Excerpt from The Patient by Michael Palmer, plus links to reviews, author biography & more

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The Patient

By Michael Palmer

The Patient
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  • Hardcover: Mar 2000,
    304 pages.
    Paperback: Jul 2001,
    304 pages.

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Working in Gilbride's lab throughout her residency while carrying a full clinical load, Jessie had learned that her boss's true forte was for self-promotion, but she had been elated to spearhead the development of ARTIE--Assisted Robotic Tissue Incision and Extraction. The apparatus was an exciting fusion of biomechanics and radiology.

Now, after some preliminary animal work, she and ARTIE were finally in the OR.

Over the past few years, Jessie had viewed countless video images produced by the intraoperative MRI system. What she was studying now was the continuous, three-dimensional reconstruction of the brain beneath the intact skull of the patient--images that could be rotated in any direction using a track-ball system bolted to the floor beside her foot. The on-screen presentations of the MRI data were undergoing constant improvement by the extraordinary genius geeks in Hans Pfeffer's computer lab. And Jessie could not help but marvel at the pictures they were producing. The malignant tumor and other significant structures in the brain could be demarcated electronically and colorized to any extent the surgeon wished.

Jessie had always been a game player--a fierce competitor in sports, as well as in Nintendo, poker, billiards, and especially bridge. She was something of a legend around the hospital for the Game Boy that she carried in her lab coat pocket. She used it whenever the hours and tension of her job threatened to overwhelm her--usually to play the dynamic geometric puzzle Tetris. It was easy to understand why the MRI-OR setup excited her so. Operating in this milieu, especially at the controls of ARTIE, was like playing the ultimate video game.

MRI--magnetic resonance imaging--had progressed significantly since its introduction in the early 1980s. But the technique had taken a quantum leap when White Memorial Hospital, the most prestigious of the Boston teaching hospitals, had designed and built an operating room around the massive MRI magnet. The key to developing the unique OR was the division of the seven-foot-high superconducting magnet into two opposing heads--"tori," the manufacturer had chosen to call them, a torus being the geometric term for any structure shaped like a doughnut. The tori were joined electronically by under-floor cables, and separated by a gap of just over two feet. It was in this narrow space that the surgeon and one assistant worked. The patient was guided into position on a padded sled that ran along a track through a circular opening in one of the magnets. Jessie understood nearly every aspect of the apparatus, but that knowledge never kept her from marveling at it.

"Let's do it," she said, crouching a bit to peer under the video screen and make brief eye contact with her friend. "Everyone ready?"

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Copyright© 2000 by Michael Palmer.

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