GRAY MATTERS is a fascinating exploration of the brain’s potential, expertly balancing scientific insight with philosophical contemplation. As a practicing neurosurgeon, Schwartz has a unique vantage point into the wonders and mysteries of the human brain, which he translates into an engaging and accessible narrative. The book dives deep into the gray matter—the seat of human cognition, emotion, and identity—and asks profound questions about the nature of consciousness, technology's impact on the brain, and the future of neuroscience.
One of the strengths of this book is its ability to make complex medical concepts accessible to a general audience. Schwartz explains the anatomy and physiology of the brain in clear and concise terms, making it easy for readers to follow along. He also delves into the history of neurosurgery, tracing the evolution of the field from ancient times to the present day.
Through his writing, the author conveys a deep sense of empathy and compassion for his patients and their families.
Some of the cases he describes are:
1. The Musician’s Tumor: Schwartz recounts the case of a professional violinist who had a brain tumor. The surgery was particularly challenging because it was crucial to preserve the patient’s fine motor skills and musical abilities. During the operation, the patient was kept awake and played the violin, allowing Schwartz to ensure that the areas of the brain responsible for these skills were not damaged.
2. The Young Athlete: Another compelling case involves a young athlete who suffered a severe head injury. Schwartz describes the delicate process of removing a blood clot from the brain and the subsequent rehabilitation that allowed the patient to return to sports. This case highlights the resilience of the human brain and the importance of timely medical intervention.
3. The Phantom Limb: Schwartz also delves into the phenomenon of phantom limb pain through the story of a patient who experienced severe pain in a limb that had been amputated. The case explores the brain’s complex relationship with the body and how neurosurgery can sometimes alleviate such mysterious conditions.
4. The Epilepsy Patient: One of the most intriguing cases involves a patient with severe epilepsy. Schwartz performed a surgery to remove the part of the brain causing the seizures. The case is notable for the precision required and the dramatic improvement in the patient’s quality of life post-surgery.

The personal stories of patients provide a humanizing touch to the hard science, making it clear that the brain is more than just an organ—it’s the core of who we are as individuals. These stories give weight to the philosophical questions Schwartz raises: How far can we push the boundaries of human cognition? What are the risks of tampering with the essence of humanity? The discussion of the challenges of making life-and-death decisions and the impact of brain injuries on individuals and their families is unsettling and thought-provoking.
In addition to its medical and personal insights, GRAY MATTERS offers a valuable perspective on the future of neurosurgery. Schwartz discusses emerging technologies, such as brain-computer interfaces and gene therapy, and their potential to revolutionize the treatment of brain disorders. He also addresses the ethical concerns that may arise as these technologies become more advanced.
While the book is primarily focused on the medical aspects of neurosurgery, Schwartz also touches on the personal toll that this demanding profession can take on practitioners. His reflections on the emotional challenges of dealing with life-and-death situations provide a valuable perspective on the human side of medicine.
This is an intellectually stimulating read that merges science and philosophy seamlessly. The book is a compelling blend of memoir and textbook and is a highly recommended read for anyone interested in the brain, medicine, or the human condition. However, those looking for a purely philosophical or speculative work might feel that the book is too grounded in clinical reality.
Regardless, Schwartz’s expertise and passion for his field shine through on every page, making this book a fascinating and informative exploration of the complexities of the human mind and the incredible advancements that have been made in the field of neurosurgery.

For readers of Atul Gawande, Siddhartha Mukherjee, and Henry Marsh, an engrossing look at the complexities of brain surgery.
Dr. Theodore H. Schwartz's debut book, Gray Matters: A Biography of Brain Surgery, takes readers deep inside the world of neurosurgery. "On these pages," Schwartz writes, "I want to tell the story of neurosurgery from its primitive beginnings…to its current state as a computer-based discipline of meticulous precision." In addition to the history of the science, he examines cases of famous and not-so-famous individuals, exploring them in forensic detail and revealing little-publicized secrets about their treatments. He also addresses the philosophical implications of brain surgery, and closes with a discussion of new technologies, some of which may one day be implanted in the human brain.

That may sound like a lot to cram into a single volume—and it actually is quite a lot to take in—but Schwartz covers all that ground with aplomb. His book is readable and informative while rarely seeming dense; it's as close as a nonfiction book about a detailed science can be to a page-turner. Much of this is due to Schwartz's narrative style: he peppers the book with personal accounts (Schwartz is a neurosurgeon as well as a professor of neurosurgery), pop-culture references (Dr. McDreamy from Gray's Anatomy makes a few appearances), and spot-on analogies (he describes the brain inside a skull as "an egg yolk suspended inside the shell of an egg").

