Rosseau's Brainstorm: Detecting Cancer

One of the country’s top neurosurgeons wants to give women who have had breast cancer a chance to know their future. Is she doing them a favor?

By Laurence Gonzales

I asked Seidman what women should do. "I would never want to create this illusion of a panacea, where every woman is going to demand that her doctor do an MRI when it hasn’t been adequately studied," he says. "But certainly having a low threshold for doing it for high-risk patients who have had breast cancer is good medicine."

The Mind Reader

One day I was in the operating room with Rosseau as she performed a craniotomy on a male patient. When she began to drill into his skull, I noticed how different from the common view real brain surgery is. I had thought of it as a very delicate operation done in a pristine white world of ethereal quiet. But there was the screaming drill, the smoke rising and the wires and tubes snaking everywhere. The work was hard manual labor. The skull is amazingly thick and tough, and getting into it is like tearing up a street. Rosseau is small but powerful, and moves with a sure-footed quickness and confidence that it is difficult to imagine deflecting. She bores in and gets the job done — or gets what she wants — with the sheer force of her personality. And a large part of it is her willingness, even eagerness, to see things from your point of view and use a kind of emotional jujitsu to bring you around to hers.

Frequently the surgery has to take place under a microscope. The images are transmitted to a large monitor and recorded. But one day, the monitor was badly out of focus. Rosseau had summoned a technician, Mike, who stood studying the problem with his arms crossed and a perplexed look on his face. Rosseau never stopped working on the patient, even as she gently went to work on Mike.

"Now, Mike. Mike," she said. "What do you think? That’s what I want to know. I mean, what would you do? Have you ever seen anything like this? Because it’s perfectly clear in my scope. I can see it over here. But we’re just not getting the kind of pictures we need. I can’t teach with this. I can’t show this to the patient’s family. They’ll think I’m operating when I can’t even see."

It was obvious that Mike did not know what the problem was and was reluctant to tear into the high-tech machine, which was draped in sterile plastic and would be a real mess to take apart and put back together with surgery going on. But with gentle, insistent, empathetic pressure, Rosseau wore him down: Watching her get inside of Mike’s head was like watching her bore into someone’s skull

Later in her office, she asked me about my work. I told her that I had written magazine articles, books, and screenplays. Her face brightened, and she sat up straighter. "Say," she said, "can I pitch you an idea?" Within seconds, I found myself caught up in her movie. "The Black Mozart," she said emphatically, leaning across her desk to trace a marquee in the air with her hands. She went on to describe a slave prodigy from Martinique who was brought to the court of Marie Antoinette.

Doctors tend to focus narrowly, but Rosseau’s range of interests is broad. A marathon runner and a voracious reader of history, she believes herself to be "the youngest member of the Chicago chapter of the Churchill Society." She has served as the national spokesperson for medical malpractice tort reform, testifying at a congressional hearing about the "unreasonable, lottery-style awards for pain and suffering that are forcing good doctors to give up the work they love." A native Chicagoan, she was an early supporter of Barack Obama. He’s a friend, although the two disagree on tort reform.

It is in the nature of the brain to get used to things. The beautiful painting you hang on your wall today may well be invisible to you a year from now. And as fascinating as it is, even brain surgery could get old. One day I watched Rosseau patiently put 200 stitches into a patient, one after another, and thought that she might well want something more from life.

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