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September 10, 1997

Judith's Pavilion: The Haunting Memories of a Neurosurgeon

Author Affiliations

University of Massachusetts Medical School Pittsfield

JAMA. 1997;278(10):871. doi:10.1001/jama.1997.03550100097048

Death haunted early neurosurgery. When Harvey Cushing began brain tumor surgery, operative mortality exceeded 50%. "Everyone dies that I touch," he wrote to his wife in 1909. Most would quit, but Cushing was driven to conquer brain tumors. By 1931, he had lowered mortality to under 10%, an amazing achievement. To weather the depressing early years, Cushing had developed a heavy armor of aequanimitas. He created the image of a neurosurgeon that endures today—the brilliant technician with a detached, even icy, demeanor.

Marc Flitter, MD, doesn't fit this stereotype. In Judith's Pavilion: The Haunting Memories of a Neurosurgeon, he demonstrates a deep empathy for suffering and dying patients in his care. The central theme of his book is death as human sadness, to be shared by patients, families, and their doctors.

Flitter tells how he dealt with devastation in a dozen well-crafted neurosurgical tales. Judith Halpern's is the most