Doty describes what it’s like to perform brain surgery:

The drone of the heavy drill as it bores through the skull. The bone saw that fills the operating room with the smell of summer sawdust as it carves a line connecting the burr holes made from the drill. The reluctant popping sound the skull makes as it is lifted away from the dura, the thick sac that covers the brain and serves as its last line of defense against the outside world (1).

In this particular instance, Doty is preparing to operate on a four-year-old boy with a medulloblastoma: a form of malignant brain tumor. He gently explains the procedure to the boy, reassuring the patient’s mother that he expects the surgery to be successful. While shaving the boy’s head, he keeps a lock of hair to give to the boy’s mother, knowing that she’ll likely want a memento of his first haircut.

Over the years, Doty has mastered the mixture of calm and concentration that surgery requires, but his less experienced assistant accidentally tears open a vein just as the operation is nearing its end. The boy begins bleeding and quickly flatlines; while the anesthesiologist works to resuscitate him, Doty tries to clamp the vein, but struggles to find it in the pool of blood.