have a surgically treatable cause, even if severe at times. However, such pain should be thoroughly investigated at some point (at least once) since exceptions do exist.

6. If it’s always present in the morning and does not improve as the day advances.

Back pain that is worse in the morning after just getting out of bed and improves with activity rarely responds to surgical intervention. This is often age related. There’s a reason professional athletes retire around age forty. 

On the other hand, if you have back pain from the time you get up and it consistently does not improve (or even worsens) with activity, you should see a physician if it persists over weeks or months.

7. If the pain increases with walking—until you MUST sit down or else.

Pain that consistently worsens with activity to the point of intolerability, especially if just sitting down for a few minutes improves or alleviates it (sitting for five or ten minutes, not an hour or two), may indicate narrowing in the spinal canal—a condition which responds very well to surgery.

8. If the pain is associated with trouble walking—and you can improve the walking by leaning over a shopping cart.

This is known as a positive shopping cart sign and is so suggestive of a problem that can be fixed that if you have noticed this you should discuss it with your physician. Note that the trouble walking may be pain or weakness or both. Sometimes patients complain of “rubbery legs.”

Typically a person notices these symptoms when grocery shopping—they have to both push the cart and lean forward over it in order to shop. Just hanging on to the cart has no effect, the uncomfortable pain persists. Typically, those with a surgically treatable problem get great relief leaning over the cart as they move around the store. In fact, leaning over the cart becomes a must and is the difference between being able to do their own shopping or not being able to shop at all.

As the severity of the condition progresses, even leaning over the cart becomes ineffective and patients stop doing their own shopping. They become homebound.

9. If the “back pain” is really buttocks and leg pain.

In general, the more leg pain one has, the more likely their problem is to be treatable with surgery. Surgery for back pain alone is, in general, a disappointing experience (except in cases of fracture, tumor, infection, or perhaps scoliosis), but back pain associated with leg pain is a different story.

To understand why, one has to consider the generalized nature of back pain, which makes it difficult to narrow down an exact cause and thus limits what surgery can do. However, the occurrence of leg pain often indicates a pinched nerve and since each nerve has a stereotypic course, the location of the leg pain often marks which nerve is pinched—and hence the location of the back problem—with more or less precision. Surgery can then unpinch, or decompress, the nerve.

Neurosurgery101—TheBlog. About life’s harder or more interesting moments…

Search Edison McDaniels at Amazon for great fiction—Ordinary folks in Extraordinary situations! Intense. Available on Kindle.

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03/5/15
Killing King

Saving King

Saving King

Click the image to go to the Amazon Kindle page to purchase this work.

A seminal work on a moment that changed the world. Stunning.

The Rev. Dr. King was shot at 6:01 pm on April 4th, 1968. He was pronounced dead 64 minutes later, after a struggle that included an emergent tracheostomy and open heart massage. In Saving King, McDaniels dramatically recreates these events in graphic detail, providing an almost minute by minute account of the first responders at the scene, followed by the action as it appears to have taken place in the emergency room. This account is based on a close reading of eyewitness reports, King’s autopsy, and the 1978 House Select Committee on Assassinations’ investigation into the MLK assassination.

Saving King is a clever work of creative nonfiction which not only dramatizes the action in heartbreaking detail, it showcases the US trauma system at work in 1968—and in 2013. One of the most interesting portions of the monograph (which runs about 8,000 words and is an intense read by any measure) comes near the end, when McDaniels goes the extra mile and shows how such a grievous injury might be handled today.

In fact, one of the things Saving King does so well is to inform the lay public about the US trauma system. In this regard it is informative and educational without seeming to be. It reads more like a novella than a monograph, and very definitely has a story to tell.

The story opens with King on the balcony of the Lorraine Motel one minute before he is shot, and doesn’t end until he is pronounced dead 65 minutes later. Along the way, we watch as the first responders (a modern term) are overwhelmed by the bleeding and essentially just scoop and run. It is a tense 15-20 minutes later before King’s airway is finally established via an emergent tracheostomy—and his breathing finally restored to something reasonable. We learn too about the incredible coincidence that led to a delay in calling an ambulance—it turns out King wasn’t the only fatal casualty that day.

The author is himself an accomplished writer, and more than qualified to write such an authoritative work. Edison McDaniels is a board certified neurosurgeon with an extensive surgical experience, including more than a little bit of trauma. He is the author of several novels, including the acclaimed Not One Among Them Whole: A Novel of Gettysburg, which  has been described as a magnificently harrowing trip into the bloody horrors of the Battle of Gettysburg. It’s about surgery in a time when every wound was potentially fatal and every operation was a minor miracle, according to the author himself.

