Neurosurgery Intern Eager for First Solo Case: Creutzfeldt-Jakob Disease Biopsy

KANSAS CITY, KS – Two weeks out of medical school, newly-minted neurosurgery intern Bill Magoo is already getting his first solo operative case and he is elated.

mad cow
“Do I look mad?!”

“Everyone says in the interview, ‘Oh we will get you in the operating room early at OUR program,’” said Bill.  “They really do mean it here!  I don’t know what Creutzfeldt-Jakob Disease (CJD) is but a craniotomy and brain biopsy sounds sweet!”

Unbeknownst to Bill, CJD is a disease characterized by rapidly progressive dementia ultimately leading to death.  Also unbeknownst to Bill, the only way to transmit the disease from one to another is by being exposed to cerebral tissue of the infected.

“Go get ‘em tiger!” Bill’s chief resident exclaimed, slapping him on the back as he began scrubbing in.

“You could do a lumbar puncture for protein 14-3-3 I suppose, but I want a definitive diagnosis,” said Dr. Chinstrap, local fearless neurologist who ordered the neurosurgery team to do the procedure via the electronic health record.

Bill had scrubbed in cases before as a medical student and occasionally as an intern already so he was able to tell something was different about the setup of the room.  A sign simply pointed to the sterile back table that said “disposable surgery tools” and no scrub tech or circulator were to be found.  While gowning up, a voice said, “Oh hey dude!” from the other end of the patient.  It was Bill’s friend Mark, an anesthesia intern, also given his first solo case today.

After a gruelling 20 hours of bumbling, Bill got the tissue sample under the verbal direction of the attending neurosurgeon, who almost scrubbed in to help move things along.

“I mean he did ok for an intern,” said Dr. Bongo, attending neurosurgeon.  “I kept having the urge to help him but I thought ‘No, what kind of teacher would that make me?’  That and ‘that’s freaking CJD in there!’”

Two and a half months later, final pathology was negative for CJD.  It always is.