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• About Another Day in the Frontal Lobe
• Dr. Firlik's bio

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Tavis: Dr. Katrina Firlik is an accomplished neurosurgeon was who was the first woman admitted to the prestigious residency program at the University of Pittsburgh Medical Center. In addition to her private practice, she is also an assistant professor at the Yale School of Medicine. She can now add author to her impressive résumé.

The new book about her life and career is called, love this title, "Another Day in the Frontal Lobe." (Laugh) So after author, we will add to her title, zoom in here, Jonathan, Mommy. Six months. Six months pregnant is Dr. Firlik. Nice to see you.

Dr. Katrina Firlik: Thank you. Glad to be here.

Tavis: Glad to have you on the program. So is the doctor a being a good patient?

Firlik: Yeah, I'm just like every other patient. I look at the Internet, I get worried about all the same things. Being a doctor doesn't make it much different.

Tavis: And it's the first time.

Firlik: It is. My first.

Tavis: So, you'd have to tell me. But so we know what this is already?

Firlik: It's a girl.

Tavis: Okay, a little girl. All right.

Firlik: (Laughs) This is her first television appearance.

Tavis: I like that. This title, I love this, "Another Day in the Frontal Lobe." That title kind of passes it off as, oh, just another routine matter. But there's nothing quite as precise and as touchy, as delicate, as brain surgery.

Firlik: Well, in a sense that's true. But also, we do have to make it a routine. It is another day in the office for us, which is why the training is so long. It's a seven-year program, and by the end of it, things are routine.

Tavis: What do you have to focus on to make it routine? I hear the point you're making. On the one hand, you want it to be routine. You don't wanna get shook every time you do a brain surgery. On the other hand, for the patient on the table, I don't want you to see this as a routine operation. I want you to take this one real seriously.

Firlik: Oh, yeah. No, every operation is taken as seriously as every other. No question about that. But we've been through the moves before. It's not new for us. And for that reason, we're not nervous every time we open up the brain. It's something that we've gotten used to and we know how to do.

Tavis: Tell me whether or not you think the brain is, in fact, the most delicate of all of the organs?

Firlik: Well, definitely I would say the most delicate and the most fascinating, which is why I went into this in the first place. Looking at the whole gamut of specialties, what's more interesting, the spleen, the kidneys? No, the brain. It's got to be the most interesting thing there is.

Tavis: How did you choose neurosurgery?

Firlik: Well, once I decided to become a doctor, becoming a neurosurgeon was kind of a no-brainer, so to speak. I had to figure out how to deal with the brain as a neurologist, a psychiatrist, or a surgeon. And it was pretty obvious for me that surgeon suited my personality. And so, interest in the brain, interest in surgery, it was a good blend.

Tavis: When you say that neurosurgery best suits your personality, what kind of personality type would that be?

Firlik: Well, I like the mechanical aspects of it, even though the brain is very mysterious and complex. I do like working with my hands, and I like the satisfaction that comes from being in the OR and being able to fix something right then and there. That's part of my personality.

Tavis: There are a number of fascinating stories in this particular book. I suspect the one that most people, or many people, would find most fascinating is the story of the patient who comes to you with a nail lodged in his head. Take your time. Tell me the story. It's a fascinating story here.

Firlik: Sure. Well, this is a man in his thirties, an otherwise healthy guy who was a carpenter. And he and his friends were putting up siding on the side of a house with an automatic nail gun. And unfortunately, his friend's hand slipped and a nail entered my patient's head in the left frontal region, right about there, and ended up embedded about two inches into the frontal lobe.

Now luckily, by the time I saw him in the ER, He was perfectly fine. Awake; alert; looked normal. Couldn't even see the nail unless you got up really close and kind of looked at his crew cut and noticed the little silver head of the nail there. And luckily got off scott-free without any neurological damage. But we had to obviously take him to the operating room, take the nail out very carefully. And at the end of that, we all said "better lucky than good," which is a common surgical slogan that luckily, everything

Tavis: How much of your survival had to do with where the nail entered his head?

Firlik: Well a lot of it. The interesting thing about the brain as opposed to other organs is everything depends on location. Certain parts of the brain, a very small injury could be life-threatening. Other parts of the brain, you could have a much larger injury and do just fine. The frontal lobes are an area where you could have a good amount of damage, and the other side will take over, for example.

Tavis: So because, to our earlier point, because the brain is such a delicate organ in our body, when you walk into a meeting with a patient and you're looking at what has to be done here, or what, in fact, can be done, what percentage out of 100 do you see that you know that, or feel, at least, that you can successfully treat what's here. Because I assume at some days, you look at stuff and say, I can't do anything here.

Firlik: That happens actually fairly frequently. It's a funny, there's a huge spectrum of disorders that we see. And some of them, even though they might look scary on the scan, don't need to be treated at all. We just watch them. Or they may live the rest of their life and have no problems whatsoever. Other problems need to be taken care of immediately.

That's part of the training also, is knowing who to operate on, when to operate, and then what to do. And it's frequently said the greatest errors in surgery are made prior to entering the operating room. In other words, it's knowing who to operate on and what to do that is the hardest part.