McDaniels’ strength in writing, which comes across loud and clear in Saving King, is his unusual ability to make the intricacies of medicine and surgery understandable to the masses. This is at least in part owing to his unique combination as an experienced surgeon, a talented writer, and a passion for both. And, in his case at least, the parts sum to more than the whole. Indeed, Taylor Polites, author of The Rebel Wife, has called him “An amazingly talented writer…”

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03/4/15
SixWordStoryEPM

Six Word Stories

 

—Other stories from the mind of Edison McDaniels—

The American Civil War Series

Not One Among Them Whole — A magnificently harrowing trip into the bloody horrors of battlefield surgery at Gettysburg in 1863. A vivid, steep descent into insanity.
An award winning novel available in trade paperback and eBook (Kindle, Kobo, Nook).

The Matriarch of Ruins (coming soon) — A widow woman struggles to keep her family together amid the onslaught of battle in 1863.
The sequel to Not One Among Them Whole. A novel.

An Endless Array of Broken Men — A surgeon struggles to save his son’s life at a battlefield hospital.
An award winning, vivid & engrossing FREE story available right here at surgeonwriter.com.

 

Thrillers Well Calculated to Keep You in Suspense

The Touched — Dr. Isaac Weed had it all, until his daughter died. Then he discovers a door to the afterlife, one never meant to be opened. Sometimes, healing can go too far.
A far surpassing supernatural medical thriller, a novel available on Kindle.

Juicing Out — Think you know how a surgeon’s thinks? Think again.
A tale of suspense, a novella available on Kindle.

Blade Man — A chilling tale of life on the road.
A twisted thrill ride, a novella available on Kindle.

The Weight of Potter’s Field (coming soon) — When an operation goes horribly wrong, a patient returns from the grave to haunt his surgeon. But it isn’t revenge he’s seeking…
A terrifying tale of things that go bump in the night at an old county hospital. A soon to be published novel.

 

Others Stories of Note

The Bottom of the Fifth — The miracles surrounding a little boy on opening day of the little league baseball season.
A short story available on Kindle.

Saving King — Dr. King struggled for 64 minutes after being shot. This is the story of that struggle.
Creative nonfiction, available on Kindle. Not for the faint of heart.

The Crucible — A brain surgeon works to save the life of a little boy on his operating table in 1951.
A gripping & empathetic short story. FREE. Available HERE.

Send to Kindle
03/4/15
Gutenberg Review

gutenburg

Gutenberg Review

—Other stories from the mind of Edison McDaniels—

The American Civil War Series

Not One Among Them Whole — A magnificently harrowing trip into the bloody horrors of battlefield surgery at Gettysburg in 1863. A vivid, steep descent into insanity.
An award winning novel available in trade paperback and eBook (Kindle, Kobo, Nook).

The Matriarch of Ruins (coming soon) — A widow woman struggles to keep her family together amid the onslaught of battle in 1863.
The sequel to Not One Among Them Whole. A novel.

An Endless Array of Broken Men — A surgeon struggles to save his son’s life at a battlefield hospital.
An award winning, vivid & engrossing FREE story available right here at surgeonwriter.com.

 

Thrillers Well Calculated to Keep You in Suspense

The Touched — Dr. Isaac Weed had it all, until his daughter died. Then he discovers a door to the afterlife, one never meant to be opened. Sometimes, healing can go too far.
A far surpassing supernatural medical thriller, soon to be serialized right here.

Juicing Out — Think you know how a surgeon’s thinks? Think again.
A tale of suspense, a novella available on Kindle.

Blade Man — A chilling tale of life on the road.
A twisted thrill ride, a novella available on Kindle.

The Weight of Potter’s Field (coming soon) — When an operation goes horribly wrong, a patient returns from the grave to haunt his surgeon. But it isn’t revenge he’s seeking…
A terrifying tale of things that go bump in the night at an old county hospital. A soon to be published novel.

 

Others Stories of Note

The Bottom of the Fifth — The miracles surrounding a little boy on opening day of the little league baseball season.
A short story available on Kindle.

Saving King — Dr. King struggled for 64 minutes after being shot. This is the story of that struggle.
Creative nonfiction, available on Kindle. Not for the faint of heart.

The Crucible — A brain surgeon works to save the life of a little boy on his operating table in 1951.
A gripping & empathetic short story. FREE. Available HERE.

Send to Kindle
03/4/15
Writers World

Writers World Passage

Writers World

—Other stories from the mind of Edison McDaniels—

The American Civil War Series

Not One Among Them Whole — A magnificently harrowing trip into the bloody horrors of battlefield surgery at Gettysburg in 1863. A vivid, steep descent into insanity.
An award winning novel available in trade paperback and eBook (Kindle, Kobo, Nook).