One of the most interesting aspects of the book is Schwartz's discussion of conditions of which most of us are peripherally aware but few understand, like Shaken Baby Syndrome (SBS) and chronic traumatic encephalopathy (better known as CTE, and probably familiar to readers because of long-term brain injuries experienced by NFL players). I didn't know, for example, that shaking alone almost never causes SBS; according to Schwartz, in one study, every instance of suspected SBS also involved head trauma (the child's head hit against something). Other highlights are his analyses of individuals who experienced brain trauma, like JFK and John McCain, and his speculation on topics like free will and how technology may eventually impact our brains. About brain-computer interfaces (BCIs), which are direct communication links between the brain and an external device, Schwartz posits that "An output BCI could… drive a car or fly a plane… [A]n input BCI would take information out of a computer and insert it directly into the brain."

What really sets the book apart, though, is how much of himself Schwartz puts into his narrative. Much of it is a terribly personal and soul-searchingly honest account. Early on he writes about his residency:

"Looking back, the work we did at the time that seemed menial and tedious…was, in fact, the essence of what it means to serve others and care for the sick. In my exhaustion, I had undoubtedly missed out on chances to truly connect with the patients under my care, human beings who were probably scared, lonely, facing their own mortality… In retrospect, I was too busy feeling sorry for myself…and more concerned with checking the clinical boxes on my to-do list than checking to make sure my patients were emotionally cared for and comforted. To this day, I feel bad about my own youthful neglect of some of those patients."

Although the author does, at times, come off a bit egotistical, one gets the sense that he's simply relaying his own truth—telling it as he sees it—and has enough experience to be confident in his opinions.

While the narrative is largely a page-turner, there is the occasional section of technical terms in which the reader might find her eyes glazing over. These are thankfully brief, and Schwartz seems well aware of when he is drifting too far into the weeds and is able to insert an anecdote to reengage the audience. Still, Gray Matters is more technical than some more recent popular books with scientific elements (The Immortal Life of Henrietta Lacks or the works of Mary Roach, for example), and leans more towards the work of Atul Gawande and Siddhartha Mukherjee.

Gray Matters is one of the better science-related books I've encountered in quite some time, and I recommend it to a wide audience. Anyone interested in the workings of the human brain will likely enjoy it, and book groups that focus on non-fiction will find many excellent topics for discussion.

I normally love books written by medical professionals. Since my grandfather died of a glioblastoma, neurosurgeons especially fascinate me. However, this over-500-page book isn't so much a biography of a neurosurgeon as much as a very detailed history of the profession. While parts were definitely interesting, especially the case studies, some of the jargon definitely made the book drag. Thank you, NetGalley, for a copy of this book in exchange for an honest review.

Dr. Theodore Schwartz is a brilliant and dedicated neurosurgeon as well as an accomplished writer. In “Gray Matters,” he gives a riveting account of his childhood, education, and career. In addition, he traces the history of neurosurgery from its inception until the present day. We read about early procedures that did more harm than good, and innovations that made brain surgery safer and more effective. Although there are quite a few technical terms in this book, Dr. Schwartz does not overwhelm us with jargon. Instead, he holds our attention by focusing on eye-opening case studies.

For example, we learn about the brain damage suffered by such famous people as JFK, RFK, John McCain, Natasha Richardson, Gabby Giffords, and Malala Yousafzai. In addition, the author enthralls us with true stories of people with potentially crippling disorders, including epilepsy, brain tumors, strokes, aneurysms, and traumatic brain injuries. Some of the most horrifying passages in these pages involve reckless practitioners (some of whom were not even qualified to perform surgery) who experimented on their patients.

Schwartz’s personal journey and his descriptions of the operations he has performed are fascinating. It is awe-inspiring that surgeons like him have the knowledge and ability to save many stroke victims, help epileptics have fewer seizures, and successfully remove brain tumors. In the final chapters of this book, Dr. Schwartz gives examples of sophisticated technologies that are being developed to improve the quality of life for individuals who cannot move, speak, or see. “Gray Matters” is a compelling and enlightening work of nonfiction that leaves us with a great deal of food for thought.

Fascinating! Schwartz weaves his own story into an exploration of neurosurgery and uses anecdotes to illustrate and illuminate. Best of all, this is written in an accessible style that educates and informs while never going over the head of the general reader. Thanks to Netgalley for the ARC. A terrific read.

Utterly outstanding. I learned so much. Dr. Schwartz gives history and details of specific cases in a readable and compassionate manner, and even adds some personal details. Years ago, when I worked as a nurse, I 'scrubbed' in surgery, and have a great appreciation for the skill of all surgeons. I highly recommend this book.

Gray Matters is a super informative novel on the life and experiences of a neurosurgeon. Schwartz does a fantastic job of explaining the nuances of his position while making it easily accessible to understand.

Loved this book! Not only are you getting the author’s story, but also the story of brain surgery.

Thank you to NetGalley for the ARC in exchange for an honest review.

I knew this was going to be a great book when Dr. Schwartz started off with an explanation as to why Dr. Harvey Cushing was such an important influence in American neurosurgery. In fact, most if not all neurosurgeons who trained in American schools can likely trace their training back to Dr. Cushing because, when it came to neurosurgery training, there was no other.