Tavis: To that point, talk to me about the advancements being made and how much better the chances are for people who have any range of neurological disorders.

Firlik: Sure. Well, every year that goes by, there are new advances in the field. We have all sorts of navigational devices; three dimensional images of the brain that can help us pinpoint exactly where to go in the brain so that we can make smaller incisions. Surgery is less invasive. Those are huge advances for the patient and the recovery time.

And new horizons in terms of what we can do for patients and what disorders we can treat. And that's an exciting area. For example, treating refractory depression, or refractory obsessive-compulsive disorder. Those are things that are kind of on the borders of surgery right now. But I think in the future, we can treat quite successfully.

Tavis: I'm not sure that there is an answer to this question, and if there is an answer, I'm not sure it's an answer worthy of TV time. But let me ask anyway, because I'm so curious about it. On this program, of course, we do a regular 'Road to Health' segment, on this television program. And on my radio program every week, I do the same thing. A regular 'Road to Health' segment on my public radio program.

And I found over years of doing these segments, which I think are very worthy and valuable, I found, though, that almost any, how might I put this? You're the doctor here. Almost any medical issue that I talk to, or talk about with a physician, there is some disparity in the treatment.

Tavis: Based upon race. Based upon ethnicity. Does that also apply to neurological disorders?

Firlik: I can't think of, off the top of my head I can't think of a single disorder that I treat where there's a disparity in the types of treatment. It's more common when you're talking about, say, hypertension medications, that sort of thing. That there may be differences. But in terms of head injuries, brain tumors, strokes, I wouldn't say that I can think of an obvious difference in the way we treat them.

Tavis: I would assume, though, and again, you tell me if I'm right or wrong. I would assume, though, that if, in fact, the disparity exists, where it might come into the picture is that brain surgery, I would assume, ain't cheap.

Firlik: (Laughs) No, it's not cheap, but this is not the type of thing where we look at the person's wallet before we operate. If somebody needs surgery, we do the surgery. I understand the point, but it's really, that's not a big decision-making point in our practice.

Tavis: I mentioned earlier that you're one of just a couple hundred women in this particular field throughout the entire country. (Laughs) Tell me why those numbers are still as skewed as they are.

Firlik: Well, first of all, I think it is changing. But it's been a male-dominated field for decades. And that's similar to other types of surgery as well. But despite the fact that there aren't that many women, I've never really thought of myself as a woman in neurosurgery. I always think of myself as a neurosurgeon.

So for that reason, I have been fully accepted. I don't have a lot of stories to tell about sexism in the field, that sort of thing. It's actually more on the point of patients that have a difficult time thinking of me as a surgeon, as opposed to colleagues in surgery.

Tavis: You've actually encountered that?

Firlik: Sure, sure. And more just a misunderstanding. Like for example, I'll see a patient for the first time and spend 30, 40 minutes with them in the office, explaining what's wrong, what needs to be done, the pros and the cons. And at the end of that, they asked the bunch of questions and then they say okay, well, thank you very much, but who does the surgery?

(Laughs) And there's a disconnect between, after a whole half-hour of explaining things, they still don't quite get the sense that I'm the surgeon, so.

Tavis: And I just knew you were gonna say, okay, nurse, thank you for that. Now, when will I see the doctor?

Firlik: (Laughs) Right, right. So that happens. Not every day, but it happens on occasion. Usually with the older patients. But I think that'll change.

Tavis: Let me ask, though, the flip side of that, which is why you see yourself, as you should, as a neurosurgeon, and not a female, not a woman neurosurgeon. Are there, you think, unique qualities that you bring to this field because you happen to be a woman?

Firlik: Well, I have had patients tell me, you're the first person I've felt comfortable with. I'm easy to talk to.

Tavis: Good bedtime manner.

Firlik: Good bedside, right, right. At least I hope I do. And so people, I think, are less maybe scared to talk to me about things than they might somebody who is seen as more of a daunting older authority figure, for example. But on the flipside, I've had a lot of male colleagues who are equally gentle in their bedside manner. So it's not necessarily a male-female thing. But a lot of patients do appreciate the fact that I'm sensitive.

Tavis: So if she turns out not to be a neurosurgeon, you're okay with that?

Firlik: (Laughs) I'm ok with that, yes. Perfectly fine.

Tavis: All right. Congratulations...

Firlik: Thank you so much.

Tavis: ...on the soon-to-be new baby, and the new book. Making a book is like having a baby.

Firlik: Oh, yeah.

Tavis: Takes you months to put this thing out. 'Another Day in the Frontal Lobe' is the new book. 'A Brain Surgeon Exposes Life on the Inside." Dr. Katrina Firlik. Nice to have you on the program.

Firlik: Thank you so much.

Tavis: Up next on this program, Emmy-nominated actor John Amos. You gotta love this guy. From "Good Times" to "Roots," now to "Dr. Doolittle Three." We'll talk to John Amos in just a moment. Stay with us.