Black Pig

This is the second chapter of Reflections of a Neurosurgeon, the book I am writing in public.

I was conflicted about even writing this chapter. It felt like I was jumping into murky waters. But once I started writing, I knew there was treasure to be found in the depths.

If you missed the first chapter, GBM, you can find it here.

“I have a dream…” - Martin Luther King Jr.

In the landscape of neuroscience, where dendrites branch like winter trees and synapses fire like distant stars, delirium remains a humbling adversary. As a doctor, I had learned to read the complex language of brain chemistry, but some nights in the hospital reminded me that consciousness is more poetry than prose.

It is winter. The high dependency unit at night became a space where science merged with metaphysics. Each bed held not a patient but a story written in shadow, their forms transmuted by the half-light into something between presence and absence - a reminder that in medicine, we often navigate the margins between what we know and what we merely believe. A whisper of cold wind threaded through the safety-locked windows. Silent witnesses to a past tragedy where despair had overcome reason, giving imagined wings to a misfiring brain. The breeze carried with it the weight of that memory, of the potential for human suffering, so great that even architecture must adapt to contain it.

Hazel lay in bed 4. She was my first independent case, and with that distinction came a particular species of fear that every young surgeon knows - not the acute terror of a difficult procedure, but the chronic anxiety that follows you home and sits beside you at dinner. I watched her chest rise and fall, each breath a quiet victory against entropy. The pulse oximeter cast its red glow across her wrinkled finger, translating life into numbers, though I had learned that life refused such simple quantification.