Gray Matters – part memoir, part history, part scientific explanation – is an attempt to delve deep into this relatively new science [of neurosurgery], and the extraordinary things that Schwartz and his peers have found about the workings of the brain... And while anatomy textbooks may give surgeons a road map, he neatly describes actual brain operations as more akin to using the Waze app, with which you’re constantly adjusting to real-life situations. Schwartz’s way with words is as skilful as his wielding of microscissors. 

Neurosurgeons are typically portrayed in one of two ways in popular culture. One is as a brilliant, if arrogant, boffin. Think of Dr Jack Shephard, the protagonist of “Lost”, a television series, or Doctor Strange, a Marvel character. The other common depiction is as a mad scientist. At best, these characters perform unethical surgeries and, at worst, become cannibalistic serial killers, such as Hannibal Lecter.

But these portrayals miss much of what modern neurosurgery really is, argues Theodore Schwartz, a neurosurgeon and professor at Weill Cornell Medicine in New York. Gray Matters, an engrossing new book, goes on a tour through different types of brain surgery.... The result is a satisfying and varied insight into an intriguing profession.

In a new book by Theodore Schwartz, Gray Matters: A Biography of Brain Surgery, readers are taken on a journey through the history of neurosurgery by the very best tour guide imaginable: a real-life brain surgeon. Schwartz is a neurological surgeon at Weill Cornell Medicine in New York City. He's also a heck of a storyteller.

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​"Neurosurgery is, at its heart, a service industry. Like a priest or a nun, we swear an oath to dedicate ourselves to a higher purpose: the health of our patients. The soldier's creed holds true for neurosurgery as well: 'I will always place the mission first. I will never accept defeat. I will never quit."​​​

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"We tend to think about neuroscientists, neurologists, and philosophers as the people who try to figure out the relationship between the brain and the mind -- how the brain creates the mind, and how the brain stores memories," observed Schwartz, neurosurgeon and author of Gray Matters: A Biography of Brain Surgery. "But the experiments that neurosurgeons can do -- because they have access to the human brain in a way that no other specialty does -- have given us the ability to contribute to that conversation in a much more meaningful and deep way than most people understand,"​​

Artificial intelligence is making impressive advances in medicine. But there are things even the most adept robotic surgeon won't grasp.

Performing surgery is not a "House, M.D." quandary in which we sift through massive amounts of data stored in our memories to arrive at the best solution - the kind of thing computers do very well. It's not like playing chess, or Go, or even diagnosing cancer from a mammogram. When it comes to surgical interventions, figuring out what to do is only the first step. The real challenge is doing it.​​

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At Readworthy, the expert editors behind BookBub are ready to help you figure out which new releases are truly worth reading. That way, you can choose faster — and start your next book sooner. They've selected Gray Matters as August's Best New Nonction, writing: "​What’s it like to conduct brain surgery — when a mere second can separate life from death? [In Gray Matters] a renowned neurosurgeon explores how doctors came to understand and operate on the human brain in this fascinating medical history.

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Most of the ships in a bottle you see in souvenir shops are built first, before inserting them into the bottle. Imagine having to assemble the ship, piece by piece, by working through the neck of the bottle with the bottle intact. That’s what it’s like to perform neurosurgery, a life-and-death technical exercise in which the surgeon must exert his or her will on the external world, working at the bottom of a deep, narrow corridor with a margin of error measured in millimeters. The key to success relies not just upon a detailed understanding of the brain’s anatomy but also on careful preparation. 

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Gray Matters is not simply a history of neurosurgery. Dr. Schwartz has written a book that is part memoir and part biography of his profession. Common problems, such as head trauma, gunshot wounds, brain tumors and strokes, are illustrated through the stories of real patients. Some cases are Dr. Schwartz’s own, tweaked to protect anonymity; others are of historical figures and celebrities. He covers huge amounts of territory, including the deplorable case of Eva Perón’s lobotomy, the brave new world of brain-computer interfaces, and the ominous implications of cutting-edge neuroscience for conventional notions of free will.

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To celebrate the launch of Gray Matters: A Biography of Brain Surgery, guests joined Dr. Theodore Schwartz for an unforgettable afternoon in the Hamptons. The event was hosted by Susan and Jeff Goldenberg, in partnership with BELLA Magazine, and special guest and actor, Mark Feuerstein. In the new book, Dr. Schwartz brings readers into his world and shows them what it’s like to hold the scalpel, wield the drill, extract a tumor, fix a bullet hole, and remove a blood clot—when every second can mean the difference between life and death. 