The Matriarch of Ruins (coming soon) — A widow woman struggles to keep her family together amid the onslaught of battle in 1863.
The sequel to Not One Among Them Whole. A novel.

An Endless Array of Broken Men — A surgeon struggles to save his son’s life at a battlefield hospital.
An award winning, vivid & engrossing FREE story available right here at surgeonwriter.com.

 

Thrillers Well Calculated to Keep You in Suspense

The Touched — Dr. Isaac Weed had it all, until his daughter died. Then he discovers a door to the afterlife, one never meant to be opened. Sometimes, healing can go too far.
A far surpassing supernatural medical thriller, soon to be serialized right here.

Juicing Out — Think you know how a surgeon thinks? Think again.
A far surpassing tale of surgical suspense, a novella available on Kindle.

Blade Man — A chilling tale of life on the road.
A twisted thrill ride, a novella available on Kindle.

The Weight of Potter’s Field (coming soon) — When an operation goes horribly wrong, a patient returns from the grave to haunt his surgeon. But it isn’t revenge he’s seeking…
A terrifying tale of surgical suspense, and of things that go bump in the night at an old county hospital. A soon to be published novel.

 

Others Stories of Note

The Bottom of the Fifth — The miracles surrounding a little boy on opening day of the little league baseball season.
A short story available on Kindle.

Saving King — Dr. King struggled for 64 minutes after being shot. This is the story of that struggle.
Creative suspenseful surgical nonfiction, available on Kindle. Not for the faint of heart.

The Crucible — A brain surgeon works to save the life of a little boy on his operating table in 1951.
A gripping & empathetic short story. Surgical suspense at its finest. FREE. Available HERE.

Send to Kindle
03/3/15
Cervical Fracture Cartoon

Cervical Fracture Explained

Cervical Fracture Cartoon

Cervical Fracture Explained

This graphic details a lateral x-ray showing a C4/5 fracture/subluxation, but there’s no bony fracture! How is that possible?

The injury here is through the disk space between the fourth and fifth cervical vertebrae (C4/5). The force of the injury ripped through the soft tissue disk and tore the ligaments front and back at this level. This is a devastating injury for two reasons.

First, with such great disruption of the ligaments, surgery is absolutely necessary to stabilize the bones. Ligaments hold bone to bone and when they tear, there is nothing to check the movement of the bones. In contradistinction, with a bony fracture, the bones will generally knit back together if immobilized in place (with a cast or pins).

Second, and perhaps more important, with such severe disruption and unstable movement of the bones, the spinal cord has been injured. The spinal cord does not heal well; such an injury is likely to result in permanent paralysis.

Think of the spinal cord as a vast cable with millions of wires. The wires carry messages between the brain and body. Compare it to the transatlantic cable, with all its wires. Imagine the cable is damaged, cut in half for instance, midway between the US and England. Imagine all of the wires are the same color and you are tasked with splicing them back together. Ten thousand feet underwater. While holding your breath.

This is the task of the neurosurgeon in repairing a damaged spinal cord (though the cord is rarely transected; it is usually bruised beyond repair). We can’t see the individual nerve fibers in the operating room (we actually don’t even expose the spinal cord in such as injury as experience has proven the cord recovers better if we don’t disturb it), and even if we could we wouldn’t be able to tell which fiber connects to which other fiber—it all looks the same and though we might use a microscope, that’s more for illumination than magnification. No way we could magnify things enough to see the individual cells, or even bundles of cells.

Fortunately, as noted above the cord is rarely transected. What this means is that it is still anatomically intact (though physiologically disrupted). Because it is anatomically intact, in at least some cases there may be potential to regenerate the appropriate connections between damaged fibers. There is much research directed to this end, though success is still many years away. But as long as the cord is anatomically in one piece, the less we manipulate it the better. It might heal—emphasis on MIGHT—but not if we disrupt it still further. Hands off is the order of the day.

In the mean time, the best we can do is realign the bones and replace the ligaments with screws and rods to stabilize everything. This decreases the amount of pain, minimizes any chance of ongoing spinal cord injury, and gets the patient up and about earlier—which minimizes peri-operative complications. Mobilizing a patient as soon as possible after such an injury is key to returning them to a viable lifestyle, both mentally and physically. It also helps to prevent DVT, pneumonia, muscle wasting, nutritional depletion, infection, etc. In short, surgery to stabilize and realign the bones is crucial to optimize the environment around a damaged spinal cord in hopes of getting some eventual healing, or at least in preventing further injury.

Bottom line. The best treatment for a spinal cord injury is not to injure the cord in the first place. NEVER DIVE HEAD FIRST INTO A BODY OF WATER. NEVER.

 

 

 

 

 

 

 

 

 

 

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