The brains of the operation

Long road, hard journey

But the road to becoming a neurosurgeon is a long one - undergraduate study, three years as a postgraduate student, three years working on a doctoral thesis, and then at least three years in the field. The long years of study are just the start of the journey, and the profession is an arduous and demanding one, involving long working hours and a great deal of stress.

On average, Zhang performs two operations a day, including on weekends, many of them related to cerebrovascular conditions and vascular malformation of the spinal cord.

A typical working day starts at 7:30 am, when Zhang attends a regular morning meeting at which the neurological staff reviews cases from the previous day and prepares for the coming day's operations.

"From 8 am, I make my ward rounds, including checking on 20 or so patients in the Intensive Care Unit, and arranging operations for the next day. Meanwhile, other members of the team, the surgeons, anesthetists and nurses, monitor the patients' conditions and head to operating rooms to conduct preparatory procedures, such as sterilizing the areas to be operated on and performing craniotomies - removing part of the skull to allow access to the brain - before the lead surgeons begin operating at about 10 am."

Zhang performs surgeries for most of the day, finishing somewhere around 8 pm, but is also required to be available at night to handle emergencies. "Sometimes, overnight surgeries will be done the next morning. So on the next day, whether to continue working or not, it depends on the workload and how I'm feeling. I have to assess if I have enough energy left to ensure that the surgery is as safe as possible," he says.

Neurosurgery is extremely meticulous and time-intensive work, because it requires precision cutting, sawing, drilling and clamping. Shorter operations take about four hours, but the longest can last about 20 hours, he adds.

In addition to his daily ward rounds, Zhang sees patients at his clinic during downtime in the operating rooms on Wednesday and Friday mornings, and also tutors a group of 10 interns.

Although Zhang is driven by the sense of achievement he feels after a successful operation, and by gratitude of the patients' families, the less-successful operations galvanize him the most. "I often recall them. I try to figure out the reasons and draw lessons from them," he said.