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Schwartz sat down with Terry Gross to discuss the past, present and future of neurosurgery. He says "I'll be training a fellow and we'll go through six, seven, eight operations and I'll tell them, all these operations that we just did together, I didn't learn how to do any of these in my training 25 years ago. They're all completely new operations. And that's a wonderful thing about a field like brain surgery, is that we are constantly applying new technology and the field is changing and you have to stay up to date, but it also keeps you active. It keeps you thinking."​

"A world-class surgeon [with] a knife and a pen." The book combines [Schwartz's] personal experience with a history of the field and an investigation of high-profile case studies, including those of Beau Biden, Natasha Richardson, and Malala Yousafzai. “I saw these neurosurgeons working under the microscope, and they looked like astronauts,” he recalls. “I mean, they’re in a special chair, they’re looking at a microscope, they’re working in this little microcosm. It was like journeying into a new world that I’d never seen before.”

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In his new book, Gray Matters: A Biography of Brain Surgery, neurosurgeon Dr. Theodore Schwartz delves into the history and practice of neuroscience. What he and his fellow scientists have discovered is that our lives are based on stories that our brains construct, and those stories are not fact, but fiction. Ted is certainly not the first guest on this podcast to talk about the relationship between brain science and storytelling— but as a neurosurgeon, he comes at it from a uniquely hands-on perspective.​

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When Theodore Schwartz, MD, a neurosurgeon specializing in minimally invasive treatments for brain tumors and epilepsy at Weill Cornell Medicine, started his career, minimally invasive surgery for skull base tumors was unheard of. Today, he says "Patients recover faster, they get out of the hospital more quickly. We retract the brain less, which leads to better outcomes."

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In an interview with Targeted Oncology for Brain Cancer Awareness Month, Theodore Schwartz, MD, spoke with editor Jordyn Sava about the challenges of targeting brain tumors, current and emerging therapies, and strategies to overcome the blood-brain barrier.

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Due to their novelty, few surgeons have acquired the necessary experience, knowledge and expertise to introduce [endoscopic transorbital] approaches into their practice, yet due to their safety and efficacy, they are rapidly becoming a critical skill set. This is the first text of its kind to codify and proliferate these new approaches more rapidly through the country and world, appealing to otolaryngologists, oculoplastic surgeons and neurosurgeons who deal with pathology involving the skull base.​

The lateral transorbital approach (LTOA) is a relatively new minimal access skull base approach suited for addressing paramedian pathology of the anterior and middle fossa. In the cover article of the Journal of Neurosurgery, the authors define target zones for this approach and describe a series of cases with detailed measurements of visual outcomes, including those obtained with exophthalmometry.

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New evidence from a zebrafish model of epilepsy may help resolve a debate into how seizures originate. In the study, published Feb. 23 in Brain, the researchers were able to track the activities of neurons throughout the entire brains of larval zebrafish during seizures. They showed that the seizures originated from an excess of “excitatory” over “inhibitory” brain cell activity in relatively confined regions of the brain and spread only when they overcame strong inhibitory activity in surrounding regions.

During a two-day training session, Washington University School of Medicine neurosurgery and otolaryngology residents were trained by surgeons who have pioneered some of today’s most advanced skull base techniques: Kris S. Moe, MD, who pioneered transorbital neuroendoscopic surgery (TONES), and Theodore H. Schwartz, MD, who developed and expanded the field of minimally invasive endonasal endoscopic skull base and pituitary surgery.

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Earlier this year, [Dr. Theodore Schwartz] became the first neurosurgeon in the United States to use the newly developed Reveal™ FGS System during brain tumor surgery. This new wearable system uses advanced specialty lighting and appropriate optical filters to provide the required lighting to perform fluorescent-guided removal of malignant brain tumors, such as glioblastoma multiforme and benign tumors called “meningiomas.”

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Theodore Schwartz regularly powers up a digital camera, called a 3D endoscope, that lets him operate at the base of the brain without having to move the organ or run the risk of injuring nerves involved in seeing, hearing and maintaining balance. A minimally invasive tool that requires no incision, the camera is inserted. . . into the nasal cavity. An image of a tumor and surrounding tissue is displayed on a large video screen. 

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A patient with metastatic brain cancer has become the first in the New York City area to receive the unique GliaSite Radiation Therapy System (RTS). Following the surgical removal of the patient's brain tumor, the GliaSite balloon catheter system was inserted into the remaining cavity. Liquid radiation was then injected to fill the balloon. The radioactive liquid remained in the balloon for several days, where it delivered radiation directly to the area in the brain where cancer would most likely recur.

Theodore H. Schwartz, MD has been recognized as a 2024 Research All-Star in the top 3% for Neurosurgery by Avant-Garde Health. This distinction acknowledges substantial and high-quality research contributions made through co-authored publications. Curated by Avant-Garde Health, the Healthcare Research All-Star list honors the top 5% of hospitals and surgeons who are leading the way in innovative research within neurosurgical care. Explore the comprehensive lists and learn more about this work here.

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Theodore H. Schwartz, MD has been given the Gentle Giant Award from the Pituitary Network Association, given to doctors who have contributed in an exceptional way to the care of patients with pituitary tumors.

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