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They were nearly three hours into the operation and not one cell of the cancer had yet been removed. But by neurosurgical standards, three hours was still well within the feeling-out period -- especially for a procedure involving experimental equipment. And despite huge progress recently, ARTIE most certainly remained experimental.
"Let's try another set of images with enhancement of the tumor, please."
To a physician, all growths, benign and malignant, were tumors, although the term "cancer" was generally reserved for malignancies -- those tumors capable of spreading to distant organs. This particular cancer, a glioblastoma, was among the most virulent of all brain tumors.
Staring straight ahead at the eight-inch monitor screen that was suspended from the ceiling to her eye level, Jessie Copeland set her gloved hands down on the patient's draped scalp, which was fixed by heavy screws to an immobile titanium frame. The physical contact wasn't technically necessary. From here on, ARTIE would be doing the actual surgery. But there was still something reassuring about it.
"You playing gypsy fortune-teller?" Emily DelGreco asked from across the table.
"I just want to make certain the guy hasn't slipped out from under the sheets, gotten up, and run away while I'm trying to decide whether or not our little robot pal is in position to begin removing this tumor. For some reason ARTIE's movements forward and left feel sluggish to me -- not as responsive to the controls as I think he should be."
"Easy does it, Jess," Emily said. "We always expect more from our kids than they can ever deliver -- just ask mine. The sensors I'm watching, plus my monitor screen, say you and ARTIE are doing fine. If you start feeling rushed, just say 'Berenberg.'"
Emily, a nurse practitioner, had been on the neurosurgical service at the Eastern Massachusetts Medical Center for several years before Jessie started her residency. The two of them, close in age if not in temperament, had hit it off immediately, and over the intervening eight years had become fast friends. Now that Jessie was on the junior faculty, Emily had moved into the tiny office next to hers and worked almost exclusively with her and her patients. Neither of them would ever forget Stanley Berenberg, one of the first brain tumor cases the two of them had done together. His operation had taken twenty-two hours. They did the delicate resection together without relief. But every minute they spent on the case proved worth it. Berenberg was now enjoying an active retirement, playing golf and carving birds, one of which -- a beautifully rendered red-tailed hawk -- held sway on the mantel in Jessie's apartment.
"Berenberg ... Berenberg ... Berenberg," Jessie repeated mantralike. "Thanks for the pep talk, Em. I think ARTIE's just about ready to start melting this tumor."
Jessie had decided to apply to medical school five years after her graduation from MIT with a combined degree in biology and mechanical engineering. She had spent those five years working in research and development for Globotech, one of the hottest R and D companies around.
"I didn't mind making those toys," she had told neurosurgical chief Carl Gilbride at her residency interview, "but I really wanted to play with them afterwards."
Under Gilbride's leadership, the Eastern Mass Medical Center's neurosurgical program, once the subject of scorn in academic circles, was a residency on the rise, drawing high-ranking applicants from the best medical schools in the country....
