Uh. Uh-uh-uh. Uh-uh-uh. Uh. Uh. Uh. Uh.
The opening chords of AC/DC’s ‘Back in Black’ ring out. The image of Angus Young – the band’s guitarist in trademark schoolboy uniform – flick fleetingly across my mind. Very fleetingly.
The large screens behind me are in focus, ready to go. I look at the anaesthetist. She gives me the nod. I check with the scrub nurse. She’s primed, prepped. Ready.
Finally, I look down at the tiny bundle of humanity on the table beneath me. I pick up my knife and I say, ‘Let’s begin.’
Ever since I was little, music has meant a lot. When I was nine, my uncle gave me a cheap Pye tape recorder. I used it to do what I imagine everybody my age did back then, which was to tape the Top 40 singles chart. I realized that when I was listening to that, the rest of the world faded away and I was able to concentrate. Everything just stuck when the volume was up. I could do my homework and read books so much more easily. Through O levels, A levels and medical school, if I didn’t have my headphones on then nothing was sinking in. There was too much extraneous noise. I was too easily distracted.
And in an operating theatre with an eighteen-month-old baby in front of you, distracted is the last thing you can afford to be. For their sake and yours, you want and need to be at the top of your game. It’s the only way to stack the odds against whatever is attacking them. Tumour, spina bifida, massive head trauma. I – we – can try to fight them all. But only when I’m concentrating.
I don’t always win. I can’t always win. But I try. I do everything possible to abide by the number-one rule in the doctors’ handbook, and the title of a book written by one of my old teachers and inspirations, Henry Marsh: do no harm. And then some. And that’s what I tell the patients and their parents when they come to the question they always eventually ask: ‘Doctor Jay, tell us. What are the odds?’
They can’t help it. They want to know, in terms they can understand, just how likely it is that their child will survive. How certain that the operation their loved one is about to undergo will be successful. They want a percentage, a number out of 100. Something they can translate. Something they can process.
I’m no mathematician, but I do my best. I’m always honest. I always reply. Sometimes the win/lose ratio is 50:50. Sometimes it’s 90:10. Sometimes it’s the opposite way round.
It doesn’t really matter. I always follow up with the same words: ‘I can tell you the odds, but whether there’s a five per cent or a ninety-five per cent chance of success, it doesn’t matter. We’re going to go for it. We’re going to do our best.’
The ‘we’ means all of us – doctors, nurses, scrub staff and, of course, parents and patients. Because the alternative doesn’t bear thinking about.
I became a doctor to save lives. I became a neurosurgeon because I believed it to be the highest achievement in medicine. I became a paediatric neurosurgeon to give a voice to those patients so long overlooked because of their age. To give them a life. To give them a chance. To give them respect.
In the background my young registrar flicks the volume dial on the speaker.
UH. UH-UH-UH. UH-UH-UH. UH. UH. UH. UH.
‘Let’s do this.’