In 2004, Dr Richard Ellenbogen spent almost 20 hours operating on a 17-year-old girl with a brain tumor. He ended up leaving a big piece of the tumor behind, mistaking it for normal brain tissue. Less than a year after the surgery, the cancer hit back and the young girl died.
The week the girl died, Ellenbogen presented the case at his team’s weekly meeting at Seattle Children’s Hospital. “There’s got to be a way to take more of the tumor out and leave more of the normal brain intact,” he sighed in frustration. The nagging feeling that he could’ve taken more tumor out wouldn’t leave him alone. Ellenbogen had faced a dilemma: if he had removed more, he would probably have removed more tumor but might also have removed normal brain tissue, with the risk that the girl would have been left severely disabled. Neurosurgeons have to be aggressive and sometimes push themselves to go further and deeper than they feel comfortable going, but they all operate under the adage ‘first, do no harm’.