I really enjoyed how Dr. Schwartz was able to weave the history of neurosurgery against his history as a neurosurgeon—from what it takes to be a great neurosurgeon to what the surgeon needs to consider before operating on the brain.

He also discusses the subject of chronic traumatic encephalopathy (CTE) a subject that is near and not so very dear to the heart of many players and fans of contact sports such as American football and soccer (football in other countries). CTE has been in the news lately because so many football players have shown the effects of a constant barrage to the head causing nerve cell death and resulting in a gradual decline in cognition. Unfortunately, some of these former athletes have resorted to suicide and for those who manage to live out their lives, the symptoms of memory loss, confusion, anger, etc., have caused a great concern for their families.

The only part of the book I really wasn’t as interested in was the philosophical discussion of brain versus mind (what makes us human, etc.). But that’s just me—other readers may find it fascinating.

I highly recommend Gray Matters: A Biography of Brain Surgery to anyone who has an interest in medical history—there’s plenty of solid history here—or interested in neurosurgery. I will caution the potential reader that this is a seriously long book, but, in the end, the read was a satisfying one.

5/5 stars

[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion, which I have given here.]

How many times have you heard "Yeah, but it's not brain surgery!"? Well, in Gray Matters, Schwartz meticulously escorts the reader through the science and people of neurosurgery so that they can get a better understanding of this field. Each of his chapters focus on a specific diagnosis or development, ranging from the field's history, to aneurysms, to brain-computer interfaces. Within each chapter he masterfully, and compellingly, covers: biographies of important figures, the specific history of that chapter's topic, standard and developmental techniques used to treat the affliction (or at least alleviate some of the suffering), multiple real-world case studies (sometimes with well-known individuals you never knew had brain surgery), and his own personal autobiographical encounters with the topic.

There's too much in this book to highlight all of what I enjoyed in each chapter. Schwartz was able to take a difficult field and render it easy to comprehend while simultaneously adding in tension and drama. He presents not just a narrative of the topic, but also vital statistics and information that allows the reader to increase their scientific literacy by engaging with his writing. As a healthcare specialist who also engages with the public (or, well, tries to!), this is no simple task. Yet the book manages exactly this.

As for negative points, there's really only two more minor elements I'd want to highlight for folks before they start reading. First, there are a small handful of sections where Schwartz ventures into "we could do this" territory, rather than "we should do this" territory. Working in Ethics, this is a common flaw I see among other healthcare providers. Simply because something could be done doesn't license us to do it, because we need to consider more than just the medical outcomes when discussing someone's life. Generally speaking, though, he's rather good at sticking to the "should" rather than the "could".

The second negative I want to highlight is that, for someone who engages in a decent amount of philosophy in this book, Schwartz tends to stick to the older canon. The field of philosophy of mind often works alongside neuro-folks (neuroscientists, neurosurgeons, and neurologists) on projects involving cognition, the mind's architecture, and so forth. I wished I'd have seen more of that, and less of Descartes.

Fascinating read but went on too long and became a little monotonous at the end. I thoroughly enjoyed the authors insight into famous and often discussed head trauma fatalities .

In "Gray Matters". Theodore Schwartz delivers a masterclass of neurosurgery 101. Schwartz tells the story of the past, present, and future of neurosurgery, including portraits of the pioneers of the field, including Cushing, Dandy, and Penfield, to a look into the future of visual prosthetics. Through case studies (including Presidents to Schwartz's own family) and strange cures (including the ingestion of seal genitals, hippopotamus testicles, tortoise blood, and crocodile feces for epilepsy), Schwartz keeps the reader engaged throughout this book.

Schwartz beautifully illustrates the dichotomy of being a neurosurgeon by writing, "At the end of the day, while the doctor in me requires deep wells of empathy and heart, the surgeon in me must be able to turn off the heart and focus solely on one thing: flawless execution." It seems that in the history of neurosurgery many wrong turns occurred when the surgeon focused too strongly on the surgical aspects of their job, leading to surgeries such as the frontal lobotomy. However, by including the pitfalls of the field of neurosurgery, Schwartz is able to give the reader a more accurate representation of neurosurgery, without painting his field in rose covered glasses.

After reading "Gray Matters" I am even more thankful that I live in a world where neurosurgery is much improved and continues to improve rapidly. We are lucky to have neurosurgeons, such as Schwartz, that have the courage to learn from the past and create a better future in a field where anyone may need services at any time (have you checked your arteries lately?).

Thank you to NetGalley and the publisher for this ARC!

A fantastic blend of autobiography, medical
history, and science! Wonderfully well written. The author is able to explain specialized medical concepts in a way that
is both clear and deeply interesting, including the stories of patients and pioneers in brain science and surgery. I lost a mentor to gliablastoma 12 years ago,
and only now do I have a better idea
of what he faced. This book would be insightful for those considering specializing in neuroscience-neurosurgery.